contacting (1) graduate schools offering degrees in the health ...

DOCUMENT RESUME

ED 024 773 VT 004 997Health Economics Studies Information Exchange. Reports of Current Research in Health Economics, andMedical Care Administration. Publication No. 1719.

Public Health Service (DHEW), Arlington, Va. Home Economics Branch.Pub Date 66Note-385p.EDRS Price MF-$1.50 FIC-$19.35Descriptors- Administration, Annotated Bibliographies, Economics, *Health Occupations, Health OccupationsEducation. Health Services, Indexes (Locaters), *Medical Services, Organization, *Research Reviews(Publications)

The first volume of a continuing series reporting research in progress in healtheconomics and medical care organization and administration was compiled bycontacting (1) graduate schools offering degrees in the health professions,sociology, economics, public administration, and public health, (2) charitablefoundations indicating an interest in medical care, and (3) persons and institutionsreceiving grants or contracts from the Public Health Service relating to healtheconomics or medical care administration. Three hundred fifty-five study reports areclassified in the following categories: (1) Costs, (2) Expenditures, (3) Organization ofFinancing Resource Clevelopment, (4) Organization of Services. (5) AdministrativeProcess. (6) Productivity, (7) Supply, (8) Demand, (9) Utilization, (10) Continuity, (11)Acceptability of Care, (12) Professional Practice, and (13) Professional Technology.(JK)

07:

ealth, Economics Studies

ZPARTMEXT OF HEALTR, EDUCATION, AITI),NYEJRAR,,g-?ublixi4ealth..Service ,

Health. SotAce PubliCation No.

U.S. DEPARTMENT Of HEALTH, EDUCATION & WELFARE

OFFICE OF EDUCATION

THIS DOCUMENT HAS BEEN REPRODUCED EXACTLY AS RECEIVED FROM THEPERSON OR ORGANIZATION ORIGINATING IT. POINTS OF VIEW OR OPINIONSSTATED DO NOT NECESSARILY REPRESENT OFFICIAL OFFICE OF EDUCATIONPOSITION OR POLICY.

, Health Economics Studies

Information Exchange

Reports of Current Research in

Health Economics, and Medical Care Administration

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE-3 Public Health Service, k.,0 0. r.' -co' ::, -

`1,4:VISION OF -MEDICAL. CARE ADMINISTRATIONHealth Economics Branch ,-,,

Public Health Service Publication No. 1719

PREFACE

This is the first volume of what will be a continuing series under-taking to report research in progress in health ecqnomics, medical careorganization and medical care administration. This volume has beendeveloped to supply the health economi3t- and the medical care researcherand planner with a resource document through which he may keep cur-rent with ongoing research in advance of its appearance in the literature.

The Health Economics Studies Information Exchange supersedes twoearlier series which reported similar information. Sources of MorbidityData issued for 11 years by the Public Health Service will no longerappear. The other, more directly related to the subject matter of theHealth Economics Studies information Exchange, is An Inventory ofSocial and Economic Research in Health published annually by the HealthInformation Foundation. Through the kindness of Mr. George Bugbeeand Dr. Odin Anderson, the Health Economics Studies InformationExchange has had access to all the sources used by the University ofChicago in preparing the Inventory.As a first step in preparing these reports, questionnaires were sentto all graduate schools offering degrees in the health professions, so-ciology, economics, public administration and public health. All the

charitable foundations who listed any interest in medicine or medicalcare were contacted. Persons and institutions receiving grants or con-tracts from the Public Health Service relating to health economics ormedical care administration also received the questionnaire. In all, about4,000 questionnaires were mailed. Copies of the form used may be foundat the rear of this volume.The first issuance of the Health Economics Studies InformationExchange reports on 355 projects. There is no way of determining the

degree of completeness of coverage achieved. Hopefully, each succeedingyear will see expansion in the listing, reflecting the Nation's mountingconcern about the economics of health and improvement in organizing itsdelivery.

Any suggestions our readers may have as to ways to make the HealthEconomics Studies Information Exchange more useful will be welcome.

Health Economics Studies Information Exchangecio Health Economics BranchDivision of Medical Care AdministrationPublic Health ServiceU.S. Department of Health, Education, and Welfare800 North Quincy StreetArlington, Virginia 22203

iii

TABLE OF CONTENTS

PREFACE

PageSTUDY, REPORTS (Each category has a divider sheet with alisting of projects in other categories whose subject matter is closelyrelated to the subject of the category) :

A. Costs (A-1 through A-29) 1B. Expenditures (3-1 through B-11) 33C. Organization or FinancingResource Development (C-1

through C-14)47D. Organization of Services (D-1 through D-51) 63E. Administrative ProcessTechniques of Research (E-1

through E-53) 117F. Productivity (F-1 through F-9) 173G. Supply (G-1 through G-24) 185

DemandMorbidity,Mortality (H-1 through H-56) 211F. Utilization .(I1.4 through I750) 271L. ContinuityAccess, to ,Care (J-1 througk J-8.) 323K,4ccept44ility of .Care.,(TC-,1 through K-42) 329L. Professional PracticeQuality (L-1 through L-22 343M. Professional Technology (M-1 through M-21) 367INDEX OF PRINCIPAL INVESTIGATORS 391INDEX OF ORGANIZATIONS 399

NOTE :

Several of the techniques of reporting the studies deserve mention.The dash (), where it appears after one of the headings of the reportformat indicates that no, information was reported in this area by theperson filling out the form. The date in parentheses next to the title ofthe study is the date on which the report was received, by the PublicHealth Service. Where a dash (--) and a date appea, under the heading"Current Status" it means that no information has been received aboutthe current status. The dates are those of the beginning and estimatedend of the project period. This period, when compared to the date ofreceipt of the report by the Public Health Service will allow an estimateof degree of completion.

This volume is loose-leaf so that later issuances of study reports may beinserted in the proper subject category. Divider sheets are furnished foreach of the 13 subject classifications and for the indexes. The entirevolume is perforated so that it may be placed in a standard 3-ring binder.

vi

\ ;

A. Costs of Health Services

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on costs: B-6;C-5; 0-7; D-5; D-30; D-36 ; D-43; D-51 ; E-49; F-5; 0-9; H-16;H-33; H-41; 1-4; 1-18; 1-29; 1-33; K-3.

1

A-1 The Effect of the Thi7d Party Reimbursement System upon HospitalCosts and Financing (1/19/66)

A TICITTA rimZA .11AZ .1 11,11013 JL

Objectives: To test the hypothesis that cost-based third party reimbursement formu-lae serve to increase hospital costs.

Content: The project will attempt to isolateand identify managerial responses to variouspayment techniques, and the subsequent ef-fect of these responses upon long-term hos-pital costs and finances, with special empha-sis on the following: the effect of Blue Crossand Welfare reimbursement formulae uponhospital costs and finances, and the effect ofan all-inclusive per diem reimbursement for-mulae (Welfare) as opposed to the split ratefor routine and non-routine services (BlueCross),

Methods: Information will be gathered fromMassachusetts because of the large propor-tion of the population (almost 50 percent)that is insured by Blue Cross and because ofthe State's position as one of the most activeparticipants in the Federally sponsored Med-ical-Aid-to-the-Aged Program.

CURRENT STATUS(Sept. 1965-66)

ORGANIZATION(S)

Boston City Hospital

PRINCIPAL INVESTIGATOR (S)Kaitz, Edward M.

STAFFFull-time:1 economist

Part-time:None

COST

FINANCING ORGANIZATION(S)Boston City Hospital

PUBLICATION PLANSNone as of the moment

FOR FURTHER INFORMATION

Edward M. Kaitz, Special Consultant, BostonCity Hospital, 818 Harrison Ave., Boston,Mass. 02118

A-2 Economics of Mental Health (5/20/66)

ABSTRACT

Objectiveq: Analy7e mental health operationsand the implications of patient terminationfor costs and fee assessment ;

Develop economic and social criteria applic-able for patient fee schedule construction ;

Assist in formulation of public policy for men-tal health.

Content : Completed normative budget forKansas farm families. Established a fee as-sessment form for use in community mentalhealth centers.

Developed patient termination profile of cen-ters.

Participated in State-wide comprehensive sur-veys of : mental health, mental retardation,and public health.

Methods: Reviewed patient records.Applied city-oriented procedures to farm fam-

ily data. -.

Participated in State:V-1cl; conferences.

CURRENT STATUSRelatively inactive. (Jan. 1963-67)

ORGANIZATION (S)

Dept. of Family Economics, Kansas State Univ.

PRINCIPAL INVESTIGATOR (S)Morse, Richard L. D.Rasmussen, Albie (Mrs.)

4

STAFFFull-time:

Part-time:1 family economist

COSTUnder $5,000FINANCING ORGANIZATION(S)Agricultural Experiment Station, Kansas State

Univ.

PUBLICATION PLANSAlbie Rasmussen, "Kansas Farmer's Family

Budget," Kansas Agricultural ExperimentStation

Albie Rasmussen, Richard Morse, "Fee Assess-ment and Farm Family's Ability to Pay,"Community Mental Health Services (Depart-ment of Social Welfare)

Gartner, Joseph, "The Economics of MentalHealth," Proceedings: Workshop for Com-munity Health Centers and Psychiatric Out-Patients' Clinics, Division of Inst. Mgmt.,State Department Social Welfare, Topeka,Kansas

FOR FURTHER INFORMATIONRichard L. D. Morse, Head, Dept. of Family

Economics, Kansas State Univ., Justin Hall,Manhattan, Kans. 66502

A-73 Nationwide Study of Hospital Costs in the Period since World War Il.(1125/66)

ABSTRACTObjectives: T.o deteri e the forces and In-Hurl

fluences responsible for changes in hospitalcosts during the postwar period, t measurethese effects, and to relate them to,changesin hospital use, quality of care, medical tech-nology, organization of people and resources,and environmental factors such as -Piketrends, insurance coverage and legirlation.The purpose ,is to understand the ,fundamen-tal fidora':gOing tóthe production of hospital service ratherthan to explain the paiticular, trends of thestudy period.

..:{Content: The study is in 3 parts:

cal study of ArendsAlasect, on,.accounting, andoperating, data from a group of Western,-);New York hOSpitals, With `it' uniform account-

-1fing and reporting system; ,a detailed ,case-by-case study of a seleCted' 060 Of hOspi-tals selected from across the country; and aneconometric study of the cost function todetermine statistically how costs respond tovariations in hospital characteristics andoperating conditions.

Methods: The three parts use different tech-niques. The first uses the tools of account-ing and cost analysis in a traditional ap-proach, the second employs a wide varietyof investigative and statistical techniquestc pinpoint the reasons for particular costchanges in case study hospitals, and the laststudy uses a co-variance analysis techniqueto test the applicability of a numbe of eco-nomic models of cost behavior with theWestern New York data.

CURRENT STATUSiknalysis and writing are complete, typescript

now being edited for publication. (1960-1966).

ORGANIZATION(S)Graduate School of Business AdministratiOn,

Univ. of MichiganPRINCIPAL INVEkiGATOR(S)Gottlieb, Sy:nond R.Fitzpatrick, Thomas B.Wirick Grover C. (Jr.)STAFFFull-time:1 accountant1 economist1 hospital administrator

Part-time:1 ar .lountant1 hospital administrator

COST$100,000-$149,999

FINANCING ORGANIZATION(S)Health Information Foundation, The Univer-

sity of Chicago, Chicago, Ill.

PUBLICATION PLANSNot finalPublication expected in 1966

FOR FURTHER INFORMATIONGrover C. Wirick, Jr., Ph. D., Economist, Bur.

of Hospital Administration, Rm. 46, Gradu-ate School of Business Admin., Universityof Michigan, Ann Arbor, Mich. 48104

A-4 The Production Function and theServices (8

ABSTRACTObjectives: To estimate the shape of the long-

run cost function and production functionfor physicians' services, by type of prac-tice, speciality and geographic region.

Content:

Methods: Multiple regression analysis of a na-tionwide direct sample survey of physicians'incomes, costs, etc.

CURRENT STATUSFinal data analysis. (Jan.Oct. 1966)ORGANIZATION(S)Div. of Medical and Hospital Admin., School of

Public Health, Univ. of Calif., L.A.PRINCIPAL INVESTIGATOR(S)Hopkins, Carl E., Ph.D.Yett, Donald E.

6

)

Long-run Cost Function for Physicians'/10/66)STAFFFull-time:None

Part-time:3 economists

COST

Under $5,000

FINANCING ORGANIZATION(S)USPHS

PUBLICATION PLANS1967

FOR FURTHER INFORMATIONCarl E. Hopkins, Ph.D., School of Public

Health, University of California, Los An-geles, Calif. 90024

_

4-5 Economic Returns to Health Services (Exploratory Study) (9/12/66)ABSTRACTObjectives: To explore the feasibility of es-

timating the costs and economic benefits ofpersonal health services in order to computerates of return for these services.

Content : Determination of the most suitablemethods for colleding and interpreting data,and the best sources of data, on córits ofhealth services and their benefits in the formof additional output and earnings.

Methods: Use of illustrative data from one ormore health care organizations and from em-ployers concerning selected employees.

CURRENT STATUSIn progress. (June 1966May 1968)ORGANIZATION(S)Mount Holyoke College

PRINCIPAL INVESTIGATOR(S)Robertson, Robert L., Ph. D.


Part-time:None

COST

$35,000$49,999


PUBLICATION PLANSNo publications to date


Robert L. Robertson, Ph. D. (until August1967), 2147 N. E. Weidler, Portland, Ore.97232; (after this date) Mount Holyoke Col-lege, South Hadley, Mass. 01075

7

4.,

A-6 Study of Costs and Patient Characteristics in Proprietary Nursing Homes(6/30/66)

A re,Sri.`R ACT

Objectives: To establish norms in relation tolength of stay and costs of patient care inproprietary nursing homes by diagnosis and/or rehabilitation potential.

Content: Nursing homes for this study willbe selected from seven geographically scat-tered States. Patients shall be grouped into21 categories and analysis shall be directedtoward: (1) degree to which patient needsfor therapeutic and restorative services arebeing met; (2) degree to which these pa-tient needs are not being met ; and (3) costsincurred by the homes in supplying theseservices and the charges being made to thepatients who receive them.

Methods: The nursing homes will be selectedfrom Florida, Georgia, Missouri, Texas, Utah,California, and Washington State. Progressreports and a final report will give an analy-sis of the study.

CURRENT STATUS(June 1966Apr. 1968)

8

oRGANEArrioN(S)Hillhaven, Inc., Tacoma, Wash.

PRINCIPAL INVESTIGATOR(S)Diamond, Fred

STAFF

None

Part-time:1 medical care specialist1 accountant

COST$15,000$24,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONFred Diamond, Hillhaven, Inc., 515 South M

St., Tacoma, Wash. 98405

A-7 Cost Study of Nursing Homes in California (8/4/66)

ABSTRACTrn^gl.fa,j-1,sva .I.UatCa. 441C UVVVIU ZIVIII.. %AL LAJOld

reporting programs for nursing homes usingdata already collected and to assist in thedevelopment of a reimbursement formulabased on "reasonable costs."

Content: Included in this study are 1,150 nurs-ing homes in a variety of geographic set-tings. "Health Care Facility Cost Statement"was sent to the 1,150 nursing homes for thepurpose of determining methods of paymentfor nursing home services based on "reason-able costs." All data shall be collected andabstracted. The cost data will be analyzed bythe eight cost centers developed for thestandardized cost reporting system for nurs-ing homes in California. These cost centersare: Special Services, Nursing, Dietary, So-cial Services, Housekeeping, Laundry Linen,Plant Operation and Administrative.

Methods: The project will be carried out bypersonnel of the State Health Department,and through the use of automated dataprocessing equipment.

CURRENT STATUS

ORGANIZATION(S)_.n _ 14.1-kitiiiitn Mil WA tte JJein. tn. r num; rienit,n,

PRINCIPAL INVESTIGATOR(S)Muldaven, MichaelDerry, John

STAFFFull-time:1 economist1 statistician

Part-time:None

COST

$25,000$34,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONMichael Muldaven, Calif. State Dept. of Public

Health, 2151 Berkeley Way, Berkeley, Calif.94704

9

I

A-8 Study of the Costs to a Teaching Hospital of a Program of Consultationto Nursing Homes (9/14166)

ABSTRACT

Objectives: To determine types of costs borneby a hospital in providing consultation tonursing homes and estimate the costs in-curred by nursing homes in bringing up theirlevels of care in meeting the luaspital'sstandards.

Content: The Massachusetts General Hospi-tal now has close ties with eight proprie-tary nursing homes, representing 750 bedsthroughout the Greater Boston Area. Thestudy will: (1) describe their entire nursinghome consultation program ; (2) computecosts for operating consultation services; (3)attempt to estimate the cost in raisingstandards in eight participating nursinghomes and discover points at which levels ofcare actually improve.

Methods: The contractor shall use its account-ing staff and its social service departmentto conduct this project. Costs will be ascer-tained through review of detailed records.The consulting staff will attempt to assessthe changes in costs of operation of the nurs-ing llomes by referral to records within thehome itself.

CURRENT STATUS(June 1966-68)

ORGANIZATION(S)Massachusetts General Hospital

PRINCIPAL INVESTIGATOR(S)Clark, Eleanor

STAFFFull-time:1 social worker, counselorPart-time:1 medical care specialist1 statistician

COST$15,000$24,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONMiss Eleanor Clark, Massachusetts General

Hospital, Fruit St., Boston, Mass. 02114

A-9 Analysis of Costs and Services in 700 Nursing Homes Located inMassachusetts (6/25/66)

ABSTRACT

Objectives: To investigate the relationship be-tween costs and levels of service in nursinghomes.

Contents: The study will analyze the relation-ship of costs and levels of services in 700nursing homes in Massachusetts. The follow-ing factors will be used : size, ownership, lo-cation, size of staff, approximate length ofstay of patients and cost factors. The studywill attempt to find out what percent of totaloperating expenses nursing and dietary costoccupy for different sizes and types of nurs-ing homes. The study will supply data onvarious activities in nursing homes to betranslated into a computer simulation ofnursing home characteristics.

Methods: The study will be conducted by study-ing the records of the nursing homes in-cluded in this study. Progress reports willbe made as well as a final report.

CURRENT STATUS

(June 1966Feb. 1968)

ORGANIZATION(S)Massachusetts Health Research Institute, Inc.PRINCIPAL INVESTIGATOR(S)Levy, Sam, Ph. D.Vahey, Virginia V.STAFFFull-time:1 registered nursePart-time:1 medical care specialist1 registered nurseCOST

$35,000$49,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONSam Levy, Ph. D., Massachusetts Health Re-

search Institute, Inc., 8 Ashburton Pl., Bos-ton, Mass. 02176

11

A-10 Hospital Cot4 Trends in Western Pennsylvania (1/13/66)ABSTRACTObjectives: To interpret hospital cost trends

in western Pennsylvania.Content: This will be a series of studies be-

ginning at the most superficial layer andgoing into greater depth later on. Depart-mental and total per diem costs will beshown for approximately 100 hospitals inwestern Pennsylvania for the years 1951through 1964, by several sizes, geographicallocation, scope of service and other classifi-cations of hospitals. Later, sections of thestudy will deal with salary and other costs,total expenditures, inpatient and outpatientcosts, etc.

Methods: Per diem figures as actually repOrtedperiodically to the' hospitals (developed byaudit) will be used first to show simple rela-tionships. Following this, detailed analyseswill be made using the basic audit recordswhich have been preserved.

CURRENT STATUSDesign of codes, work sheets and punch card

layouts for first twelve analyses are being de-veloped. (Dec. 1965indefinite)

ORGANIZATION(S)Research Dept., Blue Cross of Western Penn-

sylvania

12

PRINCIPAL INVESTIGATOR (S)Brodie, DorothyFitzpatrick, Thomas B.

STAFFFull-time:

Part-tim( :

1 medical eare specialist1 socio)ngist

COST

FINANCING ORGANIZATION(S)None

PUBLICATION PLANS

Serially by Blue Cross of Western Pennsyl-vania and distributed to Western Pennsyl-vania hospitalsFirst bulletin due March1966


Dorothy Brodie, Research Dept., Blue Cross ofWestern Pennsylvania, One Smithfield St.,Pittsburgh, Pa. 15222

A-11 Average Earnings of Physicians and Surgeons in Canada, 1957-1964

ABSTRACTObjectives: Examination of trends in gross and

net earnings, expenses of practice, and ofnon-medical income, all in relation to totaloutlays on health care.

Content: Tabulations from sampled data de-rived from income tax returns, by incomeclass, age group, residence, and type of in-come.

Methods: Selection and organization of datafrom sampled aggregations shown in com-puter print-outs.

CURRENT STATUSNational and provincial summary tables ready

for publication, detailed tables in process forlater publication. (1964-1966)

ORGANIZATION(S)Dept. of National Health and WelfarePRINCIPAL INVESTIGATOR(S)Williams, L. G.Plet, G. W.

STAFFFuli-tiwie:

None

Part-time:2 economists1 statistician

COST

FINANCING ORGANIZATION(S)

Dept. of National Health and Welfare

PUBLICATION PLANSDNHW-1966


J. E. Osborne, Dir., Research and StatisticsDirectorate, Dept. of National Health andWelfare, Brooke Claxton Building, Ottawa3, Ontario, Canada

13

A-12 Factors Affecting the Costs of Hospital Care in the Western PennsylvaniaArea (1/12066)

ABSTRACTOblectives: To seek out factors affecting the

costs of hospital care and to evaluate the rel-ative impact of specific factors on these costs.(Inpatient hospital care per patient day andper admission.) It is hoped that this studywill reveal something about the ehape ofmarginal cost and the existence or absenceof economies of scale in hospital operations.

Content : Tentative Table of Contents: Intn,-duction; Data ; Analytical Model; Hypothe-sized iFactors Related to Hospital Costs ; Hy-pothesized Forms of Relationship; Results;Summary of Findings; Implications of Find-ings. Appendix AList of Equations andComputer Programs ; Appendix BDataForms and Work Sheets.

Methods: Twenty-four variables and twodummy variable3 are initially chosen on thebasis of the frequency of their inclusion inthe literature and on a theoretical expecta-tion of their "causal" relationship with thecosts. Using the variables thus chosen, 6families of hypotheses about the nature ofthe variables' association with the costs willbe tested through various forms of multipleregressions. These multiple regressions areof linear and additive forms with interac-tion terms and segmented variables. Curvi-linear forms (quadratic) and multiplicativerelationships (logarithmic) are also included.In order to incorporate all the data available,a computer program of covariance analysisis adopted in combining cross section andtime series data. The data used are the finan-cial reports of 68 non-profit, general hospi-

tals in Western Pennsylvania for an 11-yearperiod from 1952 to 1963, except 1956. Thesereports are filed semi-annually with the BlueCross of Western Pennsylvania Plan by thehospitals participating in the Plan.

CURRENT STATUSAll data are collected, processed, and key-

punched. Some computer output is obtained.Out of the 8 chapters contemplated at thepresent time, 6 are written. (Oct. I964Apr.1966)


sylvania

PRINCIPAL INVESTIGATOR(S)Ro, K. K.STAFFFull-time:1 economistPart-time:

COST


PUBLICATION PLANSYale Economic EssaysSpring 1967 issue

FOR FURTHER INFORMATIONK. K. Ro, Research Dept., Blue Cross of West-

ern Pennsylvania, One Smithfield St., Pitts-burgh, Pa. 15222

A-13 Canadian Survey of Dental Practice (12/6/65)

ABSTRACTObjectives: To correlate dentists' income, ex-

penses, etc. with such variables as province,city size, age, and year of graduation.

Content: The project will include a study ofthe following subjects : (1) gross income andexpenses of dentists in private practice andsalaried employment according to province,city size, age, year of graduation, organiza-tion, and type of practice, (2) number ofpatients and patient visits per dentist ac-cording to different variables including num-ber of employees and extent of "business,"(3) percentage of dentists employing speci-fied numbers, types, and combinations ofauxiliaries and average salary by type ofauxiliary, and (4) cost of dental servicesper patient and estimates of percentage ofthe population receiving dental services andof expenditures on dental services by regionand province.

Methods: Data for the study is being gatheredfrom Questionnaires completed and returnedby Canadian dentists.

CURRENT STATUSFirst 5 of 12 chapters have been printed and

distributed. (Fall 1963Spring 1966)

t

ORGANIZATION(S)

Canadian Dental Association

PRINCIPAL INVESTIGATOR(S)Brown, B. Isabel (Mrs.)

STAFFFull-time:

None

Part-time:1 economist

COST

$5,000$9,999


PUBLICATION PLANS

All or part of the survey will be published inthe Journal of the Canadian Dental Associa-tion at intervals throughout 1966

FOR FURTHER INFORMATIONMrs. B. Isabel Brown, Dir., Canadian Dental

Assoc., Bur. of Economic Research, 234 St.George St., Toronto 5, Ontario, Canada

15

A-14 Coniparative Coiti of Altérhatiires Inititutiorial Arrangements in theTreatment ,of, the Mentally (516/66)

ABSTRACTObjectives: What are the relative economic

efficiencies of the alternative institutionalarrangements in the treatment Of the men-tally ill? Are there economic advantages fortreating the mentally ill in general hospitalsand local facilities rather than in State hos-pitals? And specifically, what are the Prob-lems to be overcome in making judgmentsabout the relative economic efficiencies ,ofthese types of institutions?

Content: Three institutions were selected:State mental hospital, a general:communityhospital, and a day treatment center. Fromthese inetittitiOns; '''records' Were Obtainedconcerning the patient populations, includ-ing personal, social,,pre- and post-care,data.Actual costs of treatment and the care' pro=Vida lwereAlethrmined, and; oñ the basis ofthese-data ,i*ildbthe 'length of stay, cOmpari-sons were''ileVeloped on a per patient' andcase basis.I\

Conclusions:" la Care and treatment in CoM-' munity ,facilities and ''general 'hospitals are

lesi costly than hi' Statelhospitals for inten-sive 'treatinent prograMai although the nar-gin is not great, and the State mental hospi-tal cannot be ruled out for developing shortterm and intensive care; (2) the crucial con-sideration in making comparison among in-stitutions is the comparability of the patientpopulations and the severity of illness ex,-perienced by those patients; (3) emphasis is

16

being given to the opinion that public insti-tutions neglect capital carrying costs andtherefore appear to have iow costs, whensuch may not be the case.

CURRENT STATUSIn, writing stage. (July 15, 1963-Sept. 1, 1966)

ORGANIZATION(S)Econoznics Dept., University of Washington

PRINCIPAL INVESTIGATOR(S)McCaffree, Kenneth M.

S.

STAFF

None


COST$,25,000-$34,999

FINANCING ORGANIZATION(S)USPHSUniversity of Washington Graduate School

PUBLICATION PLANS'One article now accepted by American Journal

of Public Healthp-1966

FOR FURTHER INFORMATIONKenneth M. McCaffree, Assoc. Prof., Econom-

ics Dept., University of Washington, Seattle,Wash. 98105

A-15 Cost of Poor Health by Disease Category: United States, 1962(5/10/66)

ABSTRACTObjectives: To estimate the potential benefits

of improvements in the level of health bydisease, thereby providing information whichmay be used by public and private healthagencies more effectively to allocate theirfur Imong alternative health activities.

Cor.. . The study will estimate benefits ac-corcung to the three digit classification sys-tem of the Manual of the International Sta-tistical ClassifiL tion of Diseases, Injuries,and Causes of Death. Benefits, in moneyterms, will be estimated by an analysis ofthe impact of disease, injury, and prematuredeath upon the utilization and availabilityof resources and the distribution of income.

Methods: A section of the study would be de-voted to a verbal treatment of psychic bene-fits which arc not reducible to monetaryterms. The quantitative estimates obtainedwould be based upon or derived from exist-ing data.

CURRENT STATUSIn progress. (Feb. 1965Not known)

OR(iANIZATION(S)Dept. of Economics, Southern Methodist Univ.,

Dallas, Tex. 75222USPHS

PRINCIPAL INVESTIGATOR(S)Kirby, Glenn, Jr.Murphy, J. CarterSTAFFFull-time:2 economists

Part-time:

COSTUnder $5,000


PUBLICATION PLANSUndecided

FOR FURTHER INFORMATIONGlenn Kirby, Jr., Instructor, Municipal Uni-

versity, Omaha, Neb.

17

A-16 Hospital Costs in Massachusetts (5/13166)

ABSTRACTObjectives: To develop a flexible analytic pro-

cedure and data format which will make rel-evant information on hospital use and costs,in whatever form it is now collected, usablefor research and analysis.

Content: The project, while studying hospitalcosts and usage, has developed a generalizedinformation handling system which will re-sult in the meaningful utilization of the vastand diverse sources of data routinely col-lected by various individuals and agencies. Aconsiderable amount of time on this projecthas been directed to the development ofa data processing system called MEROPS(Medical Economics Regression Option Pro-gramming System) which is fully applicableto similar systems anywhere in the world.

Methods: Data regarding Massachusetts hos-pital costs and usage that is routinely col-lected by Blue Cross, the Division of Hospi-tal Costs and Finances, insurance companies,and others were used in the system devel-oped.

CURRENT STATUSIn the process of being written up.

18

ORGANIZATION(S)Dept. of Economics and Littauer School of

Public Admin., Harvard University

PRINCIPAL INVESTIGATOR(S)Ingbar, Mary Lee, Ph. D.

STAFFFult-Pme:Nom.

Part-time:1 economist1 medical care specialist

COST


PUBLICATION PLANSUnknown


Mary Lee Ingbar, Ph. D., Graduate School ofPublic Admin., Harvard University, 1746Cambridge St., Cambridge, Mass. 02138

I

A-17 A Study of Operating Costs in 199 Hospitals (2/8/66)ABSTRACT

Objectives: To make a detailed study of theoperating costs for Blinois hospitals.

Content: The study lists operating costs forall departments of hospitals and comparesthe expenditures of the different depart-ments with hospital size. Comparisons aremade between 1963 and 1964 expenditures toascertain rate of increase. Data on percentof occupancy, average ltngth of stay, num-ber of employees, etc., is also included andrelated to hospital size.

Methods: Information for the study was gath-ered from 199 Illinois hospitals which annu-ally submit a copy of "E-spital Statementsof Reimbursable Cost."

CURRENT STATUS

A study covering 10 years was completed in1956 ; since then a comparison study hasbeen conducted every year, comparing oneyear with another. It is planned to doanother 10-year study in 1968. (1947-un-known)

ORGANIZATION(S)Illinois Dept. of Public HealthP1RDICIP,IL IN VE,TrIG AT= ( S )

STAFFFull-time:1 accountantPart-time:None

COST

Under $5,000


PUBLICATION PLANSPrinted by the DepartmentAugust every yearFOR FURTHER INFORMATIONRobert J. McMahon, Hospital Accounts Ana-

lyst, Bur. of Hospitals, Div. of Hospitals andChronic Illness, Illinois Dept. of PublicHealth 518 State Office Bldg., Springfield,Ill. 62706

19

A-18 Costs of Patient Care Programs in Mental Hospitals (7/15/65)

ABSTRACTObjectives: To develop accounts and statistical

data sufficiently refined to relate the costsof operating mental hospitals to the patientcare programs occasioning these costs.

Content: This study will relate programs ofpatient care to the actual costs of operatingmental hospitals.

Methods: Interviews with appropriate person-nel are being conducted. Statistical and ac-counting data is being obtained from themental hospitals to determine the above.

CURRENT STATUS(May 1965Apr. 1967)

ORGANIZATION(S)Graduate School of Business Admin., Univ. of

Mich.

PRINCIPAL INVESTIGATOR(S)Foyle, William R.

20

STAFFFull-time:IMILIIII.M1111.1M.

Part-time:

COST


PUBLICATION PLANS

FOR FURTHER INFORMATIONWilliam R. Foyle, Graduate School of Business

Admin., University of Michigan, Ann Arbor,Mich. 48106

0

1,

i

A-19 Relative Value Study Also involved in cooperation with other agenciesin Health Care Planning, Health Facilities Planning, Nursing Home Studies,etc. (12/17/65)

ABSTRACTObjectives: To establish relativity between

medica), surgical, radiological, and patholog-ical procedures. To determine going rate forsuch procedures by community.

Content: Relative Value Units.Methods: Questionnaires, IBM analysis, review,

etc.

CURRENT STATUSFirst printed book published Aug. 1965. (Apr.

1963ongoing)

ORGANIZATION (S)Hawaii Medical AssociationMedical Societies of Hawaii CountiesPRINCIPAL INVESTIGATOR(S)Hawaii Medical Association members and staff

plus statistical services of Pacific ResearchCorporation

STAFFFull-time:None

Part-time:13 medical care specialists15 physicia:as2 statisticians

COST

$5,000$9,999

FINANCING ORGANIZATION(S)Hawaii Medical Association

PUBLICATION PLANS

FOR FURTHER INFORMATIONLee McCaslin, Ex. Sec., Hawaii Medical Assoc.,

510 S. Beretania, Honolulu, Hawaii 96813

21

A-20 Cost of Medical CareInternational Study (4/15166)ABSTRACTObjectives: To determine the cost of medical

care in a number of countries and to developan accounting system for international appli-cation.

Content: Itemized expenditure and sources offinance of the various components of per-sonal health care on a countrywide basis.

Methods: Authorities in the various countriesare asked to complete a specially preparedquestionnaire.

CURRENT STATUSData from questionnaires have already been

processed and analyzed. (1962-1966)

ORGANIZATION( S)World Health Organization

PRINCIPAL INVESTIGATOR(S)Abel-Smith, Brian, Ph. D.Bridgman, R. F., M.D.

22

STAFFFull-time:None

Part-time:1 economist1 medical care specialist2 statisticiansCOST

FINANCING ORGANIZATION(S)World Health OrganizationPUBLICATION PLANS"Public Health Papers," WHO, Geneva end of

1366

FOR FURTHER INFORMATIONR. F. Bridgman, Chief Medical Officer, Organi-

zation of Medical Care, World Health Or-ganization, Geneva, Switzerland

A--21 A Demonstration of Reducingof Services

ABSTRACTObjectives: (1) To determine ways and means

of reducing hospital operating costs by shar-ing as many services of the acute generalhospitals as feasible without impairing ex-isting functioning of such services ; and (2)to measure the results in a valid and precisemanner.

Content: Five acute, voluntary general hospi-tals in Minneapolis, Minnesota, are partici-pating in this project. Plans have been for-mulated to begin sharing such services aslaundry and linens, printing and stationery,at the outset, and other areas such as pur-chasing, group warehousing, central supply,food and meal preparation, plant mainte-nance and repair, laboratory, accounting andstatistics, housekeeping, and other areas willbe explored.

Methods: Major phases will involve standard-izing and centralizing of major functions ofthe service areas. One hospital will serve asa "Control-Hospital" to make feasible thecomparison of costs while other hospitalsshare that service. A feasibility study ofeach service to be considered for sharing willinitiate each step and a final evaluation atend of study-period by the participating hos-pitals will determine future sharing of theservice and with othet 'local hospitals.

CURRENT STATUSAbout to launch first service to be shared, as

completion of first feasibility study nears forlaundry and linens and printing and station-ery. Joint purchasing and central warehous-

Hospital Operating Costs by the Sharing(11/22/65)

ing feasibility study about to start, whichwill be third area of sharing to be consideredby 'staff and participating hospitals. (June1965-69)

ORGANIZATION(S)School of Public Health, Univ. of Minn.

PRINCIPAL INVESTIGATOR(S)Jaco, E. Gartly, Ph.D.

STAFFFull-time:1 hospital administrator

Part-time:2 accountants2 medical care specialists1 sociologist1 statistician5 hospital administrators

COST$200,;1110$249,999


PUBLICATION PLANSSometime in 1967 first articles should be com-

pleted; final document on overall projectabout early 1970.


E. Gartly Jaco, Ph.D., Res. Dir., Program inHospital Administration, University of Min-nesota Medical Center, 1260 Mayo Bldg.,Minneapolis, Minn. 554r5

23

A-22 Survey of Salaries and PersonnelAdministrators in Nursing Educational(3/11/66)

ABSTRACTObjectives: To provide data on salaries and

other employment conditions of professionalregistered nurses employed in professionaland practical nursing educational programs.

Content: Survey covers educational prepara-tion, salaries, and insurance benefits for full-time nurse faculty members.

Methods: Mail questionnaires sent to all State-approved schools.

CURRENT STATUSIn process of tabulating and summarizing.

(Dec. 1965-June 1966)

ORGANIZATION (S )American Nurses' AssociationPRINCIPAL INVESTIGATOR(S)Moses, Evelyn B.

STAFFFull-time:None

24

Practices for Teachers andPrograms, December 1965

Part-tima:

1 statistician1 statistical supervisor

COST


American Nurses' Association

PUBLICATION PLANS

Facts About Nursing, ANA-1966 editionMultilith report by ANAJune 1966


Evelyn B. Moses, Assist. Dir., Research andStatistics Program, American Nurses' Asso-ciation, 10 Columbus Circle, New York, N. Y.10019

a-

t

A-23 Sludy Of Employment Ginditions of Nurses Employed in Non-FederalPsychiatric Hospitals, June 1965 (3/11/66)

ABSTRACTObjectives: io p-rovide data on salaries and-

other employment conditions of professionalregistered nurses employed in non7Féderallyoperated psychiatric hospitals.

Content: Survey covers budgeted ,vadancies forregistered nurses salaries 'for fin& positions:of registered nurses, licensed practical,nurses and nursing aides; vacation, sick,leave, shift differenlial, holiday;"retireiiient,'and educational leave provisions fortered nurses.

Methods: Mail qUestionnaired Sent to all nôn-'Federally operated pSyChiatrie

CURRENT! STATUSIn processing of tabulating and surinnarizing.

(June 1965-Mar.P6,6)-ORGANIZATM(S)American 'Nurses' Association

PRINCIPAL INVESTIGATOR(S)Moses, Evelyn B.

STAFF

N'one

Part-time:1 Satistician

superyisOr

COST

FINANCING ORGANIZATION(S)American isturse' As.sOciaiion

PUBLICATION._ PLANS,

Facts About Nursing, ANA-1966 edition :,Multilith report produced by ANA-March 1966

FOR FURTHER INFORMATIONEvelyn B. Moses, Assist. Dir:, Research aid

Statistics Program, American Nurses' ASsO-ciation, 10 Columbus Circle, New York, N. Y.10019

25

A-24 Determination of Optometric Service Fees (11/30/65)ABSTRACTObjectives: To determine prevailing costs of

professional ontometric services independentof costs of consumed andjor prescribedophthalmic materials, by classes of service,geographic regions, size of city, age of op-tometrist, and year of practice.

Content: Survey sample of optmetriststhroughout the United Statb3.

Methods: Direct questionnaire.

CURRENT STATUSOriginally designed questionnaire undergoing

final revisions. (Nov. 1965Apr. 1966)

ORGANIZATION ( S)Division of Optometry, Indiana University,

Bloomington, Ind. 47405American Optometric Association

PRINCIPAL INVESTIGATOR(S)Hofstetter, H. W.Bailey, J. Harold

26

!

1

STAFFFull-time:

Part-time:1 statistician1 optometrist1 administrative director of AOA

COST

Under $5,000


American Optometric Association

PUBLICATION PLANSJournal of the American Optometric Associa-

don, 1966

FOR FURTHER INFORMATIONJ. Harold Bailey, American Optometric Associa-

tion, 700 Chippewa St., St. Louis, Mo. 63119

*

A-25 Cost and Expenditure Reporting Systems for Community Mental HealthCenters and for Community Mental Health Planning (4/20/66)

ABSTRACTObjectives: To study the ways in which and

the extent to which the sources of mentalhealth services financing are changing, andthe effect of such changes on the nature andcost of services in community mental healthservices.

Content: First, reporting systems will be de-v eloped for collecting information regardingsources of financing for medical health serv-ices. Then, using the data obtained, the effectof changing methods of financing on thenature and cost of services will be analyzed.Special emphasis will be placed on measuringthe impact of changes in the sources offunds brought about by the passage of theCommunity Menial Health Centers Staffingand Construction Programs as well as theSocial Security Amendments of 1965, includ-ing local implementation of these programs.

Methods: Information will be derived fromconsultation with personnel presently oper-ating mental health centers and govern-mental agencies responsible for developingreporeng systems. Selected centers will par-ticipate in testing the use of the reportingsystem.

CURRENT STATUS- (June 1965-Oct. 1966)

ORGANIZATION(S)

National Institute of Mental Health, Bethesda,Md.

Committee of Special Studies, The New YorkAcademy of Medicine, 2 East 103rd St., NewYork, N. Y. 11236

PRINCIPAL INVESTIGATOi2 (5)Lieberman, Marvin

STAFF

Full-time:2 economists

Part-time:None

COST

$15,000424,999


PUBLICATION PLANS


Marvin Lieberman, Mental Health FacilitiesBr., National Institute of Mental Health,Bethesda, Md. 20014

27

A-26 Cost and Care of Children with Cystic Fibrosis of Pancreas (12/2/65)ABSTRACTObjectives: To acquire, collect and analyze,

with the assistance of computers, data rele-vant to the study of cystic fibrosis of thepancreas, in order to develop a program forfinancial aid to families of afflicted chil-dren.

Content: A complete study was made, utilizingcomputers, of the clinical aspects of cysticfibrosis, including the following: (1) agecomposition of the clinic patients, (2) vari-ations in drug therapy, (3) hospitalizationpatterns, and (4) analysis of blood constitu-ents in cystic fibrosis patients. A study wasmade of the socioeconomic characteristics ofthe families and patients and the costs of thepatient's care.

Methods: The data was gathered from medicalrecords, hospital cost records, family inter-views, etc. Much of the analysis and datastorage was dale by computer.

CURRENT STATUSReport being printed. (June 1962Dec. 1965)ORGANIZATION(S)Columbia-Presbyterian Medical Center and

Babies Hospital

28

PRINCIPAL INVESTIGATOR(S)Bauman, William A., M.D.

STAFFFull-time:

None

Part-time:1 accountant5 physicians1 registered nurse

COST

$150,000-4199,999


Div. of Special Services, New York State Dept.of Health, Albany

PUBLICATION PLANS

Private publicationDecember 20, 1965


William A. Bauman, M.D., Chief, PediatricClinics, Cultambia-Presbyterian Medical Cen-ter, 622 West 168th St., New York, N. Y.10032

r

A-27 Overhead Hospital Costs and Pricing in a Short-Term General Hospital(11/24/65)

ABSTRACT

Objectives: To formulate a pricing policybased on the nature of daily costs.

Content: Most nursing cost found to be over-head on daily basis, i.e., not scheduled tocoincide with weekly business rhythm.

Methods: Statistical and theoreticalfloor byfloor breakdown.

CURRENT STATUSIn processpaper concerning yearly costs and

methodology. (1963-1966)

ORGANIZATION(S)Dept. of Economics, Univ. of Georgia

PRINCIPAL INVESTIGATOR(S)Cohen, Harold A.

RTAFF

Full-time:None


COSTUnder $5,000


PUBLICATION PLANSNothing definiteFOR FURTHER INFORMATIONHarold A. Cohen, Assist. Prof. of Economics,

Dept. of Economics, University of Georgia,Athens, Ga. 30601

A-28 A Pilot Methodological StudyAreas of Poor and Overc

ABSTRACTflIvislo4;Tace rP" iirresnevi-; nen 4'".... j...... w a c v A ,I.I Mt' VW% erlinftel CI eloc win est% C.

JILlitol, .1.1%."40 1.1 J. aaavaa

uring cost of ill health due to poor housing.Such analysis would provide procedures forestimating the direct and indirect costs ofpoor health.

Content : The effects of the environment on itsoccupants will be measured in terms of dol-lar costs to the society ; an analysis of thesampling problems related to ethnic, culturaland geographic variation will be included.

Methods: Review of the literature concerningincidence and costs of disease in poor andovercrowded housing; a sample and a demo-graphically matched control group will bedeveloped ; a survey of existing records inthe area of health and welfare will be made.

CURRENT STATUSAbout 50 percent completed. (June 1965May

1966)

ORGANIZATION(S)Dept. of Economics, Texas Christian University

30

of the Cost of Debilitating Conditions inrowded Housing (1211/65)

PRINCIPAL INVESTIGATOR(S)w......4.1..,..... T...1...... TVT W. VLACL111, Uk1.11.11 .1.4.

Durham, Floyd

STAFFFull-time:None

Part-time:1 economist1 psychologist

COST$5,000$9,999


PUBLICA"ION PLANSTo be determined later

FOR FURTHER INFORMATIONJohn L. Wortham, Chairman, Dept. of Eco-

nomics, Texas Christian Univ., Fort Worth,Tex. 76118

C)

U

A-29 Cost Study of Dental Education (11/23/65)ABSTRACTObjectives: To determine a cost picture of

dental education in the United States andCanada.

Content: A Cost Study.Methods: Cost accounting was reported from

45 active schools in the United States andCanada to the committee. This data was thencomputer programmed under various cate-gories of interest ; the data was then organ-ized and printed in book form.

CURRENT STATUSCost Study of Dental Educationa case-bound

report has been completed. (July 1963Nov.1965)

ORGANIZATION(S)School of Dentistry, University of North Caro-

lina, Chapel HillAmerican Association of Dental SchoolsPRINCIPAL INVESTIGATOR(S)Brauer, John C.

Norwood, George M., Jr.Muth, RimnnChase, Charles L.

STAFFFull-time:

Part-time :

COST

$75,000$99,999

FINANCING ORGANIZATION(S)W. K. Kellogg Foundation, Battle Creek, Mich.PUBLICATION PLANSNov. 1965

FOR FURTHER INFORMATIONReginald H. Sullens, Sec., American Associa-

tion of Dental Schools, 840 North LakeShore Dr., Chicago, Ill. 60611

31

B. Expenditures for Health Services

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on expendi-tures: C-3; H-46.

(

,

I

;

B-1 Expenditures on Personal Health Care in Canada, 1953-1961 (6/24/66)

itiaSTI1 A (Yr

Objectives: To measure the expenditures madein Canada on Personk0 Health Care Servicesduring the period 1953-1961, for the use ofthe Royal Commission on Health Servicesand others interested in health economics.

Content: Expenditures on all Personal HealthCare Services in Canada; expenditures onservices 4 hospitals, including active treat-ment hospitals, mental hospitals, tubercu-losis hospitals, and Federal hospitals; andexpenditures on physicians' services, pre-scribed drugs, and dentists' services.

Methods: Compilation, collation, and analysisof existing records from many sources.

CURRENT STATUS

Revised and up-dated comparison of this publi-cation planned for early in 1967 ; new editionhav ing data ahead to 1965. (1961-Mar. 1963)

ORGANIZATION (S )


PRINCIPAL INVESTIGATOR(S)Smith, Arthur F.Lachapelle, Robert J.Williams, Lloyd G.

STAFF

Full-time:1 economist


COST

FINANCING ORGANIZATION(S)Dept. of National Health and WelfarePUBLICATION PLANSDNHW-1967

FOR FURTHER INFORMATIONJohn E. Osborne, Research and Statistics Di-

rectorate, Dept. of National Health and Wel-fare, Brooke Claxton Bldg., Ottawa 3,Ontario, Canada

6V/45

B-2 Consumer Patterns of the Aged, 1950-60 (4/29/66)

ABSTRACTObjectives: To evaluate the changing patterns

a-4 Ilin nem.. " cverIncrin A ; +1 1 Iona nIn el a n IA*. ova n. 441 c.%Ai ialMoVfWho 1.... 1".iiA&IiI.41%.1.7 KAMA OVA V aases la 41.1. lal.%

aged by comparing the 1950 and 1960 pat-terns of the aged in relation to those ofyounger segments of the population.

Content: Data from the 1950 and 1960-61 Sur-veys of Consumer Expenditures by the Bu-reau of Labor btatistics provide the basisfor the analysis.

Methods: Statistical analysis of the data.CURRENT STATUSSeveral articles have been published and the

analysis is well underway. (June 1965-Aug.1967)

ORGANIZATION(S)Dept. of Sociology and Anthropology, Brown

Univ.

PRINCIPAL INVESTIGATOR(S)Goldstein, Sidney

36

STAFF

Full-time:

Part-time:1 sociologist1 statistician

COST

$50,000$74,999


USPHS

PUBLICATION PLANSVarious journals and monographAt varied

points, monograph 1968

FOR FURTHER INFORMATIONDr. Sidney Goldstein, Chairman, Dept. of So-

ciology, Brown Univ., Providence, R.I. 02912 )

(

1

i

;

i

"........,"

i

B-3 Evaluation of (CPI) Index of Hospitll Room Rates (6/8/66)ABSTRACT

Objectives: To determine feasibility and costof evaluation of Consumer Price Index ofhospital room rates. Long range objectivesof further research stemming from explora-tory work would be 1) a definitive statementof the meaning and content of the index ofhospital room rates and methods to produceit; 2) comparison of hospital accounting andBLS concepts of changes in room costs ; 3)measurement of change, if any, in quality ofservices which hospital room cost represents.

Content: Essentially review of the theory ofpure price indexes employed by BLS alongwith particular consideration for the medi-cal care and hospital components of the CPIand pursuit and examination of hospitalstatistical and accounting cost data and theirmeaning.

Methods: Fundamental bibliographical workplus contact with knowledgeable people inthe area of study.

CURRENT STATUS

Contributed paper for American StatisticalAssociation August 1966 meeting in prog-

ress ; terminal report in proeress. (June 1965-Oct. 1966)

ORGANIZATION(S)Loyola Univ., Chicago, Ill.

PRINCIPAL INVESTIGATOR(S)Martin, Leonard W.STAFFFull-time:None


COST$5,000-$9,999


PUBLICATION PLANS

Proceedings of American Statistical Associa-tionspring 1967


Leonard W. Martin, Chairman, Dept. of Eco-nomics, Loyola Univ., 820 N. Michigan Ave.,Chicago, Ill. 60611

37

..........................",OPMfelPIP.

B-4 Expenditures for and Use of Dental Services among American Families(12/20/65)

ABSTRACTObjectives: To determine expenditures and use

patterns for dental services among Ameri-can families.

Content: The project will attempt to measurethe expenditures from the various types ofdental care and will attempt to correlatedental care expenditures with age, sex, fam-ily income, etc. Comparison with expendi-tures for previous years will be made in aneffort to determine trends.

Methods: The study will collect its data froma survey of a representative national sampleof approximately 2,500 families. Data willsubsequently be verified by the dentists .whoprovided the services.

CURRENT STATUSField work has been completed; tabulations to

start immediately. (1964-1966)ORGANIZATION(S)Ceater for Health Administration Studies,

Graduate School of Business, Univ. of Chi-cago

National Opinion Research Center, Univ. ofChicago

38

PRINCIPAL INVESTIGATOR(S)Ogawa, GeorgeAnderson, Odin W.

STAFFFull-time:

Part-time:1 economist1 sociologist

COST

$200,000$249,999


PUBLICATION PLANSPreliminary bulletin, mid-year 1966, in Prog-

ress in, Health Services. Book later, prob-ably Univ. of Chicago Press-1967

FOR FURTHER INFORMATIONGeorge Ogawa, Center for Health Admin.

Studies, Graduate School of Business, Univ.of Chicago, Chicago, Ill. 60637

B-5 Family Expenditures for MedicInsurance

ABSTRACTObjectives: To determine the expenditures and

use patterns for health services by Americanfamilies and to analyze the impact of health

.f insurance on these expenditures and pat-terns of use.

Content: The study will ascertain the expendi-tures for the various areas of health care(physicians, hospital care, drugs, etc.) andwill correlate health care expenditures withage, sex, family income, etc. Comparisonswith expenditures for previous years willbe made in an effort to determine trends,and an attempt will be made to measure theeffects of health insurance on health careexpenditures.

Methods: The project will gather its informa-tion from a survey of a representative na-tional sample of 2,367 families and 7,803individuals.

CURRENT STATUSCompleting tabulations and publishing three

preliminary reports. The first one, "Trendsin Personal Health Spending," is completed;the other two early in 1966. (1963-1966)

ORGANIZATION(S)National Opinion Research Center, Univ. of

Chicago

al Care and Use of Services and Health(12/20/65)

Center for Health Adminstration Studies,Graduate School of Business, Univ. of Chi-cago

PRINCIPAL INVESTIGATOR(S)Andersen, Ronald M.Anderson, Odin W.

STAFFFull-time:1 sociologist

Part-time:1 sociologist

COST


PUBLICATION PLANS

Full report in book form, probably Univ. ofChicago Press-1967


Ronald M. Andersen, Center for Health Ad-min. Studies, Graduate School of Business,Univ. of Chicago, Chicago, Ill., 60637

39

B-6 Cost and Payment Patterns for Public Health Nursing Services in NewJersey (12113/65)

AnQTRACT

Objectives: This study, an exploratory analy-sis of cost and payment patterns for publichealth nursing services in New Jersey, hastwo main objectives: (1) to determine thecos6 of providing nursing services in asound community program of medical care ;(2) to determine the cost patterns of ren-dering bedside ure in the home.

Content: The institutional structure of publichealth nursing includes three types of healthagencies: official, nonofficial or voluntary, anda combination of the two. This study dealsprimarily with those organizations whichare not official agencies. Nonofficial or vol-untary agencies are administered by private,autonomous boards, and the chief sources offunds are contributions and dues.

Methods: Financial data were made availablefrom primary sources by the Department ofHealth. The information was originally pre-pared by individual agencies and was ac-cepted as adequate for this study.

CURRENT STATUS

(May 1963completed Sept. 1964)

40

ORGANIZATION(S)Bureau of Economic Research, RutgersThe

State UniversityPRINCIPAL INVESTIGATOR(S)Topiol, Jack, Ph.D.Stark, Harry, Ph.D.Whittier, PeterSTAFFFull-time:None

Part-time:1 accountant2 economists

COSTUnder $5,000FINANCING ORGANIZATION(S)New Jersey State Dept. of Health, TrentonPUBLICATION PLANSPublished as monograph-1964FOR FURTHER INFORMATIONJ. Carl Cook, Bur. of Economic Research, Rut-

gersThe State Univ., New Brunswick, N. J.08903

0

(

B-7 Economic Analysis of a Group Practice (11/29/65)ABSTRACTObjectives: To determine +ha way in which

the private practice of five physicians anda hospital is supported by the patients whouse their services.

Content:

Methods: The complete clinical and hospitalexperience of each patient coming to theclinic during a 12-month period was placedon cards and each service priced. Diagnosticdata assigned to each use of servicetotalrepresents economic operation of the centen

CURRENT STATUSCoding results preparatory to placing data

on IBM cards for sorting. (Jan. 1964-Apr.1966)

ORGANIZATION(S)School of Medicine, Univ. of Missouri, Columbia

PRINCIPAL INVESTIGATOR(S)Bryant, W. D., Ph.D.

Spellman, A., M.D.

STAFFFull-time:

Part-time:1 economist5 physicians1 registered nurseCOST

$25,000$34,999

FINANCING ORGANIZATION(S)Missouri State Division of Health, Jefferson

City. School of Medicine, University ofMissouri

PUBLICATION PLANS

FOR FURTHER INFORMATIONW. D. Bryant, Ph.D., Assistant Dean, School

of Medicine, Univ. of Missouri, Columbia,Mo. 65201

41

BI3 Tendency of Public and Private Expenditure in Health in Chile durk..gthe Last Ten Years (3/7/66)

ABSTRACTObjectives: To study the expendiL-Ire in

health, the participation of the public andprivate sectors in the expenditure, and thedistribution of the expenditure among "Ex-penses of Personnel," "Expenses for Goodsand Services" and "Expenses for Transfer-ency."

Content: Statistical data dealing with the ob-jectives.

Methods: Recollection of data from Govern-ment, Servicio Nacional de Salud, Corpora-cion de Fomento, Instituto de Economia,study and analysis of the data.

CURRENT STATUSStudy finished, first draft released. (Oct. 1964-

Dec. 1965)

ORGANIZATION(S)Departamento de Salud del Colegio Medico

PRINCIPAL INVESTIGATOR(S)Perez, Salvador DiazMontoya, Carlos

42

Vera, Mario

STAFFFull-time:None

Part-time :1 accountant2 economists1 medical care specialist1 physicianCOSTUnder $5,000

FINANCING ORGANIZATION(S)Departamento de Saludo del Colegio Medico

PUBLICATION PLANSWe expect to publish a summary in "Boletin

de la Oficina Panamericana" de la Organiza-ción Panamericana de Salud,1967

FOR FURTHER INFORMATIONSalvador Diaz Perez, Director de Hospital, De-

partamento de Salud del Colegio Medico,Esmeralda N° 571, 40 Piso, Santiago, Chile

-7)

( 3

L )

B-9 Charges for Complex Surgery (6/10/66)ABSTRACT

Objectives: The purpose of the study is toopen inquiry into the financial aspects ofcomplex surgery. Charges for the more diffi-cult and complex surgical procedures, someof which are rather new and require largeteams supported by elaborate equipment anddetailed protocols, are compared withcharges for simpler procedures.

Content: Charges arn being analyzed accord-ing to (1) time distribution with referenceto the surgical day or days, (2) class ofservice such as laboratory, x-ray, operatingroom, etc., and (3) a complexity rating forthe surgical procedure.

Methods: A 20 percent random sample (331patients) of those undergoing surgery in the4th quarter of 1965 at Montefiore was se-lected. Operating room records were used todraw the sample. Patient charts were con-sulted for coded diagnoses, surgery, lengthof stay, age, sex, etc. Copies of patients'bills (retrieved from tape records) are beingused to classify charges. Payment source isone of the items available on the bill.

CURRENT STATUS

The sample has been chosen and all necessarydata obtained from the various sources. A

1

computer program has been developed andthe data are currently being coded formachine analysis. (Feb.-Dec. 1966)

ORGANIZATION(S)School of Public Health and Administrative

Medicine, Columbia Univ.

PRINCIPAL INVESTIGATOR(S)Muller, Charlotte, Ph.D.STAFFFull-time:None

Part-tinte:1 economist

COSTUnder $5,000


PUBLICATION PLANSWill be decided laterFOR FURTHER INFORMATIONDr. Charlotte Muller, Assist. Prof. of Admin-

istrative Medicine, School of Public Healthand Admin. Medicine, Columbia Univ., 12E!Fort Washington Ave., Apartment 6K, NewYork, N. Y. 10032

43

B-10 Economic Factors Affecting the Costs of Prescription Drugs in theGreater Metropolitan Area of New York (11/23/65)

ABSTRACT

Objectives: To determine the price structurefor prescription drugs in the New York Met-ropnliton area and the economic conditionsthat obtain.

Content: A study of the economic corlitionsaffecting the prices of prescrip*--A field survey of a sample o-Pdrawn from the area. In each phar ,y 200of the most commonly prescribed pharma-ceuticals were priced by the prevailing pricesystem of the particular pharmacy. A com-parison of prices relative to economic condi-tions in the various sections of the area.

Methods: A questionnaire defining the samplein tcrms of ktion, number of prescriptionsfilled, store ownership, by type, neighbor-hood income levels, and 200 prescriptiondrugs priced by commonly prescribed quan-tities was used. The university computercenter is programming the surveys to es-tablish the results.

CURRENT STATUS

In the computer programming stage. (May1965-Jan. 1966)

44

ORGANIZATION(S)Dept. of Pharmacy Administration, College of

Pharmacy, St. John's Univ.PRINCIPAL INVESTIGATOR(S)Buatti, Anthony T., M.B.A., B.S.STAFFFull-time:1 economist

Part-time:1 mathematician1 statisticianCOSTUnder $5,00C


PUBLICATION PLANSNew York State PharmacistExpected date

of publication not established as yetFOR FURTHER INFORMATIONProf. Anthony T. Buatti, Chairman, Pharmacy

Admin., College of Pharmacy, St. John'sUniv., Grand Central Parkway, Jamaica,N. Y. 11435

"frMORIC.0.44,0a.re"..

4

B-11 Urban Medical Care by Source of Treatment and Sour ze of Payment(2116/66)

ABSTRACTObjectives: To analyze the scope, characteris-

tics, and impact of government expenditureson medical care for New York City residents.

Content: The project determined : (1) the rela-tive importance in total expenditures of theseparate sources of paymentcity, State,and Fedezal goveniments, out-of-pocket ex-penditures of private consumers, third partypayers, and other sources ; (2) the size andcharacteristics of the medically indigentpopulation; and (3) a basis for evaluationof the efficiency of the present structure ofpublicly-supported medical care arrange-ments, and for analysis of the current re-lationship and interdependence of public,voluntary and proprietary medical care re-sources.

Methods: The basic source data were derivedfrom the many published and unpublishedrecords, reports, etc. of public agencies pro-viding direct services or administering publicprograms, of voluntary agencies and thirdparty sources, and of analysis of expendi-tures on medical care by private consumers.

CURRENT STATUS(July 1961June 1966)

ORGANIZATION (S )Urbar Medical Economics Research ProjectGraduate Divbion, Hunter College, The City

Univ. of New YorkOffice of Program Planning Research and De-

velopment, New Yom City Dept. of Health

PRINCIPAL INVESTIGATOR (S)Piore, NoraSnyder, Eleanor M., Ph.D.

STAFFFull-time:3 economists1 statistician

Part-time:None

COST

$150,000$199,999

FINANCING ORGANIZATION (S )USPHSHealth Research Council of the City of New

York

PUBLICATION PLANS1. THE SCOPE OF TAX EXPENDITURES

FOR URBAN MEDICAL CARE. A paperpresented at the Conference of City HealthOfficers, Detroit, Michigan, Nov. 1961

2. METROPOLITAN AREAS AND PUBLICMEDICAL CARE. The Economics of Healthand Medical Care, University of Michigan,Ann Arbor, 1964

3. THE BASIS FOR MUNICIPAL CAPITALOUTLAY ON HEALTH CARE FACILITIESIN_NEW YORK CITY. April, 1964

4. Research Note : VENDOR PAYMENTS,CONTRACTS AND OTHER DISBURSE-MENTS BY THE CITY OF NEW YORK TOPRIVATE VENDORS AND VOLUNTARYINSTITUTIONS FOR HEALTH SERVICESRENDERED TO NEW YORK CITY RESI-DENTS. June, 1964

5. PUBLIC EXPENDITURES FOR THEMENTALLY ILL IN NEW YORK CITY.Public Health Reports, Vol. 79, No. 10, Oc-tober, 1964

6. Research Note : CHANGES IN PUBLICEXPENDITURES F 0 R PERSONALHEALTH CARE OF NEW YORK CITYRESIDENTS BUDGETED BY THE CITYOF NEW YORK, AND IN THE AMOUNTAND RELATIVE IMPORTANCE OF FED-ERAL AND STATE TRANSFER FUNDSOFFSETTING CITY ALLOCATIONS FORTHESE PURPOSES, FISCAL YEAR 1961AND FISCAL YEAR 1965. November, 1964

45

7. )LITAN MEDICAL ECONOM-I6b. outbatific American, January, 1965, Vol.212, No. 1

8. POVERTY PROFILESOME PROBLEMSIN MEASUREMENT. March, 1965. (To bepublished by the American Statistical Asso-ciation)

9. LOCAL NEIGHBORHOOD STUDIES:GOUVENEUR MEDICAL SERVICE AREA.Population Statistics, 1960. Report No. 1,March, 1965

i A DTTOT Tri TyrITTT A rnim A 'POT TITTTT A ATAAP,. A V J.P.U.LV, 1 ILL V 211 .r.4 211141J 1- 1111.a111

THROPIC EXPENDITURES FOR DENTALCARE IN NEW YORK CITY. A paper pre-

46

sented at the Annual Meeting of the NewYork Public Health Association, May, 1965

11. HEALTH INSURANCE COVERAGE INNEW YORK CITY. June, 1965

12. MEASURES OF THE DIMENSIONS OFPOVERTY IN NEW YORK CITY. Publishedby Urban Research Center, Hunter College,C.U.N.Y., June, 1965


Nora "Fiore, Director, Urban Diedical Econom-ics Research Project, 40 Worth Street, Room720, New York, N. Y. 10013

o

r. i

,.......,

C. Organization or Financing Resource Development ofHealth Services

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on organiza-tion or financingresource development: A-1; A-2; A-26; D-24;D-29; F-2 ; H-49; 1-35 ; L-1.

47

C-1 Psychiatric Insurance for Workers in Manufacturing Industry (8/26/66)

ABSTRACTObjectives: Analysis of certain current plans

of insurance coverage for psychiatric care,with resvect t;^ engta, gnri prnh-lens.

Content :

Methods:

CURRENT STATUSLiterature review. (May 1966-67)ORGANIZATION(S)Div. of Medical and Hospital Admin., S tool of

Public Health, Univ. of California, L.A.PRINCIPAL INVESTIGATOR(S)Katz, Alfred H.

STAFFFull-time:1 medical care specialist

Part-time:1 social worker, counselor

COST$15,000$24,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONAlfred H. Katz, School of Public Health, Univ.

of Calif., Los Angeles, Calif. 90024

91/49

C-2 The Impact of the 1965 SocialInsurance

ABSTRACTObjectives: To describe the initial impact of,

and the response to, the 1965 Social SecurityAct Amendments on the part of the privateinsurance business in areas of benefit design,underwriting, etc.

Content : Utilizing information gained bymeads of questionnaires mailed to and per-sonal interviews held with policy-makingrepresentatives of private insurers, a com-prehensive report will be made of the de-veloping reaction to the 1965 amendmentsand what courses the insurers intend to pur-sue as a result.

Methods: Information will be collected fromprivate insurers, including Blue Cross, BlueShield, and Independent Plans, as well asInsurance Companies, State "65" plans andregulatory authorities, including the appro-priate study committees of the NationalAssociation of Insurance Commissioners.

CURRENT STATUSCollecting data. (Apr.-Sept. 1966)

ORGANIZATION(S)Florida State Univ., Tallahassee

50

Security Amendments on Private Health(5/6/66)

PRINCIPAL INVESTIGATOR (S)Dickerson, 0. D.STAFFFull-time:1 economist

Part-time:None

COSTUnder $5,000

FINANCING ORGANIZATION(S)Florida State Univ.American Risk and Insurance Association,

Tallahassee, Fla.

PUBLICATION PLANSAnnals of Society of Chartered Property and

Casualty Underwriters (Application pend-ing)Sept. 1966

American College of Life Underwriters (bro-chure)Aug. 1966

FOR FURTHER INFORMATION0. D. Dickerson, Assoc. Prof. of Risk and In-

surance, Florida State Univ., Tallahassee,Fla. 32306

(

C-3 Public Medical Care Programs and Costs, Canada

ABSTRACTObjectives: Compare administrative and pro-

gram aspects of public-financed, public-con-trolled, or public-related plans now in oper-ation that finance physicians' services forthe population generally.

Content: Descriptive and interpretative mate-rial and statistical tables, plus appendir-s onprogram detail and on legislation, where per-tinent.

Methods: Correspondence and other communi-cation with senior administrators, plus directstudy of legislation and of program details.

CURRENT STATUSIn final drafts. (1965-1966)ORGANIZATION (S)Dept. of 'National Health and WelfarePRINCIPAL INVESTIGATOR (S)Williams, L. G.Cook, H. G.

STAFFFull-time:None

Part-time:1 economist1 sociologist

COST




FOR FURTHER INFORMATIONJ. E. Osborne, Dir., Research and Statistics

Directorate, Dept. ot National Health andWelfare, Brooke Claxton Bldg., Ottawa 3,Ontario, Canada

51

C-4 Voluntary Medical Insurance in Canada, 1962-1965

ABSTRACTObjectwes: Compares enrollment, premium

and expenditure, experience of profit andnon-profit voluntary physicians' servicesplans, by type of plan and type of benefit.

Content: Detailed and summary statisticalseries, and descriptive and interpretativematerial as indicated.

Methods: Correspondence and other communi-cation with plan administrators, plus directstudy of contracts and of financial and otherreports and tabulations from the plans.

CURRENT STATUSFinal checking of data. (1964-1966)ORGANIZATION ( S )Dept. of National Health and Welfare, Ottawa,

Canada

PRINCIPAL INVESTIGATOR(S)Williams, L. G.Moen, J. B.

52

STAFFFull-time:None


COST


Dept. of National Health and Welfare, Ottawa,Canada



J. E. Osborne, Dir., Research and StatisticsDirectorate, Dept. of National Health andWelfare, Brooke Claxton Bldg., Ottawa 3,Ontario, Canada

,)

C-5 Health hisurance and Psychiatric Care

ABSTRACTObjectives: To determine the length and cost

of vsychiatric care used by insurance -planmembers with enhanced benefits for privatepsychiatric care.

Content: Analyses of experience.Methods:

CURRENT STATUSCompleted. The project was begun in 1960.

ORGANIZATION(S)Dept. of Psychiatry, Univ. of British Colum-

bia, VancouverPRINCIPAL INVESTIGATOR(S)Richrnan, Alex, M.D., M.P.H.

STAFFFull-time:

Part-time:

COST


Department of National Health and Welfare,Ottawa, Canada

PUBLICATION PLANS

"Health Insurance Prepayment for Psycho-therapy in Private Psychiatric Practice,"Canadian Psychiatric Association Journal 8:121-132, 1963

"Psychotherapy, Social Class, and Medical In-surance Plans," Medical Care 4 : 15-18, 1966


Alex Richman, M.D., Head, Section of SocialPsychiatry, Dept. of Psychiatry, Univ. ofBritish Columbia, Faculty of Medicine Bldg.,10th Ave. and Heather St., Vancouver 9,B.C., Canada

58

C-6 Comparative Studies in Patterns of Medical Care Organization

ABSTRACTOT-jectives: To study the various health insur-

ance plans in the Los Angeles area and theireffect upon different aspects of medical care.The study will serve as a guide for the pro-fessions and the population to decide whichplans are most effective and whether newones are needed.

Content: The study will seek to analyze, foreach health plan, the quantity and qualityof health servic - received, their costs, andthe attitude of both providers and recipientsof services. A comparison will be made forthe different health insurance plans, of thewhole gamut of relationships between recipi-ents and providers of health services. Thestudy will also examine other medical careproblems, such as patterns for care of pub-lic welfare recipients, organization of hospi-tal services, and health services for mi-grants.

Methods: The study will involve analysis andcomparison of the various health insuranceplans in the Los Angeles area, with a sub-sequent analysis and comparison of all as-pects of medical care received through theinsurance plans.

CURRENT STATUSPreliminary survey of health insurance plans,

analysis of their structural features, underway. (Jan. 1965-Dec. 1969)

54

ORGANIZATION(S)

School of Public Health, Univ. of Calif., LogAngeles

PRINCIPAL INVESTIGATOR(S)Roemer, Milton I., M.D.Hopkins, Carl E., Ph.D.

STAFFFull-time:1 economist1 sociologist

Part-time:1 medical care specialist1 sociologist1 statistician

COST

$250,000 or more

FINANCING ORGANIZATION (S)USPHS

PUBLICATION PLANSA series of monographs, papers and a book

Nothing definite as yet


Carl E. Hopkins, Ph.D., Prof. of Public Health,School of Public Health, Univ. of Calif., 405Hilgard Ave., Los Angeles, Calif. 90024

C-7 Medical Care Costs and Voluntary Health Insurance: A Three Country(Great Britain, Sweden, U.S.) Study (5/6/66)

ABSTRACTObjectives: To collect data comparable to

studiest on OP "MP Q111.1jPet fieldad in 19K3and 1958 and to make comparisons of the1963 data with that collected in Sweden andGreat Britain.

Content : Family medical care experiences forthe year 1963 plus relevant backgroundvariables.

Methods: Personal interviews with family re-spondents and mail questionnaires from hos-pitals and insurance companies. Sample israndom of the non-institutionalalized popu-lation of the U.S., and includes 2,367 fami-lies Similar methods utilized in the Swedishand English studies.

CURRENT STATUSWriting final reports. (June 1963-66)ORGANIZATION (S)Health Information Foundation, Chicago, Ill.National Opinion Research Center, Chicago,

PRINCIPAL INVESTIGATOR(S)Andersen, Ronald

STAFFFull-time:

bo. 910gIbt,1 data processing specialistPart-time:1 sociologist

COST$200,000-$249,999

FINANCING ORGANIZATION(S)Health Information Foundation, Chicago, Ill.Dept. of Research and Planning, National Blue

Cross Association, 540 N. Lake Shore Dr.,Chicago, Ill.

PUBLICATION PLANS1) Progress in Health Servicesv. 14, No. 5,

1965; v. 15, Nos. 1 and 2, 19662) Health Information Foundation Research

series (three nation)End 19663) Book, publisher not set (U.S. only) End

1966

FOR FURTHER INFOAMATIONRonald Andersen, Health Information Founda-

tion, 5555 S. Ellis Ave., Chicago, ill. 60637

55

CS Economic Dependency, Use of Medical Services and the Means Test(2/15/66)

ABSTRACT

Objectives: This is an exploratory project toexamine the concept of economic dependencyin the United States with particular refer-ence to the costs to society as a whole ofbearing the economic burden of disability,illness, and related problems.

Content : This initial examination will attemptto define and grossly measure both formaland informal amounts and sous=ces of de-pendency income, relating them to variouscontributing conditions and to subsequentuse of health services.

Methods: After developing in some detail aconceptual scheme of dependency, alreadycollected economic and health services usedata will be employed to test extent and re-lationships. Finally a local population willbe sampled.

CURRENT STATUS

The conceptual framework has been developedand precollected data are being used to vali-date this framework. (June 1965-67)

56

ql

ORGANIZATION(S)Center for Health Administration Studies,

Univ. of Chicago

PRINCIPAL INVESTIGATOR(S)Anderson, Odin W.Richardson, William C.


Part-time:1 sociologiscc,

COST$25,000-$34,999

FINANCING ORGANIZA-71N(S)


FOR FURTHER INFORMATIONOdin W. Anderson, Center for Health Adminis-

tration Studies, Univ. of Chicago, 5555 SouthEllis, Chicago, Ill. 60649

-

)

C-9 A Survey of Eligibility Determination Procedures for the HSI Program,Florida Counties, 1965 (1/31/66)

ABSTRACTObjectives: To identify the process of deter-

mining eligibility for a State-county indigenthospitalization program; particular empha-sis to organizational aspects.

Content: This exploratory study is in anticipa-tion of a larger comparative study of eligi-bility determination for all indigent medicalcare programs.

Methods: Questionnaires to all county healthdepartments to identify range of practice.Selection of st udy sample and data obtainedthrough interviews with health, welfare andhospital personnel.

CURRENT STATUSFinal report is currently being prepared. (Jan.

1965May 1966)

ORGANIZATION(S)Florida State Board of HealthPRINCIPAL INVESTIGATOR(S)Jackson, Robert C.

Doff, Simon D., M.D.

STAFFFull-time:

Part-time:1 physician1 social worker, counselor1 statistician

COSTUnder $5,000


PUBLICATION PLANSNo plans


Robert C. Jackson, Medical Social Consultant,Florida State Board of Health, 1217 PearlSt., Jacksonville, Fla. 32201

57

C--10 Standard Accounting Terminology for Public Health Nursing Agencies(12/13/65)

ABSTRACTObjectives: To suggest standardized defini-

tions and terminology applicable to the fieldof public health nursing.

Content: The first sectioi of 3.he study dealswith the classification of nursing agencyrevenues. In the second section, the expensesof a nursing agency are listed by functionalgroups, with subclassification accounts, andalso lists natural expenses, with regard tofunctional clas^ification. The third sectionpresents a- :" 3trative statement of finan-cial posit, with definitions for all themajor terms used in the statement.

Methods: Necessary information for the studywas obtained by an intensive study of rele-vant literature, the use of consultants andthe review of the accounting practices ofexisting programs.

CURRENT STATUS(June 1964completed)

ORGANIZATION(S)Bureau of Economic Research, RutgersThe

State University

58

;

;

PRINCIPAL INVESTIGATOR(S)Kitinoja, John, Ph.D.Topiol, Jack, Ph.D.

STAFFFull-time:None

Part-time:2 accountants

COST

Under $5,000


New Jersey State Dept. of Health, Trenton

PUBLICATION PLANS

Published as monograph


J. Carl Cook, Bur. of Economic Research, Rut-gersThe State Univ., New Brunswick, N.J.08903

I

I

C-11 "Facts About Nursing," a Statistical Summary Published Annually(3/11/66)

ABSTRACT

Objectives: To provide statistics and trenddata on nurses and related areas.

Content: Covers the distribution of nurses byfield of nursing, professional nurse educa-tion, placement services, the economic statusof nurses by field of nursing, allied nursingpersonnel, related areas such as licensure,hospital facilities and utilization, health in-surance coverage, other health personnel,vital statistics, functions and purpose ofnursing organizations.

Methods: Main questionnaires, report forms,source materials collected from governmentagencies and other organizations.

CURRENT STATUSIn process of completion. (1965June 1966)ORGANIZATION(S)American Nurses' AssociationPRINCIPAL INVESTIGATOR(S)Marshall, Eleanor D.

STAFF

Full-time:None

Dart-time:2 statisticians1 statistical supervisor

COST

FINANCING ORGANIZATION(S)American Nurses' Association

PUBLICATION PLANSANAJune 1966


Eleanor D. Marshall, Assist. Dir., Researchand Statistics Program, American Nurses'Association, 10 Columbus Circle, New York,N. Y. 10019

59

C-12 An Economic Analysis of the Short-term, Voluntary, General Hospital(1110/66)

ABSTRACTObjectives: Analysis or the short-term, volun-

tary general iiospital as an economic sy stemengaged in the production and sale of aunique product outside the traditional con-text of the market. An attempt is made toapp'y the tools of both modern and tradi-tional economic analysis toward the con-struction of an economic model.

Content: Statements regarding: the nature ofmedical care as an economic good ; the his-tory of the hospital as an economic andsocial system; the applicability of economictools to analysis and prediction with respectto the hospital.

Methods: Survey of the economic attitudes ofhospital administrators. Survey of the lit-erature of economics as it applies to medicalcare. Statistical analysis of data concerningcosts and utilization of hospitals.

CURRENT STATUSRough draft. (Jan. 1965Aug. 1966)

60

ORGANIZATION(S)Lowell Technological Institute, Lowell, Mass.PRINCIPAL INVESTIGATOR(S)Hinchey, Brackston

STAFFFull-time:


COST

Under $5,000

FINANCING ORGANIZATION(S)None, at presentPUBLICATION PLANSIncomplete

FOR FURTHER INFORMATIONBrackston Hinchey, Assist. Prof. of Econom-

ics, Lowell Technological Institute, Lowell,Mass. 01853

U

C-13 Economic Analysis of the Health Insurance Industry (1212165)

ABSTRACTObjectives: 'Pc, determine the effects of the

institutional arrangement in the health in-surance industry on the supply and demandfor health insurance.

Content: Review of the development of thehealth insurance industry and evaluation ofthe industry in terms of economic efficiencyand social welfare.

Methods: Comparison of "commercial" corn-panie9 in the industry with the non-profitcompanies.

CURRENT STATUSIn process. The project was begun Sept. 1965.ORGANIZATION(S)Wayne State UniversityPRINCIPAL INVESTIGATOR(S)Gadzikowski, Gilbert

STAFF

Part-time:

COST


PUBLICATION PLANSPh.D. dissertation


Gilbert Gadzikowski, Wayne State Univ., De-troit, Mich. 48202

61

C-14 Health Insurance through Collective Bargaining in the New Haven Area(4/22/66)

ABSTRACTObjectiveq: To gurvey the health insurance

benefits actually available in a community tothe members of labor unions, and to theirdependents, through collective bargainingprovisions.

Content: Quantitative data, and analyses, on :The labor union population of the NewHaven Labor Force Area; health insuranceprovisions through collective bargainingagreementscontracts, insurance carriers,benefits and their limitation; insurance pre-miums; and estimates of the effectiveness ofthe insurance.

Methods: Community survey through labororganizations and governmental sources toascertain all labor union locals in the area;questionnaire survey and personal follow-upof labor unions; analyses of questionnairereturns, collective bargaining agreements,insurance booklets, etc., and statistical an-alyses of the data.

CURRENT STATUSPreliminary draft completed for publication.

Updating of findings to be undertaken in1966. Presented at the APHA annual meet-ing, Oct. 1965, Chicago, Ill. (1963-1966)

ORGANIZATION(S)Dept. of Epidemiology and Public Health, Yale

School of Medicine

62

PRINCIPAL INVESTIGATOR(S)Falk, I. S.Pepper, Anita

STAFF

J.4one

Part-time:2 medical care specialists2 statisticians

COST

$35,0110$44,999

FINANCING ORGANIZATION(S)Yale UniversityUSPHSGreater New Haven Central Labor Council,

New Haven, Conn.Connecticut State Labor Council, Hamden

PUBLICATION FLANSAmerican Journal of Public HealthNov.

1966

FOP:'. FURTHER INFORMATION

I. S. Falk, Professor of Public Health (Med-ical Care), Dept. of Epidemiology and Pub-lic Health, Yale School of Medicine, 60 Col-lege Street, New Haven, Conn. 06510

D. Organization of Health Services

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on organiza-tion of services : A-21; B-11; 0-6 ; E-15; E-24 : E-26; E-32 ;E-52 ; F-8 ; F-9 ; H-14 ; H-19 ; H-22 ; H-33 ; II-36; I-1; 1-9; 1-19;1-34; K-10; L-18; M-17.

i

D-1 Hospital-Health Department Re1ation5hips and Their Effects

ABSTRACTObjectives: Case Studies of both jointly ad-

ministered and separately administeredcounty hospitals and local health depart-ments in California to determine the extentof prevention and extra-mural health serv-ices provided with and without such unifica-tion. The study also pursues the generalproblem of local health departments' involve-ment in medicahcare activities today, as wellas the participation of independent volun-tary, general hospitals in preventive and out-of-hospital health services.

Content :

Methods:

CURRENT STATUSFinal Write-up. (1965-1966)ORGANIZATION(S)Div. of Medical and Hospital Admin., School

of Public Health, Univ. of Calif., L.A.

(5/26/66)

PRINCIPAL INVESTIC 4 "'OR (54)

Anzel, Daniel M.


Part-time:None

COST

$5,000.49, 999


USPHS

PUBLICATION PLANS


Daniel M. Anzel, School of Public Health, Univ.of Calif., Los Angeles, Calif. 90024

405

D-2 Geriatric Rehabilitation in

ABSTRACT

Objectives: To add to the growing body ofknowledge contributing to the formation ofpliblic policy and voluntary action vrauu 1.G"

gard to geriatric health problems.Content: The project will deal with these three

areas pertinent to the health care problemsof the aged: (1) the organization of com-munity resources for the care of the chronicillnesses of the geriatric patient, (2) theeconomics of providing health care in thecommunity hospital or nursing home for thechronically ill patient, emphasizing patientsin the lower socioeconomic groups, (3) thesocial and psychological dynamics importantto the effectiveness of geriatric rehabilita-tion programs in community hospitals.

Methods: Data for the study is being collectedfrom community hospitals and from com-munities themselves.

CURRENT STATUSData in analysis, write-up in progress. (June

1964-66)

ORGANIZATION(S)Dept. of Sociology and Anthropology, Frank-

66

a Community Hospital (4/29166)

lin County Public Hospital, Greenfield, Mass.School of Engineering, Univ. of Mass.

PRINCIPAL INVESTIGATOR(S)Rising, Edward J,, Ph.D.Dornblaser, Bright M.STAFFFull-time:None

Part-time:1 medical care specialist1 physician1 psychologist1 sociologist1 industrial engineerCOST$50,000$74,999


PUBLICATION PLANS

Far FURTHER INFORMATIONEdward J. Rising, Ph. D., School of Engineer-

ing, Univ. of Mass., Amherst, Mass 01003

D-3 Program Analysis Study (12/20/65)ABSTRACTObjectives: To study the transition of an in-

orien+,-tion from that of a mentalhospital to that of a community health cen-ter, and to objectively analyze the futurerole of the mental hospital in provid-ing comprehensive care to its geographiccommunity.

Content: The project will be directed at col-lecting information regarding the followingfour areas: (1) analysis of the treatmentoutcome of patients in a mentai hospitalwhich is developing into community men-tal health cmiter; (2) comparison of theinteraction between a mental hospital-basedprogram and its community with that be-tween a general hospital-based program andits community; (3) analysis of the changeof a hospital's orientation from that of atraditional mental hospital with limited pro-gram emphasis to that of a comprehensivehealth center with broad program emphasis,and (4) study of the function of professionaland nonprofessional staffs. This will allnwcomparisons between the impact whichcenter is now having on its patients in con-trast to that of a decade ago.

Methods: Boston State Hospital, undergoingth r. transition from State mentai hospital tocommunity mental health center, is beingutilized for the project, and the data is cur-

rently being collected on a variety of sub-jectiv e and objective parameters.

CURRENT STATUSBeginning phases of exploration. (Sept. 1965

70)

ORGANIZATION(S)Laboratory of Community Psychiatry, Dept.

of Psychiatry, Harvard Medical SchoolPRINCIPAL INVESTIGATOR(S)Caplan, Gerald, M.D.Schulberg, Herbert C., Ph.STAFFFull-time:2 psychologistsPart-time:1 social worker, counselor1 statistician2 psychiatristsCOST$250,000 or moreFINANCING ORGANr kTION(S)USPHS, Washington, D.C.PUBLICATION PLANS.11M0110.01.

Dr. Herbert C. Schulberg, Lab. of CommunityPsychiatry, Harvard Medical School, 58 Fen-wood Rd., Boston, Mass. 02115

67

D-4 Value of Demographic and Social Data to Hospital Planning andOperation (11/22/65)

ABSTRACTObjectives: (1) To demonstrate usefulness and

value of demographic and socio-economicdata to the planning of future utilization ofacute hospital facilities in the urban com-munity, and (2) to indicate ways of improv-ing operation of such facilities to meetchanging demands on such services in thecommunity.

Content: A two-year survey of all acute gen-era1 hospitals in the Minneapolis metropol-itan area on patients using these facilitieshas been conductei. r ata are of three cate-gories : (1) Patient characteristics, such asextent of hospital insurance coverage, age,sex, race, social class, mobility status, fam-ily status, amount of bill from hospital,amount of bill covered by insurance, majormedical diagnosis, length of stay, by servicearea of hospital, length of residence in thecommunity, census tract, etc.; (2) hospitaltraits, such as type of ownership, size, occu-pancy level, location, age, etc.; (3) admittingphysician characteristics, such as length oftime practicing in the community, length oftime attending patient admitted, generalpractitioner or specialist, board certified ornot, solo or group or partnership practice,single or multiple hospital appointment, etc.

Methods: A 10 percent sample of patients ad-mitted to hospitals over 300 beds and 20 per-cent sample of patients admitted to smallerhospitals were conducted for 2-year periodon 17 acute general hospitals in the area.Data were gathered at time of admission,during and following discharge from hos-pital, by various personnel in hospital. Data

68

on punch-cards and tape for computer com-putations and statistical analysis.

CURRENT STATUSAbout completed on computer tapes. Analysis

of statistical data underway. (Jan. 1963July 1966)

ORGANIZATION ( S)Program in Hospital Admin., School of Public

Health, Univ. of Minn.PRINCIPAL INVESTIGATOR(S)Jaco, E. Gartly, Ph. D.STAFFFull-time:None

Part-time:5 medical care speolalists2 sociologists1 biostatisticianCOST$100,000$149,999


PUBLICATION PLANSAnticipate several articles in hospital and

medical care journals, and hope for a mon-ograph on overall project. Publication dates:Fall of 1966 and periodically during 1967and 1968

FOR FURTHER INFORMATIONE. Gartly Jaco, Ph.D., Univ. of Minn. Medical

Center, 1260 Mayo Bldg., Minneapolis, Minn.55455

.....*".

U

D-5 Project Responsibilitya Project in the Packaging and Delivery ofHealth Services in Rural Communities To Be Based on Studies of RuralHealth Manpower, Health Services and Health Facilities (511166)

ABSTRACTObjectives: To evaluate costs, acceptability,

community impact, ecologic and sociologicaspects and the educational and research op-portunities in a rural community health pro-gram utilizing the group clinic-paramedicalteam approach.

Content: Group Clinic-Emergency Hospital-Nursing Home Facility with University Med-ical School appointed personnel. Utilizationof paramedical personnel in studying im-proved methods of packaging and deliveringhealth services to a rural regional area.

Methoi;s: Evaluation by medical educators,medical economists, sociologists, publichealth and community officials. Utilizationof "health intelligence facility" in manpowerevaluation.

CURRENT STATUSSite has been selected. Facility construction

plans being developed. Personnel recruitmentjust beginning. (Sept. 1965indefinite)

ORGANIZATION(S)University of Oklahoma Medical CenterOklahoma Health Sciences Foundation, Inc.,

Kerr McGee Building, c/o Mr. Dean McGee,Oklahoma City

PRINCIPAL INVESTIGATOR(S)Points, Thomas C., M.D., Ph.D.Dennis, James L., M.D.

(

RTAFPFull-time:4 physicians2 registered nurses1 social worker, counselor1 laboratory technologist1 public health nurse1 resident physicianPart-time:1 accountant1 economist15 medical care specialists1 physician1 psychologist1 sociologist2 statisticiansCOST

$200,0004249,999

FINANCING ORGANIZATION(S)University of Oklahoma Medical CenterWakita Industries, Inc., Wakita, Okla. 73771Oklahoma Health Sciences Foundation, Inc.PUBLICATION PLANSConcept to be published in The Journal of the

Amrican Medical Associationin pressFOR FURTHER INFORMATIONThomas C. Points, M.D., Univ. of Okla. Medical

Center, 800 N.E. 13th St., Oklahoma City,Okla. 73104

69

D-6 Group Practice As Applied to the Profession of Pharmacy (6/17/66)

ABSTRACTObjectives: To consider the application of the

concept of group practice as a form of pro-fessional practice suitable for pharmacy.

Content: The basic format will consist of stud-ies in the following areas: (1) currently em-ployed business structures used in pharmacyand other professions, (2) proposed conceptsof group practice in pharmacy, (3) liabilitiesassumed by the practitioner upon enteringa group practice, and (4) current methodsof compensation in group practice and othertypes of business organization.

Methods: Intensive searches are being madeto collect the necessary information. A sub-sequent summary, with recommendations,will be made.

CURRENT STATUS

ORGANIZATION (S )Pharmaceutical Administration Dept., College

of Pharmacy, Wayne State Univ.

70

PRINCIPAL INVESTIGATOR(S)Dee, Donald A., R.Ph.Dauphinais, Raymond J., R.Ph., LL.M.

STAFFFull-time:None

Part-time:2 pharmacists

COST

Under $5,000


College of Pharmacy, Wayne State Univ.

PUBLICATION PLANSMaster's thesisavailable for publication.

FOR FURTHER INFORMATIONProfessor Raymond J. .Dauphinais, College of

Pharmacy, Wayne State Univ., Detroit,Mich. 48202

(

D-7 A Review of Medical Care Plans with Emphasis on Those ProvidingComprehensive Medical Care (12/4/65)

ABSTRACTObjectives: To review the programs of com-

prehensive medical care as conducted bymedical schools and by organizations such asthe Health Insurance Plan of Greater NewYork and The Kaiser Foundation of Cali-fornia, with the objective of establishing atthis school a program of comprehensive med-ical care which can serve as a resource forteaching and patient care and research.

Content: Review of literature pertaining toabove and personal visits to approximately25 centers in the U.S. and abroad to discussthe programs of these institutions.

Methods: This study may not be consideredresearch in the usual sense. Rather, it is ameans of surveying existing programs anddiscussing with leaders in the field thechanges that should be made in our tradi-tional teaching hospitals to overcome frag-mentation of patient care and to establishan appropriate setting for the teaching ofthe principles of comprehensive medical care.

CURRENT STATUSThe principal investigator is on sabbatical

leave to carry out the study described above.(Oct. 1965-67)

ORGANIZATION ( S)College of Medicine, Baylor Univ.

PRINCIPAL INVESTIGATOR (S )Olson, Stanley W., M.D.STAFFFull-time:1 physicianPart-time:None

COST

$15,000-$24,999

FINANCING ORGANIZATION(S)Supported through institutional funds

PUBLICATION PLANSIndefinite at this time-1967

FOR FURTHER INFORMATIONStanley W. Olson, M.D., Dean; College of Med-

incine, Baylor Univ., 1200 Moursund Ave.,Houston, Tex. 77025

71

D-8 Evaluation of Public Health Programs for the Aged (1216165)ABSTRACTObjectives: The general pu.vose of the project

was to investigate chronic illness and theaged in a Florida county with special con-cern for the role of public health in view ofthe significance of long-term conditions ascauses of morbidity and mortality. The spe-cific objectives were to increase knowledgeabout the health and medical-care practicesof an older population and to plan, establish,and evaluate programs in community healthto better satisfy unmet needs of the elderly.

Content: The report describes Pinellas Countyand its health resources, the methods of thehousehold survey, and the sample popula-tion. Chronic conditions, impairments, andlimitation of activity and mobility are de-scribed for the sample using age, sex, andincome as variables. The use and costs ofmedical services incurred are analyzed, also,in terms of age, sex and annual income.Other supplementary studies are describedand experience in the development of healthprograms is reported. Finally, the effect ofresearch in a local health department isconsidered.

Methods: Most of the data were obtained by ahousehold survey of the noninstitutional,residential population of Pinellas Countyaged 65 and over. Over 2,500 persons wereinterviewed using a schedule prepared forthe purpose. The probability sample wasdrawn by a systematic rant..-in procedure.Total nonresponse amounted to 8.9 percentof the eligible persons. Census and samplestatistics were in reasonable agreement forage and sex distributions. Health condition

72

was measured by use of check-lists of symp-toms and of chronic diseases ; social classposition, by means of the major or careeroccupation.

CURRENT STATUSReport under preparation for publication.

(Sept. 1958Dec. 1965)ORGANIZATION(S)Pinellas County Health Dept.PRINCIPAL INVESTIGATOR(S)Carter, H. W., M.D.Webber, Irving L., Ph.D.STAFFFull-time:1 physician1 sociologist

Part-time:2 physicians1 registered nurseCOST$250,000 or more

FINANCING ORGANIZATION(S)Pinel as ' .ninty Health Dept., St. PetersburgFlorida State Board of Health, JacksonvilleUSPHS

PUBLICATION PLANSMonograph #9Florida State Board of Health

Monograph SeriesJanuary 1966FOR FURTHER INFORMATIONH. W. Carter, M.D., Dir. Div. of Research,

Pinellas County Health Dept., Box 3242, St.Petersburg, Florida 33731

1 sociologist1 health educator

-U,

1

D-9 Medical Care in Latin America (8/26/66)ABSTRACTObjectives: Descriptive and analytical studies

of overall systems of medical care organiza-tion in several Latin American countries.Focus is on the diversity of patterns of or-ganization for different sectors of the popu-lation, involving different systems of fi-nancing and sponsorship by differentgovernmental and voluntary agencies. Evi-dence of coordination among the diverse sys-tems is sought.

Content:

Methods:

CURRENT STATUSInvestigated to date : Peru, Chile, Mexico,

Costa Rica, Brazil, El Salvador. Preliminarywork in Venezuela, Colombia, Argentina.(1962indeBnite)

ORGANIZATION(S)Div. of Medical and Hospital Administration,

School of Public Health, Univ. of Calif., L.A.

PRINCIPAL INVESTIGATOR(S)Roemer, Milton I.

STAFFFun-time:

Part-time:1 medical care specialist

COST

$15,000$24,999

FINANCING ORGANIZATION(S)Organization of American States (Pan Amer-

ican Union and Pan American HealthOrganization)

PUBLICATION PLANS

FOR FURTHER INFORMATIONMilton I. Roemer, School of Public Health,

Univ. of Calif., Los Angeles, Calif. 90024

73

D-10 Medicine and Medical Organization in Soviet Russia (5/19/66)

ABSTRACTObjectives: To provide a comprehensive pic-

ture of the Soviet Health service, using astructural-functional frame of reference.

Coatent: The following topics are covered inthe Study: Russian medicine prior to 1917;the importance of ideology in shaping thehealth service ; a brief history of the service ;organization and administration of the serv-ice; health personnel (all levels), includingstatistical materials, their recruitment,training and posting; medical services andfacilities for the urban and rural population ;preventive services ; medical regearch; andfinancing.

Methods: The necessary information for theproject is being obtained through an inten-sive study of publications containing relevantfacts.

CURRENT STATUSSeveral articles have been published. A

book : Soviet Socialized Medicine: An Intro-duetion will be published in 1966 by TheFree Press. (1959-1967)

74

ORGANIZATION(S)Dept. of Sociology and Anthropology, Boston

University, Mass.

PRINCIPAL INVESTIGATOR(S)Field, Mark G.STAFFFull-time:None


COST$35,000$44,999


PUBLICATION PLANS

'FOR FURTHER INFORMATIONMark G. Field, Professor of Sociology, Dept.

of Sociology and Anthropology, BostonUniv., 232 Bay State Road, Boston, Mass.02215

D-11 Task Allocation and Structure of Health Resources (1/20/66)ABSTRACTObjectives: To study the effects of the organi-

zational structure of medical care on theclient system in terms of the performmceof medically relevant tasks and the effective-ness of the utilization of health care per-sonnel.

Content: The working hypothesis is that effec-tive functioning of an organization for pa-tient care is related to the structure of theorganization. First, the project will comparethe various forms of organization of medicalcare with respect to the allocation and per-formance of medically relevant tasks. Infer-ences will then be drawn from this compari-son as to which form of organization is mostconducive to effective utilization of mem-bers of the health care team. Indicators ofeffectiveness of utilization will include con-gruence between training for a task andperformance of it, amount of duplication oftasks, cost to patient in time and money,and adequacy of the distribution of medi-cal and paramedical time per patient visit.

Methods: Field work will be used to collectdata for the study, and subsequent analysisof the assembled data will be performed forthe desired information.

CURRENT STATUSPreparation for field work. (Sept. 1965-67)ORGANIZATION ( S)rorence Heller Graduate School for Advanced

Studies in Social Welfare, Brandeis Univ.,Waltham, Mass.

PRINCIPAL INVESTIGATOR(S)Schooler, Kermit K, Ph.D.STAFFFull-time:1 psychologist1 sociologist

Part-time:1 physicianCOST$200,000$249,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONKermit K. Schooler, Ph.D., Assist. Prof., Flor-

ence Heller Graduate School in Social Wel-fare, Brandeis Univ., Waltham, Mass. 02154

75

D-12 Demonstration and Evaluation of Hospital Staffing Methods(10/11/65)

ABSTRACT

Objectives: To develop an effective method-nlogy frIr st^c4-g requirementsin hospitals.

Content: Standards will be developed whichcan be applied to individual hospitals forcomparison purposes.

Methods: Time studies of various functions ofdepartment personnel will be conducted.

CURRENT STATUS(Aug. 1965-66)

ORGANIZATION(S)Hospital Systems Research Group, Industrial

Systems Research Laboratory, Institute ofScience and Technology, Univ. of Mich., AnnArbor

PRINCIPAL INVESTIGATOR(S)

76

STAFF

Part-time:

COST


PUBLICATION PLANS

FOR FURTHER INFORMATIONKarl G. Bartscht, Hospital Systems Research

Group, Univ. of Mich., Rm. 239 W. Engineer-ing, Ann Arbor, Mich. 48106

D-13 Descriptive Analysis of WashinNursing Homes and Nursing

ABSTRACTObjectives: To provide a highly detailed de-

scriptive analysis of Washington State's sys-tem of matching patients' needs, capabilityof homes and level of payment. The analysiswill describe the history of their program,its relationship to the various State agenciesand the operation of the program itself.

Content: The study will compile a report whichwill deal wth the following areas of the pro-gram: (1) medical care, (2) nursing homeprograms, (3) system of classification, (4)functions of classification nurses, (5) con-sultation services, and (6) administrativeprocedures.

Methods: The study will be in the form of areport descrilling the history, development,organization and operation of the classifica-tion program for nursing homes and welfarenursing home patients.

CURRENT STATUS(June 1966Jan. 1967)

gton State Classification System forHome Patients (6124166)

ORGANIZATION(S)Washington Dept. of Public AssistancePRINCIPAL INVESTIGATOR(S)Baker, Katherine (Mrs.), R.N.STAFFFull-time:None

Part-time:1 registered nurseCOSTUnder $5,000


PUBLICATION PLANS

FOR FURTHER INFORMATIONMrs. Katherine Baker, R.N., Washington Dept.

of Public Assistance, P.O. Box 1162, Olym-pia, Wash. 98601

77

D-14 Analysis and Description of Ideal Care in Nursing Homes and RelatedFacilities (8/4/66)

ABSTRACTObjectives: To develop a goal for nursing

home care which will reflect the highest pos-sible level of care for all patients and de-velop a conceptual framework for providingthis care.

Content: The development of this goal andframework will provide (1) a goal againstwhich the present levels of care can bemeasured and (2) a framework of care plansand patterns against which the value of cur-rent proposed programs can be measured.The study will document and report, in nar-rative and tabular forms, by diagnosis andcondition, the following patient needs: medi-cal needs requiring the attention of physi-cians; nursing needs ; rehabilitation needs;social service needs; mental health needs ;

recreational needs.Methods: This study will use the resources of

the Boston College School of Nursing, whichwill draw upon the Massachusetts GeneralHospital, the Massachusetts State Depart-ment of Health, and others to examine thepatients in nursing homes. Staff and con-sultants will analyze the patient records. Afinal report will be compiled and the resultsand details of the study outlined.

78

CURRENT STATUS(1966-1968)

ORGANIZATION(S)

School of Nursing, Boston College, Mass.

PRINCIPAL INVESTIGATOR(S)Shaughnessy, Mary

STAFFFull-time:

Part-time:

COST

$100,000$149,999


PUBLICATION PLANS


Mary Shaughnessy, School of Nursing, BostonCollege, 140 Commonwealth Ave., ChestnutHill, Mass. 02167

D-15 A Study of Home Care in Psychiatric Patients (3/30/66)ABSTRACT

Objectives: To increase the general practition-er's understanding of psychiatric problemsby making available to them support andfacilities not otherwise pro, ided. For thepatients the main objectives are (1) to treatthem in their own home, (2) to shorten theperiod of illness, (3) to treat them moreeffectively by involving the family and thehome, and (4) to treat them after dischargeand prevent or reduce any readmissions.

Content: Initally the patients eligible for thisproject were Saskatoon residents who hadbeen admitted to the psychiatric ward andshowed residual disability ar great likeli-hood of a relapse. Fnally there had to belikelihood of benefiting from support givento the patient and his family in the home.Later on patients were admitted to the pro-gram who had not necessarily been in thepsychiatric ward previously, provided theymet the other criteria.

Methods: Patients who were eligible were ran-domly allocated to home care and controlgroups. The grours received treatment pre-scribed for them by physicians in the usualway, except they did not receive the extrafacilities provided through the home carestaff. A special questionnaire is used toassess the effects of the patient's illness onhis nearest relative. The relative is then in-terviewed about the patient's condition im-mediately prior to his referral and reinter-viewed approximately three months after

the patient enters the program or becomesa control patient.

CURRENT STATUSProgram is active both from service and

research viewpoints. (May 1962-68)ORGANIZATION (S)Univ. of Saskatchewan

PRINCIPAL INVESTIGATOR(S)Smith, Colin, M., M.D.

STAFFFull-time:1 psychologist1 registered nursePart-time:10 physicians8 registered nurses1 social worker, counselorCOST$100,000$149,999

FINANCING ORGANIZATION(S)USPHSSaskatchewan Dept. of Public Health, Regina,

Canada

PUBLICATION PLANSSome reprints; others in preparation

FOR FURTHER INFORMATIONDr. Colin M. Smith, Assoc. Prof. of Psychiatry,

Univ. of Saskatchewan, Saskatoon, Sas-katchewan, Canada

D-16 A Day-Night Center for Addicted Persons (6/2/66)ABSTRACTObjectives: To study forces which shape the

life sttyles of persons addicted to variousdrugs; to redefine treatment goals in termsof rehabilitation; to collect data on patternsof behavior of addicts and values acquiredfrom the milieu of different treatment cen-ters; to provide for involvement of com-munity resource persons in coordinatingefforts of the Day-Night Center with thoseof other public and voluntary agencies inthe community; and, finally, to train non-medical personnel in principles of preventingand treating addiction.

Content: Three things will be achievedthrough the establishment of the center foraddicted persons : (1) collection of dataabout the processes of addiction, rehabilita-tion and relapse; (2) preparation of publicleadership for informed planning and action;and (3) the creation of a Day-Night Centerwill provide the therapeutic milieu and thebasis for the research function.

Methods: Involvement of community resourcepersons in coordinating efforts of the Day-Night Center with other agencies will beprovidei through an advisory board.

CURRENT STATUSFully operative. (July 1965-68)

80

ORGANIZATION(S)Div. of Community Mental Health, Dept. of

Psychiatry, New York Medical College

PRINCIPAL INVESTIGATOR(S)Brotman, Richard

STAFFFull-time:3 physicians2 psychologists2 registered nurses

4 social workers, counselors2 sociologists

Part-time:2 social workers, counselors1 teacher

COST

$250,000 or more


PUL T 4.TION PLANS

FOR FURTHER INFORMATIONProf. Richard Brotman, Dir., Div., of Com-munity Mental Health. Dept. of Psychiatry,New York Medical College, 105th St. andFifth Ave., New York, N.Y. 10029

11-17 Division of Labor among Health and Welfare Agencies (11124165)ABSTRACT

Objectives: To discover the relationshipsamong the various health and welfare agen-cies, from the point of view of the clientsand patients approaching them, that is,through the pattern of attempts to getservices, failures, successes, referral pat-terns, interagency contacts, etc.

Content: A series of interrelated studies ofpolice, clergy, general practitioners, psychi-atric clinics, medical clinics, medical socialservice, religious charities, casework agen-cies, public welfare, nursing services, men'sshelter, etc. Core agencies studied are re-ported in terms of their boundary conditionsand the populations served, others in termsof their connection with the core agencies.

Methods: Two major approaches: (1) observa-tion at intake of the attempts to get servicefollowed by record abstracts, and subsequentdevelopment of matrices of who-to-whompatterns of referral; (2) interviews of cer-tain agents.

CURRENT STATUS

Seven reports have been made. Final analy-ses are being done. (Data is nearly ana-lyzed.) Writing of a book tying the studiestogether is under way. (1960-1966)

ORGANIZATION(S)Mental Health Research Unit, Syracuse, N.Y.PRINCIPAL INVESTIGATOR(S)Cumming, ElaineSTAFFFull-time:1 psychologist1 social worker1 sociologist

Part-time :2 statisticians1 anthropologist6 sociologists

COST

$200,000-$249,999

FINANCING ORGANIZATION(S)New York State Dept. of Mental Hygiene,

AlbanyUSPHS

PUBLICATION PLANSAtherton Press-1967FOR FURTHER INFORMATIONElaine Cumming, Mental Health Research

Unit, Rm. 518, State Office Bldg., Syracuse,N.Y. 13202

81

D-18 Demonstration of Health MaintHealth Program

enance Services in a Prepaid Group(5/13/66)

ABSTRACTObjectives: To demonstrate a specially organ-

ized complex of health maintenance servicesin the setting of a general medical care planand to ..-Taluate the effects and costs of suchservices in a defined population group.

Content: Provision of supportive services tochronic disease patients and their familiesby public health nurses, a social worker anda health educator closely integrated with aprogram of intensive medical follow-up bypersonal physicians ; and evaluation of theeffects of this program on the physical,mental and social health of health planmembers who have certain types of chronicmedical conditions.

Methods: Selection of study and control co-horts (500 in each) by a combination ofmatching and randomization. Evaluat;on ofhealth status, utilization, attitudes andknowledge of patients and staff perceptions.Cost to be made of various aspects of thehealth maintenance program. Before-afterand study-control comparisons.

CURRENT STATUSCompleting first year of service. Evaluation

forms and procedures completed. (July 196569)

82

ORGANIZ A TIAN (s)

Community Health Foundation, Cleveland, 0.PRINCIPAL INVESTIGATOR(S)

STAFFFull-tim6:2 physicians3 registered nurses1 social worker,

counselor

1 sociologist1 health educator

Part-time:1 accountant1 medical care specialist

COST$250,000 or more

FINANCING ORGANIZATION(S)USPHSCommunity Health Foundation

PUBLICATION PLANSAmerican Journal of Public Health

FOR FURTHER INFORMATIONGlenn Wilson, Ex. Dir., Community HealthFoundation 11717 Euclid Ave., Cleveland, 0.44106

( )

D-19 Organizational Factors Related to Program Input and Output of LocalPublic Health Departments (1/6/66)

ABSTRACTObjectives: The major purpncla nf tha stnely in

to determine the extent to which, and waysin which, organizational and administrativestructures and behavior influence the natureand effectiveness of local public health prac-tices in the United States. It seeks to dis-cover what methods of organization andadministration (1) contribute most signifi-cantly to the maximization of input-outputratios in local public health services, and(2) are most significantly related to differ-ences in the responses of local public healthdepartments to the community conditions inwhich they operate. It hopes to accomplishthese aims through statistical analysis ofthe relationships among the following vari-ables in 123 local public health departments:Independent Variables: Health departmentorganizational and administrative char-acteristics such as span of control, formalcentralization-decentralization, styles of man-agement, goal perceptions, morale, profes-sionalization, generalization vs. specializationand communications networks ; InterveningVariables: Community characteristics suchas method and amount of financing, popula-tion characteristics, community type, com-munity perception and interest groupaggregates, physical and disease character-istics of the community ; and how these vari-ables and their interrelationships affect theDependent Variables: (1) Input-output ratios(e.g., program productivity), (2) Variationsin health agency responses to differences incommunity t-:.inditions, (3) innovations, (4)client attitudes, (5) cooperation with com-munity agencies, and (6) unit costs.

Content :

Methods:

CURRENT STATUSBegin pretesting of local health departments.

(Sept. 1965-69)

ORGANIZATION(S)Public Health Systems Research Project, 555

South 43rd St., Philadelphia, Pa. 19104

PRINCIPAL INVESTIGATOR(S)Palumbo, Dennis J., Ph.D.Hanlon, John J., M.D.Hebb, Adele (Mrs.)Polk, Lewis, M.D.

STAFFFull-time:None

Part-time:1 medical care specialist 1 statistician2 physicians 2 political scientists1 sociologist

COST

$250,000 or more


PUBLICATION PLANSAdministrative Science Quarterly


Dennis J. Palumbo, Ph.D., Univ. of Pennsyl-vania, Philadelphia, Pa. 19104

88

D--20 Volume I, Canada's Health Programs: A Summary Review Volume II,Canada's Health Programs: Provincial Health Services

ABSTRACT

Objectives: The purpose of this study is tosupply a current reference on governmentaland voluntary health services organized inCanada to the general public and also aspectsof interest to the health disciplines and oth-ers engaged in health work.

Content : Volume I is a summary review of thedistinctive features of the nature, scope andselected financial aspects of Federal, pro-vincial and local government health servicesand of voluntary health organizations. Vol-ume II consists of separate chapters, one foreach of the 10 provinces, describing in de-tail the administration and other character-istics of their health programs includingpublic hospital insurance plans and medicalcare schemes where in effect.

Methods: This is primarily a descriptive andfact-finding survey based upon analysis ofofficial reports of the various health agenciesat all levels and areas of the country, andreview of the literature, which are supple-mented by direct communication with theagencies concerned. Although no formalevaluation has been attempted of any onehealth service, certain comparative data in-cluding costs are presented in various sec-tions in both volumes.

84

CURRENT STATUSIn final drafts. (Oct. 1963Vol. I, Aug. 1966 ;

Vol. II, June 1966)

ORGANIZATION(S)Dept. of National Health and WelfarePRINCIPAL INVESTIGATOR(S)Mennie, W. A. Heggtveit, C. R. (Mrs.)Gough, Anna Closs, S.Raghuram, N. V.STAFFFull-time:None


COST$35,000$49,999

FINANCING ORGANIZATION(S)Dept. of National Health and WelfarePUBLICATION PLANSFall 1966


Directorate, Dept. of National Health andWelfare, Brooke Claxton Bldg., Ottawa 3,Ontario, Canada

D7-21 Investigation of Factors Influencing Community Cooperation inDeveloping a Program of Balanced Hospital and Alternate Care (3/31/66)

ABSTRACTObjectives: A study of present and future

patient care needs as seen by (1) hospitaladministrators, physicians and other healthprofessionals, and (2) the general public, inorder to develop a methodology which willprovide comparative data on the plans andexpectations of those concerned with the de-velopment of health care facilities and serv-ices for a program of balanced total healthcare.

Content: Phase Idevelopmental period in-cluding pilot studies of health professionalsand community leaders, survey of chroni-cally ill in the region, analysis of censusdata on regional population and formulationof research design. Phase II (commencing)intensive and comprehensive study of tworepresentative communities with particularattention to health and the popular healthculture, present and prospective linkages be-tween the local communities and the profes-sional systems.

Methods: Initially, survey research. Currently,ethnographic methods to delineate key vari-ables followed by questionnaire to populationof two communities to quantify as required.

CURRENT STATUSPreliminary and pilot studies carried out and

interim progress report prepared, "The De-

velopment of Health Services in a RuralHospital Region," March 1966 (200 pp.). De-tailed investigation of two representativecommunities about to commence. (Apr. 196568)

ORGANIZATION ( S)St. Martha's Hospital and St. Francis Xavier

University, Antigonish, Nova Scotia, Canada

PRINCIPAL INVESTIGATOR(S)Loyola, Maria (Sister)



COST

$35,000$49,999

FINANCING ORGANIZATION(S)Dept. of National Health and Welfare

PUBLICATION PLANS


Desmond M. Connor, Ph.D., Res. Dir., St.Francis Xavier Univ., Antigonish, NovaScotia, Canada

85

D-22 A Comprehensive Dental Care Program for the Indigent Chronically Illand Aged in Nashville, Tennessee (513/66)

ABSTRACT

Objectives: To develop a community dentalcare program for the aged and chronicallyill citizens of Nashville, Tennessee.

Content: In order to develop the program, thecharacteristics of the population to be in-volved were measured in terms of the needof full-mouth rehabilitation ; the extent towhich the population can benefit from re-habilitation; the type, frequency, mid costof dental services needed for their rehabili-tation; and the effects of rehabilitation onthe community in social and economic terms.Evaluation of this information was madeand, subsequently, a demonstration dentalcare program was developed and is currentbin operation.

Methods: Nashville, Tennessee, citizens areeligible for the program if they give evi-dence of financial need and if they are 65years of age or over, live in a nursing home,or have been chronically ill for three or moremonths. Interviews -with persons obtainingcare through the program are conducted todetermine socioeconomic data and otherinformation.

CURRENT STATUS

Analyses and evaluation of data throughMar. 1966. Initiation of testing second inter-view schedules, (July 1964.47)

86

ORGANIZATION(S)School of Dentistry, Meharry Medical Col-

lege, Nashville, Tenn.

PRINCIPAL INVESTIGATOR(S)Mob)ey, Eugenia L., D.D.S., M.P.H.STA' F

2 dentists1 registered hygi -4st2 social workers,

counselors

Part-time:4 dentists2 physicians1 sociologist1 statisticianCOST$100,000-$149,999


PUBLICATION PLANSJournal of the Tennessee Dental Association,

Journal of the American Dental AssociationDate not known

FOR FURTHER INFORMATIONEugenia L. Mobley, D.D.S., Proj. Dir., School

of Dentistry, Meharry Medical College, 1005-18th Ave., North, Nashville, Tenn. 37208

D-23 A Study To Determine the Potential of Rehabilitation in the Home(1/19/66)

ABSTRACTObjectives: To demonstrate, if possible, that

a considerable number of patients can bedischarged to their homes much earlier inthe course of their illness, after being dis-abled by injury or disease.

Content : To compare the speed and complete-ness of recovery for patients with similaraffliction provided rehabilitation in the hos.pital and patients treated in the home. Thiscomparison will be made in terms of medicalefficacy and economic feasibility.

Methods: Physical therapy treatment and thenecessary medical and nursing care will beprovided in the home instead of the hospital.When sufficiently recovered, these patientswould be transferred tc the outpatient physi-cal therapy department or the hospital forcontinued care. Hopefully, this method willresult in the same degree of recovery of thepatient as compared to the hospitalized pa-tient at less cost.

CURRENT STATUSCollection of data on the study patients was

completed November 30, 1965. Currentlythis data is being reviewed in order to estab-lish significant correlations to support theprimary objectives and determine useful ad-ditional comparisons. The final report willbe written with 1) essential major compari-sons (hospital versus home), 2) collateralcomparisons, 3) secondary comparisons.(Dec. 1962July 1966)

ORGANIZATION ( S )King County Hospital, Seattle, Wash.

PRINCIPAL INVESTIGATOR(S)Warren, Richard M.Blomquist, Robert H., M.D.

STAFFFult-time:2 physicians1 registered nurse2 social workers,

counselors1 statistician2 physical and

occupationaltherapists

Part-time:2 accountants1 medical care specialist2 physicians3 registered nurses2 social workers, counselors2 physical and occupational

therapists

COST

$50,000$74,999


PUBLICATION PLANSUndetermined


Richard M. Warren, Dep. Supt., King CountyHospital, 325 Ninth Ave., Seattle, Wash.98104

87

D-24 Design of a Community (Group Practice) Program for ComprehensiveFamily Care in Association with a Teaching and Research Medical Center(4/22/66)

ABSTRACTObjectives: Explorations for the design and

development of a group practice program tooperate as a community center for prepaidcomprehensive family care ; and, by associa-tion with the Yale-New Haven Medical Cen-ter, to serve as a resource for medical andrelated education in a group practice setting,and as a research resource on group practiceoperation and on medical care needs, satis-factions, attitudes, costs, etc., in the popula-tion served.

Content: Design of the plan; participationwith the community groups in the develop-ment of the population to be served (labor,co-ops, welfare groups, etc.) ; pattern for thefunctional organization and staffing of thehealth center; schematics for the facility;design for the educational functions; andplan for the research studies.

Methods: Various. Statistical studiez on thepotential population to be served ; surveyand review of functional patterns in grouppractice plans elsewhere, architectural stud-ies ; consultations on educational methods,etc.

CURRENT STATUSGeneral outline of the plan accepted by (a)

community labor and public groups, and (b)policy authorities of the Yale-New HavenMedical Center ; and application for a sup-

88

port contract is pending (recruitment ofstaff and other next steps waiting on re-sults). (1963-1968 or 1969)

ORGANIZATION(S)Dept. of Epidemiology and Public Health,

Yale School of Medicine

PRINCIPAL INVESTIGATOR(S)Falk, I. S.

STAFFFull-time:1 physician1 statisticianPart-time:3 physicians1 statisticianCOST$100,000$149,999

FINANCING ORGANIZATION(S)Yale Univ., New Haven, Conn.USPHS

PUBLICATION PLANS'None at this time

FOR FURTHER INFORMATIONI. S. Falk, Prof. of Public Health (Medical

Care), Dept. of Epidemiology and PublicHealth, Yale School of Medicine, 60 CollegeSt., New Haven, Conn. 06520

I

0D-25 A Hearing Conservation Program for Children in Kansas (12/15/65)ABSTRACTObjectives: "The overall objectives are to co-

ordinate existing programs for all school-actechildren in the State and to develop practicalmethods for hearing testing of infants andpreschool children. Experience in this projectwill provide the basis for developing, throughState and local resources, a comprehensivehearing conservation program for children,of prevention, treatment, and rehabilitation."

Content: "The project includes education, pre-vention, casefinding, diagnosis, and planningfor rehabilitation. Children with hearing im-pairment will be referred to the privatephysician for medical examination. The pri-vate physician may then refer his patient toa regional otological diagnostic clinic forfurther evaluation. The otolaryngologists'diagnosis and medical recommendations aresent to the referring physician for treat-ment."

Methods: "The project extends identificationaudiometry (by means of a mobile unit).Priority is given to rural communities whereno hearing screening service is available. Inthose communities with partial screeningprograms efforts are made to improve meth-ods of screening and referring for diagnosisand treatment."

CURRENT STATUSHearing testing has been extended to 14

counties located in western and northeastern

Kansas. More than 25,000 children havebeen screened and nearly 1,000 children havebeen identified as having significant hearinglosses. (July 1963-68)

ORGANIZATION(S)Hearing Conservation Program, Maternal

and Child Health Division, Kansas StateDept. of Health, Kan.

PRINCIPAL INVESTIGATOR(S)Schloesser, Patricia T., M.D.Gendel, Evalyn S., M.D.

STAFFFull-time:1 registered nurse2 audiologists

Part-time:2 physicians

COST$200,000$249,999


PUBLICATION PLANS


Gilbert G. Ritchey, Dir. of Hearing Conser-vation, Kansas State Dept. of Health, StateOffice Bldg.-5th Floor, Topeka, Kan. 66612

89

0D-26 Assignment of Public Health Nurses to Acute General Hospitals To Plan

for Care after Discharge (5/23166)

ABSTRACTObjectives: To measure the need for public

health nurses in acute general hospitals toplan care for patients after discharge.

Content: The project seeks to determinewhether the assignment of a public healthnurse clinician to a hospital, under the ad-ministrative control and guidance of a healthdepartment, will improve the medical nurs-ing, and social management of patients re-quiring long-term care, including care athome. In addition, the study attempts todetermine whether such assignment mightshorten the hospital stay and improve pa-tient care by planning before discharge forthe appropriate level of care as well as forthe services required by the individualpatient.

Methods: Rochester, New York, hospitals werethe site of the project. A well prepared pub-lic health nurse was placed in one hospitalto aid in planning for the care after dischargeof the patients likely to need this care. Asimilarly prepared nurse was placed in asecond hospital to collect the same type ofdata on the same type of patients, but with-out giving service. After one fear, thenurses switched hospitals, with service sub-sequently given at the second hospital andonly data collected at the first.

90

CURRENT STATUSBeing written up. (Nov. 1962Aug. 1965)

ORGANIZATION(S)Monroe County Dept. of Health, Rochester,

N.Y.


STAFFFull-time:3 registered nurses

Part-time:1 physician1 registered nurse1 statistician

COST$50,000$74,999


PUBLICATION PLANS


Margaret L. Rathbun, M.D., Dep. Dir., Mon-roe County Dept. of Health, 44 Marshall St.,Rochester, N.Y. 14607

D-27 Well Aging Conference (6/30/66)

ABSTRACTObjectives: To fill the gap in health services

for elderly persons in .Erie Count-y who arenot under medical care.

Content: The project will perform, through awell aging conference, the following activi-ties pertinent to improving health serv:;.cesfor the aging medically indigent population:(1) determination of the incidence of chronic

eases and methods of detection and pre-ition of progression of these diseases ;

(2) stimulation, through clinic experience,of interest on the part of physicians andcommunity agencies in the overall needsof aging patients ; (3) determination of theproblems of securing adequate care for pa-tients with medical and social problems; (4)stimulation of hospitals to establish facilitiessimilar to those of the Well Aging Confer-ence for the detection of chronic illnesses ifthese facilities prove to be a practical andeffective approach ; and (5) establishment ofan optimal period for follow-up healthappraisals.

Methods: The Well Aging Conference is lo-cated in the clinic rooms of the Erie CountyDept. of Health in Buffalo, N.Y. Two sessionsare alloted for each patient: (1) the initialvisit for the purpose of screening examina-tions, ard (2) another visit for a physicalexamination and counseling services. TheConference is available without charge to themedically indigent population of Erie Countypast 60 years of age.

CURRENT STATUS

Data analysis and write-up ; clinical activityended May 1966. (July 1961Sept. 1966)

ORGANIZATION(S)

Erie County Dept. of Health

PRINCIPAL INVESTIGATOR(S)Elsea, William R., M.D.

STAFF

Full-time:1 registered nurse1 social worker,

counselor

Part-time:3 physicians2 registered nurses1 statistician

COST

$200,000$249,999

FINANCIN G ORGANIZATION ( S)

USPHSErie County Dept. of Health, Buffalo


FOR FURTHER INFORMATIONWilliam R. Elsea, M.D., Dep. Com., Erie

County Dept. of Health, 601 City Hall, Buf-falo, N.Y. 14202

91

D-28 Family Health Care Program of Yale-New Haven Medical Center(6/28/66)

ABSTRACTObjectives: To demonstrate a specially organ-

ized complex of health maintenance servicesto indigent families, using the concept of thehealth team to coordinate the efforts ofmedical and paramedical personnel.

Content: The project will concentrate on thefollowing two areas of study : (1) demon-stration of the effectiveness of specially or-ganized health maintenance and generalmedical care services, in providing compre-hensive and personal patient care in theframework of family interrelationships, and(2) to teach the principles and the practiceof comprehensive health services to studentsof the various health professions, whose cur-rent orientation and training will determineso much of their future effectiveness in serv-ice to this and other communities.

Methods: The program has been planned as asequence of four phases: (1) conceptualiz-ing and planning phase, (2) one-year pilotor testing phase, (3) three-year operationalstage, and (4) evaluation phase. Familiesserved by the project must live in NewHaven near Yale Medical School and mustnot be receiving regular medical care froma private physician.

92

CURRENT STATUSCompleting first year. (Sept, 1965-69)ORGANIZATION(S)Yale University School of Medicine

PRINCIPAL INVESTIGATOR(S)Weinerman, E. R., M.D.Beloff, J. S., M.D.

STAFFFull-time:

Part-time:

COST

$100,000$149,999

FINANCING ORGANIZATION(S)Office of Economic Oportunity, Washington,

D.C.


FOR FURTHER INFORMATIONJerome S. Beloff, M.D., Assist. Prof. of Pedi-

atrics and Public Health, :Yale Univ., Schoolof Medicine, 333 Cedar St., New Haven,Conn. 06520

D-29 Health Survey of Services to the Poor in Cincinnati (8/22/66)ABSTRACT

Objectives: To survey the health servicesavailable to the poor in Cincinnati.

Content: The study will attempt to describethe complete picture of medical care servicesto the poor inclAing financing, utilization,quantity, and quality. There is an intensiveeffort through both formal questionnairesand informal opinions to find the opinions ofthe clients of the health programs.

Methods: The basic unit of the study is acommittee widely representative of the ma-jor providers of service. The Greater Cin-cinnati Hospital Council has offered assist-ance and use of th t records. A question-naire was sent to 700-800 clients of theprograms.

CURRENT STATUSThe study is just beginning; completion in one

year.

ORGANIZATION(S)

City of Cincinnati (Ohio) Health Dept.Public Health Federation, 2400 Reading Road,

Cincinnati, 0.

Greater Cincinnati Hospital Council, 2400Reading Road, Cincinnati, 0.

PRINCIPAL INVESTIGATOR(S)Macleod, K. I. E., M.D., M.P.H.Milliken, Sewall, M.P.H.Ransohoff, JerrySTAFF

Part-time:

COST$15,000$24,999

FINANCING ORGANIZATION(S)USPHSCity of Cincinnati, Ohio

PUBLICATION PLANSPreliminary reportNov. 1966FOR FURTHER INFORMATIONKenneth I. E. Macleod, M.D., Health Corn., Cin-

cinnati Health Dept., City Hall, Room 236,Cincinnati, 0. 45202

93

D-30 Development and Evaluation of a Program of Comprehensive MedicalCare for the Medically Indigent Including the Chronically I11 and Aged(1/10/66)

rIcirwrob rim111..00 I 111.21Ar 1

Objectives: To help develop, for the medicallyindigent of St. Paul, an ideal comprehensivemedical care facility, and to determine im-pact on the public and its cost.

Content: The project will assist in the develop-ment of complete outpatient medical care ona part-pay basis for 6,000 to 8,000 indigentpatients per year at St. Paul Medical Center.Complete outpatient diagnostic, medical con-sultation, treatment and preventive medicineservices will be provided at the Center aswell as a comprehensive medical care infor-mation and referral service.

Method: The program will be implementedfollowing preparatory planning studies.After the program has begun, intensiveevaluation will demonstrate its cost, prac-ticability, public acceptance, and signifi-cance.

CURRENT STATUS

Summarizing data and writing papers and re-ports. (Sept. 1962-Jan. 1966)

ORGANIZATION(S)

Saint Paul Medical Center

PRINCIPAL INVESTIGATOR(S)Miller, Winston R., M.D.

STAFFFull-time:14 registered nurses1 social worker, counselor1 statistician

Part-time:1 accountant4 physicians1 social worker, counselor

COST

$250,000 or more

94

FINANCING ORGANIZATION(S)Saint Paul Medical CenterUSPHS

PUBLICATION PLANS

1. A System to Provide and Teach Comprehen-sive Medical Care, W. R. Miller, M.D., Jour-

nal of the American Medical Association189:1-5, July 6, 1964

2. Development of Interagency Coordinationin a Program of Comprehensive MedicalCare, I. H. Strantz, B.Se.N. and W. R. Miller,M.D. Accepted for publication AmericanJournal of Public Health, April, 1966

3. Ambulation of "Ambulatory" HandicappedPatients, I. H. Strantz, B.Sc.N. and W. R.Miller, M.D. Accepted by "Geriatrics" Medi-cal Journal in August, 1965

4. Characteristics of Medically Indigent Part-Pay Patients, I. H. Strantz, B.Sc.N.; W. R.Miller, M.D. and S. E. Williams, B.A. To besubmitted to the AJPH September 1965

In Preparation: Medical Attitudes of Part-PayPatientsIn a Comprehensive Medical CareSystem with Interns and Residents ; Com-munity Attitudes to a Part-Pay MedicalCare Facility for the Medically Indigent ; AnAppraisal of the Quantity, Cost, Quality andPatient Acceptance of Medical Care for Dia-betes and Arteriosclerotic Heart Disease;Systematic Data Collection and Comprehen-sive Medical Care in the Out-patient Facil-ity ; Prenatal Care for the Medically Indi-gent in a Total Medical Care Facility ;

Medical Attitudes of Part-Pay Prenatal Pa-tients Toward Comprehensive Medical Serv-ices; Range Quantity and Cost of ContinuingComprehensive Medical Care for ChronicDisease Patients.

FOR FURTHER INFORMATIONWinston R. Miller, M.D., Medical Director, St.

Paul Medical Center, 279 Rice St., St. Paul,Minn. 55102

D-31 Study of Organization of Pediatric Ambulatory Services for Patient Careand Teaching (5/5/66)

ABSTRACTObjectives: To examine methods of organizing

pediatric ambulatory services for effectivepatient care and teaching.

Content: The study will attempt to determinethe most effective ways of organizing pedi-atric outpatient clinics in order to providehigh quality patient care services, studentteaching, and house staff training.

Methods: Information will be gathered for theproject by visiting and closely inspectingAmerican and European outpatient clinics.Interviews will be held with personnel at theclinics.

CURRENT STATUSNearing completion (Feb.-Sept. 1966)ORGANIZATION(S)Dept. of Pediatrics, Yale Univ. School of Medi-

cine

PRINCIPAL. INVESTIGATOR(S)Blodgett, Frederic M., M.D.

STAFFFull-time:

Part-time:

COST

FINANCING ORGANIZATION(S)U.S. Children's Bureau, Washington, D.C.

PUBLICATION PLANSIn report to Children's Bureau and in Text-

book of Ambulatory Pediatrics-1967 or1968

FOR FURTHER INFORMATIONFrederic M. Blodgett, M.D., Assoc. Prof. of

Pediatrics, Dept. of Pediatrics, Yale Univ.School of Medicine, 333 Cedar St., NewHaven, Conn. 06510

95

D-32 Impact of Zone Center Program on a Community (Macon County MentalHealth Community Study) (116166)

A T11[117111'1' "Fr%2.1.00 -LAM/ 1

Objectives: To determine the effects on Illinoiscommunities of the establishment of zonedmental health program with facilities ineach zone.

Content: The project will con2st of studiesrelated to the following three major areas:(1) description in objective analytic termsof the community system for dealing withpersons thought to be mentally or emotion-ally disordered ; (2) testing of many inter-related hypotheses about changes in thetreatment system following establishment ofthe zone center ; and (3) interpretation ofthe changes which occur by reference tocomplete information about the developmentof the zone center itself.

Methods: Structured interviews are being heldwith samples drawn from the general pub-lic, community professionals, and mentalpatients. More extensive, unstructured inter-views are being conducted with agency ex-ecutives and community leaders. Data aboutpatients is also being collected from theclinical records of hospitals and the localmental health clinics.

CURRENT STATUSData gathering has begun for most parts of

. the study. (May 1965-71)

96

ORGANIZATION(S)The Jane Addams Graduate School of Social

Work, Univ. of Ill..

PRINCIPAL INVESTIGATOR(S)Taber, MerlinQuay, HerbertBordua, DavidSTAFFFull-time:1 psychologist3 sociologists

Part-time:1 psychologist1 sociologist


FINANCING ORGANIZATION(S)USPI,IS

PUBLICATION PLANSAr,licles in professional journals. Complete re-

FOR FURTHER INFORMATIONMerlin Taber, Assoc. Prof., The Jane Addams

Graduate School of Social Work, Univ. ofIll., 1207 W. Oregon St., Urbana, III. 61801

D-33 The Administration of Public Health in Canada (7/20165)Objectives: To provide up-to-date information

on the organization and development of Fed-eral Provincial, and local health services inCanada, and give details of functionsresponsibilities of the Provincial Depart-ments of Health.

Content : The study will make an overview,arranged by type of service or disease en-tity, of the whole range of activities of Pub-lic Health Departments.

Methods: Health services and facilities as ad-ministered by Governments will be de-scribed. Recent developments will be pre-sented so as to reveal the interrelationshipof activities that, though under separateadministrations, have a common goal.

CURRENT STATUS(1963July 1965)

ORGANIZATION(S)Dept. of National Health and WelfarePRINCIPAL INVESTIGATOR(S)Mennie, William Heggtveit, Claire R.

gnel

Closs, T, SeanGough, Anna F.

STAFFFull-time:

Part-time:

COST

Raghuram, Neel V.

FINANCING ORGANIZATION(S)Dept. of National Health and Welfare, Ot-

tawa, Canada

PUBLICATION PLANS


John E. Osborne, Research and Statistics, Di-rectorate Dept. of National Health and Wel-fare, Brooke Claxton Building, Ottawa 3,Ontario, Canada

97

D-34 Research for Mental Health Center Planning (8/30/65)

ABSTRACTObjectives: To develop psychologically based

physical specifications to support the thera-peutic objectives of mental health centers.

Content: The project will address itself to fiveareas: (1) design of facilities to support thetherapeutic milieu, (2) design of programfunctions, (3) patterns of procedure forphysical planning, (4) programs for post-construction phase and, (5) drafting of leg-islative proposals reflecting areas onethrough four.

Methods:, The project will be carried outthrough interviews, physical investigations,work with community leaders.

CURRENT STATUS(Jan. 1961June 1966)

ORGANIZATION(S)The Medical Foundation, Inc., 227 Common-

wealth Avenue, Boston, Mass.

98

PRINCIPAL INVESTIGATOR(S)McGrath, Marck Hutcheson, R, R., M.D.Spivack, Mayer Burditt, RussellSTAFFFull-time:

Part-time:

COST

FINANCING ORGANIZATION(S)Permanent Charity Fund, 100 Franklin St.,

Boston, Mass.

PUBLICATION PLANS


Harold W. DeMone, Jr., 227 CommonwealthAve., Boston, Mass. 02116

,

D-35 Local Health Unit Activities in Medical Care Administration (2/28/66)ABSTRACTObjectives: To update the last nationwide

study (late 1940's) of medical care activitiesof local health departments and to facilitatethe study and planning of medical programsat the local, State, and federal level.

Content: The following areas will be covered:(1) medical care professional personnel, (2)responsibilities assumed by the local healthdepartments in relation to community healthfacilities, (3) medical care programs andservices of local health departments, othergovernment agencies, and voluntary agen-cies, (4) activities of the local health depart-ment directed toward assuring or improvingquality of care in the community, and (5)inter-agency relationships.

Methods: Data is being gathered by a ques-tionnaire mailed to all local health depart-ments in the country, and will be tabulatedand analyzed to produce baseline data andcomparisons among different bodies politic.

CURRENT STATUSDetails on process'Ang the study data are being

ironed out. (Aug: 1965-66)

ORGANIZATION(S)USPHS

PRINCIPAL INVESTIGATOR(S)Myers, Beverlee A. (Mrs.)Mosley, Mary L. (Mrs.)Newport, John F.STAFF

None

Part-time:2 medical care specialists1 sociologist

COST$15,000-$24,999


PUBLICATION PLANSMonographsometime in 1966FOR FURTHER INFORMATIONMrs. Beverlee A. Myers, Division of Medical

Care Administration, U.S. Public HealthService, Washington, D.C. 20201

99

D-36 Medical and Ancillary Care Services for Children with a Variety ofHandicapping Conditions (1/4/66)

ALSTRACTObjectives: The provision of new data and the

testing of current opinions regarding healthservice programs for handicapped children,with the ultimate aim of contributing to im-provements and innovations in the services.The program is conducted in close coopera-tion with public and private agencies inH.E.W. Region V and is eventually to serveas a regional resource and center of researchcompetence.

Content: Research tasks now proposed include1) evalua tion of services for handicappedchildren (with emphasis on the evaluationof the program of a center of treatment forchild amputees), 2) studies of the long termcosts of the provision of care to handicappedchildren, 3) problems of institutionalizationand institutional care for children (with spe-cial emphasis on the needs of mentally re-tarded children for health services).

Methods:

CURRENT STATUSThe various studies are at different stages and

implementation. They began in 1964 ; arelong-term.

ORGANIZATION ( S )Maternal and Child Health Unit, Dept. of

Health Development, School of PublicHealth, Univ. of Mich., Ann Arbor

100

t

Univ. of Mich. Region V Research Programin Maternal and Child Health and CrippledChildren Services

PRINCIPAL INVESTIGATOR(S)Smith, Donald C., M.D.

STAFF

Full-time:1 medical care specialist2 physicians1 social worker, counselor1 sociologist

Part-time:1 physician1 sociologist/ statistician

COST

$250,000 or more


Children's Bureau, Washington, D.C. 20201

PUBLICATION PLANS

FOR FURTHER INFORMATIONHarold A. Decker, M.D., Assist. Prof., Ma-

ternal and Child Health, School of PublicHealth, Univ. of Mich., Ann Arbor, Mich.48104

D-37 Development of a Coordinated Home Care Program (12/2/65)ABSTRACTObjectives: To develop within the Erie County

Health Department a centrally administeredand professionally supervised program ofout-of-hospital medical care and health-related services in the home to chronicallyill, aging, and other patients.

Content: The study will inventory, evaluate,and improve Erie County's out-of-hospitalhealth and health-related services and re-sources by identifying gaps in present serv-ices and by planning new and improvedservices. A funding structure will be de-veloped for the support of these services.

Methods: An intensive study will be made ofexisting Erie County out-of-hospital healthand health-related services. Appropriate pro-fessions, agencies, and community groupswill be brought into this program whereand when needed.

CURRENT STATUS(Jan. 1964-67)

ORGANIZATION (S)Coordinated Home Care Program, Erie County

Health Dept., Buffalo


STAFFFull-time:1 medieal enn3 specialist1 registered nurse1 social worker, counselor1 physical therapist1 home economistPart-time:1 accountant4 physicians2 social workers, counselors1 nutritionist1 occupational therapist1 physical therapistCOST

$100,000-$149,999

FINANCING ORGANIZATION(S)New York State Health Dept.Blue Cross of Western New YorkPUBLICATION PLANS

FOR FURTHER INFORMATIONMitchell E. Roth, Dir.Coordinated Home Care Program, Erie County

Health Dept., 2211 Main St., Buffalo, N. Y.14214

161

D-38 Interagency Relations in Provision of Health Services (11/30/65)

ABSTRACTObjectives: This is a study of the organization

of medical care for the control of tubercu-losis in a metropolitan setting, the CalumetRegion of Indiana. Specifically, we would liketo know how interagency relations affect theentire control process, including the diag-nosis of tuberculars, their initiation into thetreatment cycle, their referral from agencyto agency, and the quality and comprehen-siveness of care provided.

Content: The research is based upon the prem-ise that much of what is known medicallyabout tuberculosis control fails to be trans-lated into practice because of inadequaciesof interagency coordination. Agency rela-tions that affect success or failure ,.'i con-trolling tuberculosis in the region will beanalyzed in terms of exchange, power andadaptations.

Methods: Methods for data collfction includequestionnaires administered to functionariesin the agencies and to the recipients of careas well as more intensive interviews of anunstructured variety with both.

CURRENT STATUSDevelopment of field contacts and initiation of

102

the interviews for the purpose of question-naire construction. (Sept. 1965-Dec. 1967)

ORGANIZATION(S)Dept of Sociology, Purdue Univ.PRINCIPAL INVESTIGATOR(S)Eichhorn, Robert L.Wysong, Jere A.STAFFFull-time:1 sociologist


COST$15,000-$24,999

FINANCING ORGANIZATION(S)Purdue Research FoundationUSPHS (pending)

PUBLICATION PLANSPossible bookDec. 1968

FOR FURTHER INFORMATIONRobert L. Eichhorn, Prof. of Sociology, Dept.

of kiociology, Purdue Univ., W. Lafayette,Ind. 47907

D-39 A Study of the Regionalization Program of Napa State Hospital(12/7/65)

ABSTRACTObjectives: To determine the effect on patient

care, on hospital staff relationships and roleperformance, and on hospital-community re-lations of a regionalization program initiatedby a large State mental hospital.

Content: The study aims to provide base-linedata which will be helpful for followup notonly with reference to regionalization butalso regarding 1) decision-making and thechange process in a large State mental hospi-tal ; 2) treatment ideologies of staff as relatedto attitudes on regionalization and attitudestoward change and toward authority.

Methods: Review of literature on regionaliza-tion at other State mental hospitals; inter-views with selected personnel; computationof statistics and their analysis; developmentof a questionnaire for ascertaining staffmembers' attitudes on regionalization ; ob-servation at staff meetings and on wards;analysis of hospital reports and of reportsof hospital-community interactions.

CURRENT STATUSThe main portions which still remain to be

done are the analyses of the questionnaireswhich were just completed by staff membersin the regionalized units of the hospital andthe preparation of the report itself andpapers to be based on this report. (Aug.1965-Mar. 1966, first stage ; followup sur-vey planned within a year)

AltattNI7ATInN(S)Research Dept., Napa State Hospital, Imola,

Calif.

PRINCIPAL INVESTIGATOR (S)Babow, Irving, Ph.D.


Part-time:1 physican1 psychologist

COST

$5,00049,999


Napa State Hospital, Calif. Dept of MentalHygiene

PUBLICATION PLANS

Articles will be submitted to public health,mental health and sociology journals. Thereport should be completed by March 1966,but it is not likely that articles will be pub-lished before October 1966.


Irving Babow, Ph.D., Research Social Scientist(Mental Health), Research Dept., Napa StateHospital, Imola, Calif. 94558

103

D-40 The Social and Economic Problems of Hemodialysis Treatment forChronic Renal Failure (8/26/66)

ABSTRACTObjectives: A national study, with three major

purposes: (a) to identify the methods andcriteria for patient selection in hemodialysisprograms in the United States, and themajor selection problems; (b) to documentthe numbers of patients referred for treat-ment, and the numbers accepted and re-jected at the various treatment centers; (c)to explore and identify basic socioeconomic,psychological and demographic data on thehemodialysis patient population, and to be-gin to assess rehabilitation in terms of emo-tional, family social and vocational adjust-ment.

Content:

Methods: The universe of study is some 265300 patients currently being treated in some65 treatment facilities. Mailed question-naires, supplemented by field visits and in-terviewing, will provide the basic data forthe study.

CURRENT STATUSLiterature review completed ; questionnaire

being developed. (June 1966-67)

104

ORGANIZATION(S)

Div. of Medical and Hospital Administration,School of Public Health, Univ. of Calif., L.A.

PRINCIPAL INVESTIGATOR(S)Katz, Alfred H.

STAFFFull-time:None

Part-time:1 social worker, counselor

COST

$15,010$24,999


PUBLICATION PLANS


Alfred H. Katz, School of Public Health, Univ.of Calif., Los Angeles, Calif. 90024

.

D-41 National Tuberculosis Association Collaborative Interdisciplinarypatient Research and Demonstration Project (6/22/66)

ABSTRACTObjectives: To facilitate the development of

improved integrated systems of out-patienttuberculosis services which include diagnosis,treatment, follow-up and supervision offeredin such manner as to be medically effectiveand acceptable to those in need of suchservices.

Content: In three health department TB clinicsthe administrative, medical, nursing and pa-tient variables will be studied by standardinstruments.

Methods: Through experimental models a sys-tems analysis will be made of these inde-pendent variables as they relate to healthoutcome so as to indicate changes that wouldbe expected to improve health outcome.

CURRENT STATUSGeneral project protocol, research design and

research models are in draft form. Imple-mentation of data collection instruments isscheduled for September 1966. (June 196669)

ORGANIZATION(S)National Tuberculosis AssociationSchool of Public Health, Univ. of North Caro-

lina, Chapel Hill

PRINCIPAL INVESTIGATOR(S)Clayton, Lewis B., M.D., M.P.H.

Johnson, Albert L., Ph.D., M.P.H.Levine, Sol, Ph.D.Strauss, Anse lm, Ph.D.Taylor, Robert

STAFF

Full-time:2 registered nurses

Part-time:1 medical care specialist1 physician1 psychologist3 sociologists1 statistician

Out-

COST

$250,000 or more


National Tuberculosis Assoc. and Constituentsand Affiliates

PUBLICATION PLANSNot determined


Lewis B. Clayton, M.D., Dir., Epidemiologyand Statistics Div., National TuberculosisAssoc., 1790 Broadway, New York, N. Y.10019

105

D-42 Health Referral Service for Armed Forces Rejtctees (5/9/66)

ABSTRACT ORGANIZATION(S)Objectives: To improve the health of young

men who have been rejected for service inthe armed forces of this country becauseof a health problem.

Content: The counseling and referral serviceis the first and largest of similar projectsin this country. While the Health Depart-ment hopes to improve the health of youngmen rejected for military service by earlyreferral, the long-range purpose of this pro-gram is to determine how the Health D9-partment can most effectively act as a cen-tral coordinating unit to bring about maxi-mum utilization of both private and com-munity health resources for this group.

Methods: The project counsels and directs Se-lective Service rejectees to obtain neededtreatment for the conditions discovered atSelective Service screening examinations.Each young man is offered individual coun-seling and, in accordance with his own need,referral is made to private physicians, vol-untary and municipal hospitals, government,social or community agencies.

CURRENT STATUSProject has been completed. The final report is

being prepared for publicatior, (May 1962Oct. 1965)

106

Medical and Health Research Assoc. of NewYork City, Inc., New York City Dept. ofHealth

PRINCIPAL INVESTIGATOR(S)Vandow, Jules E., M.D.

STAFF

8 registered nurses2 social workers, counselors1 statistician


COST

$250,000 or more


USPHS

PUBLICATION PLANSPublic Health Reports

FOR FURTHER INFORMATIONJules E. Vandow, M.D., Proj. Dir., Medical

and Health Research Assoc. of New YorkCity, Inc., 40 Worth St., New York, N. Y.10007

D-43 The Effects of Special Patient Care Structures on the Behavior ofNursing Personnel

ABSTRACTObjectives: To determine impact of reorgani-

zation of hospital environment on work pat-terns of nursing personnel. To assess costsof operating special care structures inte-grated into medical and surgical units of ateaching hospital.

Content: Special care structures were designedbased on social psychological theory and cer-tain outcomes resulting from the establish-ment of the new structures were predicted.Management aspects, such as supervisionof personnel and operational costs, are alsoconsidered.

Methods: Non-participant observations of be-havior, interviews, and examination of hos-pital records are chief sources of data. "Before-after" studies are made to determineeffects of structural changes.

CURRENT STATUSMimeographed interim report submitted to

sponsoring foundation , final report due inJune 1966. Most data (except for coststudy) have been collected and are partiallyanalyzed. Analysis of all data will continue.(June 1964-66)

ORGANIZATION(S)St. Louis Univ., 221 N. Grand Blvd., St. Louis,

Mo. 63103

Kellogg Research ProjectHealth Orzaniza-tion Research Program, St. Louis University

PRINCIPAL INVESTIGATOR(S)Richart, R. H., Ph.D.Wessler, Richard

STAFF

Full-time:None

Part-time:

1 psychologist1 sociologist

COST

$50,000$74,999


W. K. Kellogg Foundation (Division of Hospi-tals), 250 Champion St., Battle Creek, Mich.49016

PUBLICATION PLANS


R. H. Richart, Ph.D., Community Studies, Inc.,2300 Holmes, Kansas City, Mo. 64108

107

D-44 Studies are Made in Various Sections of Metropolitan Area as Necessaryfor Planning (12/10165)

ABSTRACTObjectives: To interpret tn tha enmnirmity,

services existing and needed, and to makerecommendations concerning short and longrange plans for all types of medical carefacilities.

Content: To assemble and keep current basicneed, facilities service, statistics and otherdata necessary to project the need as re-lated to hospitals, nursing homes, rehabilita-tion centers, community mental health cen-ters and other facilities concerned withhealth care.

Methods: Acquisition of information regardingpopulation served, types of service, unmetneeds and other related facts concerninghospitals, nursing homes, clinics and relatedinstitutions and programs in the community.

CURRENT STATUSNecessary staff has been assembled, prelimi-

nary studies are underway relating to pa-tient origin and current services availablethrough existing hospitals in the metropoli-tan area. (July 1965-1968-70)

ORGANIZATION(S)Hospital -nd Health Planning Dept., Com-

munity Council of the Atlanta Area, Inc.,Atlanta, Georgia

108

PRINCIPAL INVESTIGATOR(S)Williams, R. C., M.D.Branton, A. F., M.H.A.Taylor, J. K., M.H.A.

STAFF

Full-time:2 medical care specialists

Part-time:1 physician

COST

$150,000$199,999

FINANCING ORGANIZATION(S)USPHSUnited Appeal and a local foundation, Atlanta,

Georgia

PUBLICATION PLANSProgress reports will be issued at intervals

FOR FURTHER INFORMATIONR. C. Williams, M.D., Director, Hospital and

Health Planning Dept., Community Councilof the Atlanta Area, Inc:, 215 Palmer Bldg.,41 Marietta St., N.W., Atlanta, Georgia30303

D-45 A Guidebook for the Governing Boards of Community Mental HealthCenters (1211/65)

ADOMDArim1.7.1.A.JAAmrs.vil

Objectives: To provide a comprehensive guidefor the Governing Boards of CommunityMental Health Centers.

Content: Includes the philosophical conceptsof community mental health centers andcontains practical suggestions and guidelinesfor the local administration. Chapters in-clude a brief history of the mental healthmovement in the United States, an abridgeddiscussion of mental illness, discussion ofrecruiting and employing staff, importanceof record keeping and staffing, ways of es-tablishing a mental health center, etc.

Methods: An analysis of some 20 centers inKansas.

CURRENT STATUSShould be received from printer during Decem-

ber 1965. 201 pp.

ORGANIZATION (S)Governmental Research Center, Univ. of Kan-

sas

PRINCIPAL INVESTIGATOR(S)Cape, William H.STAFF

Part-time:1 political scientistCOSTUnder $5,000


Community Mental Health Services, Div. ofInstitutional Management, State Board ofSocial Welfare, Topeka, Kans.

PUBLICATION PLANS

FOR FURTHER INFORMATIONDirector, Community Mental Health Services,

Div. of Institutional Management, StateBoard of Social Welfare, State Office Bldg.,Topeka, Kans.

109

D-46 Provisions for Pharmaceutical Services in Small Minnesota Hospitals(12/1/65)

ABSTRACTObjectives: Examination of the origins, extent

and methods used to provide pharmaceuticalservices to small hospitals in Minnesota.

Content : Patterns of professional pharmacyservice develop in different locations whichreflect the individual characteristics of theindividuals involved. Determination of theelements of a satisfactory relationship be-tween pharmacist and hospital will help tofoster additional relationships and extensionof pharmaceutical services.

Methods: An initial questionnaire establishedthe hospitals that received part-time phar-macy service. Site visits were made to allhospitals and discussions were held with alladministrators and all pharmacists.

CURRENT STATUSCompleted. (Sept. 1964June 1965)

ORGANIZATION(S)College of Pharmacy, University of Minnesota

110

PRINCIPAL INVESTIGATOR(S)Kabat, Hugh F.Winship, Henry W., IIISTAFFFull-time:

Part-time:2 pharmacistsCOSTUnder $5,000

FINANCING ORGANIZATION(S)College of Pharmacy, Univ. of MinnesotaPUBLICATION PLANSJournal of the American Pharmaceutical Asso-

ciationFall 1966FOR FURTHER INFORMATIONHugh F. Kabat, Assoc. Prof., College of Phar-

macy, Univ. of Minn., Minneapolis, Minn.55455

D-47 Pattern Variations in Provision of Out-of-Hospital Medical Care(6/1/66)

ABSTRACT PiRINCIP A I, INVESTIGATOR (S )Objectives: To examine the pattern variations Childs, Alfred W.

among the various methods of providing out-of-hospital medical care. STAFF

Content: The actions of the therapist provid- Full-time:ing out-of-hospital medical care will be stud- Noneled through analysis of the numbers andtypes of medical care services, including Part-time :diagnostic or therapeutic procedures and 1 medical care specialistdrugs provided by physicians. The projectwill also examine the effects of certain phy- COSTsician or patient characteristics on the pat- $5,000$9,999tern of care provided. The possibility of

FINANCING ORGANIZATION(S)using automated methods for continuous an-alysis of medical services will be examined. Faculty Research Grant, School of PublicMethods: The project will be based on the Health, Univ. of Calif.collection and analysis of all data pertinentto out-of-hospital medical services. PUBLICATION PLANS

CURRENT STATUSStudy is in progress. (April 1965Dec. 1969)

None

FOR FURTHER INFORMATIONORGANIZATION(S) Alfred W. Childs, M.D., Assoc. Clinical Profes-Institute of Business and Economic Research, sor of Medical Care Admin., School of Public

Committee on Health Economics and Admin- Health, Univ. of Calif., Berkeley, Calif.istration, Univ. of Calif. Berkeley 94720

111

D--48 Evaluation and Improvement of Home Care Program, Richmond,Virginia (218166)

A DeNFIIIM A rimrai".7./ AirlA.,

Objectives: (1) To evaluate existing structureof home care services in Richmond, Va., (2)to improve existing program based on evalu-ation.

Content: (1) Investigation of historical as-pects of program, (2) investigation of cur-rent status of program, (3) design of im-proved proctram.

Methods: (1) Review of documents pertainingto home care, (2) interviews with officialand voluntary health, and other, agencies,(3) conferences with Health Departmentand Instructive Visiting Nurse Association,(4) review of similar programs in otherlocations.

CURRENT STATUSEvaluation almost complete. (June 1965-66)

ORGANIZATION(S)Medical College of Virginia

112

PRINCIPAL INVESTIGATOR(S)Spencer, F. J., M.D.STAFFFull-time:1 registered nursePart-time:1 physician

COST

$10,000414,999


PUBLICATION PLANSNone

FOR FURTHER INFORMATIONDr. F. J. Spencer, Chairman, Dept. of

ventive Medicine, Medical College ofginia, 1200 East Broad St., Richmond,ginia 23219

Pre-Vir-Vir-

D-49 Study of Use of Maternity Beds by Selected Gynecological Patients(11/29/65)

ABSTRACT

Objectives: To test the continued validity ofthe concept that the maternity service shallbe completely separated from the gyneco-logical service.

Content: The study will determine the feasi-bility of utilizing available bed space in ma-ternity wards for gynecological patients whocan be adequately cared for there. A speci-fied set of guidelines will be followed to de-termine conditions for admission of gyneco-logical patients to maternity wards.

Methods: 550 patients at 4 pairs of hospitalsare being examined. One of the hospitals ofeach pair has a mixed gynecological and ma-ternity load on the maternity service. Theother does not have a mixed load. Detailedquestionnaires for each patient are collectedand analyzed and followups of a sample ofpatients will be made.

CURRENT STATUS

Four pairs of hospitals presently participating;550 patient questionnaires reviewed. (March1965on going)

ORGANIZATION(S)Bureau of Maternal and Child Health, New York

State Dept. of HealthPRINCIPAL INVESTIGATOR(S)Katz, 3elig, H., M.D.Gesche, Melita, M.D.Harro, Dale E., M.D.STAFFFull-time:

Part-time:2 physiciansCOSTUnder $5,000

FINANCING ORGANIZATION(S)New York State Dept. of HealthPUBLICATION PLANS

FOR FURTHER INFORMATIONSelig H. Katz, M.D., Dir. Bur. of Maternal and

Child Health, New York State Dept. ofHealth, 84 Holland Ave., Albany, N. Y. 12208

113

D-50 Community Power, Health Policy and Administration (/23/66)ABSTRACT

ohjertivact: To relate the findings and hypothe-ses of community leadership and decision-making, in the manner that they are perti-nent, to the processes by which public healthpolicy is formulated and implemented at thecommunity level.

Content:

Methods: Interviews with elites and civil serv-ants in regard to specific public health poli-cies : water purification. Analysis of officialrecords.

CURRENT STATUS

Grant just received. Work not yet begun.(June 1966-67)

ORGANIZATION(S)

Center for Urban Studies, Univ. of Omaha

114

PRINCIPAL INVESTIGATOR(S)Reynolds; HarryMartin, Cora

STAFFFull-time:None

Part-time:1 sociologist1 political scientistCOST

$15,000-$24,999


PUBLICATION PLANSNone so far

FOR FURTHER INFORMATIONHarry Reynolds, Center for Urban Studies,

Univ. of Omaha, Omaha, Neb. 68132

D-5 1 Implementation and Analysis of a Comprehensive andHome Care Program (616166)

ABSTRACTObjectives: (1) Inventory, evaluate and im-

prove out-of-hospital medical care ; (2) de-termine long-range financing ; (3) demon-strate role of local health department in acomprehensive and coordinated home careprogram.

Content: Ongoing, out-of-hospital medical caredata.

Methods: Analysis of pertinent data.CURRENT STATUSIn process. (Jan. 1964Dee. 1967)ORGANIZATION(S)Coordinated Home Care Program, Erie County

Dept. of Health, Buffalo, N. Y.New York State Dept. of Health, 84 Holland

Avenue, AlbanyHospital Service Corp. of Western New York

(Blue Cross), Buffalo

PRINCIPAL INVESTIGATOR(S)Ehinger, Robert F., M.D., M.P.H.Roth, Mitchell E., B.S.

STAFFFull-time:

Coordinated

1 medical care specialist1 physician1 registered nurse1 social worker, counselor1 home economistPart-time:1 medical care specialist3 physicians1 nutritionist1 physical therapist1 occupational therapist

COST

$100,0004149,999

FINANCING ORGANIZATION(S)New York State Dept. of HealthHospital Service Corporation of Western New

York (Blue Cross)

PUBLICATION PLANS

FOR FURTHER INFORMATIONRobert F. Ehinger, M.D., Coordinated Home

Care Program, Erie County Dept. of Health,2211 Main St., Buffalo, N. Y. 14214

115

,

E. Administrative ProcesgTechniques of Research inHealth Services

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on the ad-minish 9ve processtechniques of research: A-14; A-28; H-17;1-1.) 1-29 L-16; M-13.

E-1 Involvement of Top Decision-Makers as an Instil" aent To PromoteChange in the Organization and Financing of Commur. 'ty Health Services(1/10166)

ABSTRACT

Objectives: To test the extent to which syste-matic involvement of top community de-cision-makers in the constructive analysisof problems of public health organizationand finance will lead to positive action toimprove the current pattern of operations.

Content: Task Forces will be oriented as tothe carrent programs and mechanics of thevarious types and sizes of local health agen-cies. Then, the Task Forces will gather in-formation and suggestions by visitingcommunity health service facilities. Con-clusions will be drawn regarding sourcesof difficulty in the organization ahd financ-ing of community health services in thepresent and future. A final evaluation ofthe project will be made in terms of thesubstantive consequences of the entireeffort.

Methods: The project will involve six regionsof Michigan. In each region, influential de-cision-making community leaders outside thehealth field will be recruited. Ten-to four-teen-man Task Forces will be formed andgiven necessary orientation. A Committee ofForty for Health will be created from mem-bers of the Task Forces to compile and ana-lyze the results of the efforts of the TaskForces.

CURRENT STATUSTask Forces are organized and are in the proc-

ess of studying community health servicesthroughout the State of Michigan towardimprovement of the organization and financ-ing of the necessary serviPes. (Jan. 1965-67)

ORGANIZATION(S)Dept. of Community Health Services, School

of Public HealthUniv. of Mich.Michigan Dept. of Public Health, LansingMichigan Health Officers, Assoc., LansingPRINCIPAL INVESTIGATOR(S)Getting, Viado A., M.D., Dr. P.H.Ziegler, Arthur D., M.P.H.STAFFFull-time:1 physician1 sociologist1 statistician2 community organization specialists1 administrative specialist

Part-time:None


FINANCING ORGANIZATION(S)USPHSW. K. Kellogg Foundation, Battle Creek, Mich.

PUBLICATION PLANSJournal of the American Public Health Asso-

ciation-1967Public Health Reports-1966Interim reports to be published independently

by the Research Program-1966-1967

FOR FURTHER INFORMATIONArthur D. Ziegler, Res. Assoc. in Community

Health Services, School of Public Health,Univ. cf Mich., Ann Arbor, Mich. 48106

ii /119

,`Itt-", ft,';37",

E-2 Preventive Health Services Research Program (11/30/65)

ABSTRACTObjectives: To evaluate multiphasic screening

as a part of an annual health examinationas to its effectiveness in the prevention ofillness and in the reduction of mortality andmorbidity.

Content: A thorough study, utilizing auto-mated multiphasic screening, will investi-gate preventive medical methods for moreeffective detection, prevention, and controlof chronic disease and disability. The pro-gram will demonstrate automated and com-puter techniques such as computer diagnosis,automatic source data collectioh and input,and machine analysis of certain tests.Asymptomatic patients found to have ab-normal tests will be studied and investiga-tions conducted to determine the effective-ness of treatment directed to postponing orpreventing overt illness and disability.

Methods: The medical resources of the Kaiser-Permanente medical care program will beused, and automated zwiltiphasic screeningwill be implemented to gain the informationfor the study.

CURRENT STATUSIn progress. (1965-1972)

120

ORGANIZATION(S)Permanente Medical Group, Oakland, Calif.PRTNel ir INVPATIGA TOR (R)

Collen, M. F.

STAFFFull-time:60 physicians

1 psychologist20 registered nurses

1 sociologist1 statistician

Part-time:


FINANCING ORGANIZATION(S)Kaiser Foundation Hospitals

PUBLICATION PLANS

FOR FURTHER INFORMATIONMorris F. Collen, M.D., Dir., Medical Methods

Research, Permanente Medical Group, 1924Broadway, Oakland, Calif. 94612

011, fair-Aratt40.1.4,46, ,47,11110/111I.VV21114041.51.1,11,,r,,,,a

E-3 Community Structure and Involvement (4/28/66)ABSTRACTObjectives: To study community structure and

to determine the effect of social status andother stratifying characteristics on the in-volvement of individuals in communityaffairs.

Content: In the first phase of the project.community structure is being studiedthrough historical reconstruction of pro-grams of community action and analysis ofthe persons involved in them according tothe following characteristics: age, educa-tion, occupation, sources of income, organi-zational affiliations, and attitudes towardthe community. The second phase of theproject involves the identification of com-munity social strata and a subsequent cor-relation between stratifying characteristicsand the involvement of persons in commu-nity action activities.

Methods: For the analysis of communitystructure, two cities of 20,000 populationwere studied through participant observa-tion and structured interviews with selectedinformants. For the second phase, stratifica-tion was measured by delineating residentialareas through the use of key informantswho reported on historical factors, neighbor-ing patterns, residential segregation, andsocioeconomic clustering. Analysis of thecollected data is being made.

CURRENT STATUS

ORGANIZATION( S)Social Science Research Center, Miss. State

Univ.

PRINCIPAL INVESTIGATOR(S)Kaufman, Harold F.Wilkinson, Kenneth P.

STAFFFull-time:6 sociologists

Part-time:2 sociologists

COST

$150,000$199,999


National Institute of Mental Health, Bethesda

PUBLICATION PLANS

Professional journals in sociology, local publi-cations, book (s), publisher to be determinedSummer 1966, spring 1968


Harold F. Kaufman, Social Science ResearchCenter, Miss. State Univ., State College,Miss. 39762

121

E-4 Use of Cost-Benefit Analysis in Health Services Planning for DevelopingCountries (8/26/66)

ABSTRACT

Objectives: A comparative study, in severaldeveloping countries, of feasibility and ac-tual use of cost-benefit analysis in the set-ting of priorities for public health programs.

Content:

Methods:

CURRENT STATUSLiterature review and preparation for data

collection in first country, Taiwan. (June1966-67)

ORGANIZATION (S )Div. of Medical and Hospital Admin., School

of Public Health, Univ. of Calif.PRINCIPAL INVESTIGATOR(S)Rossman, John

122


Part-time:None

COST

Under $5,000


PUBLICATION PLANS

FOR FURTHER INFORMATIONJohn Rossman, School of Public Health, Univ.


E-5 Economic Level, Dental Health, Interest Response to a PoliomyelitisVaccination Program and Voting Behaviour in a Fluoridation Plebiscite(1/10/66)

ABSTRACTObjectives: To determine the influence of eco-

nomic level upon dental health status, votingbehaviour in a fluoridation plebiscite, andinterest response to another public healthmeasure, specifically a Sabin oral Poliomye-litis Immunization Program,

Content: The town of Jasper Place, Alberta,Edmonton, Canada, was selected for thestudy. In this study, better dental healthwas found in children from high economicgroups as compared with low economicgroups. Adults and preschool children fromhigh economic groups demonstrated greaterinterest response to the polio vaccinationprogram. Voters from the middle and higheconomic groups turned out to vote in thefluoridation plebiscite. The high and middleeconomic groups voted strongly in fa/or offluoridation while low economic groupsvoted strongly against it.

Methods: Twenty-two residential subdivisionsin the town were classified into low, middle,and high economic groups. For the dentalhealth study, dental records were reviewedand assessed. For the response program,records were obtained from the town healchunit. The records showed responses fromadults, preschool children and school chil-dren. Finally, for the plebiscite survey, mu-nicipal records were studied and differences

in voting between the three economic oyoungwere obtained.

CURRENT STATUSCompleted. (1961-1965)

ORGANIZATION(S)Univ. of Alberta

PRINCIPAL INVESTIGATOR(S)MacRae, P. D., D.D.S.

STAFFFull-time:None

Part-time:1 statistician1 dentist

COSTUnder $5,000


PUBLICATION PLANSJournal of the Canadian Dental Association,

Nov. 1965

FOR FURTHER INFORMATIONP. D. MacRae, D.D.S., Assoc. Prof. of Pediatric

Dentistry, Univ. of Alberta, Edmonton, Al-berta, Canada

123

E-6 Systems Development Project (9/6/66)

ABSTRACTObjectives: To develop national, uniform sta-

tistical report forms to be used by the Chil-dren's Bureau in order to evaluate the ad-ministration and delivery of services ren-dered in various projects.

Content: The report forms will be - 3ed byvarious projects in submitting such dataas: (1) the number and identifying char-acteristics of patients classified by age,sex, and race; (2) the amount and type ofservices provided to such patients, includingcasefinding, diagnosis, treatment and aftu*-care; and (3) the results of the servicesrendered. The study will assist various proj-ects in the development of specific farms forreporting their activities in the same areasof casefinding, diagnosis, preventive healthservices, treatment, correction of defects,aftercare, and followup.

Methods: Data processing equipment and com-puters will be made available from the Med-ical Data Processing Center of the Universityof Minnesota Medical School. Progress re-ports will be compiled as well as reports de-tailing forms and systems produced.

CURRENT STATUSProject is in initial organization stage. (July

1966-71)

124

ORGANIZATION(S)University of Minnesota

PRINCIPAL INVESTIGATOR(S)Weckwerth, Vernon E., Ph.D.

STAFF

Full-time:1 administrative specialist1 records specialist

Part-time:1 economist1 physician1 registered nurse1 statistician1 systems analyst

COST

$250,000 or more




Vernon E. Weckwerth, Ph.D., Univ. of Minn.,803 Washington Ave., S.E., Minneapolis,Minn. 55414

E-7 Automated Planning and Control of Dietary Functions (3/8/66)ABSTRACTObjtctives: To study and analyze the planning

and control functions in a hospital dietarydepartment and to design and implement aplanning and control system which will allowmaximum use of electronic data processing.

Content: There are several major areas of re-search in the overall project for design ofthe total dietary system on a computer base.These include (1) forecasting short and longrun demands for menu items, (2) inventorycontrol, (3) bids-purchase orders and speci-fications, (4) production and scheduling, (5)recipe and menu planning. One of the majorefforts is in the area of developing mathe-matical models for selective menu planning.

Methods: The project will employ the tech-niques of management analysis, operationsresearch, industrial engineering, statisticsand accounting.

CURRENT STATUSIn progress, with grant proposal pending.

(Sept. 1965-69)

ORGANIZATION(S)Center for Health and Hospital Admin., Univ.

of Fla.

_

ProrNripe nwr STIC-ATOR(S)

Gue, Ronald L., Ph.D.Fellers, John D.

STAFF

Part-time:2 mathematicians1 dietician

COST

$100,000-$149,999

FINANCING ORGANIZATION(S)University of FloridaUSPHS (pending)

ilUBLICATION PLANSHospitalsSummer 1966Industrial EngineeringSurnmer 1966


Ronald L. Gue, Ph.D., Center for Health andHospital Admin., Univ. of Fla., Gainesville,Fla. 32603

126

I

E-8 Identification of Problems in Nursing Home Operations with Evaluation ofAlternative Methods for Improvement and Development of Plans for aSeries of Experimental and Demonstration Nursing Homes (6/30/66)

ABSTRACTObjectives: To identify problems in nursing

home operations and to evaluate alternativepossible solutions ; also to develop a series ofplans for experimental and demonstrationnursing homes.

Content: In the identification and descriptionof exisi:ng problems the study will include:(1) construction of nursing homes; (2)nursing home services ; and (3) nursinghomes and the health care community. Inthe evaluation of alternative solutions toidentified nursing home problems, an esti-mated time-cost determination will be made.

Methods: The study will use the resources ofthe Columbia University School of Adminis-trative Medicine and Public Health whichwill draw upon an advisory committee con-stituted of key leaders in the nursing homefield.


ORGANIZATION(S)Columbia University

PRINCIPAL INVESTIGATOR(S)Bauinzarten, HaroldSTAFFFull-time:None

Part-time:1 hospital administrator

COST$25,000$34,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONHarold Baumgarten, Columbia Univ., 630 W.

168th St., New York, N.Y. 10032

_

Role Conceptions of Pharmacy and Community Health (11/29/65)ABSTRACTObjectives: The objectives of this proposed re-search are o gain knowledge about the oc-cupational role perceptions CI the pharmacistheld by various groups and to explore the

implications of these perceptions for an in-creased utilization of the professional talentsof the pharmacist.

Content: Specifically, the study is intended todevelop instruments for quantitatively meas-uring occupational role perceptions of thepharr lcist and to use these instruments todelineate such roles as perceived by the gen-eral public, medical practitioners, and phar-macists themselves. The long-range goal ofthis work is to implement the increasedutilization of the pharmacist in communityhealth through modification of role structure.Methods: Two types of instruments will bedeveloped in this study. One will be a busi-ness-professional scale, using a Likert proce-dure ; the other, a semantic differential scaleto measure the connotative meanings of"pharmacist." The instruments will be ad-ministered to samples of pharmacists, physi-cians, pharmacy students, and the generalpublic.

CURRENT STATUSIn progress. (June 1965-67)ORGANIZATION(S)College of Pharmacy, Ohio State UniversityPRINCIPAL INVESTIGATOR (S)Knapp, David A.STAFFFun-time:None

Part-time:2 psychologists1 pharmacy administratorCOST

$15,000424,999


PUBLICATION PLANSNone at present

FOR FURTHER INFORMATIONDavid A. Knapp, Assist. Prof., Pharmacy Ad-

min., College of Pharinacy, Ohio State Univ.,1958 Neil Ave., Columbus, 0. 43210

127

E-10 Design of a Cost-Benefit Analysis of the Nursing Home and PatientClassification System (6/30166)

ABSTRACTObjectives: To develop a study design for use

of cost benefit analysis to determine the eco-nomic efficiency of Washington State's sys-tem of nursing home care and nursing homeclassification systeme

Content: The study will provide a detailed de-scription of the nursing home care providedto Welfare patients in Washington and thesystem of classification and nurse supervi-sion of nursing homes and the care providedtherein. The study will also describe the dataand techniques needed to perform a cost ef-fectiveness analysis of the program.

Methods: The study will be carried ont by in-terviewing personnel in State and local agen-cies. Data will be analyzed in a final report.

CURRENT STATUS(June 1966Apr. 1967)

ORGANIZATION(S)

128

PRINCIPAL INVESTIGATCR;8)TY - Al MR 11.1.1AUV1/41411. te, nenne t rn..1.).

STAFFFull-time:None


COST

$10,000$14,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONKenneth M. McCatTree, Ph.D., 5014-18th

Ave., N.E., Seattle Wash. 98105

1

,

,

E-11 A Description of the Barriers to Employment Faced by Persons withCardiac Disease (12/16/65)

ABSTRACTObjectives: To define and describe the barriers

to employment faced by persons who havehad diagnosed heart disease.

Content: Using survey techniques, the studyhas sought to define the legal, administra-tive, and social barriers to employment facedby persons with heart disease.

Methods: Interviews with eminent physicians,lawyers, union representatives, Welfare andHealth professionals, patients and other au-thorities on the re-employment of handi-capped persons.

CURRENT STATUSReport writing. (Aug. 1964Feb. 1966)ORGANIZATION(S)Cardiac Rehabilitation Project, Upstate Medi-

cal Center, Syracuse, N.Y.

PRINCIPAL INVESTIGATOR(S)Higgins, A. C.

'5

STAFFFull-time:

Part-time:

COST

$35,000-144,999_


Bureau of Heart Disease, New York StateDept. of Health, Albany



A. C. Higgins, Proj. Dir., Cardiac Rehabilita-tion Project, Upstate Medical Center, 750 E.Adams St., Syracuse, N.Y. 13210

129

E-12 A Case Study of Administrative Processes (12/14165)

ABSTRACTObjectives: A study of the administrative

processes involved in implementing a cooper-ative program between the New York CityHealth Department's Bedford DistrictHealth Center and St. John's Episcopal Hos-pital to provide ambulatory services for per-sons in the Bedford-Stuyvesant area of NewYork City.

Content : The study will encompass informa-tion pertinent to tie medical needs and thedecision to negotiate for coordinated serv-ices; the steps leading to the developmentof the contract; formal and informal rela-tionships indigenous to its implementation;development and functioning of clinic stafforganization ; maintenance of relationshipswith the community ; administrative proce-dures for documenting program operation,for maintaining standards of ouality of care,and managing the fiscal aspects of thearrangement.

Methods: Observation, interviews, and an.

alysis of written material.CURRENT STATUSThis study is being conducted in three phases:

the study of the negotiations, the study ofthe implementation of the cooperative pro-gram, and the analysis and evaluation of

130

data. We are currently in the first phase.(Sept. 1965Dec. 1966).

ORGANIZATION(S)Graduate School of Public Admin., New York

Univ.

PRINCIPAL INVESTIGATOR(S)Hilling, Helen Clark, Ph.D.Walden, Daniel C.

STAFF

Full-time:1 administrator

Part-time:1 administrator

COST$25,000434,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONDr. Helen Clark Hilling, Prof. of Public Admin.

Graduate School of Public Admin., NewYork Univ., #4 Washington Square, No.,New York, N.Y. 10003

1

........,

E-13 Evaluation of Chronic Disease Screening Programs (5/11166)ABSTRACTObjectives : To devise and test a mathematical

model for the assessment of the effective-ness ol Chronic Disease Screening Programsin terms of the potential years of life ex-pectancy salvaged.

Content : A stochastic model has been de-veloped in which variables include age, eco-nomic status, stage of disease at diagnosisand probability of diagnosis with and with-out a screening program. The model will betested using data from the Cervical CytologyScreening Program in Monroe County, NewYork.

Methods:

CURRENT STATUSData collection is complete. Computer pro-

grams are being prepared to evaluate thedata in terms of the model as specified.(Sept. 1965-66)

ORGANIZATION (S)Epidemiology Residency Program, New York

State Dept. of Health, Albany

PRINCIPAL INVESTIGATOR (S)Voors, A. Wontar, M.D.

STAFF

Full-time:None


COST

$5,000$9,999

FINANCING ORGANIZATION (S)New York State Dept. of HealthUSPHS

PUBLICATION PLANSNot yet formulated


A. Wouter Voors, M.D., Epidemiology Resi-dency Program, New York State Dept. ofHealth, 84 Holland Ave., Albany, N.Y. 12208

131

E-14 A Study of the Work Adjustment of Disabled People Working inHospital (5/10/66)

ABSTRACTObjectives: A description of the adaptations to

chronic illness on the part of disabled em-ployees, their co-workers and their super-visors, and a determination of factors associ-ated with successful and unsuccessful jobadjustment.

Content: Information will be collected con-cernirig job satisfaction on the part of thedisabled worker, and co-workers' and super-visors' evaluations of the disabled -worker'sperformance.

rethods: Structured interviews with ap-proximately 200 employees, 200 firstlinesupervisors, and 600 co-workers.

CURRENT STATUSGrant application pending. (Nov. 1966-68)

ORGANIZATION(S)Patient Care Research Unit, Dept. of Physical

Medicine and Rehabilitation, New YorkMedical College

PRINCIPAL INVESTIGATOR(S)Muller, Jonas, N., M.D.

132

Nauen, Richard, M.D.Rosenthal, Julian E., M.D.STAFFFull-time:1 psychologistPart-time:3 physicians1 psychologist1 registered nurse1 sociologist

COST$50,000-$74,999

FINANCING ORGANIZATION(S)USPHSpendingPUBLICATION PLANS

a

FOR FURTHER INFORMATIONMartin Weitzner, Ph.D., Chief, Patient Care

Research Unit, Dept. of Physicial Medicineand Rehabilitation, New York Medical Col-lege, Fifth Ave. at 106 St., New York, NX.10003

(

/

E-15 High Risk Maternal and Child Health (1/8/66)ABSTRACTObjectives: To ascertain the effect of coordi-

nated continuous mntArnAl owl Phi ld care onthe "High Risk Pregnancy" grovp ofpatients.

Content:

Methods: By extending and coordinating nurs-ing and social services beyond the limits nowaccepted, we hope to provide a more uniformservice to the patient.

CURRENT STATUSClinics in operation and receiving new pa-

tients. (July 1965unknown)

ORGANIZATION(S)School of Medicine, State Univ. of New York at

BuffaloDept. ol: Health, BuffaloErie County

PRINCIPAL INVESTIGATOR (S)Mosher, W. E., M.D., M.P.H.Anderson, U.M., M.D., F.A.A.P.

Marra, E., M.D., M.P.H.Randall, C. L., M.D.rnota, R. J., M D.STAFFFull-time:1 registered nurse1 social worker, counselorPart-tinte:3 physicians4 registered nursesCOST$250,000 or more

FINANCING ORGANIZATION(S)U.S. Children's Bureau, Washington, D.C.Erie County Dept. of Health, BuffaloPUBLICATION PLANSNone at presentFOR FURTHER INFORMATIONRonald J. Foote, M.D., Proj. Dir., School of

Medicine, State Univ. of New York at Buf-falo, Capen Hall, Buffalo, N.Y. 14214

133

E-16 Continued Care by Nurses and

ABSTRACTObjectives: To study in a controlled, experi-

mental manner the effects of care given byvisi:ing nurses.

Content: A unique research design permitsseparation of observer effects on patientsfrom effects related to nurses' visits. The in-troduction of a research program into twoservice settings (hospital and visiting nurseagency) has influenced both service pro-grams and required special strategies. Sincenursing care is offered to all patients as-signed to the randomly selected "treatment"group, the opportunity is presented to iden-tify groups of patients who can best respondto such care.

Methods: The criteria for the study are meas-ures of the physical, psychological, and so-cial function of 300 patients discharged froma chronic disease hospital, assigned by arandom system to treatment and controlgroups, and observed for two years.

CURRENT STATUSThe study, which began April 1963, is in

progress.

ORGANIZATION(S)School of Medicine, Western Reserve Uni-

versityBenjamin Rose Hospital, 2073 Abington Rd.,

Cleveland, 0.

134

Doctors: An Experiment (12/2/65)

Visiting Nurse Association, 3300 Chester Ave.,Cleveland, 0.

Frances Payne Bolton School of Nursing, 2063Adelbert Rd., Cleveland, 0.

PRINCIPAL INVESTIGATOR(S)Ford, Amasa B., M.D.

STAFF

Full-time:4 registered nurses2 sociologists

Part-time:4 physicians1 psychologist3 registered nurses1 statistician

COST

$250,000 or more


PUBLICATION PLANS

American Journal of Public Health-1966


Amasa B. Ford, M.D., Assist. 15rof. of Medi-cine, School of Medicine, Western ReserveUniv., 2040 Adelbert Rd., Cleveland, 0. 44106

-

E-17 Improvement of Dietary Service in Nursing Homes thrnugh SharedProfessional Service and Selective Training of Food Service Personnel(1128166)

ABSTRACTObjectives: To show how regular dietary con-

sultation services may be provided to nurs-ing homes through shared professional serv-ices and to demonstrate how to improve themanagement of the dietary service in nurs-ing homes.

Content: Training and recruitment of non-professional personnel will take place. A cur-riculum will be developed for food servicesupervisors to assist in supervision of prac-tical experience for trainees in nursinghomes.

Methods: This project consists of three phases.The first phase concerns itself with develop-ment of demonstration methodology and therecruitment and orientation of project staff.The second phase will consist of the provi-sional services to selected nursing homes,and the third phase will be an evaluation ofthe program. An advisory committee willassist the project staff during the life ofthis project.

CURRENT STATUSIn second phase of project. (Aug. 1964-67)ORGANIZATION(S)Toledo District Board of Health, Toledo, 0.

I


STAFFFull-time:' nutritionistPart-time:1 physician1 registered nurse1 statistician1 nutritionist1 health educator1 sanitarian

COST

$50,000$74,999


Toledo District Board of Health, Toledo, 0.USPHS

PUBLICATION PLANS


h:'bert Mark, M.D., Health Commissioner,Toledo District Board of Health, 635 N. ErieSt., Toledo, 0. 43624

135

E--18 Evaluation of Demonsixation Home Care Program (515166)

ABSTRACT4.1, .C.,,....41,41.11... ...c est.ILAUCCIIIVIM; 10 cvnittam I,uu Avaasuixxvj U.i. CO-

tablishing hospital-based home care pro-grams in other hospitals in AlleghenyCounty patterned after the simplified modelof the demonstration program.

Content: Nature and extent of services pro-vided, analysis of costs, attitudes towardservices and program of home care staff,home care patients and referring physi-cians.

Methods: Records analysis and structured in-terviews. Time period embraces fiscal 1966.Selected characteristics of patients placedon home care during first six months w -0compared by same characteristics of patientsdischarged from hospital during October1965, and not placed on home care. Interviewinformation and data on services receivedare being collected on all patien.s placed onhome care between January 1 and March 31,1966, extending over a 3-month period, end-ing June 30, 1966.

CURRENT STATUSStaff and physician interviews completed. Data

being analyzed. Patient interviews and serv-ice accounting in progress. (Sept. 1965-66)

,

136

ORGANIZATION(S)Health and Welfa..a "a" nf All"g11"137 C°:PRINCIPAL INVESTIGATOR(S)Lambert, Camille, Jr.Bonn, JaneMcCormick, John G.

STAFFFull-time:None

Part-time:1 psychologist1 sociologist1 political scientist

COST$10,000414,999

FINANCING ORGANIZAT(ON(S)Community Chest of Allegheny Co.

PUBLICATION PLANSHWA publicationOctober 1966

FOR FURTHER INFORMATIONCamille Lambert, Jr., Health and Welfare

Assoc. of Allegheny Co., 200 Ross St., Pitts-burgh, Pa. 15219

E-19 A Model Prescription Reconling System (1212165)

ABSTRACTObjectives: To develou a model method nf re-

cording the information derived from theprescription order form used by medicalpractitioners to prescribe medication fortheir private patients.

Contents: The study is developing a model sys-tem of recording information contained inthe prescription form used by physician's pa-tients to obtain prescribed medication frompractitioners of pharmacy located in com-munity pharmacies and, in some instances,hospital pharmacies. The data obtained willbe used to conduct statistical studies of drugutilization by the chronically ill and aged,actuarial studies, market research studiesof a retrospective nature, and studies of in-dividual and family consumption of and ex-penditures for prescribed medication._

Methods: Various methods of recording thenecessary information are being utilized de-pending upon the prescription dispensingvolume of the individual pharmacies in-volved. An advisory committee consisting ofrepreseaitatives from the medical profession,pharmaceutical manufacturers, local and na-tional public health associations and theUSPHS will complement the cooperation ofthe American Pharmaceutical Association.

CURRENT STATUSDPnwangfrinfinn crrant. (fia: 1963-April 1966)

ORGANIZATION(S)

School of Pharmacy, Univ. of Pittsburgh

PRINCIPAL INVESTIGATOR(S)McEvilla, Joseph D., Ph.D.

STAFF

Full-time:1 mathematician

Part-time:1 economist1 statistician

COST

$200,000-$249,999


PUBLICATION PLANSHospitals; Journal APHA-1966


Dr. Joseph D. McEvilla, Prof. of Pharmacy Ad-min., School of Pharmacy, Univ. of Pitts-burgh, 244 Salk Hall, Pittsburgh, Pa. 15213

137

E-20 Evaluati.on of Well Child Clinics in Manitoba (3/31/66)

ABSTRACTObiectives: To determine prneednrnl En gig,

services offered, and effectiveness of childhealth conferences.

Content:

Methods: Phase Ireview of present recordsof all children attending child health confer-ences, visit to conference, and assessment bystaff. Phase IIretrospectke study of childhealth care and its source based on samplingof school entrants.

CURRENT STATUSPhase Icompleted, with report in prepara-

tion. Phase Hto start Sept. 1966. (Apr.1965-67)

ORGANIZATION(S)Manitoba Dept. of HealthPRINCIPAL INVESTIGATOR(S)Mor3son, James B., M.D., D.P.H.

138

3arsky, Percy, M.D., F.A.A.P.


Part-time:1 registered nurse1 physician

COST$5,000-$9,999

FINANCING ORGANIZATION(S)Dept. of National Health and Welfare, Ottawa

PUBLICATION PLANSNot finalized


James B. Morison, M.D., Dir. of Health Serv-ices, Manitoba Dept. of Health, Winnipeg1, Manitoba, Canada

.......,-

t

E-21 A Study of Stock Control in Prescription Departments (5/4/66)ABSTRACTOhjertivaa: To develop a rational system for

the management of the drug inventory inthe prescription departments of pharmacies.

Content: (1) Present systems used in stockcontrol or lack thereof ; (2) feasible plansfor the adoption of a stock control programin the prescription departments of averagepharmacies ; (3) the economic advantages ofsuch stock control programs.

Methods: (1) A survey of selected pharmaciesin eastern Washington ; (2) the developmentof a plan for such pharmacies; (3) experi-mentation with the plan in selected pharma-cies.

CURRENT STATUSPreliminary studies are underway to investi-

gate the feasibility of the study throughparticipation of pharmacies in Spokane,Wash. and Lewiston, Idaho. (Sept. 1965uncertain)

ORGANIZATION(S)College of Pharmacy, Washington State IP

Pullman, Wash.

PRINCIPAL INVESTIGATOR(S)Bang, liaakon, Ph.D.

STAFF

ronePart-time:1 pharmacy professor6 pharmacists

COST

Under $5,000


College of Pharmacy, Washington State Univ.,Pullman, Wash.

PUBLICATION PLANSUncertain


Dr. Haakon Bang, Prof. of Pharmacy Admin.,College of Pharmacy, Washington StateUniv., Pullman, Wash. 99163

189

E-22 Human Relations in Patient Care (11/30/65)

ABSTRACTObjectives: An exploration of the human vari-

ables associated with the care of hospitalizedmedical and surgical patients.

Content : This study traces in detail the ex-periences of patients during the course ofone hospitalization. Detailed information isgathered on the patients, their illnesses,their families, nurses who cared for them,and physicians who cared for them duringthis illness. Data are gathered on the pa-tients' reactions to hospitalization one monthafter discharge and one year after dischargefrom the hospital. Precise cost of hospitali-zation, who paid for it, and when the billwas paid are included in this study.

Methods: A 5-percent random sample wastaken of married white patients admitted toa university medical center over a two-yearperiod. Patients, family members, nurses,physicians and administiators were inter-viewed systematically with schedules de-veloped for the project. These were supple-mented by systematic observations in thepatients' rooms. A total of 26 schedules wereused in the data gathering.

CURRENT STATUSAll data have been gathered and are almost

completely analyzed. A book-length manu-

140

script is being prepared and is approxi-mately two-thirds written. (Jan. 1960-67)

ORGANIZATION(S)Yale Univ., New Haven, Conn.PRINCIPAL INVESTIGATOR(S)Duff, Raymond S., M.D.Hollingshead, August B., Ph. D.STAFFFull-time:1 physician3 registered nurses3 sociologistsPart-time:2 physicians3 sociologists1 statist icianCOST$250,000 or more


PUBLICATION PLANSJohn Wiley and Sons, New York City-1967

FOR FURTHER INFORMATIONRaymond S. Duff, M.D., Yale Univ., 1965 Yale

Station, New Haven, Conn. 06520

)

E-23 Connecticut Homemaker Services Coordination-Training, MsistanceEvaluation (2/18/66)

ABSTRACTObjectives: A Statewide program to study or-

ganized homemaker services as a supportivemeasure which contributes to the preventionand control of the progress of medical andsocial breakdown.

.Content: Statistical materials will be used for

evaluation, and other criteria will be de-veloped and applied to existing programs totest their usefulness. Concurrently, a train-ing phase was conducted to assist those ser-vices in recruiting appropriate homemakersand a Statewide program of financial assist-ance +o local homemaker services was con-tinued and expanded.

Methods: Provision of a uniform record sys-tem to all local homemaker services and thecollection of data on a uniform statisticalbasis provided the basic materials for de-scription and evaluation of service. Trainingwas conducted by the State department ofhealth and other selected and approved per-sonnel. Financial assistance to local home-maker services was administered in accord-ance with policy approved by the PublicHealth Council.

CURRENT STATUSThe description and evaluation of services is

still in process. The program in general hasbecome a part of the continuing operation ofthe State department of health. (July 196265)

ORGANIZATION(S)Connecticut State Dept. of Health

PRINCIPAL INVESTIGATOR(S)Barrett, Harold S., M.D.

STAFFFull-time:1 social worker, counselor1 home economics specialist1 health educator

Part-time:3 physicians12 registered nurses2 health educators

COST

$25,000$34,999


Connecticut State Dept. of HealthUSPHS

PUBLICATION PLANS

Already published: Statistical Manual, Train-ing Manual, Directory of Homemaker Serv-ices (First and Second Editions), and threeHistorical and Summary Articles

In Press: Statistical ManuctiSecond EditionIn Process: Training Manual (Second Edi-

tion), History of Connecticut HomemakerPrograms and Services, and other paperson evaluation of services-1966


Harold S. Barrett, M.D., Dep. Com., Conn.State Dept. of Health, 79 Elm St., Hertford,Conn. 06116

141

E-24 New Methods of Establishing a Continuum of Community Care forProblem Drinkers (6/2/66)

ABSTRACTObjectives: To demonstrate new methods of

establishing a continuum of community carefor problem drinkers.

Content: The project will consist of the fol-lowing endeavors: (1) development of newmethods of intervening into the lives ofproblem drinkers by attempting changes intheir environment as well as in their per-sonalities, (2) dissemination of communitymental health principles and procedures ofcomprehensive and continuous care forchronic abusers of alcohol to the staffs ofcommunity agencies and organizations, tomedical students and hospital personnel, andto other actual or potential caretakers, and(3) evaluation of these new methods aimedat individual intervention and attempts ofeducating staffs of referral agencies andrepresentatives of community agencies andorganizations.

Methods: The objectives of the project willbe achieved by establishing a demonstrationproject for serving problem drinkers re-ferred by 20 various agencies selected so asto represent major types of caretakingagencies which CON13 into contact with prob-lem drinkers. These agencies will be organ-ized into a Conference Board of Delegates.

CURRENT STATUSFully operative. (Feb. 1965-70)

142

ORGANIZATION(S)Div. of Community Mental Health Dept. of



STAFFFull-time:3 physicians2 psychologists2 registered nurses4 social workers, counselors2 sociologists


COST

$250,000 or more


PUBLICATION PLANS


Richard Brotman, Dir., Div. of CommunityMental Health, Dept. of Psychiatry, NewYork Medical College, 105th St. and FifthAve., New York, N. Y. 10029

1

E-25 The Mission of the Pharmacist in Nuclear Disaster (12/7/65)

ABSTRACTOhjectivm f rrn avomirso the mission of the

pharmacist in nuclear disaster.Content: The study includes a review of the

changing role of the pharmacist during thewars of this century. The effect of a nuclearholocaust is studied with respect to its effecton the providing of medical care. It is de-termMed that, in the event of atomic attack,medical service would be so severely dis-rupted that pharmacists might have to carefor many medical emergencies which are or-dinarily cared for by physicians.

Methods: Oklahoma City is studied to securedata for the project. Death rates for physi-cians and pharmacists are determined forvarious sizes of hypothetical bombs droppedin the center of the city.

CURRENT STATUS

Completed. The study began Nov. 1964

ORGANIZATION(S)

School of Pharmacy, Southwestern State Col-lege, Weatherford, Okla.

PRINCIPAL INVESTIGATOR(S)Rrn licher, Charlea L., Ph.D., M.A.STAFFFull-time:None

Part-time:1 pharmacistCOSTUnder $5,000


PUBLICATION PLANSThis study has been accepted for publication

in Military Medicine, the official journal ofthe Association of Military Surgeons of theUnited StatesDecember 1965 or early 1966edition

FOR FURTHER INFORMATIONCharles L. Braucher, Ph.D., Assoc. Prof., Phar-

macy Admin., School of Pharmacy, South-western State College, Weatherford, Okla.73096

143

E-26 A Study of Patient Care in a General Hospital (8/2/66)

kBSTRACTi Meet:yea: To define. oly1 °beer ie humex vari-

ables which have a significant influence uponthe care of patients in a general hospital.It is assumed that patient care is influencedby the family, the patient, the physicians,the nurses, other hospital personnel, otherpatients, and friends. Interactions of patientswith each of the above groups are beingexplored.

Content: The activities of physician and thenurse, the two professional persons respon-sible for the care of patients, are bei-agstudied systematically. The organization ofmedical care and the socio-economic statusof patients as they are related to patientcare are other concerns of this study.

Methods: The study is located in a majorteaching center. The study groups are a ran-dom sample of hospitalized medical and sur-gical patients; physicians, nurses, and para-medical personnel caring for each patient;and the family and friends of each patient.Data analysis is in progress.

CURRENT STATUSA book-length monograph is in preparation.

(1960-67)

144

ORGANIZATION(S)Yale-Ylew Haver: Irle,spitalYale University

PRINCIPAL INVESTIGATOR(S)Duff, Raymond S., M.D.Hollingshead, August B.

STAFFFull-time:1 physician1 sociologist

Part-time:None

COST$150,000$199,999


PUBLICATION PLANSUncertain as yet, possibly Wiley & Sons, New

Yorkearly 1968FOR FURTHER INFORMATIONRaymond S. Duff, M.D., Assist. Prof. of Pedi-

atrics, We Univ., School of Medicine, NewHaver., C....1n. 06520

E-27 Computer System for Institutional Menu Planning (5/5166)ABSTRACT

Objectives: Development and testing of math-ematical programming models through on-line applications in hospital dietary depart-ments.

Content: Information system and computersystem design, programming and alogrithmdevelopments followed by operational test-ing.

Methods: Research cooperation establishedwith four hospitals and installation of re-mote terminals linked to a central computer.

CURRENT STATUSImplementation completed in one hospital,

methodology and saving tested and docu-mented, two hospitals 50 percent operational.(1964-1967)

ORGANIZATION(S)School of Business Admin., Tulane Univ., New

Orleans, La.

PRINCIPAL IN VESTIGATOR(S)Balintfy, Joseph L., D. Eng.

STAFFFull-time:2 mathematicians1 statistician2 programmers2 dietitians

Part-time:None

COST

$200,000$249,999


PUBLICATION PLANSHealth Science ResearchOctober 1966HospitalsJune 1966FOR FURTHER INFORMATIONJoseph L. Balintfy, D. Eng., Assoc. Prof. of

Operations Research, School of Business Ad-min., Tulane Univ., 6823 St. Charles Ave.,New Orleans La. 70118

145

E-28 Project on Research Administration (2/8/66)

ABSTRACT

Objectives: To identify factors in the researchenvironment Which inhibit nr prnmnta sci-entific accomplishment in the life sciences.

Content: Dependent Variablesinnovation,productivity, importance of problem, over-all significance of findings, creativity.Independent Variablese.g., type of setting,authority patterns, communication nets, ideaflow, type of financing, freedom.

Methods: Case study of 10 research settings.Case study included interviews, observation,questionnaires, study of documents and rec-ords. The research output of the projectsstudied in each setting will be evaluated byexperts in the field for innovation, produc-tivity, importance of the problem and over-all significance of the findings.

CURRENT STATUS

Case sites completedanalysis underway.(May 1963-66)

146

g

ORGANIZATION(S)University of ChicagoPRTN01PAT INVESTIGAT^R(S)Gordon, GeraldMarquis, SueSTAFFFull-time:2 sociologists

Part-time:

COST$75,000$99,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONGerald Gordon, Project Director, University of

Chicago, 5555 S. Ellis, Chicago, Ill. 60637

E-29 Estimate P f Variance for Selected Medical Diagnoses (7114/66)ABSTRACTObjectives: To determine the minimum num-

ber of hospital admissions which need beexamined in any diagnosis category in orderto arrive at estimates of such things as aver-age length of stay or 90th percentile of allstays with 95 percent or better confidence.

Content: The hospital admissions recorded bythe New Jersey Blue Cross Plan for the year1965. This data is listed in frequency distri-butions for length of stay by diagnosis andage.

Methods: The variance in length of stay willbe estimated for specific diagnosis categoriesby age and sex. This number will then beused to determine the minimum number ofcases necessary in that diagnosis class forthe desired estimates.

CURRENT STATUSData is now being obtained from the New

Jersey Blue Cross Plan. (JulyOctober 1966)ORGANIZATION(S)Div: of Research and Planning, Blue Cross

Association


Veney, James E., Ph.D.

STAPF

Full-time:

1 atatistician

Part-time:

1 sociologist

COST

Under $5,000


Blue Cross Association

PUBLICATION PLANS

Inquiry, a publication of BCAWinter 1967FOR FURTHER INFORMATION

James E. Veney, Ph.D., Dir., Div. of Researchand Planning, Blue Cross Assoc., 840 N.Lake Shore Dr., Chicago, Ill. 60611

147

i

E-30 A Guide for the Study of Perineal Mortality and Morbidity (5/12/66)ABSTRACTObjectives: To explore and define the problems

of perinatal morbidity and mortality in Brit-ish Columbia. With the problem defined, ef-forts will be made to improve the educationprocess for those whose responsibility in-cludes this area.

Content: The study will (1) establish inci-dence patterns of important disease entitiesand congenital anomalies, (2) act as an ad-visor and stimulation of group of health pro-fessionals and laymen in understanding theproblems of perinatal morbidity and mortal-ity, (3) assist the medical school and otherUniversity departments in filling gaps in theeducation of undergraduate students andpractitioners regarding perinatal morbidityand mortality, (4) act as a clearinghouse forinformation concerning current research andnew techniques of therapy and patient man-agement.

Methods: Collection of data by use of surveyform and questionnaires, personal inter-views, and lectures.

CURRENT STATUS(Sept. 1965-vnitinuing)

ORGANIZATION(S)College of Physicians and Surgeons of British

Columbia

PRINCIPAL INVESTIGATOR(S)Hardyment, A. F., M.D.STAFFFuU-time:None


COST$15,000424,999

FINANCING ORGANIZATION(S)Dept. of National Health and Welfare, Ottawa,

Canada

PUBLICATION PLANS

FOR FURTHER INFORMATIONA. F. Hardyment, M.D., Perinatal Morbidity

and Mortality Study of British Columbia,1807 West 10th Ave., Vancouver 9, B.C.,Canada

0

E-31 Evaluation of Disability and

ABSTRACTObjectives; (1) To assess th.: validity of de-

terminations regarding the disability and re-habilitation potential of applicants for OldAge and Survivors Insurance benefits ; and(2) to delineate the important sources oferrors in these determinations.

Content: In evaluating the potential of disabil-ity and rehabilitation, information about sev-eral factors characteristic of the individualare required. The five areas of evaluation in-cluded in this study are (1) social (includingeconomic), (2) medical, (3) psychological,(4) occupational, and (5) vocational. A panelrepresenting members of the clinical teammeets regularly to discuss evidence and find-ings of their evaluations and arrive at cer-tain assessments.

Methods: Evaluations are made on an inpa-tient basis in Ohio and an outpatient basis inLouisiana and Minnesota. Narrative reportsare submitted during the course of the studyby member3 of the clinical team in their re-spective areas. After research forms arecompleted they are prepared for data proc-essing, along with other forms including thefeed-back and follow-up information. A gen-eral follow-up is contemplated to study thestatus of all claimants participating in theevaluation.

CURRENT STATUSFinal stages of analysis and preparation of a

final report. (Jan. 1961-66)ORGANIZATION (S)Ohio State Univ., Columbus

Rehabilitation Potential (5/18/66)

Tulane Univ., New Orleans, La.Kenny Foundation, Minneapolis, Minn.

PRINCIPAL INVESTIGATOR(S)Nagi, Saad Z.

STAFFFull-time:3 psychologists1 registered nurse3 social workers, counselors3 sociologists1 statistician2 occupational therapists

Part-time:8 physicians2 registered nurses3 social workers, counselors2 occupational therapists

COST

$250,000 or more

FINANCING ORGANIZATION(S)Vocational Rehabilitation Administration,

Washington, D.C.

PUBLICATION PLANS

A monograph entitled Disability and Rehabili-tation: A Study in the Legal, Clinical andSelf DefinitionsEarly 1967


Saad Z. Nagi, Prof. of Sociology, The OhioState University, Columbus, 0. 43210

149

E-32 Elm Haven Concerted Services Health Project (!!5/66)ABSTRACT

Objectives: Evaluation of health experiences,attitudes and needs of the population of alow income public housing project and de-velopment of new programs, services andattitudes as a part of a "concerted" effortinvolving eight other types of social, educa-tional, vocational, etc., service.

Content: Public health nursing, medical, andhome health aide service together with ele-ments of fact finding, evaluation and com-munity organization for better health.

Methods: Survey, statistical compilation ofutilization of health services.

CURRENT STATUSActive. (Sept. 1964-67)

ORGANIZATION(S)New Haven Health Dept., New Haven, Conn.

PRINCIPAL INVESTIGATOR(S)Atwater, John B., M.D., Dr. P.H.STAFFFull-time:8 registered nursesPart-time:3 physiciansCOST

$150,000$199,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONJohn B. Atwater, M.D., Dir. of Health, New

Haven Health Dept., 161 Church St., NewHaven, Conn. 06608

E-33 Application of Program Budgeting and Cost Utility Analysis to a Hospital(1/9/66)

ABSTRACTObjectives: The principal objective of the

study is the problem of measuring and com-paring alternative resource a':, cations.

Content:

Methods: The study will seek to study theproblem of identifying objectives of the var-ious departments or programs of the hospi-tal; establish both empirical methods foridentifying the level of achievement andoperational criter:a for evaluating the levelof achievement and procedure to estimatethe probable effect of addition& or alterna-tive resource allocations.

CURRENT STATUSThe research design has been completed. Cur-

rently collecting data on hospital operation.(Dec. 1965Aug. 1966)

ORGANIZATION(S)Center for Research, College of Business Ad-

min., The Pennsylvania State Univ.

PRINCIPAL INVESTIGATOR(S)Rigby, Paul H.

STAFF


COST

Under $5,000


Pennsylvania State University

PUBLICATION PLANS


Paul H. Rigby, Dir., Center for Research, Col-lege of Business Admin., The PennsylvaniaState Univ., 229 Boucke Blvd., UniversityPark, Pa.

151

,_

E-34 Screening Elderly Nursing Home Patient Problems (12/8/65)ABSTRACTObjectives: To explore the -f35tRibi1ity nf Aevel.

oping a diagnostic interview for detectingsocial and personal problems and adjustmentpatterns of chronically ill elderly patientsprior to their admission to nursing homes.

Content: A fairly structured interview de-signed to predict social and personal prob-lems appears to be successful when adminis-tered by a highly skilled research-orientedsocial worker. The proposed project v ill aimat executing a detailed two-stage test of thereliability and validity of the developing di-agnostic interview among recently admitted,chronically ill elderly, under more severetest conditions (more patients in more di-verse homes, and interviewed by lesserskilled nursing home personnel).

Methods: Interviews will involve newly or re-cently admitted chronically ill elderly whoare communicative, in cooperating publicvoluntary and proprietary nursing homes inErie County.

CURRENT STATUSStudy in progress with staff employod and first

phase of klata collection now being completed.(Sept. 1965Aug. 1967)

152

ORGANIZATION(S)Research Foundation of State Univ. of N.Y.,

P.O. Box 7126, Albany, N.Y. 12224School of Social Welfare, State Univ. of N.Y.

at Buffalo

PRINCIPAL INVESTIGATOR(S)Fowler, Irving A., Ph.D.STAFFFull-time:1 social worker, counselor2 statisticiansPart-time:15 social workers, counselors1 sociologist

COST

$100,000$149,999


PUBY 1r TION PLANSNo plaii..,

FOR FURTHER INFORMATIONMarilyn J. Gibbin, Proj. Dir., Nursing Home

Research, 5409 Main St., Williamsville, N.Y.14221

_

E-35 Survey of Health Care Economics Research (3111166)

ABSTRACTObjectives: The purpose of the study is to de-

termine and evaluate the kinds and types ofdata currently available on the economics ofhealth care in relation to voluntary hospitals.

Content:

Methods: The study is developing a bibliogra-phy of pertinent materials on health careeconomics, as well as summarizing and eval-uating the literature, research reports andother existing relevant data.

CURRENT STATUSIn process of collecting materials. (Apr. 1965

Oct. 1966)

ORGANIZATION ( S )American Nurses' AssociationPRINCIPAL INVESTIGATOR(S)Stuckey, Ronald

STAFFFull-time:None

Part-time:1 statistician1 medical administrator

COST

FINANCING ORGANIZATION(S)American Nurses' Association



Ronald Stuckey, American Nurses' Associa-tion, 10 Columbus Circle, New York, N.Y.10019

153

E-36 Self Administration of Dental Caries Preventives (12/6/65)ABSTRACTObjectives: To test the effectiveness of self-

administration of a dental caries preventiveagent.

Content: Children, ages 6-12, will be dividedinto treatment and control groups on thebasis of dental age and past caries experi-ence. Initial and 6-months treatments willbe made. Initial plus yearly dental examina-tions will be made.

Methods: Children will be treated in groups bybrushing a known effective prophylaxis pasteon their teeth under supervision (5-minuteapplications). Specific brushing techniqueshad to be developed.

CURRENT STATUSPilot projects completed along with laboratory

data. Full scale studies being initiated. Ini-tial dental examinations completed on firststudies. Work started Sept. 1964; comple-tion date unknown.

ORGANIZATION(S)Dental Division, Indiana State Board of HealthSchool of Dentistry, Indiana Univ., 1211 W.

Michigan St., Indianapolis

154

PRINCIPAL INVESTIGATOR(S)Gish, Charles W.Muhler, JosephMercer, Victor

STAFFFull-time:

Part-time:3 dentists2 dental hygienists

COST

$15,000424,999


PUBLICATION PLANSJournal of American Dental Associationdate

unknown


Charles W. Gish, D.D.S., Dir., Div. of DentalHealth, Indiana State Board of Health, 1330W. Michigan St., Indianapolis, Ind. 46202

0E-37 Preparation of Case Studies on Administrative Processes in Medical Care

(5/17/66)ABSTRACTObjectives: Preparation for teaching purposes

of case studies on problems and processes inthe administration of medical care.

Content: Description of specific programs,problems, or situations in medical care.

Methods: Field studies and interviews, litera-ture search.

CURRENT STATUSCase studies entitled "Medical Care Planning

in a Small Urban Community," "The Closingof the Rip Van Winkle Clinic," and "A Hos-pital's Concern for Extended Care" havebeen completed. Several additional studiesare still in progress, including one entitled"Cooperative Planning for a New School ofNursing." (Feb. 1966-67)

ORGANIZATION(S)Dept. of Public Health Practice, School of Pub-

lic Health, Harvard Univ.PRINCIPAL INVESTIGATOR(S)Penchansky, Roy, D.B.A.

STAFFFull-time:

Part-time:2 economists2 medical care specialists1 physician2 technical writers

COST

$15,000$24,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONRoy Penchansky, D.B.A., Assist. Prof. of Ad-

min. in Medical Care, School of Public Health,Harvard Univ., 55 Shattuck St., Boston,Mass. 02115

155

E-38 Evaluation of Progressive Patient Care at McPherson Community HealthCenter, Howell, Michigan (5/4166)

ABSTRACTnhjectives: Tn gtiuly the IITIPoet af raorganiza_

tion of a community general hospital intothe five stages of Progressive Patient Care.

Content: Survey of management of planning,review of reactions of personnel, measuresof patient nursing need by nurse evaluationand record analysis, time of study of nurseactivities, step-down analysis of all hospitalcosts.

Methods:

CURRENT STATUSManuscript completed. The project was begun

July 1963. Publication of results by 1967 isanticipated.

ORGANIZATION (S)Bureau of Hospital Admin., Univ. of Mich.,

Ann ArborPRINCIPAL INVESTIGATOR(S)Griffith, John R.Weeks, Lewis E., Ph.D.

156

STAFFEL.11 -1'1,GGli-141av;

1 specialist incommunication

Part-time:1 accountant6 registered nurses1 hospital administrator

COST

$50,000$74,999


W. K. Kellogg Foundation, Battle Creek, Mich.

PUBLICATION PLANS

Unsettled-1967


John R. Griffith, Assoc. Prof., Bureau of Hos-pital Admin. 41 Business Admin. Building,Univ. of Mich., Ann Arbor, Mich. 48104

E-39 A Study of Patient Care Involving a Unit Dose System (12/20/65)

ABSTRACT

objectives: To determine the advantages anddisadvantages of a unit dose drug distribu-tion system.

Content: The study analyzes the following rel-evant factors involved in measuring the effi-ciency of a unit dose drug distribution sys-tem as opposed to a central pharmacy: (1)medical errors and discrepancies, (2) amountof nursing time released from medication ac-tivities, (3) amount of consultive activity ofthe pharmacist, (4) amount of lost revenuedue to missed charges, (5) floor-space re-quired, (6) costs of packaging medicine, (7)salary costs, (8) nature of patient record,and (9) educational aspects.

Methods: Data was collected from a decentral-ized unit dose substation serving 130 bedsand 4 wards of a selected hospital. The sub-station was operated for an 11-month period.

CURRENT STATUS

Work on the final report write-up is being con-ducted at the present time. (Jan. 1964Apr.1966)

ORGANIZATION(S)

College of Pharmacy, Univ. of IowaPharmacy Dept., Univ. Hospitals, College of

Medicine, Univ. of Iowa

PRINCIPAL INVESTIGATOR(S)Te,ster, William W.

STAFFFull-time:2 registered nurses6 pharmacists1 industrial engineerPart-time:1 physician1 psychologist1 registered nurse1 industrial engineer1 sociologist1 statistician2 pharmacistsCOST$250,000 or more


PUBLICATION PLANSA series of articles will be published in The

American Journal of Hospital Pharmacy,Aug. 1964, Oct. 1965, and periodically there-after

FOR FURTHER INFORMATIONWilliam W. Tester, Assoc. Prof., College of

Pharmacy, Univ. of Iowa, Iowa City, I. 52240

157

E-40 Some Economic Characteristics of Mortality in the United States : SomeAspects of the Contribution of the Health Industry to the Economy (1/19/66)ABSTRACTObjectives: To ascertain the relationship be-

tween inputs of productive factors in thehealth industry and environmental factorswith health as an output, as measured bymortality statistics.

Content: The study consists mainly of a singleequation multiple regr3ssion of mortalityagainst various measures of health industryinputs (physicians, nurses, and hospital fa-cilities) and of environmental factors. Fu-ture studies will be concerned with concep-tual problems in assessing the contributionof the health services to health and of healthto economy, in terms of productivity on thejob.

Methods: Information for the study is basedupon 1960 age-adjusted data for the 48States.

CURRENT STATUSThe first paper is being revised for comment

and oral presentation. The second is at anearlier stage. The project was begun in Sept.1964; no completion date has been set.

158

i

ORGANIZATION(S)National Bureau of Economic Research

PRINCIPAL INVESTIGATOR (S)Fuchs, Victor R.

STAII`Full-.one:NI iie


COST$10,000414,999

FINANCING ORGANaATION(S)The Ford Foundation, 477 Madison Ave., New

York, N.Y. 10022

PUBLICATION PLANSNo plans

FOR FURTHER INFORMATIONVictor R. Fuchs, Assoc. Dir. of Research, Na-

tional Bureau of Economics Research, 261Madison Ave., New York, N.Y. 10016

E.-41 Utilization of the American Hospital Formulary Service (12/1/65)ABSTRACT

Objectives: To measure the usefulness of theAmerican Hospital Formulary Service in theclinical setting; to note factors that mightincrease its effective utilization.

Content: Determination of those factors thatare important in the hospital professionals'selection of a printed reference source astheir primary reference source and determi-nation of their reasons for not using theAmerican Hospital Formulary Service.

Methods: Interviews in the clinical settingwere conducted with physicians, nurses,practical nurses, student nurses and studentpractical nurses.

CURRENT STATUS

Completed. (Jan.4uly 1966)

ORGANIZATION(S)

College of Pharmacy, Univ. of Minn.

PRINCIPAL INVESTIGATOR(S)Kabat, Hugh F.Seim, Harold C.

STAFFFull-time:


FINANCING ORGANIZATION(S)College of Pharmacy, Univ. of MinnesotaPUBLICATION PLANSAmer J. Hosp. Pharm.Feb.--March 1966FOR FURTHER INFORMATIONHugh F. Kabat, Assoc. Prof., College of Phar-

macy, Univ. of Minnesota, Minneapolis,Minn. 55455

4 59

E-42 A Pharmaceutical Procurement Program for Private Hospitals(12/1/65)

ABSTRACTObjectives: Determination of the feasibility of

a bid system of purchasing in private hos-pitals not utilizing a formulary system.

Content: A bid system of procurement was es-tablished for St. Joseph Hospital. Evaluationof the system was undertaken.

Methods: 198 pharmaceuticals constitutLig 8.5percent of the 2,400 items inventoried wereselected for bidding. Items selected had beenpurchased annually in a value exceeding $50if more than 600 doses were used or if valueexceeded $100.

CURRENT STATUSCompleted. (Nov. 1963-64)

ORGANIZATION(S)College of Pharmacy, Univ. of Minn.

PRINCIPAL INVESTIGATOR(S)Kabat, Hugh F.

160

Callahan, PatrickSTAFFFull-time:None


FINANCING ORGANIZATION(S)St. Joseph Hospital, 69 W. Exchange St., St.

Paul, Minn.

PUBLICATION PLANSAmer. J. Hosp. Pharm. 22:471-475 Aug. 1965

FOR FURTHER INFORMATIONHugh F. Kabat, Ph.D. Assoc. Prof, College of

Pharmacy, Univ. of Minn. Minneapolis, Minn.55455

o

,

E-43 A Study of the University of Minnesota Hospital Drug DistributionSystem (1211165)

A INTRACT

Objectives: Examination of the time intervalsbetween designation of the medication needsof a patient and ultimate administration ofthe first dose of the medication.

Content: The work flow of the pharmaey isirregular. Examination of each time intervalcan establish the place where drug ordersare being delayed.

Methods: Time stamps were used to clock alldrug orders at the time of writing, transcrip=tion, transñiisSlon to pharmacy, time iripharmacy; and arrival on the nursing unit;

CURRENT STATUSCompleted. (MaySept. 1964)ORGANIZATION(S)College of PhitrinicY,'UniV. of Minn.

PRIiiCIPAL 41IVESTi9ATOR(S)

,

Kabit, HUgliSchroeder, Roger D.

STAFFFull-time:

Part-time:2 pharmacists

COST

Urider $5,000

FINANCING ORGANIZATION(S)-

College Of Pharmacy, UniV:UOV. of Minn.; HO4Pital!3:

PUBLICATION PLANS

None


'

Hugh F. Kabat, Assoc. Prof.;,College of Phar-4macy, Univ. of Minn., Minneapolis, Minn.55455

let

E-44 Drug Information Needs in the Hospital Environment (12/1/65)

ABSTRACT

Obiectives: Determination of the types of druginformation most frequently required byphysicians and nurses.Determination of the relative importance ofcertain types of drug information by physi-cians and nurses.

Content: Establishment of the types of infor-mation most frequently needed will help hos-pital pharmacists to determine the basic in-formation about drugs that will be neededto establish a drug information center.

Methods: A comprehensive questionnaire wasused both on a mail basis and as an inter-view guide to a large sample of physiciansand nurses.

CURRENT STATUS

Completed. (Jan.Oct. 1965)

ORGANIZATION(S)

College of Pharmacy, Univ. of Minn.

162

PRINCIPAL INVESTIGATOR(S)Kabat, Hugh F.Benson, S. BruceSTAFFFull-time:


FINAN CING ORGANIZATION(S)College of Pharmacy, Univ. of Minn., Veterans

Admin. Hospital, Minneapolis, Minn.

PUBLICATION PLANSAmer. Hosp. Pharm.Fall 1966FOR FURTHER INFORMATIONHugh F. Kabat, Assoc. Prof., College of Phar-

macy, Univ. of Minn., Minneapolis, Minn.55455

E-45 Social Structure and Illness: A Sociological Study of Chronic Disease(5/4166)

ABSTRACTObjectives: To develop and test a theory to ex-

plain variations in death rates from chronicdisease.

Content: The development of the theory ofsocial stress ; tests of theory regardingchronic disease rates in the United States ;svmmary and conclusions.

Ids: Largely "demographic" in that onlyand vital statistics data were avail-

able.

CURRENT Si ATUSFinal chapter is in second draft. Monograph

will be submitted for publication soon.(1962-May 1966)

ORGANIZATION(S)Department of Sociology, Univ. of OregonPRINCIPAL INVESTIGATOR(S)Martin, Walter T.

Dodge, David L.

STAFF

Full-time:


COST

$5,000-$9,999


PUBLICATION PLANS

UnknownHopefully 1966


Walter T. Martin, Chairman, Dept. of Sociol-ogy, Univ. of Oregon, Eugene, Ore. 97403

163

E-46 A Socio-professional Characterization of the Prescription-CompoundingFunction (1/6/66)

ABSTRACTObjectives: To elucidate the nperntinnal char-

acter of the remaining compounding func-tion in prescription practice, and to make apreliminary study of the expressed attitudesand needs of community pharmacists towardthis function.

Content: Evolution of the compounding func-tion as part of the occupational role of phar-macists ; purposes and methodology; fre-quency and character of prescription tech-niques utilized and equipment needed; atti-tudes, values, and needs of community phar-macists centering about the compoundingfunction.

Methods: National sample of compounded pre-scriptions (collected 1964, Gosselin Associ-ates) evaluated on five selected variables,with frequency distributions established bycomputer; findings interpreted as occupa-tional function and placed in perspective ofavailable data from earlier periods. Inter-view schedule developed and applied in fieldto community pharmacists of one county(Dane, Wisconsin) ; tabulations by McBeesort supplement narrative discussion andinterpretation.

CURRENT STATUSMaster of science thesis being completed. (Jan.

1965-66)

164

ORGANIZATION(S)C1,1-...1 -.0 1M- -OLLUJUI r1141-111iilVt UMV. UI

WTV

PRINCIPAL INVESTIGATOR(S)Sonnedecker, GlennRivera-Gonzalez, Randolfo

STAFF

NLae

Part-time:2 medical care specialists

COST

$10,000-$14,999


American Foundation for Pharmaceutical Ed-ucation, Washington, D.C.

State Legislature of Wisconsin (through theGraduate School, Univ. of Wis.)



Glenn Sonnedecker, Ph. D., Prof., School ofPharmacy, Univ. of Wis., ".4adison, Wis.53706

E-47 Model Stocks of Prescription Drugs (1/3/66)ABSTRACTObjectives: This project will attempt to de-

velop model stocks for the largest selling ormost often prescribed drugs in several typesof pharmacy operations.

Content: The economk objective of any phar-macy is to sustain itself and to make someprofit over and above all costs. Its social ob-jective is to protect public health and tooffer its services on a least cost basis. Oneway in which both of these are achieved isto exercise good buying practises and inven-tory controls to reduce inventory to a mini-mum effective stock in units and dollars. Thequestion is, what col ,titutes acceptablestock models for efficient management andoperation?

Methods: Analysis of purchases, purchasedates, inventory records, prescription rec-ords, and other pertinent and available in-formation will attempt to quantify data forstudy in community, hospital and institu-tional pharmacies. Models developed will belimited to the fastest moving prescriptiondrugs. Said models should allow determina-tion of proper order quantities, order times,average investments, etc. in the manage-ment of drug operations.

CURRENT STATUSData collected, being analyzed and organized.

Ph.D. dissertation. (Jan. 1964Aug. 1966)

ORGANIZATION(S)Dept. of Pharma& Adnth., S^Ihonl of Phar=

macy and Pharmacal Sciences, Purdue Univ.PRINCIPAL INVESTIGATOR(S)Evanson, Robert V.Rodowskas, Christopher A.STAFF

1 pharmacal * economistPart-time:1 pharmacal * economistCOSTUnder $5,000

FINANCING ORGANIZATION(S)American Foundation for Pharmaceutical Edu-

cation (Fellowship Funds), 777-14th St.,N.W., Washington, D.C. 20005

PUBLICATION PLANSJournal of Pharmaceutical Sciences of the

APhA. Date unknownFOR FURTHER INFORMATIONRobert V. Evanson, Head, Dept. of Pharmacy

Adrnin., School of Pharmacy and PharmacalSciences, Purdue Univ., Lafayette, Ind.47907*The area of Pharmacy Administration is categorized

by special subject areas within its instructional andresearch objectives as economics, management andmarketing.

165

E-48 Studies of Decision Making on Early Retirement

ABSTRACT

Objectives: A study of the decision when toretire, as affected by health, job, and eco-nomic and other considerations. It combinesa national sample with a special study ofUAW members 58-61 years old.

Content: A study of retirement planning ofthose not retired, of retrospective :nforma-tion from those already retired, and a screen-ing plus follow-up of UAW members makinga decision whether or not to take advantageof a special early retirement supplement.

Methods: A national cross section survey plusa screening and follow-up interview with aparticularly interesting group of UAWworkers.

CURRENT STATUS

Development of instruments. (Nov. 1965-67)

ORGANIZATION (S )

Survey Research Center, Univ. of Mich., AnnArbor

166

PRINCIPAL INVESTIGATOR(S)Katona, GeorgeMorgan, JamesSonquist, JohnSTAFFFull-time:

Part-time:

COST$200,000-$249,999

FINANCING ORGANIZATION(S)Social Security Administration, Washington,

D.C.

PUBLICATION PLANSMonograph by Survey Research Centerearly

1968

FOR FURTHER INFORMATIONGeorge Katona, Survey Research Center, Univ.

of Mich., Ann Arbor, Mich. 48106

E-49 The Effect of Managerial Controls on Hospital Costs (217166)ABSTRACT

Objectives: To study the effect of managerialpolicies and practices on hospital costs andefficiency.

Content:

Methods: Data have been obtained from theAmerican Hospital Association's Manage-ment Review Program and from the Hospi-tal Activities Study. The sample consists of350 short-term general nonfederal hospi-tals.

CURRENT STATUSInitial analysis is underway. (Jan. 1966-June

1967)

ORGANIZATION(S)American Hospital Association,Center for Health Admin. Studies, Graduate

School of Business, Univ. of Chicago

PRINCIPAL INVESTIGATOR(S)Neuhauser, Duncan

STAFFFull-time:1 tusr4.e.etron. ....11......!...:~.1..,../..."a aruoatIVO0 42U1111111bLIQUW

(organization theory)

Part-time:None

COST

$10,000-$14,999

FINANCING ORGANIZATION(S)University of ChicagoAmerican Hospital Association

PUBLICATION PLANS


Duncan Neuhauser, Res. Assoc., Center forHealth Admin. Studies, Graduate School ofBusiness, Univ. of Chicago, Chicago, Ill. 60601

167

E-50 An Evaluation of a Foster Grandparent Program (5/2/66)

ABSTRACTObjectives: To evaluate a foster grandparent

program in a school for retarded children.Content: Evaluation of the impact of the pro-

gram on (1) the children served, (2) olderpersons working as foster grandparents, (3)the institution in which the program exists.

Methods: Testing of children and foster grand-parents; interviews with foster grandparentsand staff of institution.

CURRENT STATUSData collecting in process. (Feb. 1966-67)

ORGANIZATION( S)Dept. of Economics and Sociology, North Texas

State Univ.PRINCIPAL INVESTIGATOR(S)Friedsam, H. J.Dick, H. R.

168

STAFFFull-time:


COST$25,000-$34,999

FINANCING ORGANIZATION(S)Office of Economic Opportunity, Washington,

D.C.

PUBLICATION PLANSNot definite

FOR FURTHER INFORMATIONHiram J. Friedsam, Dir., Dept. of Economics

and Sociology, North Texas State Univ.,Denton, Texas 79605

E-51 The Adjustments Necessary in Small Hospitals and. NursingAccounting Systems under Medicare (5/6/66)

ABSTRACTObjectives: To determine the extent of change

necessary since the passage of Medicare ofaccounting systems in small hospitals andnursing homes.

Content :

Methods: Private research without financialhelp from collegepersonal contact with dif-ferent hospitals in area as well as librarymaterial.

CURRENT STATUSResearching problem. (Feb.Sept. 1966)ORGANIZATION (S)Texas Technological College, Lubbock

PRINCIPAL INVESTIGATOR(S)Roberts, Arthur T., Ph.D.

STAFFFull-time:

Part-time:1 accountant

COSTUnder $5,000


Homes

PUBLICATION PLANSHope to publish in Journal

FOR FURTHER INFORMATIONArthur T. Roberts, Ph. D., Prof. of Accounting,

Texas Technological College, Lubbock, Texas79406

169

E-52 Demonstration of a State Information System for Health FacilitiesPlanning (2/1/ 66)

AIZTRACTObjectives: To develop, test, and refine a com-

puter-based system for collection and dis-semination of information pertinent to thedevelopment of planning for better coordina-tion of health facilities.

Content: The project will first determine whatdata should be collected. Then, the followingaspects will be developed, tested, and evalu-ated: (1) reports for State, regional, andarea planning, and institutions operations,(2) basic structures of the three computerfiles (institutions file, geographic file, andstandards file), (3) procedures for data proc-essing and computer programming. Patientcase abstracts from inpatient institutionswill then be collected for a period to be de-fined and the cost to the institutions of pro-viding data to the project will be determined.

Methods: The project will work in collabora-tion with physicians, health facility admin-istrators, health planners, government agen-cies, and others to develop the proceduresnecessary to meet the expressed needs ofthose using the collected data.

CURRENT STATUSStaff in process of recruitment, committees in

process of formation, discussions with usersnow underway to determine specific tasks to

170

be done. (July 1965-1967 with revision to12/31/67 likely)

ORGANIZATION(S)Bureau of Hospitals, California Dept. of Public

Health

PRINCIPAL INVESTIGATOR(S)Derry, John R.

STAFF

1 city planner1 hospital administrator1 medical record librarian

Part-time:



PUBLICATION PLANSTo be determined, interim.reports are likely

FOR FURTHER INFORMATIONJerome W. Lubin, Bureau of Hospitals, Califor-

nia Dept. of Public Health, 2151 BerkeleyWay, Berkeley, Calif. 94704

E-53 A University's Responsibility to Community Hospitals (5111/66)ABSTRACTObjectivect: T^ /late:n*14' if a university, par-

ticularly its school of medicine and teachinghospital, has any responsibility to commu-nity hospitals and, if so, how to exercise thatresponsibility.

Content: The development of a multidisciplineconsulting team.

Methods: Offering consultation services to com-munity hospitals in a wide variety of sub-jects and evaluating the need for suchstudies, the method to be used in conductingthem and the improvement gained by them.

CURRENT STATUSNearing termination. (Apr. 1963-Mar. 1966)

ORGANIZATION (S)School of Medicine, University of North Caro-

lina

PRINCIPAL INVESTIGATOR(S)Cadmus, Robert R., M.D.STAFFFull-time:2 hospital administrators

1 architect.

1 demographerPart-time:2 physicians1 registered nurse1 socielogist1 architect1 medical technologist

COST$150,000-$199,999


PUBLICATION PLANS"How a University Helps Smaller Hospitals,"

The Modern Hospital, Vol. 103, No. 6Dec.1964

"A Teaching Hospital's Responsibility to Com-munity Hospitals," Journal of Medical Edu-cation (in print)

.

FOR FURTHER INFORMATIONRobert R. Cadmus, M.D., Chairman, Dept. of

Hospital Admin., School of Medicine, Univ.of North Carolina, Chapel Hill, N.C. 27514

171

( )F. Productivity of Health Services

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on produc-tivity: D-9, D-11 ; D-12; D-19; E-7; E-33; H-53; 1-45.

Biodental Engineering

ABSTRACTObjectives: To lpply research and design in

the area of biodental engineering for thepurpose of increasing the efficiency and pro-ductivity of the practicing dentist and toproduce a plan for added patient comfort.

Content: The dental operatory and related lab-oratories will be studied from a human-fac-tors point of view so as to specify an opti-mum operatory space layout for the dentistworking with auxillary personnel. Concur-rent with the study will be the design ofdental equipment in an attempt to optimizethe dental unit through factors involvingminiaturization, efficiency, reliability, andcost to the dentist. Ultimately, a model oper-atory will be produced, and specifications forthis model will be circulated to dental stu-dents and practicing dentists so that newoffices may be planned on a sound basis andthat present facilities may be reexamined.

Methods: The services of a design engineer,dentist, psychologist, research engineer, ar-chitect, and architectural designer will beutilized for the various aspects of the project.

CURRENT STATUSDesign and construction of dental unit, design

of chair, design of experimental modularoperatories. (July 1965-67)

Research Project (6/20/66)

ORGANIZATION(S)Tufts University

PRINCIPAL INVESTIGATOR(S)Hill, Percy H.Calisti, Louis J. P., D.D.S.

STAFFFull-time:

Part-time:1 design engineer1 dentist1 psychologist1 research engineer1 architect1 architectural designer

COST

$75,000$99,999


PUBLICATION PLANS


Prof. Percy H. Hill, Tufts Univ., Medford,Mass. 02155

1

F-2 The Allocation of Medical and Pharmaceutical Research among Diseases(4/27/66)

ABSTRACTObjectives: To construct an optimizing solu-

tion to the problem of the allocation amongdiseases of scarce resources for medical andpharmaceutical research.

Content: The basic hypothesis is that re-sources probably should not 'be allocatedequally among diseases and that a solutionfor optimizing the allocation can be con-structed. The project will consist of (1) theconstruction of an optimal rule of researchresources among diseases, (2) the plugginginto the rule of the relevant numbers for dif-ferent diseases, (3) the derivation from theforegoing of the optimal allocational resultswith assumed expenditure constraints, e

(4) an examination of the allocational prac-tices of the medical and pharmaceutical re-search institutions to attempt to concludewhether they have been consistent with theoptimizing rules.

Methods: The project will examine variousparamenters of disease including incidence,age-sex composition of population contract-ing it, duration of illness, death and recoveryrates, the intensity (cost) of treatment, theextent to which it produces externalities(whether and how contagious), and the costof acquiring increments of knowledge per-

mitting more efficient therapy and a higherincidence of cure.

CURRENT STATUS(MayDec. 1966)

ORGANIZATION(S)Duke University

PRINCIPAL INVESTIGATOR(S)Rottenberg, Simon



COSTUnder $5,000

FINANCING ORGANIZATION(S)Social Science Research Council, New York,

N.Y.

PUBLICATION PLANS

FOR FURTHER INFORMATIONSimon Rottenberg, Professor, Dept. of Eco-

nomics, Duke Univ., Durham, N.C. 27706

F-3 Health Maintenance Study of a Selected(1/18/66)

ABSTRACTObjectives: To determine the efficacy of pre-

ventive medicine for the elderly by estab-lishing a periodic health appraisal, and todetermine the predictive value of these pro-cedures for rate of survival.

Content: The study group are 200 tenants ofYork House, an apartment house designed tomeet the needs of elderly residents, 62 yearsof age or older. These subjects will receivean intensive medical study each year for fiveyears beginning in 1963. A control group of200 community elderly of comparable age,socioeconomic status and ethnic grouping,have received a similar comprehensive studyin 1963 and will again in 1967.

Methods: A complete physical examination willbe done including a rectal examination. Alsoincluded is a special cardiopulmonary exami-nation which includes chest photofluorogramand electrocardiogram. Laboratory tests willinclude blood urea nitrogen, blood sugar, he-matocrit, urine-protein and microscopic bloodcholesterol, sedimentation rate, and specialstudies will be done for ocuiar tension, visionand hearing. All data secured on each studysubject is being recorded on code sheets inpreparation for statistical analysis on Rem-ington Rand computers.

CURRENT STATUSThird year of project has been completed.

(Feb. 1963-67)

Group of Older People

ORGANT7 ATTAN(Q)

Philadelphia Geriatric InstitutePRINCIPAL INVESTIGATOR (S)Yaffe, Silvia F.Ward, Morton, M.D.STAFFFull-time:None

Part-time:4 medical care specialists6 physicians1 psychologist2 registered nurses1 statistician1 otologist1 bio-chemist

COST$50,000-$74,999

FINANCING ORGANIZATION(S)Benjamin Rosenthal Foundation, 350 Fifth

Ave., New York, N.Y.Philadelphia Geriatric Institute

PUBLICATION PLANSNot definite at this time

FOR FURTHER INFORMATIONSilvia F. Yaffe, Dir., Philadelphia Geriatric In-

stitute, 5301 Old York Road, Philadelphia,Pa. 19141

177

F-4 Economic Efficiency of Medical Services Market (5/13/66)ABSTRACTObjectives: To analyze the economic efficiency

of the markets comprising the medical serv-ices hylustry.

Content: The project will seek to analyze mar-ket behavior of consumers, physicians andhospitals, and will subsequently attempt torelate these in some meaningful way whichwill facilitate the understanding of the com-plexity of economic arrangements that havebeen developed in this industry.

Methods: The study is primarily exploratoryand a number of aspects will be dealt within an analytic rather than empirical way.

CURRENT STATUSStudy began Sept. 1966.

ORGANIZATION(S)Dept. of Economics, Harvard University

178

PRINCIPAL INVESTIGATOR(S)Stevens, Carl M., Ph.D.STAPF

1 economist

Part-time :None

COST

FINANCING ORGANIZATION(S)USPIIS


FOR FURTHER INFORMATIONCarl 1VI, Stevens, Ph. D., Reed College, Port-

land, Cregon 97202

F 5 The Service Manager System:

ABSTRACTObjectives: To provide to nursing units a self-

sufficient service organization responsible forhousekeeping, dietary and clerical functions.

Content: This research project will reveal themechanics of the Service Manager by meansof activity analysis and measure improve-ments in patient care which may result fromservice management of the nursing unit.

Methods: The housekeeping, dietary, and cleri-cal functions will no longer be performed bythe nurse. Housekeepers and maintenancemen will be transferred from the hospital-wide housekeeping and maintenance depart-ments to perform these functions. Activityand analysis will compare the new system ofservice management with the traditionalmanagement.

CURRENT STATUSMeasuring instrument for activities on the

nursing units fully developed and in use.Measuring instruments for patient welfarein use but undergoing steady development.Cost studies to begin January 1967, or ear-lier (June 1965-May 1967)

ORGANIZATION(S)Patient Services, Barnes Hospital Medical Cen-

ter, Barnes Hospital Plaza, St. Louis, Mo.63110

Nurse Efficacy and Cost (8/17/66)

Institute of Technology, St. Louis Univ. P.O.Box 8020, College Station, St. Louis, Mo.63156

PRINCIPAL INVESTIGATOR(S)McKenna, Joseph V.

STAFFFull-time:

Part-time:4 registered nurses3 industrial engineers

COST

$100,000-$149,999


PUBLICATION PLANSBrodt, D. E., "Innovation for Nursing and

Health Organizations: The Service Man-ager," Hospital Progress, Sept. 1966


Joseph V. McKenna, Patient Services, BarnesHospital Medical Center, Barnes HospitalPlaza, St. Louis, Mo. 63110

179

F-6 Application of Automatic Data Processing Equipment to the ControlRestricted Drugs in the Hospital (12/1/65)

ABSTRACTObjectives: Reduce manhours involved in rec-

ordkeeping for narcotics, barbiturates andother dangerous drugs in the hospital.

Content: Development of a system to controlall dangerous drugs by a perpetual inventorycontrol utilizing automatic data processing.

Methods: Presently available equipment wasutilized. A system for automatic data proc-essing using coded cards was implemented,evaluated and modified.

CUMENT STATUSCompleted. (Mar. 1961June 1962)ORGANIZATION (S)College of Pharmacy, University of Minnesota

PRINCIPAL INVESTIGATOR(S)Kabat, Hugh F.Richards, Charles F.

180

STAFFif'ull-time:

of


FINANCING ORGANIZATION(S)College of Pharmacy, University of MinnesotaVeterans Admin. Hospital, Minneapolis, Minn.PUBLICATION PLANSAmer. J. Hosp. Pharm. 21:377-379 (Aug.)

1964

FOR FURTHER INFORMATIONHugh F. Kabat, Associate Professor, College of

Pharmacy, Univ. of Minn., Minneapolis,Minn. 55455

_

,

U

F-7 Manpower Study of Quarantine Inspector PositionsABSTRACTObjectives: To determine the work load meas-

urement standards for Quarantine Inspec-4,......sAnm

Content: This is a study of the work activitiesof a Quarantine 7.nspector with an attemptto identify constants which will permit thedevelopment of measurable standards.

Methods: (1) Comparative evaluations, (2)mathematical models, (3) descriptive sum-maries, (4) direct inspection.

CURRCNT STATUSOngoing. (May 1965Sept. 1966)

ORGANIZATION (S )Division of Foreign Quarantine, U.S. Public

Health ServiceBureau of the Budget, Executive Office of the

President

PRINCIPAL INVESTIGATOR(S)Thellwell, RaymondRobinson, NormaILthenbuhler, ErvinKeeny, Roy

141M,....

(I/19/66)Reider, FredSpangler, Huston, M.D., M.P.H.STAFFFull-time:

Part-time:1 economist2 mathematicians2 medical care specialists1 physician1 statistician2 quarantine specialistsCOST

$5,000$9,999



FOR FURTHER INFORMATIONHuston K. Spangler, M.D., Div. of Foreign

Quarantine, U.S. Public Health Service, East-ern Ave., Silver Spring, Md. 20910

181

F-8 Medical Staff Organization and Hospital Performance (117166)ABSTRACTObjectives: To study medical staff organiza-

tion in general hospitals, with respect to theimpact of different patterns on the hospital'soverall program of patient-care (inpatientand outpatient), professional education, med-ical research, and preventive or communityservice.

Content : All hospital functions bearing a prox-imate relationship to the actions of doctorswill be studied. These findings will be relatedto those of associated studies, including (1)surveys of contractual physicians in a na-tional sample of general hospitals and theirrelationships to hospital services and facili-ties, and (2) comparative accounts of medi-cal staffing patterns and associated featuresof hospitals in Europe and America. Fromthis combination of data, conclusions will bedrawn on the influence of medical staff pat-terns on the hospital's scope of service andgeneral performance.

Methods: A series of twelve general hospitalsin Southern California has been selectedalong a scale of medical staff structuring:high, moderate, and low. Data is being gath-ered on the formal and informal dynamics ofthe medicp1 staff, and the listed elements ofhospital performance. The data will form thebasis of the study.

182

CURRENT STATUSData collection completed and analysis under-

way, (Time 961-3/in)% 1967)

ORGANIZATION(S)School of Public Health, University of Cali-

fornia, L.A.

PRINCIPAL INVESTIGATOR(S)Roemer, Milton I.

STAFFFull-time:1 medical care specialist1 sociologist


COST8200,600$249,999


PUBLICATION PLANS

Book-1967, perhaps


Carl E. Hopkins, Prof. of Public Health, Schoolof Public Health, Univ. of Calif., Los An-geles, Calif. 90024

F-9 Studies in Mental Health Care (5/24/66)

ABSTRACTObjectives: To investigate the rates of return

to mental hospitals of patients receiving dif-ferent types of care in the community witha view of developing greater hospital-com-munity coordination.

Content : The return of 6,200 patients to fourhospitals in a 12-month period will be ana-lyzed in relation to the following communitycare patterns: 1) mental health clinic, 2)other agencies, i.e., family service, welfare,public health, 3) nursing home, 4) familycare, 5) no community care.

Methods: Return rates will be developed forthe following intervals of time that the pa-tient remained in the community: one week,2-3 weeks, one month, two months, 3-5months, 6-11 months, and 12 or moremonths. Sex differences and differences be-tween hospitals will be analyzed.

CURRENT STATUSData analysis. (Jan. 1965Oct. 1966)ORGANIZATION(S)Bureau of Psychological Services, DePaul Uni-

versity


Zolik, Edwin S., Ph.D.

STAFFFull-time:

Part-time:1 psychologist1 sociologist1 statistician

COST

$10,000$14,999

FINANCING ORGANIZATION(S)USPHSDePaul University

PUBLICATION PLANSCommunity Mental Health Journal-1967

FOR FURTHER INFORMATIONEdwin S. Zolik, Ph.D., Chairman, Dept. of

Psychology, DePaul Univ., 25 E. JacksonBlvd., Chicago, Ill. 60604

183

alo,

G. Supply of Hea'th Services

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on supply :D-10 ; D-35; D-37 ; H-49 ; 1-26 ; 1-33.

/6(V/185

G-1 An Economic Analysis of the Factors Affecting the Supply of Physicians(3/16/66)

ABSTRACT

Objectives: To examine possible explanationsfor the decreasing number of physicians de-spite the increasing income of medical doc-tors.

Content: The study will first examine the fol-lowing aspects of the cost of physicians'training: (1) comparison of the direct costsof medical education with the direct costs ofother graduate education, (2) comparison ofthe rate of return on investment in trainingto become a physician with the rate of re-turn in comparable professions, and (3) an-alysis of the sources of financing to meet thecosts of training. In addition, the study willexamine the adequacy of capacity of medicalschools, their faculty supply, operational ex-penses, funds for expansion, and will exam-ine the quality of applicants to determinewhether it is rising or falling.

Methods: Data for the project will be obtainedfrom various sources and will subsequentlybe analyzed for the desired information.

CURRENT STATUS

ORGANIZATION(S)Economics Dept., Boston College

PRINCIPAL INVESTIGATOR(S)Esposito, LouisSTAFFFull-time:1 economistPart-time:NoneCOSTUnder $5,000FINANCING ORGANIZATION(S)Boston CollegePUBLICATION PLANS

FOR FURTHER INFORMATIONProf. H. Michael Mann, Dept. of Economics,

Boston College, Chestnut Hill, Mass. 02167

/1087

G-2 Study of Home Nursing Services in California (12/13/65)

ABSTRACT

Objectives: To obtain uniform descriptive dataon patients served by as many home nursingprograms in California as possible, and toattempt the expansion and improvement ofhome nursing care services by using the as-sembled data as a guideline.

Content: The study describes the patients re-ceiving home nursing care in California andmeasures the amount of service the patientsare receiving. xs. determination is beinL madeof the type of diseases for which this sarviceis being given and the kinds of care received,as well as physician estimates of the numberof hospital or nursing home days savedthrough the use of home nursing programs.An evaluation is being obtained from partici-pating agencies of patients' conditions upondischarge in relation to the amount of nurs-ing care given, and an evaluation is beingmade of the use of, or need for, supplemen-tal personnel in home nursing programs.

Methods: All local health departments withhome nursing programs and all VisitingNurse Associations are contacted and askedto participate in this study. Each participat-ing agency completes two forms, an admis-sion form and a discharge form, on each pa-tient. These forms contain all questions rele-vant to the study, and the informationderived from them will be tabulated andanalyzed at the end of the study.

188

CURRENT STATUSApproximately 40 percent of data collected.

(Sept. 1965unknown)

ORGANIZATION(S)Calif. State Dept. of Public Health

PRINCIPAL INVESTIGATOR(S)Lillick, Lois C., M.D.Gilchrist, Sarah, R.N.

STAFFFull-time:None

Part-time:1. physician2 registered nurses2 statisticians

COST$5,000$9,999


PUBLICATION PLANSPublic health and nursing journals


Lois C. Lillick, M.D., Public Health MedicalOfficer III, Bureau of Chronic Diseases, Calif.State Dept. of Public Health, 2151 BerkeleyWay, Berkeley, Calif. 94704

G-3 Canadian Dental Students' Register (12/8165)

ABSTRACTObjectives: To make a comprehensive annual

report ^T. n4-. A *WS 4. POItetAG1/0 in CanadiaVII U11 n dentalschools.

Content: The study determines, annually, vari-ous characteristics of the Canadian dentalstudent population, including the following:(1) numbers of male and female undergrad-uates, graduates, and post-graduate studentsand dental hygiene students, (2) capacity ofclasses, (3) attrition of students by cause,(4) predental education and residential dis-tribution of students with ratios to totalpopulation, and (5) education costs.

Methods: Information for the project is beingobtained by correspondence with the deansof Canadian dental schools. For Canadianstudents in the United States, data is beingobtained from the American Dental Asso-ciation.

CURRENT STATUS1965-66 report will be completed early 1966

(annual). Data collection started with the1944-45 term.

ORGANIZATION(S)Canadian Dental Association

PRINCIPAL INVESTIGATOR(S)Brown, B. Isabel (Mrs.)STAFFFull-time:None


COSTUnder $5,000


PUBLICATION PLANSJournal of the Canadian Dental Association

Spring 1966

FOR FURTHER INFORMATIONMrs. B. Isabel Brown, Dir., Bur; of Economic

Research, Canadian Dental Association, 234St. George St., Toronto 5, Ontario, Canada

189

G-4 Applicants and Applications to Canadian Dental Schools (12/8/65)ABSTRACTObjectives: To report, annually, the number

and status of applications to Canadian den-tal schools.

Content: The project makes a yearly report,for Canadian dental schools, of the numberof applicants and applications by school, byresidence, by status of application, and bynumber of applications submitted. Also in-cluded will be reports of the number of qual-ified applicants not accepted by any Cana-dian school and the ratios of applicants touniversity-aged population and availablespaces.

Methods: The data for the study is collectedfrom questionnaires completed annually bythe admissions committee of each Canadiandental school and containing information asto the home address of and admission statusaccorded to applicants.

CURRENT STATUS1965 report to be completed early in 1966.

Data collection started in 1961.

190

ORGANIZATION(S)Canadian Dental AssociationPRINCIPAL INVESTIGATOR(S)r),........%, 1:3 T-,1.-....1 /1UT-1- %.1.0.1. V YV Ilp 1.). IZ4IJC1 .1.YLI b.)

STAFFFull-time:None


COSTUnder $5,000


PUBLICATION PLANSMimeograph of the Canadian Dental Associa-

tionSpring 1966FOR FURTHER INFORMATIONMrs. B. Isabel Brown, Dir., Bur. of Economic

Research, Canadian Dental Association, 234St. George St., Toronto 5, Ontario, Canada

G-5 Dental Personnel in Canada (12/8/65)

ABSTRACTObjectives: To report the annual number and

geographic distribution of dentists in Can-ada.

Content: The project determines, annually,various characteristics of Canadian dentists,including the following : (1) numbers of maleand female dentists by province, (2) num-bers of deaths, retirements, relocations, andadditions, (3) population per dentist ratios,(4) number of dental specialists, (5) num-ber of practicing dental hygienists, and (6)number of dentists in health services andFederal Government departments.

Methods: Information is being obtained byquestionnaires completed by provincial den-tal registrars, provincial dental directors,dental schools, Federal Government depart-ments, etc.

CURRENT STATUS1965 report to be compiled early in 1966. Data

collection started in 1943.ORGANIZATION(S)Canadian Dental Association


Brown, B. Isabel (Mrs.)

ST AFF

Full-time:None


COST

Under $5,006


PUBLICATION PLANS

Journal of the Canadian Dental AssociationSummer 1966


Mrs. B. Isabel Brown, Dir., Bur. of EconomicResearch, Canadian Dental Association, 234St. George St., Toronto 5, Ontario, Canada

191

G-6 Treatment Facilities for Emotionally Disturbed Children (515!66)

ABSTRACTObjectives: To determine the nature and quan-

tity of treatment resources for emotionallydisturbed children existing in AlleghenyCounty.

Content: Information collected on the follow-ing organizational characteristics: structure,personnel, budgets, type of p.1..' served,type of service rendered. le. , treat-ment, agency relationships aiik. `:,;,-,rne.

Alethods: Mail survey of all t,- .14 1,- -talent re-

sources was conducted, including agenciesand private practitioners.

CURRENT STATUSData being processed. (Aug. 1965-Nov. 1966)ORGANIZA TION ( S)Health and Welfare Association of Allegheny

County

PRINCIPAL INVESTIGATOR(S)Janavitz, Mary B.Hummer, Paul A.

192

STAFFFull-tinie:

Nolle

Part-time:1 psychologist1 sociologist1 social worker

COST

$15,000$24,999


Health and Welfare Association of AlleghenyCounty

PUBLICATION PLANS

HWA publicationDec. 1966

FOR FURTHER INFORMATIONMary 13. Janavitz, Health and Welfare Associ-

ation of Allegheny County, 200 Ross St.,Pittsburgh, Pa. 15219

G-7 R-(esources)-U-(se)-N-(eed) for Health Services 'n(1/21/66)

ABSTRACTObjectives: Fully identify health services: (1)

resources, (2) use by New Mexicans, and(3) needs. Convert data to total and yearlyinvestments. Establish relationships to na-tional patterns.

Content : Complete description of mources(with some allusion to out-of-State type) ;

county and State use of resources; rounddollar costs or public and private invest-ments per year; geographic-ecologic-eco-nomic correlations of use, and estimates ofunmet needs.

Methods: Inventory of official public voluntaryscientific or charitable, non-profit, proprie-tary, and private resources and their experi-ence ratings ; analysis of data; identificationof significant elements; summary of generalsituation.

CURRENT STATUSAbout 40 percent complete. (Oct. 1965Apr.

1966)

ORGANIZATION(S)New Mexico Dept. of Public HealthPRINCIPAL INVESTIGATOR(S)Atkins, Walter D., D.D.S., M.P.H.

STAFF

Full- f.ime:

None

Part-time:1 accountant2 medical care specialists20 physicians1 psychologist5 registered nurses1 social worker, counselor3 statisticians3 dentists

New Mexico

COST

Under $5,000


From organizational budget

PUBLICATION PLANS

Not determined as yet


Dr. Walter D. Atkins, Dep. Dir., New MexicoDept. of Public Health, 408 Galisteo St.,Santa Fe, N.M. 87501

193

G-8 Medical Care Resources and Utilization Research Project (8/1/66)ABSTRACTObjectives: To develop information about med-

ical care resources and utilization on whichto base State and local planning aimed atcoordinating, extending, and improving thePublic Assistance Medical Care and MedicalAssistance for the Aged programs.

Content: In a more general design the projectwill provide (1) community profiles of medi-cal care resources available to public as-sistance recipients, (2) a description of thecharacteristics of recipients, (3) measure-ments of the volume of utilization of varioustypes of medical care by public assistancerecipients and the means of payment forsuch care, and (4) identification of factorsrelated to utilization on an assessment oftheir relative importance.

Methods: The Utilization Research Project isdirected by the California State Departmentof Soth.I Welfare Research Units, estab-lished in two project counties, are under thedirection of a State-employed Project Di-rector who has overall responsibility for theconduct of the project and coordination ofthe project units.

CURRENT STATUSThe project is currently unaerway in both Los

Angeles and Alameda Counties. (Aug. 1964June 1967)

ORGANIZATION ( S)Research and Statistics Division, California

State Dept. of Social Welfare

194

Los Angeles County Bureau of Public Assist-ance, 5555 Ferguson Drive, City of Com-merce, Calif.

Alameda County Welfare Dept., 401 Broad-way, Oakland, Calif.

PRINCIPAL INVESTIGATOR(S)Wood, Ralph B.Dowd, Ronald P.Macduff, Susan

STAFFFull-time:2 medical care specialists1 sociologist

Part-time:None

COST

$100,000$149,999


California State Dept. of Social Welfare

PUBLICATION PLANSTo be published by the California State De-

partment of Social Welfare June 1967


Ralph B. Wood, Proj. Dir., Research and Sta-tistics Div., California State Dept. of SocialWelfare, 2415 First Ave., Sacramento, Calif.95818

G-9 Measuring the Effect of Health Services on Communities (5/12166)ABSTRACT

Objectives: To collect information on the fol-lowing: (1) available resources (excludinzthe private sector) for the medical care ofthe indigent ; (2) costs of medical servicesto Ministries of Health and Social SecurityInstitutions ; (3) utilization of services.

Content: This survey is a national enterprisecarried out with international assistance.The 10 Latin American countries participat-ing are Brazil, Chile, Costa Rica, Colombia,El Salvador, Honduras, Mexico, Panama,Peru, and Venezuela. The survey will alsodetermine the population entitled to receivemedical care both in Social Security Institu-tions and in institutions under the juris-diction of the Ministries of Health in theabove countries.

Methods: The study will survey the abovecountries on certain general information tomake a preliminary txploration at the be-ginning of the survey. At a later date opera-tional research will be undertaken to includepopulation coverage, use and accessibility ofservices, and cost of different types of medi-cal care.

!

CURRENT STATUSProject in preparationnot yet begun.11111(2ANI7ATIAN(S)

Pan American Health Organization, Washing-ton, D.C.

PRINCIPAL INVESTIGATOR(S)Ruderman, A. P., Ph.D.STAFFFull-time:

Part-time:

COST

FINANCING ORGANIZATION (S)

PUBLICATION PLANS

FOR FURTHER INFORMATIONDr. A. P. Ruderman, Economic Adviser, Pan

American Health Organization, Washington,D.C. 20037

195

G-10 Characteristics of Physicians Engaged in Private Practice in aNeighborhood of New York City (515166)

ABSTRACT

Objectives: To obtain information from physi-cians in private practice regarding theirpractices, experiences with chronic patients,and opinions about coronary artery disease.

Content: For a specific, delineated city neigh-borhood, the study analyses the follovvingpertinent information from the physicians:(1) type and characteristics of medical prac-tice including hospital admitting privilegesand case load of some common chronic dis-eases ; (2) experiences with the diagnosisand treatment of chronic coronary arterydisease; (3) opinions and recommendationswith respect to diet, exercise, smoking, andthe use of anticoagulants ; and (4) an esti-mation of the current use of, and need for,laboratory and other services.

Methods: The Washington Heignts HealthDistrict of New York City was selected asthe study area. About 270,000 persons, witha high proportion of elderly persons, are lo-cated in the area. Information was gatheredby interviewing the physicians practicing inthe area.

CURRENT STATUS

Field work completed ; analysis in progress ;one paper published in 1966. (1961-1966)

196

AD11 A 7aTr7 A nnird-tivr 'els.VAV1711.1111411.1 AMIN flk 0/

Div. of Epidemiology, Columbia Univ. Schoolof Public Health and Admin. Medicine

Health Research Training Program, New YorkCity Dept. of Health

PRINCIPAL INVESTIGATOR(S)Schweitzer, Morton D., Ph.D.Gearing, Frances R., M.D.STAFFFull-time:

Part-time:2 physicians1 epidemiologist

COST$25,000$34,999


PUBLICATION PLANSAmerican Journal of Public HealthApril

1966

FOR FURTHER INFORMATIONMorton D. Schweitzer, Ph.D., Assoc. Prof. of

Epidemiology, Columbia Univ. School of Pub-lic Health and Admin. Medicine, 600 West168th St., New York, N.Y. 10032

1

1

i

G-11 Medical and Hospital Services in Southern Illinois

ABSTRACTObjectives: To indicate private physician and

general services available in 31 southernIllinois counties and further services neededto meet adequate standards.

Content: The survey is a complete enumera-tion of present personnel and facilitiesavailable.

Methods: Data were obtained from the Ameri-can Medical Association Directory and fromthe Directory of the American Hospital As-sociation, supplemented by a short question-naire answered by hospital administrators.

CURRENT STATUS(1962July 1965)

ORGANIZATION(S)Div. of Area Services of Southern Ill. Univ.PRINCIPAL INVESTIGATOR(S)Lively, C. E., Ph.D.

Wake ley, Ray E., Ph.D.Kellerman, BertSTAFF

Full-time:

Part-time:

COST

(8/17/65)

FINANCING ORGANIZATION(S)Southern Illinois University, Carbondale, Illi-

nois

PUBLICATION PLANS

FOR FURTHER INFORMATIONC. E. Lively, Ph,D., Div. of Area Services,

Southern Ill. Univ., Carbondale, Ill. 62901

197

G-12 Distribution of Home States ofLocation of Optometry

ABSTRAC,'

Objectives: To determine optimum location ofnew schools of optometry.

Content: Review of studies of optometric man-power needs; analysis of methods for mak-ing more qualified students availabt, forcareers in optometry.

Methods: Determination of ratios of optome-try students to the State, considering factorsof population; percent of high school gradu-ates entering college ; location of existingschools, etc. Using statistical means.

CURRENT STATUS

Data accumulation. (Sept. 1965-66)

ORGANIZATION (S)

College of Optometry, Pacific University

PRINCIPAL INVESTIGATOR(S)Baldwin, William R.

Optometry Students and Its Relation toSchools (11/26165)

STAFFFull-time:

Part-time:1 optometristCOSTUnder $5,000

FINANCING ORGANIZATION(S)Committee on New Academic Facilities, Amer-

ican Optometec Assoc., 7000 Chippewa St.,St. Louis Mo. 63119

PUBLICATION PLANSJournal of the American Optometric Associa-

tionEarly 1967FOR FURTHER INFORMATIONWilliam R. Baldwin, Ph.D., Dean, College of

Optometry, Pacific University, Forest Grove,Ore. 9711

G-13 A Program for Research in Hospital Manpower Problems (2/18/66)ABSTRACT STAFFObjectives: To review current research in hos- Flal_time:

pital manpower ; to determine areas whereadditional research is needed ; and to deter-mine the advisability of establishing a pro- Part-time:gram of hospital manpower research in theIndustrial Relations Section of PrincetonUniversity.

Content :

Methods:

CURRENT STATUS(Jan.Mar. 1966)ORGANIZATION (S)Industrial Relations Section, Princeton

versity

PRINCIPAL INVESTIGATOR(S)Somers, Anne R.

Uni-

COST

Under $5,000


PUBLICATION PLANS


Mrs. Anne R. Somers, Res. Assoc., IndustrialRelations Section, Princeton University, P.O.Box 248, Princeton, N.J. 08540

199

G-14 Western New York Inventory of Community Health Services forCardiovascular Disease (11 18/66)

ABSTRACT

Objectives: To initiate an inventory of com-munity health services concerned with car-diovascular disease and to aid in measuringthe long-range effects of Federal expendituresfor the development of new services.

Content: The study will: (1) devise a compre-hensive lit,t of ongoing community servicesconcerned with the nrevention and manage-ment of cardiovascular disease, (2) ascer-tain which types of information describingthese services could be obtained on local,State, and national levels through mailedself-administered questionnaires, (3) deter-mine the comparability of information ob-tained from a wide range of sources bymailed questionnaires with that obtained byinterview methods, and (4) develop, for thepurpose of local, State, and national surveys,a list of official and voluntary agencies pro-viding these services.

Methods: The area to be surveyed includes the7 counties of western New York. The staffwill develop a list of services appropriate toa predetermined list of diagnostic categoriesand compile a list of agencies, both officialand voluntary, which provide these services.The latter data will be collected by mail sur-vey and interview.

CURRENT STATUS

Preparation and pretest of interview question-:mire. (Mc. 1965-66)

200

ORGANIZATION(S)School of Medicine, State University of New

York at BuffaloBureau of Heart Disease, New York State

Dept. of Health, AlbanyBuffalo Regional Office, New York State Dept.

of Health, BuffaloUSPHS

PRINCIPAL INVESTIGATOR (S)Hiss, J. G., Fred, M.D.STAFFFull-time:None

Part-time:4 physicians1 statistician1 epidemiologistCOST

$5,000$9,999

FINANCING ORG.,__NIZATION(S)Bureau of Heart Disease, Div. of Chronic Dis-

ease Services, State of New York Dept. ofHealth, Albany

PUBLICATION PLANS

FOR FURTHER INFORMATIONJ. G. Fred Hiss, M D, Dir., Bureau of Heart

Dise2se, Div. of Chronic Disease Services,New York State Dept. of Health, Albany,New York

's

k

G-15 State Plan for Hospital and Medical Facilities Construction (1/14/66)ABSTRACT

Objectives: Detern-ane patterns of medical careand priority of needs for construction ofmedical facilities.

Content: Describes total hospital beds, utiliza-tion and project's needs by geographic areain Montana.

Methods: Field investigations and question-naires.

CURRENT STATUSIn preparation : continuous process.

ORGANiZATION(S)

Montana State Board of Health

PRINCIPAL INVESTIGATOR(S)Munzenrider, Robert J.

STAFFFull-time:

Part-time:1 architectCOSTUnder $5,000



FOR FURTHER INFORMATIONRobert J. Munzenrider, Dir., Div. of Hospital

Facilities, Montana State Board of Health,Cogswell Building, Helena, Mont. 59601

201

G-16 Inventory of Positions in Medical Care Administration and PotentialPersonnel Requirements, Los Angeles, and United States (8/26/66)

ABSTRACT

Objectives: Health-related agencies in Los An-geles area are being surveyed to develop aninventory of present positions in medicalcare administration, anticipated futureneeds, and specifics of the training requiredfor such positions. Projection to nationalneeds will be attempted.

Content:

Methods:

CURRENT STATUSData collection partially completed. (JuneDec.

1966)

ORGANIZATION(S)Div. of Medical and Hospital Admin., School

of Public Health, Univ. of Calif., L.A.PRINCIPAL INVESTIGATOR(S)Roemer, Milton I.

202

Dubois, DonaldKorney, Betty Jo

STAFFFull-time:None


COST

Under $5,000


PUBLICATION PLANS

FOR FURTHER INFORMATIONMilton I. Roemer, M.D., School of Public

Health, University of California, Los An-geles, Calif. 90024

(

i

G-17 1966 Inventory of Professional Registered NursesABSTRAf :TObjectives: To provide data on the numbers

and characteristics of professional nurseshaving current licenses to practice in theU.S.

Content: Study will show the numbers ofnurses employed and not employed in nurs-ing in each State and the U.S. as a wholeand their age group, marital status, sex,field of employment, type of position, educa-tional preparation and areas of clinicalpractice.

Methods: Questionnaires are completed byeach nurse as part of her license applicationform or as a separate survey qv estionnaire.These are collected in a central location andcollated. Duplicates are eliminated and eachnurse is assigned to the actual State in whichlocated.

CURRENT STATUSCollecting questionnaires. (July 19613-Oct.

1967)

ORGANIZATION(S)American Nurses' Association

PRINCIPAL INVESTIGATOR(S )Marshall, Eleanor D. (Mrs.)Moses, RvelynSTAFFFull-time:None

12.

Part-time:2 statisticians1 statistical supervisor

COST

$100,000-$149,999

FINANCING ORGANIZATION(S)USPHSAmerican Nurses' Associatio,

PUBLICATION PLANSFacts About Nursing, ANA-1968 editionSeparate reportearly 1968FOR FURTHER INFORMATIONMrs. Eleanor D. Marshall, American Nurses'

Association, 10 Columbus Circle, New York,N.Y. 10019

203

G-18 Services for Blind Persons in the Greater Peoria Area, April 1965(12/9/65)

ABSTRACTObjectives: To assess health, welfare, educa-

tion, recreation, and rehabilitation servicesof the TRI-COUNTY AREA available toblind persons, and their utilization by blindpersons for the purpose of projecting futurecommunity planning on behalf of blind andvisually impaired persons.

Content : Specific subject areas include factsabout the blind population, se-Mces for chil-dren, vocational rehabilitation, rehabilitationcenters, workshops, home teaching, mobility,social casework, blind assistance, mentalhealth services, social group work, recrea-tion, volunteer services, and library services.The report covers current uses of these serv-ices and recommendations for the future.

Methods: QuesJonnaires were used for gather-ing detailed data on the known blind popula-tion, followed by interviews of over 100persons by the survey team. Persons inter-viewed included Federal, State and local per-sons in agencies and organizations, membersof the organized blind groups and local inter-ested citizens. A community survey commit-tee of 22 persons was established by theCommunity Council for the survey team towork with.

CURRENT STATUSCompleted. (Sept. 1964Apr. 1965)

ORGANIZATION (S)American Foundation for the Blind

204

PRINCIPAL INVESTIGATOR(S)Fitzgerald, H. K., D.S.W.Eisenberg, ArthurLevin, MorrisMoor, Pauline M.School, Geraldine T., Ph.D.Voorhees, Arthur L.STAFF

Part-time:1 psychologist2 social workers, counselors1 vocational rehabilitation

worker2 educatorsCOST$15,000$24,999

FINANCING ORGANIZATION(S)American Foundation for the BlindCommunity Council of Peoria, 509 West High

St., Peoria, M.PUBLICATION PLANSA report published by American Foundation

for the Blind is currently available, $1.00 percopy

FOR FURTHER INFORMATIONDr. H. Kenneth Fitzgerald, American Founda-

tion for the Blind, 15 West 16th St., NewYork, N.Y. 10011

G-4 9 Mental Health Manpower Study (12/7/65)

ABSTRACTObjc-ctives: To present information and data

relevant to the alleviation of manpowershortage in all areas of the mental healthfield, with particular emphasis on psychia-try, psychology, psychiatric social work, andpsychiatric nursing.

Contents: Volume I. Annotated Bibliography,Discussion of Conceptual Approaches, Sum-mary of Techniques Employed, Current Re-search, Results of Survey among CaliforniaPsychiatrists. Volume II. Background Paperson Education, Rer ujtment, Utilization, Fi-nancing, Tec' Jgy, Community HealthCenters. Origi_ I articles by individualsprominent in the field of mental health. Re-sults of survey of training directors in psy-chiatry, current bibliography, and otherpapers.

Methods: Survey of literature, correspondencewith individuals and organizations, surveys.

CURRENT STATUSVol. I now in process of publication (Apr.-Sept.

1964) ;Vol. II nearing completion (Sept. 1964-Spring 1966).

ORGANIZATION(S)Bur. of Research and Planning, California

Medical Assoc., 693 Sutter St., San Fran-cisco, Calif. 94102

PRINCIPAL INVESTIGATOR (S)Klutch, MurrayCallahan, PatriciaWood, DonaldJones, MichaelSTAFFFull-time:2 psychologistsPart-time:1 psychologist1 sociologist1 statisticianCOST$50,000-$74,999


PUBLICATION PLANSCalifornia State Dept. of Mental Hygiene-

1966 for both publications

FOR FURTHER INFORMATIONRalph Littlestone, Chief of Planning, Cali-

fornia State Dept. of Mental Hygiene, 1500Fifth St., Sacramento, Calif. 95818

205

G-20 An Economic Research Program in Health (1/18/66)

ABSTRACTObjectives: To undertake studies on the supply

and demand for medical care and its com-ponents, to study the structure and perform-ance of the medical care markets, and toinvestigate the effect of health on economicdevelopment.

Content:

Methods:

CURRENT STATUSSince the grant for this Economic Research

Program was just received, we are in theprocess of developing a series of studies andhiring several research assistants to aid intheir completion. (Jan. 1966Dec. 1968)

ORGANIZATION(S)Program in Hospital Admin., School of Busi-

ness, Univ. of Michigan

206

PRINCIPAL INVESTIGATOR(S)Feldstein, Paul J.

STAFFFull-time:

Part-time:

COST$100,000$149,999


USPHSg

PUBLICATION PLANS


Paul J. Feldstein, Asst. Prof., Program in Hos-

pital Admin., School of Business, Univ. of

Mich., Ann Arbor, Mich. 48104

G-21 A Study to Assess the Present and Future Adequacies of Personal andEnvironmental Health Services for Salt Lake County, Utah (1/10/66)

ABSTRACTObjectives: To assess the present and future

adequacies of personj and environmentalhealth services in Salt Lake County.

Content:

Methods: Community self study and citizensgroup,.

CURRENT STATUS(Apr. 1965Mad. 1966)

ORGANIZATION(S)Bureau of Economic and Business Research,

College of Business, University of UtahCommunity Services Council, 72 West Second

So., Salt Lake City, UtahPRINCIPAL INVESTIGATCR(S)Stewart, William M.Ward, Robert

4

STAFF

1 economist

Part-time:

COST

$15,000$24,999


PUBLICATION PLANSApril 1966


William M. Stewart, Proj. Coord., Bur. of Eco-nomic and Business Research, College ofBusiness, Univ. of Utah, Salt Lake City,Utah

207

G-22 A Nursing Home Survey of New Orleans 1965. Facilities and Personnel12/6/65)(

ABSTRACT

Objectives: To enumerate the type of organi-zation of State Division of Hospital Ap-proved Nursing homes in New Orleans,Louisiana ; their objectives as stated by Di-rector of nursing home ; personnel and serv-ices available to patients in nursing homes.

Content: 39 nursing homes in Greater NewOrleans were contacted. The objectives ofthe survey were accomplished in as com-plete form as possible. Cooperation was ob-tained from all persons contacted.

Methods: A 135-item questionnaire was de-vised and used to record the interview withthe nursing home administrator which oc-curred in the home. Interviewing was doneby both investigators, as were data coding,analysis and summary.

CURRENT STATUSCompleted with preliminary summary written.

(JulySept. 1965)ORGANIZATION(S)Section of Chronic Disease, Gerontology and

Medical Care, Div. of Public Health Admin.,Tulane University School of Medicine

208

PRINCIPAL INVENTITI ATOR(C)

Barbaccia, Joseph C., M.D., M.P.H.Schlorff, Velma

STAFF

Full-time:

Part-time:

COST

Under $5,000


PUBLICATION PLANS


Joseph C. Barbaccia, M.D., Assist. Prof., Pub-lic Health Administration, Tulane Univ.School of Medicine, Dept. of Tropical Medi-cine and Public Health, 1430 Tulane Ave.,New Orleans, La. 70112

G-23 Availability and Distribution of Physicians' Services id North Carolina(1122/66)

ABSTRACTObjectives: To discover determinants of physi-

cian distribution.Content: A determination of correlation be-

tween certain demographic and social vari-ables of population of North Carolinacounties and the ratio of physicians (andcertain specialties) to population in thesecounties.

Methods: (1) Rankorder correlations, (2)analysis of coyariance, utilizing U.S. Censusand American Medical Association data.

CURRENT STATUSAlmost completed. (July 1965Mar. 1966)ORGANIZATION ( S)Department of Preventive Medicine, University

of North Carolina

PRINCIPAL INVESTIGATOR(S)Huntley, R. R., M.D.Hogan, Michael

STAFF

Full-time:None

Part-time:ysician

1 statistician

COST

Under $5,000

FINANCING ORGANIZATION(S)General institutional research support

PUBLICATION PLANSJanuary 1967


Robert R. Huntley, M.D., Assist. Prof., Dept.of Preventive Medicine, Univ. of North Caro-line, Chapel Hill, N.C. 27514

209

G-24 Incidence of Hospitalization by Cause (5/23/66)

ABSTRACTObjectives: To present, through a continuing

study of a selected population, periodic rec-ords of changes in annual incidence rates ofhospitalization according to sex, age, andcause of hospitalization for surgical and non-surgical admissions.

Content: Quarterly tabulations showing an-nual admission rates of inpatient hospitaliza-tion, per 1,000 employees of the MetropolitanLife Insurance Company who are coveredunder the Company's Group ComprehensiveMedical Expense Plan.

Methods: Claim records of inpatient hospi-talizations are assembled for quarterly pe-riods, accumulated to obtain year-to-datetotals, and traced three months beyond theend of period. Study is based on episodes ofhospitalization. Hospitalization for samecause, occurring less than three montlis fromend of previous period of hospitalization, isconsidered a continuation of prior episode.

CURRENT STATUSStudy is now in its second year and it is antici-

pated that it will be continued indefinitely.(Jan. 1965continuing)

210

ORGANIZATION(S)Metropolitan Life Insurance Co.

PRINCIPAL INVESTIGATOR (S)Eide, K. Arne

STAFFFull-time:None

Part-time:2 statisticians

COST

";.NANCING ORGANIZATION(S)

PUBLICATION PLANS

The Statistical Bulletin, Metropolitan Life In-surance Co.currently in publication, con-tinuing


K. Arne Eide, Stat. Assoc., Metropolitan Lifeifls. CO., 1 Madison Avenue, New York, N.Y.10010

t\ )

o

0

H. Demand for Health Services Morbidity and Mortality

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on demandsmorbiditymortality ; A-6; D-16; D-22; D-26; D-27; E-2; E-45;G-2 ; G-8 ; G-12 ; G-15 ; G-20; 1-5 ; 1-49 ; L-15.

211

irC

....1.*OrmolgOIM

4:2VN

H-1 Cohort Analysis of Admissions to Stockton State Hospital for Fiscal Year1955-56 (7/16/65)

ABSTRACTObjectives: To describe a patient population

entering a State hospital and rates of releasefrom hospital.

Content : The entire admission population forone year (2,206 patients) was categorizedaccording to several demographic variablessuch as sex, legal class, prior hospitalization,etc.

Methods: Hospitalization status for each sub-ject was determined at several points oftime up to three years following admission.

CURRENT STATUS(Feb. 1964Aug, 1965)

ORGANIZATION(S)Research Department Stockton State HospitalPRINCIPAL INVESTIGATOR(S)Griswold, Robert L.

STAFFFull-time:

Part-time:

COST.6

FINANCING ORGANIZATION(S)California Dept. of Mental Hygiene

PUBLICATION PLANS


Robert L. Griswold, Research Dept., StocktonState Hospital, 510 East Magnolia St., Stock-ton, Calif. 95202

/47213

H-2 Racial Identity as a Factor in Mental Illness (1/4/66)

ABSTRACTObjectives: To determine whether a relation-

ship exists between the Negro's identifica-ti^n with his own Paid other racial groups,and mental illness.

Content: The study attempts to identify anypossible relationships which may exist be-tween psychiatric problems in Negroes andthe sociological identification problems whichNegroes may possess with regard to theirown and other races.

Methods: Data for the study was collectedfrom person-to-person interviews with 2,912Philadelphia Negroes, composed of repre-sentative samples cf both the normal popu-lation and the psychiatrically diagnosedmentally ill.

CUREENT STATUS(Nov. 1964Dee. 1966)

ORGANIZATION(S)Temple University

214

PRINCIPAL INVESTIGATOR(S)Kleiner, Robert J., Ph.D.Parker, Seymour, Ph.D.

STAFFFull-tiin,).:

Part-tir,e:

COSTUnder $5,000


PUBLICATION PLANS

FOR FURTHER INFORMATIONRobert J. Kleiner, Ph.D., Temple University,

Broad and Montgomery, Philadelphia, Pa.19122

11-3 Morbidity Among a Sample ofExpenditures of the Families in Public

ABSTRACTObjectives: (1) To continue previous study of

apparent morbidity among the populationduring a period of 1964; (2) the expenditureof the families in professional payments,laboratory examinations and drugs.

Content: Studies among the family's members,the level of education, occupational status,relationship with some of the different socialsecurity systems, the medical benefits ex-pected and received during their sickness, theexpenditure made for them in public andprivate Medical Service.

Methods: Survey of the families of the sample.CURRENT STATUSPunch card is finished. In state of projecting

the plan of tabulation and analysis. (Sept.1964Mar. 1967)

ORGANIZATION(S)Departmento de Salud det Cotegio Medico, Cen-

tro de Estudios Sociales de la Facultad deEconomia de la Universidad de Chile, GayN°2360, Santiago

the Population of Great Santiago andor Private Medical Services (3/7/66)

PRINCIPAL INVESTIGATOR(S)Perez, salvsidnr niaz

STAFFFIAll-time:None

Part-time:1 economist1 medical care specialist1 sociologist

COST

Under $5,000


Departmento de Salud del Colegio Medico,

PUBLICATION PLANS


Salvador Diaz Perez, Director de Hospital, De-partamento de Salud del Colegio Medico, Es-meralda N°571, 4°Piso, Santiago, Chile

215

11-4 The Erie County Survey of Long-term Childhood Illness (1/18/66)ABSTRACT

Objectives: To provide the statistical informa-tion necessary to plan for the forthcomingexpansion of the Medical Rehabilitation Pro-gram of the State of New York to includechildren with long-term medical conditionsnot included previously under existing pro-grams.

Content: In this study, the following determi-nations will be made: (1) the number ofcases of each long-term illness diagnosed peryear, (2) the number of cases of each long-term illness present in the community at apoint in time, (3) the associated mortality,(4) impact of each disease on the child, fam-ily, and community, and (5) epidemiologicalrelationships of disease to variables such asage, sex, race, and socio-economic factors.

Methods: Involved in the study will be all chil-dren under 16 years of age in Erie County.Case findings will include hospital records,physicians' records, death certificates, andschool exclusions.

CURRENT STATUSData collection is complete. Analysis of the

data and publishing of the findings are inprogress. (June 1962-66)

ORGANIZATION ( S)Medical School, State University of New York

at Buffalo

216


Sultz, Harry A., D.D.S., M.P.H.

STAFFFull-time:None

Part-time:1 physician1 social worker, counselor1 sociologist1 statistician1 epidemiologist

COST

$100,000$149,999


State of New York Department of Health

PUBLICATION PLANS

American Journal of Public Health, The ErieCounty Survey of Long-Term Childhood Ill-ness: 1. MethodologyJuly 1966


Harry A. Sultz, D.D.S., Clinical Assoc. Prof.,Dept. of Preventive Medicine, School of Med-icine, State University of New York at Buf-falo, Capen Hall Buffalo, N.Y. 14214

(

U

H-5 Post-Hospital Experience of Long-term Patients (12/6/65)ABSTRACT

Objectives: To obtain and examine data on se-lected aspects of experience of patients re-cently discharged from a State-owned hospi-tal for active treatment of chronic non-men-tal diseases.

Content: An exploratory study of post-hospitalcareers of personsresidents of metropoli-tan Bostonwho several months prior tothe start of the investigation had receivedin-patient care in the Lemuel Shattuck Hos-pital in Boston, Massachusetts. Post-hospitalexperience of these former patients is sur-veyed in terms of certain social phenomenarather than in terms of clinical events assuch. Descriptive information is collected (a)on such patient characteristics as age, sex,broad diagnostic category, length of hospitalstay, marital status, religion, ethnic back-ground, and type of residential environment,and (b) on such aspects of post-hospital ex-perience as residential or institutional set-ting, changes of setting, types of healthservices received, degree of self-care andambulation capacity.

Methods: Data for the various parts of thestudy are derived from records, questionnaireadministered to a high-percentage sample offormer patients, and, for one part of thestudy concerned with a small group of se-lected cases, from interviews with membersof hospital staff and with patients. In addi-tion to certain substantive findings in thelittle-documented area of non-clinical post-hospital events, the study also hopes to iden-tify some questions pertinent to the organ-ization of locally available chronic disease

care and amenable to further, more system-atic investigation.

CURRENT STATUSData collected, most of the processing com-

pleted, descriptive analysis underway. (19631966)

ORGANIZATION(S)Massachusetts Health Research Institute, Inc.,

8 Ashburton Pl., BostonMassachusetts Dept. of Public HealthBureau of Chronic Disease Control, Massachu-

settsPRINCIPAL INVESTIGATOR(S)Phillips, Harry T., M.D. D.P.H.Vlasak, George J., Ph.D.STAFFFull-time:1 sociologist

Part-time:1 physician1 sociologist1 statisticianCOST

$15,000$24,999


PUBLICATION PLANSPlans not definite as yetFOR FURTHER INFORMATIONDr. George J. Vlasak, Post-Hospital Experience

Study, R. 1110 No., Lemuel Shattuck Hospi-tal Building, 170 Morton St., Boston, Mass.02130

217

11-6 Brown University Health Study of Older Persons (5113/66)

ABSTRACTObjectives: Longitudinal study of a Probability

sample of older couples in Providence, RhodeIsland. Study of the changing relationshipsbetween health status and practices and so-cioeconomic, demographic, and social partici-pation.

Content: Extensive information on above itemsobtained from panel (originally 605 couples)in three rounds of field interviewing.

Methods: Field survey.

CURRENT STATUSCompletion of third round of interviews ; an-

alysis underway. (1961-1969)

ORGANIZATION(S)Population Studies and Training Center, Dept.

of Sociology and Anthropology, Brown Uni-versity

PRINCIPAL INVESTIG ATOR (S)Burnight, Robert G.Martel, Martin U.

218

STAFFFull-time:1 sociologist1 computer programmer

Part-time:1 physician3 sociologists

COST$200,000$249,999

FINANCING ORGANIZATION(S)National Institute of Child Health and Human

Development, Bethesda, Md. 20014

PUBLICATION PLANSArticles in various journalscurrentlyMonograph, publisher unknown-1969

FOR FURTHER INFORMATIONRobert G. Burnight, Prof. of Sociology, Dept.

of Sociology and Anthropology, Brown Univ.,Providence, R.I. 02912

( )

01

H-7 Parameters of Demand for PhysiciansABSTRACTlbjectives: To obtain determinants of demand

for physicians.Content: Multiple regression analysis of phy-

sician man-hours consumed as a function ofpopulation characteristics: a disaggregatedstudy by separate procedures and specialties,and in contrasting organization settings.

Methods:

CURRENT STATUSWorking on conceptual model (June 1966-69)ORGANIZATION(S)Div. of Medical and Hospital Admin., School of

Public Health, Univ. of Calif., L.A. 90024PRINCIPAL INVESTIGATOR(S)Roemer, Milton I.Kisch, Arnold I.

(8/26/66)STAFFFull-time:1 economist

Part-time:1 economist2 medical care specialists1 statistician

COST

$150,000$199,999

FINANCING ORGANIZATION(S)Ford Foundation (pend-Mg)

PUBLICATION PLANS


Milton I. Roemer, School of Public Health, Univ.of Calif., Los Angeles, Calif. 90.024

219

11-8 The Relationship of Environmental Factor to the Type and Frequencyof Cancer Causing Death in Women (Catholic Nuns) (12/1/65)

ABSTRACTObjectiveg: To qtlidy the relationship of envi-

ronmental factors to the type and frequencyof cancer causing death in Catholic nuns dur-ing the calendar year 1964.

Content: Compiling and computerizing vitalrecords of 110,000 of 180,000 Catholic nunsin United States. Studying and recording thecause of death of this fully controlled groupfor year 1964, with emphasis on type andsite of cancer.

Methods: All information is forwarded to theHealth Secretary of the Conference of MajorReligious Superiors in Washington, D.C., bothon living and deceased. Three medical reportson deceased: (1) copy of certificate of death,(2) medical report for hospital or physician,(3) medical history report from Superior ofcommunity aided by 800 members of Catho-lic Physicians Guild.

CURRENT STATUS75 percent completed. (Sept. 1964Mar. 1966)ORGANIZATION(S)Committee on Medical Care of Clergy and Re-

ligious, Univ. of Dayton

220

Research Department, Univ. of Dayton

PRINCIPAL INVESTIGATOR(S)Fecher, Con J., Ph.D.Nix, James T., M.D., Ph. D.

STAFF

Full-time:1 statistician


COST

$35,000$49,999


American Cancer Society, New York, N.Y.

PUBLICATION PLANS


Con J. Fechei, Ph.D., Co-Investigator, Com-mittee on Medical Care of Clergy and Reli-gious, University of Dayton, Dayton, 0.45409

c

II-9 Morbidity Survey of Members of Catholic Sisterhoods (5/6/66)

ABSTRACT

Objectives: Scientific studies of occupation hab-its and environment have shown that indi-viduals and groups can acquire predisposi-tion to some diseases and resistance toothers. Catholic religious orders for womenembrace the life of celibacy ; cigarette smok-ing is prohibited to members and alcoholicconsumption is limited. This morbidity sur-vey is to determine the above influence ifany and compare these data with that ofother white females.

Content: The survey covers a period of fiveyears, 1961 to 1965, containing a living pop-ulation of sisters aggregating 45,000.

Methods: Medical Identification Card : To pro-vide information on immunization, dietaryrestrictions, drug sensitivity and othermedical findings. These measures are to beperformed either by the community in-firmarian or doctor, annually, at periodicintervals, or when necessary.

Record of Recent Illness : This will provide acontinuous record of current disabilities (typeof disease, injury, symptom or reason) clas-sified according to acute or chronic chrono-logically recorded with respect to severity,duration, and result.

i

CURRENT STATUSCompleted medical identifications are being re-

turned to principal investigator for process-ing. (Jan. 1961-1966)

ORGANIZATION(S)

PRINCIPAL INVESTIGATOR (8)Fecher, Con J., Ph.D.STAFFFull-time:

Part-time:10 physicians15 registered nursesCOSTUnder $5,000

FINANCING ORGANIZATION(S)Research Department, University of DaytonPUBLICATION PLANSLinacre Quarterly and other medical journals

after January 1967FOR FURTHER INFORMATIONCon J. Fecher, Ph. D., Prof. of Economics, Univ.

of Dayton, Dayton, Ohio 45409

221

II-10 Assessing the Need for Psychiatric Care; a Review of the Validity ofEpidemiologic Surveys

ABSTRACTObjectives: Review of criteria for assessing

needs for psychiatric care.Content: Review of literature.Methods:

CURRENT STATUSCompleted. The project was begun in 1964.

ORGANIZATION(S)Dept. of Psychiatry, University of British Co-

lumbia

PRINCIPAL INVESTIGATOR(S)Richman, Alex, M.D., M.P.H.

STAFFFull-time:

222

Part-time:

COST


Canada

PUBLICATION PLANSCanadian Psychiatric Association Journal

June 1966British Journal of PsychiatryJune 1966FOR FURTHER INFORMATIONAlex Richman, M.D., Head, Section of Social

Psychiatry, Dept. of Psychiatry, Univ. ofBritish Columbia, Faculty of Medicine Bldg.,10th Ave. and Heather St., Vancouver 9,B.C., Canada

H-11 Morbidity Statistics of the British Columbia GovernmentMedical Services (21.14166)

ABSTRACTObjectives: Report prepared annually settinct

forth the year's experience with regard tomembership served (age and sex) ; volume,costs, and type of service; diagnoses of ill-ness; medical specialties.

Content: Rendering service; number and costof various types of operations, etc. Member-ship in the plan averages about 50,000.

Methods: Data from claim forms submitted byphysicians is transferred to punch cards andanalyzed mechanically.

CURRENT STATUS(1965continuing)

ORGANIZATION(S)Div. of Vital Statistics, Health Br., Dept. of

Health Services and Hospital Ins., BritishColumbia, Canada

PRINCIPAL INVESTIGATOR(S)Watts, IC. H.

STAFFPa 111,..f4444 aVVVV-Vg/ III",

None

Part-time:1 statistician

Employees'

COST

Under $5,000


British Columbia Government

PUBLICATION PLANS


Leonard W. Hole, Senior Research Officer, Div.of Vital Statistics, Health Br., Dept. ofHealth Services and Hospital Insurance, Par-liament Buildings, Victoria, B.0 , Canada

223

11-12 Design a Study To Allow Optimum Utilization of Nursing Homes forPatient Care Needs (6/30/66)

ABSTRACT

Objectives: To arrange for the necessary explo-ration work and study design for a projectwhich will explore the needs for nursinghome care in an insured population.

Content: The study will be directad at: (1) de-termining the medical need for and cast ofnursing home care and home health servicesby age, sex and specific groups; (2) deter-mining optimum balance between the use ofhome health services, nursing homes andhospitals in the continuum of medical carewhich will supply the best possible care withthe most efficient and effective use of facili-ties and personnel; and (3) determining theeffect of the provision of nursing home andhome health services on the costs of in- andout-of-hospital services.

Methods: The project will investigate the cov-erage offered by comprehensive prepaidgroup practice plans, two of which shall beselected as study sites, and develop a designfor a study to provide optimum utilizationof nursing homes and home health servicesfor patient care needs under these plans.

224

CURRENT STATUS(June 1966Feb. 1967)

ORGANIZATION(S)Group Health Association of AmericaPRINCIPAL INVESTIGATOR(S)McCamman, DorothySTAFFFull-time:

Part-time:

COST$15,000$24,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONDorothy McCamman, Group Health Association

of America, 1321-14th St., N,W., Washing-ton, D.C. 20025

11-13 A Study of the Needs of Chronically III Patients in the Community(5/10/66)

ABSTRACT

Objectives: A follow-up study of the needs ofa group of chronically ill patients dischargedfrom a hospital is the central concern of theproposed research. Objectives include a de-termination of the patient's health and socialneeds, as well as his current functional ca-pacity as perceived by the patient, the pa-tient's family and a professional observer.

Content: Information will be collected concern-ing patient's illness and disability record, hisunderstanding and attitudes towards hishealth, his medical and health services,his work and employment satisfaction, andhis economic situation.

Methods: Structured interviews with 1,000chronically ill patients two months after hos-pital discharge. Two hundred patients willbe additionally observed six months afterthe initial interview.

CURRENT STATUSGrant application pending. (Nov. 1966-68)

ORGANIZATION(S)Patient Care Research Unit, Dept. of Physical

Medicine and Rehab., New York Medical Col-lege


Muller, Jonas N., M.D.Nauen, Richard, M.D.Rosenthal, Julian E., M.D,

STAFFFull-time:4 registered nurses

Part-time:3 physicians1 psychologist1 sociologist

COST

$75,000-$99,999

FINANCING ORGANIZATION(S)USPHSpending

PUBLICATION PLANS


Martin Weitzner, Ph.D., Chief, Patient CareResearch Unit, Dept. of Physical Medicineand Rehab., New York Medical College, FifthAve. at 106 St., New York, N.Y. 10029

225

011-14 Morningside Gardens Reiirement-Health Services Research and

Demonstration Project (612166)ABSTRACTObjectives: The objectives of the study are to

establish services and to develop v-1unteerefforts among the residents in a middle-in-come project where about two-thirds of thepopulation are sixty years and over.

Content: Two social workers and a publichealth nurse provide a variety of services tothe older residents. These services are beingdocumented as they occur and will be relatedto information collected in a baseline surveyabout health patterns and medical costs. Fol-low-up questionnaires will provide informa-tion on changing patterns of health ca- withthe arrival of Medicare.

Methods: The service personnel provide serv-ice both to individuals and groups. The eval-uation of the demonstration project will ex-amine the different kinds of participationsand the characteristics of participants andnon-partcipants. We will also examine a va-riety of other questions concerning life-style,morale subjective health experience and pat-terns of care, as well as costs of physicians'care, drugs, appliances, hospitalization andinsurance.

CURRENT STATUSThe project is in its third year of operation.

The project service personnel have estab-lished a wide range of contact with the olderadults in a variety of different kinds of serv-ices. The research is in the beginning of an-

226

alysis with additional follow-up material stillto be collected bi-monthly for the next 6-8months. (Sept. 1964-67)

ORGANIZATION(S)Community Health Studies Unit, St. Luke's

Hospital Center

PRINCIPAL INVESTIGATOR(S)Torrens, Paul R., M.D., M.P.H.

STAFFFull-time:1 registered nurse2 social workers, counselors2 sociologists1 statistician

Part-time:2 x.,hysicians

COST$150,0004199,999


PUBLICATION PLANSArticles to be submitted to sociological and

public health journals-1967 or 1968

FOR FURTHER INFORMATIONDr. Jane Z. Hauser, Community Health Studies

Unit, St. Luke's Hospital, 113th St. and Am-sterdam Ave., New York, N.Y. 10025

11-15 Health Needs and Utilization of Health Services and Facilities: SullivanCounty Health Survey, 1964 (1/27/66)

ATIRTRACT

Objectives: To obtain a broad view of thehealth needs and the utilization of health fa-cilities in a sparsely populated rural area; tocompile morbidity statistics; to estimate cur-rent health practice patterns; to reveal datafrom which clues could be obtained for thedevelopment of additional health programsor facilities in the community.

Content: Data regarding inactive medical andparamedical personnel in sample; use of phy-sician, hospital, nurses in the past 5 years;incidence of accidents, and acute and chronicillnesses in families; immunization ; nutri-tion; maternal and child health; income;mental and emotional health ; dental and eyestatistics; what the families considered weretheir and the county's needs.

Methods: Interview schedule. Personal inter-view with householders in every fourthhousehold in the county and in every house-hold in the boxough of Dushore.

CURRENT STATUSReport availabla cil request. Study report is to

be used by county commissioners and an ag-riculture extension group from Penn State

in planning health programs for county.(JuneAug. 1964)

ORGANIZATION(S)Bu. of Planning, Evaluation and Research,

Pennsylvania Dept. of HealthPRINCIPAL INVESTIGATOR(S)Colfiesh, Virginia, (Mrs.)STAFFFull-time:1 registered nursePart-time:None

COST$5,000$9,999

FINANCING ORGANIZATION(S)Pennsylvania Dept. of Health

PUBL. fION PLANSPennsylvania Dept. of Health Dec. 1965

FOR FURTHER INFORMATIONMrs. Virginia Colfiesh, Bureau of Planning,

Evaluation and Research, Pennsylvania Dept.et Health, Rex 90, Harrisbug, Pa. 17120

227

H-16 Determination of the Value and Need of a Continuity of Care Program,and Cost (2/1/66)

ABSTRACT

Objectives: To ascertain the need for and costof a program for providing home nursingcare to the chronically ill of a community.

Content: Following conferences with local hos-pital administrators and physicians to workout details for the project, nursing and phys-ical therapy services were made available tochronically ill individuals in their homes andreferrals were made to other agencies as in-dicated. A study was made to determine thecost of the program and the per visit cost.The -service statistics and information fromthe cost study are being used in budget andstaff planning.

Methods: The project has been carried onthrough the health department of Lorain,Ohio, in cooperation with local physiciana andhospital administrators. The methods usedfor determining costs are those found inHow to Determine Nursing Expenditures inSmall Health Agencies.

CURRENT STATUSAs the project nears completion date we are

looking for other sources of funds to con-tinue the program. (July 1962-66)

228

ORGANIZATION(S)

Lorain City Health Dept.


Health department staff

STAFFFull-time:1 physician10 registered nurses

Part-time:1 physical therapist

COST

$50,000$74,999

FINANCING ORGANIZATION(S)Ohio State Dept. of Health, Columbus

PUBLICATION PLANS


I. C. Riggin, M.D., Health Commissioner, Lo-rain City Health Dept., 205 West 14th St.,Lorain, Ohio 44052

11-17 An Evaluation of the Use of the Photofluorographic Examination(5/5/66)

ABSTRACTObiectives: In view nf the great need appal.-

ently reflected by various agencies interestedin the aged, it was decided to evaluate theuse of the photofluorographic examination inthe aged, particularly those in nursing andconvalescent homes, for low income or indi-gent groups.

Content : 297 patients were examined duringthe years 1962 and 1963 ; 1964 and 1965 datawill be evaluated this summer.

Methods: Nursing and convalescent homes arerequired by State law to have admissionx-rays of patients. The University of Penn-sylvania, in conjunetion with the City De-partment of Health, Tuberculosis ControlSection, has made this service available. Thefilms are taken in Health District No. S. Theyare interpreted by the principal investigator(S.C.S.), and photofluorogram and/or14 x 17 x-ray films are interpreted and re-corded on IBM cards. IBM cards are madeout on each patient receiving such an ex-amination. Every two years the cards willbe evaluated.

CURRENT STATUSContinued accumulation of data and statistical

evaluation. (1961-1966)

ORGANIZATION(S)Dept. of Public Health arid Preventive Medi-

cine, School of Medicine, Univ. of Pennsyl-vania

PRINCIPAL INVESTIGATOR(S)Stein, Samuel C., M.D.Ingalls, Theodore H., M.D.STAFFFull-time:None

Part-time:1 physician1 registered nurse1 statisticianCOST$5,000$9,999

FINANCING ORGINIZATION (S)School of Medicine, University of PennsylvaniaPUBLICATION PLANS

FOR FURTHER INFORMATIONSamuel C. Stein, M.D., Dept. of Public Health

and Preventive Medicine, School of Medicine,Univ. of Pennsylvania, 4219 Chester Ave.,Philadelphia, Pa. 19104

229

H-18 Long-stay Patients in Canadian Mental HospitalsABSTRACT

Objectives: To analyze changes in the numberand characteristics of long-stay patients inCanadian mental hospitals in order to assessfuture demand.

Content: Analyses of data from the Age-SexCensus (of patients in Canadian mental hos-pitals) maintained by Dominion Bureau ofStatistics.

Methods:

CURRENT STATUSPublication prepared. (1964-1966)

ORGANIZATION(S)Department of Psychiatry, University of Brit-

ish Columbia

PRINCIPAL INVESTIGATOR(S)Richman, Alex, M.D., M.P.H.STAFFFull-time:

230

Part-time:

COST


Canada

PUBLICATION PLANS

Estimating longitudinal changes in the num-ber of patients hospitalized in Canadian psy-chiatric institutions, Acta Psychiatrica Scan-dinavica 41 : 177-203, 1965

Long-stay patients in Canadian mental hospi-tals 1955-1963, completed for publicationCanadian Medical Association Journal-1966


Alex Richman, M.D., Head, Section of SocialPsychiatry, Dept. of Psychiatry, Faculty ofMedicine Bldg., 10th Ave. and Heather St.,Vancouver 9, B.C., Canada

11-19 The Homebound PatientDental Needs and Methods for ProvidingDental Care (1/6/66)

triaTILA.C, T.

Objectives: To determine how the dental needsof the chronically ill homebound patient canbest be met. The initial emphasis will bedirected at determining the magnitude of theproblem and the likely directioh for commu-nity action.

Content: These homebound patients would beclassified into two groups: (a) those able tobe treated, and (b) those patients unable toreceive dental care. For those who can re-ceive treatment, the project will attempt todetermine the most feasible treatmentsources for initial care and follow-up treat-ment.

Methods: Experience gained through providingtreatment would hopefully spell out factorsinfluencing decision-making criteria in thisarea.

CURRENT STATUSStudy now in progress. (May 1963Jan. 1967)ORGANIZATION(S)Community Health Services, Philadelphia Dept.

of Public HealthDiv. of Dental Health, Philadelphia Dept. of

Public Health

Philadelphia County Dental Society

PRINCIPAL INVESTIGATOR(S)Soricelli, David A., D.D.S., M.P.H.Borish, Albert L., D.D.S.Reichman, Leonard, D.D.S.Bronstein, Edward, D.D.S., M.P.H.

STAFF

None

Part-time:1 statistician5 dentists

COST$75,000$99,999


PUBLICATION PLANSIndefinite


David A. Soricelli, D.D.S., Dim:. Div. of DentalHealth, Philadelphia, Dept. of Public Health,500 S. Broad St., Philadelphia, Pa. 19146

281

( )

11-20 Assessing Potential for Out-of-Hospital Residents for Long-Term,Institutionalized Patients (5/5166)

ABSTRACTObjectives: To assess the number of persons

in a large chronic illness hospital who couldlive outside the institution and to determinethe kind of supportive services necessary.

Content: Patients are to be evaluated for livingoutside of the hospital on the basis of infor-mation on extent and nature of physical dis-ability, functional abilities and interpersonalbehavior. Perceptions of patients towardout-of-hospital living arrangements also willbe examined.

Methods: A check list type of survey instru-ment has been designed to be completed bynurses in attendance. On the basis of dataanalysis, a pool of prospective candidateswill be interviewed to assess their attitudestoward living out of the hospital and to de-sign appropriate supportive services.

CURRENT STATUSData collected on 900 patients. Data processing

has started. (Sept. 1965-July 1966)

ORGANIZATION(S)Health and Welfare Association of Allegheny

County

232

PRINCIPAL INVESTIGATOR(S)Lambert, Camille, Jr., Ph.D.McCormick, John

STAFFFull-time:None

Part-time:1 psychologist1 sociologist

COST

$5,000-$9,999

FINANCING ORGANIZATION(S)Health and Welfare Association of Allegheny

County

PUBLICATION PLANS

HWA publicationSept. 1966


Camille Lambert, Jr., Ph.D., Res. Dir., Healthand Welfare Association of AlleghenyCounty, 200 Ross St., Pittsburgh, Pa. 15219

11-21 Queen's UniversityChild Health Program (12/21/65)ABSTRACTObjectives: (1) Study of growth and develop-

ft:mt of childrAn, (2) atraas ond criais instudent families.

Content: During the past two years the ChildHealth Program of the Departments of Pre-ventive Medicine and Pediatrics at Queen'sUniversity has become well established andis accepted as an integral part of the servicefor student families and for the community.This has been accomplisNed by the provisionof regular child health supervision to a largenumber of student and community familiesand an extensive participation in communityhealth planning and activities. Coordinationof the program with the services of the De-partment of Pediatrics and with the familyphysician has assured total care for the chil-dren enrolled in the program.

Methods: See Content.CURRENT STATUS

(Sept. 1963Long-term)ORGANIZATION(S)Child Health Program, Queen's UniversityPRINCIPAL INVESTIGATOR(S)Read, J. H., M.D.De lva, P. L., M.D.

Steele, Robert, M.D., D.P.H.Alexander, Jean, M.D.Owe, welen Ovra.)Strick, Frances (Mrs.)

STAFFFull-time:3 plwsicians1 regldered nurse1 soc' .1 worker, counselor

1 physician1 registered nurse

COST$25,000434,999

FINANCING ORGAWZATION(S)Federal and Provincial Departments of Health

PUBLICATION PLANSC.M.A.J. 88, 14, 1963. Canada's Mental Health

Vol. XIII, 4, 1965. Other publication datesunknown at present


J. H. Read, M.D., Child Health Program,Queen's University, Kingston, Ontario, Can-ada

11-22 A Study of Psychiatric Problems in General Practice (4/12/66)ABSTRACTObjectives: (1) To determine the extent of

psychiatric morbidity in a Saskatchewan ru-ral general practice, (2) to help general prac-titioners provide inpatient and outpatientcare for their psychiatric patients with thesupport and supervision of psychiatrists.

Content: All patients seen by the general prac-titioners, both in their outpatient clinic andin the hospital serviced solely by them, arestudied with special reference to psychiatricproblems encountered both in and out of hos-pital. Supervision is provided by visits everytwo weeks from psychiatrists who providefurther education for the practitioners, su-pervise them in case work, and give an indi-cation of the reliability of theiv psychiatricdiagnosis.

Methods: Basic data relating to all patientsseen are punched onto IBM cards so that thematerial assembled can be readily analyzedlater. Special detailed notes are kept of psy-chiatric problems.

CURRENT STATUSThe study is currently proceeding quite satis-

factorily. A description of it has appeared inthe Lancet, 2, 1005, 1965. Another descrip-tion is included as a chapter in "New Aspects

234

of the Mental Health Services" edited byFreeman and Farndale (in press). (May1964Mar. 1967)

ORGANIZATION(S)University of SaskatchewanPRINCIPAL INVESTIGATOR(S)McKerracher, D. G., M.D.Smith, Colin M., M.D.

STAFFFull-time:


COST$25,000$34,999


Canada

PUBLICATION PLANSFurther publications are pending

FOR FURTHER INFORMATIOND. G. McKerracher, M.D., Professor of Psychi-

atry, Univ. of Saskatchewan, Saskatoon,Sask.., Canada

11-23 Hospital Morbidity Statistics

ABSTRACTObjectives: To provide interprovincially-com-

parable data on certain characteristics ofpatients in hospitals, for use in measuringthe incidence of illnesses in hospitals, evalu-ating experience, studying trends, and plan-ning changes in facilities.

Content : Statistical tables, for Canada as awhole and for individual provinces and terri-tories, setting out details for the age, s6.:, in-sured status, length of stay in hospital, diag-nosis, and surgical operations of patientsleaving hospital during the year of reference.

Methods: Compilation and consolidation of dataprepared, from hospital admission-separationforms, by provincial and territorial insuranceplans.

CURRENT STATUSYearly publication. (1963annual)

ORGANIZATION(S)Dept. of National Health and Welfare

PRINCIPAL INVESTIGATOR(S)McKenzie, A. C.

STAFFFull-time:None


COST


PUBLICATION PLANSDNHWDecember of each year


Directorate, Dept. of National Health andWelfare, Brooke Claxton Building, Ottawa 3,Ontario, Canada

235

11-24 To Repeat in Denmark the Canadian Study of Italian Children and toExtend in Italy Our Data of Patients with Down's Syndrome (6/29/66)

ABSTRACT

Objectives: To contribute to a workl-wide sur-vey of dermatoglyphics in relation to medicalgenetics.

Content: Control series of 100 normal Danishchildren and 100 mongoloid children. Sametype of series for Italian children.

Methods: Dermal prints of fingers, palms andsoles made in schoolG and institutions by theHollister method or the Faurot method.

CURRENT STATUSMajority of prints are completed. Analysis is

in progress. (1965-1967)

ORGANIZATION (S)Department of Zoology, University of TorontoPRINCIPAL INVESTIGATOR (S )Dupont, Annalise, M.D.Johnson, Helen (Mrs.)

236

Sartorelli, Camillo, M.D.STAFFFull-time:1 human geneticistPart-time:1 human geneticist1 medical care specialistCOST

$5,000$9,999

FINANCING ORGANIZATION(S)0111011:`

PUBLICATION PLANS

FOR FURTHER INFORMATIONAnnalise Dupont, M.D., Dept. of Zoology, Univ.

of Toronto, Toronto 5, Canada

H-25 A Sociomedical Investigation of the Health and Living Conditions ofPersons Aged 70 Years or More in Metropolitan Toronto (4/26/66)

ABSTRACTAbject, Ives: To in mines,. 44s nCirklOGOO vim soelomedleal needs

of older people at home in Metropolitan To-ronto to determine what additional servicesand facilities are needed.

Content: Survey of older people by means of aquestionnaire applied by staff public healthnursesnoninstitutionali zed pensioners.

Methods: Pilot surveyhousing project forolder people. Random sample of old age pen-sioners from Old Age Security files. Writtenconsent before visit by public health nurses.

CURRENT STATUSPilot survey completed. Final survey, 450 ques-

tionnaires completed (30 percent response).Coding and transmission to IBM cards. Inprocess of analysis of results. (Apr. 1964Mar. 1965)

ORGANIZATION(S)School of Hygiene, Univ. of TorontoPRINCIPAL INVESTIGATOR(S)Schwenger, Cope W., M.D., D.P.H.Sayers, Allison, R.N.

STAFFFull-time:

1 physician1 registered nurse

Part-time:

1 statistician

COST

$15,000-424,999


Department of National Health and Welfare,Ottawa, Canada

PUBLICATION PLANS

None


Cope W. Schwenger, M.D., Assoc. Prof. of Pub-Health, Dept. of Public Health, School of

Hygiene, Univ. of Toronto, Toronto 5, On-tario, Canada

237

11-26 Continuing Master Sample Survey of Health and Welfare Services(2/14/66)

ABSTRACTObjectives: The Master Sample Survey will

provide systematic information which will(1) characterize the whole population ofPuerto Rico, (2) reveal the dimensions andmagnitude of the chronic illness problem andother health problems of the island as awhole, ' indicate the net consequences ofthe , programs created to deal withthe prevention, control and care of theseproblems, and (4) characterize the impact ofchronic illness on fu.nily units, as well as onindividuals.

Content: The survey will gather data whichwill be significant in a) the development ofisland-wide indices for the evaluation ofhealth and welfare programs designed toserve the chronically ill and aged, b) the an-alysis of needs and gaps in services for thechronically ill and aged in terms of changinghousehold, family and personal characteris-'tics, e.g., education, income, ocoxpation, fam-ily composition, etc.

Methods: Quarterly island-wide surveys wereconducted through a multistage stratifiedarea probability sample cf households, de-signed in such a way as to permit a series ofrepresentative samples of the population. TheMaster Sample will survey annually about3,000 households, which will be subdividedinto four quarterly sub-samples.

CURRENT STATUSContinuing. (Dec. 1962June 1966)

238

ORGANIZATION(S)Department of Health, Santurce, P. R.

PRINCIPAL INVESTIGATOR(S)Munoz, Raul A.

STAFFFun-time:1 sociologist3 statisticiansPart-time:None

COST

$200,000$249,999


USPHSDepartment of Health, Santurce, P. R.

PUBLICATION PLANSMat lin, Norman, Ph.D., Elizabeth Luck, Acute

and Chronic Conditions and Medical Care inPuerto Rico, October 1963November 1964,San Juan, Puerto Rico, September 1965

Luck, Elizabeth, Knowledge of Dengue inPuerto Rico, September 1965

Luck, Elizabeth, Juan A. Torres, Rene A. Mor-ell, Immunization Level of Children inPuerto Rico, December 1965

FOR FURTHER INFORMATIONRaul A. Munoz, Director, Office of Research,

Department of Health, Santurce, P. R.

^

(

11-27 The Demand for Rehabilitative Activities in Medical and Surgical WardUnits (617/66)

ABSTRACTObjectives: The occurrence of particular de-

mands for rehabilitative actions at a medicaland a surgical ward unit at a universityclinic.

Content: The material consists of 450 cases re-spectively from a medical and a surgicalward unit.

Methods: Standardized interviews by socialworkers the day before discharge , two yearsafter the discharge a household interview.

CURRENT STATUSThe field work is completed and the computing

has begun. (April 1, 1962-1967)ORGANIZATION(S)Karolinska institutets, socialmedicinska insti-

tution, Stockholm 60, Sweden

PRINCIPAL INVESTIGATOR(S)Inghe, Gunnar

STAFFFull-time:4 social workersPart-time:1 physician1 statisticianCOST

$` ,000-$34,999

FINANCING ORGANIZATION(S)The Swedish Medical Research Board, Svea-

vägen 166, 18 tr. Stockholm, SwedenPUBLICATION PLANSA becoming Acta sociomedica, Scandinavica

Probably in 1967FOR FURTHER INFORMATIONGunnar Inghe, Professor, Karolinska institu-

tets, socialmedicinska institution, Stockholm60, Sweden

239

11-28 A Study of Families on the ProChildren and Unemployed Parents

gram of Aid to Families with Dependentin Eastern Kentucky (11030/65)

ORGANIZATION(S)Dept. of Sociology, Univ. of Kentucky

PRINCIPAL INVESTIGATOR (5)Johnson, Cyrus M.

STAFFFull-time:None


COST

$25,000434,999


ABSTRACTObjectives: To describe, for a wide variety of

areas including health and health care, thecondition of low income families in EasternKentucky.

Content: The data in this study reveals thatthe families in question are rather isolatedgeographically and are minimally in touchwith the outside world through mass com-munication media. In general they havemany children and live in dilapidatad homes,with few modern conveniences and with ashortage of food and clothin. Ill health, inboth its acute and chronic foi_as, is frequent.Most of the men have had little regular em-ployment for a number of years and theireducational level is so low as to be a serioushandicap in possible training programs.

Methods: Data was collected from interviewswith a representative sample of 324 welfarefamilies in seven Eastern Kentucky counties.

CURRENT STATUSIn process of analyzing data. (Mar. 1964-June

1966)

240



Cyrus M. Johnsor., Assist. Prof., Dept. of So-ciology, Univ. of Kentucky, Lexington, Ky.40506

-11

11-29 Socioethnologic Factors in the Etiology of Toxemia of Pregnancy,tion of Infants under Three (119166)Congenital Malformations and Hospitaliza

ABSTRACTObjectives: In a total population, to measure

(1) the incidence of pregnancy and labor,(2) the incidence of congenital malforma-tions, (3) the causes of infant deaths, (4)the rates and causes of hospitalization underthe age of three. These will be corrblated toeach other and to socioeconomic and ethnicparameters.

Content: Prospective follow-up of all births(5,750 per year) in Jerusalem area and allpregnant women from January 1, 1964. Se-rology and hematology of 85 percent of preg-nant population. Recording of all (99+per-cent) births in hospitals, examinations of allnewborn (99+percent), inquiry into all in-fant deaths and causes of all spells of hospi-talization of infants in each of the 3 hospi-tals. Special clinic investigations of cases oftoxemia and matched controls.

Methods: Case finding in association with Mu-nicipality and Ministry of Health, Maternaland Child Health centers, and follow-upthrough these services. Interviews by publichealth nurses who also visit maternity andpediatric wards. Record linkage by computerof all records of each family. For cases oftoxemia, selection of controls matched for 6attributes, and addition of dietary and clini-cal investigations.

CURRENT STATUSRunning well, 250 cases of toxemia of preg-

nancy and 500 controls are being anal-ized.Recording of births and infant deaths, 1964

65, completed. Congenital malformation re-corded since August 1964, and infant hospi-talization (pilot) since October 1965. (Jan.1964-67)

ORGANIZATION(S)Dept. of Medical Ecology, Hebrew University-

Hadassah Medical School

PRINCIPAL INVESTIGATOR(S)Davies, A. Michael, M.D.STAFFFull-time:1 physician3 registered nurses1 statistician2 dietitiansPart-time:3 physicians2 statisticiansCOST$150,000$199,999

FINANCING ORGANIZATION(S)U.S. Children's Bureau, Washington, D.C.U.S. National Institute of Dental Research,

Bethesda

PUBLICATION PLANSNone yet

FOR FURTHER INFORMATIONA. Michael Davies, M.D., Head, Dept. of Medi-

cal Ecology, Hebrew University-HadassahMedical School, P.O. Box 1172, Jerusalem,Israel

241

11-30 Study of Relationship of Environmental Factors to the Type andFrequency of Cancer Causing Deaths in Catholic Nuns during CalendarYears of 1963, 1964, 1965, and 1966

ABSTRACTObjectives: To study relationship of environ-

mental factors to the type of frequency ofcancer causing deaths in Catholic nuns dur-ing the years 1963, 1964, 1965, and 1966.

Content: The infrequency of cancer of the cer-vix in nuns has been attributed to celibacyand virginity, yet nuns frequently developcancer of the uterine fundus, cancer of theovary and cancer of the breast. Undoubtedlythe restrictions of religious lifie affect the in-cidence of cancer and other diseases.

Methods: The notification of death for each nunis checked by the community or personalphysician, verified by the Mother Provincial,as well as by the Health Secretary of theConference of Major Religious Superiors torWomen. A detailed medical history, alongwith death certificate, is compiled for eachnun from 223 communities with a populationof 108,342. After notice of death is received,the personal physician of the deceased sisteris contacted for all medical information onthe past history, hospitalization and autopsydata, and the State Board of Health is con-tacted to provide a copy of her death cer-tificate. .

CURRENT STATUSThe study began in 1963.

242

ORGANIZATION(S)11111.

PRINCIPAL INVESTIGATOR(S)Nix, J. T., M.D., Ph. D.Fecher, Con, Ph. D.

STAFFFull-time:

Part-time:1 accountant1 physician2 sociologists

COST


PUBLICATION PLANS


J. T. Nix, M.D., Chairman, Joint Committee inHealth Care of the Clergy and Religious, Na-tional Federation of Catholic Physicians'Guilds, 1407 South Carrollton Ave., New Or-leans, La. 70118

11-31 Demand for Medical Care Facilities (1/4/66)ABSTRACT

Objectives: To analyze the relationship betweensocial, economic, and demozraphic character-istics of an area and its use of medical carefacilities.

Content: The study will involve the followingthree basic areas: (1) analysis of patient ad-missions and medical and financial circum-stances to determine the degree to which thelength of stay is affected by changes incharges and other economic circumstances,(2) examination of relationships betweencharacteristics of an area and its use of vari-ous types of facilities, and (3) developmentof models for areawide planning which en-able one to deal specifically with the relation-ships between the applicable economies ofscale for determining the size of an institu-tion and the travel cost and accessibility re-quirements for distributing facilities over thearea.

Methods: Information for the study is beinggathered from 1962 medical records for fiveNew England States and from the observa-tion of a particular urban area.

CURRENT STATUSIn process. (July 1963-67)ORGANIZATION(S)Dept. of Economics, Harvard Univ.

Graduate School of Public Admin., HarvardUniv., Littauer Center

PRINCIPAL INVESTIGATOR(S)Rosenthal, Gerald



COST

$100,000$149,999


PUBLICATION PLANS

Proceedings of the American Statistical Asso-ciationSpring 1965

Journal of the American Public Health Associ-ationNovember 1965

Journal of the American Hospital AssociationNovember 1963


Gerald Rosenthal, Assistant Professor, Dept.of Economics, Harvard Univ., 1746 Cam-bridge St., Cambridge, Mass. 02138

243

11-32 Long-stay Patients in Canadian Mental Hospitals (5/66)

ABSTRACT

Objectives: To analyze changes in the numberand characteristics of long-stay patients.

Content : Analysis of changes of patients inCanadian Mental Hospitals will be made toassess future demand.

Methods: Data will be obtained from the Age-sex Census of patients in Canadian MentalHospitals maintained by Dominion Bureau ofStatistics.

CURRENT STATUS

(1964-1966)

ORGAN/ZATION(S)

Dept. of Psychiatry, Univ. of British Columbia


Richman, Alex

244

STAFFFull-time:

Part-time:

COST1111.

FINANCING ORGANIZATION(S)Department of National Health and Welfare,

Ottawa, CanadaPUBLICATION PLANS

FOR FURTHER INFORMATIONAlex Richman, Dept. of Psychiatry, Univ. of

British Columbia, 10th Ave. and Heather St.,Vancouver 9, B.C., Canada

011-33 Demonstration Program for Dental Care for the Aged and/or

Chronically In (12/10/65)ABSTRACTObjectives: To establish a program to supply

dental care to the aged and chronically ill ofa region of Puerto Rico.

Content: The project consists of the followingstages: (1) enlargement of the pool of datarelating to the prevalence of oral diseases andoral health needs of the chronically ill andaged, (2) determination of the economic fea-sibility and limitations for treatment of theinstitutionalized patient, (3) providing ofspecialized consultation and treatment serv-ice, (4) providing of facilities for clinical ex-perierce for undergraduate and graduatedental students and dental assistants, (5)implementation of treatment care programsthat realistically relate oral health needs,manpower, materials, and money limitationsin this area, (6) reporting on the costs andlimitations for treatment of the homebound,and (7) reporting on the costs of dentalhealth care of this population segment andthe economic feasibility of providing it.

Methods: The project is being implemented atthe Guaynobo Health Center in Puerto Rico.Data has been gathered for 1,100 cases, anddetailed studies are being made of this data.A monograph containing findings of the proj-ect will be published.

CURRENT STATUSOn uhedule. (1963-1967)

ORGANiZATION(S)School of Dentistry, University of Puerto RicoPRINCIPAL INVESTIGATOR(S)McKelvey, Lowell E., D.D.S., M.S.Bodine, Roy L., D.D.S.Sojo Morales, L., D.D.S.Cabanas, R., D.D.S.Harris, N., D.D.S., M.S.STAFFFull-time:1 sociologist2 dentistsPart-time:3 dentistsCOST

$150,000$199,999FINANCING ORGANIZATION(S)

PUBLICATION PLANSNot deterznined-1967FOR FURTHER INFORMATIONLowell E. McKelvey, D.D.S., Dean, School of

Dentistry, Univ. of Puerto Rico, San Juan,P.R. 00905

245

11-34 (1) Study of Mortality of Executives Undergoing Periodic Examinations ,(2) Incidence of Disease in Executives; (3) Scope and Patterns inLaboratory Examinations of Executives (11123165)

ABSTRACT

Objectives: To study health and disease pat-terns in executives to determine death andmorbidity rate.

Content: The project involves the periodic med-ical examination of a group of executives. Adefinite and complete pattern of examinationis used at all times to allow standardizationof data. Mortality and morbidity statisticsare being compiled and will be reviewed andanalyzed subsequently.

Methods: The study involves a group of 7,000executives examined over a ten-year period.

CURRENT STATUS

Preliminary studies completed. Reviewing dataas it develops. (1955-1967 or 1968)

ORGANIZATION(S)

Charles E. Thompson, M.D. and Associates


Thompson, Charles E., M.D.Zaus, Earl A., M.D.

246

Staack, H. Frederick, Jr., M.D.Gynn, Thomas N., M.D.STAFFFull-time:None

Part-time:1 accountant4 physicians3 registered nurses1 social worker, counselorCOST$5,000$9,999

FINANCING ORGANIZATION (S)None

PUBLICATION PLANS'Journal of the American Medical Association

and the Journal of Occupational Medicine-1967

FOR FURTHER INFORMATIONEarl A. Zaus, M.D., Charles E. Thompson, M.D.and Associates, 720 N. Michigan Ave., Chi-cago, III. 60611

11-35 Impact of Water Fluoridation

ABSTRACTObjectives: The study is being done to deter-

mine the effect that water fluoridation hason dental practice, and to determine preva-lent and significant differences between den-tal practice in fluoridated and fluoride-defi-cient communities. All previoucs findings havebeen based on examination of teeth in chil-dren in both types of communities, ratherthan on detailed examination of dental prac-tice.

Content : The study is designed to help estab-lish possible dental needs of future genera-tions, and methods of meeting these needs.The results of the investigation should pro-vide information for public officials to helpjudge future dental manpower needs, and forpublic health officials, dental educators, den-tal students and recent graduates, prospec-tive dental students and counselors, and or-ganized dentistry to help plan for the future.It will help dentists comprehend economicchanges which may occur.

Methods: Surveys will be conducted in twogroups of communities which have beenmatched socio-economically, demographically,and culturally. One group has communitywater fluoridated to the optimum level natu-rally and the other group is fluoride-deficient.Records of each dentist in practice in thesecommunities will be studied, and pertinentdata recorded. Results of a feasibility studyprovide the basis for the final study.

CURRENT STATUSThe feasibility phase of the project was started

early in 1963. A mail questionnaire was car-ried out at that time. Interviews were con-ducted in the Chicago area during January

e",4.1k11#1...'t

on the Practice of Dentistry (1/20/66)

and February of 1965. Dentists in Cham-paign and Urbana, Ill., were interviewedduring October and November 1965. A re-sponse of approximately 98 percent coopera-tion in the latter cities was obtained. Tech-niques have been established as a result offindings during the feasibility study whichshould produce cooperation from dentists whopractice in the communities to be surveyed.Data has been obtained relating to all aspectsof practice as well as to aspects of personalincome. (Sept. 1964-69)

ORGANIZATION (S )College of Dentistry, University of IllinoisPRINCIPAL INVESTIGATOR (S)Douglas, Bruce L., D.D.S.Wallace, Donald A., Ph,D., M.S.

STAFFFull-time:1 registered nursePart-time:1 dentist1 professor of dental radiologyCOST

$150,000$199,999



FOR FURTHER INFORMATIONSylvia B. Coppersmith, R.N., Res. Admin., Col-

lege of Dentistry, Univ. of Illinois, PalmoliveBuilding, Room 329, 919 North MichiganBlvd., Chicago, Ill. 60611

247

11-36 Community Services Research

ABSTRACTObjectives: To explore the health needs and

wants of the public, and the design and im-plementation of more effective and compre-hensive community services.

Content: The study will involve: (1) assess-ment of public health needs of the com-munity, (2) development and testing of newmethods and techniques applicable to dentalpractice, public health problems, (3) assess-ment of certain standards of medical anddental practice, and (4) assistance in thedesign and development of research on aconsultative basis.

Methods: Basis for the study will consist ofmulti-disciplinary assessments emanatingfrom the interest and collaboration of theMedical School, State University of NewYork at Buffalo, its departments and otherUniversity divisions, and to Erie County De-partment of Health, its divisions and serviceprograms.

CURRENT STATUSProgram personnel are participating in the de-

sign and conduct of studies concerned withlong-thrm childhood illness, medical econom-ics, cardiovascular disease services, preven-tive dental techniques; and record designfor community service agencies. (Sept.1965-69)

ORGANIZATION ( S)School of Medicine, State Univ. of New York

at Buffalo

248

and Development Program (1/18/66)PRINCIPAL INVESTIGATOR(S)Sultz, Harry A., D.D.S., M.P.H.

STAFFFull-time:1 psychologist1 social worker, counselor1 sociologist1 epidemiologist

Part-time:2 physicians1 statistician

COST

$250,000 or more

FINANCING ORGANIZATION(S)USPHSFunds administered by the Research Founda-

tion of State University of New York, P.O.Box 7126, Albany, New York 12224

PUBLICATION PLANS

American Journal of Public Health, The ErieCounty Survey of Long-Term Childhood Ill-ness : 1. MethodologyJuly 1966

New York State Dental Journal, The Cheekto-waga Dental Study: A Case Report-1966


Harry A. Sultz, D.D.S., Clinical Assoc. Prof.,Dept. of Preventive Medicine, School ofMedicine, State Univ. of New York atBuffalo, Capen Hall, Buffalo, N. Y. 14214

( )

0

11-37 Illness and the Utilization of Medical Aid (5/11/66)

ABSTRACTObjectives: To determine those socio-cultural

features (ethnicity, social class, etc.) whichare associated with resistances to seek neces-sary medical help and to identify socio-cul-tural factors which lead to variations in theways patients make use of medical advice.

Content: The study will analyze the particularsocial contexts in which illness arises bymeasuring relationships among the follow-ing sets of variables: (1) demographic char-acteristics, (2) socio-cultural factors affect-ing decisions about seeking medical help, (3)the actual event of seeking and receivingmedical aid, (4) behavior and attitudes re-sulting from being defined as ill by medicalauthority, and (5) the course of Illness andthe nature of social disability.

Methods: An intensive study of 300 cases isbeing performed to collect pertinent infor-mation. Subsequent compilation and analysisof the data will be performed.

CURRENT STATUSData collection and analysis. (June 1964-67)

ORGANIZATION(S)Community Health Project, Dartmouth Medi-

cal School (Dept. of PsYChintrY) tNew Hampshire

PRINCIPAL INVESTIGATOR(S)Segal, Bernard E.Phillips, Derek L.STAFFFull-time:


COST$50,000$74,999

FINANCING ORGA NIZATION(S)USPHS

PUBLICATION PLANS

Tin nnvari

FOR FURTHER INFORMATIONDerek L. Phillips, Dept. of Sociology, New

York University, New York, N. Y. 10003

249

11-38 Study of Community Mental Health Clinics (416166)ABSTRACTObjectives: To make a comprehensive study of

mental hpalth Plne ill New York State toobtain information about the patients andthe characteristics of their course of treat-ments in a variety of clinics.

Content: The study will (1) obtain informa-tion about the characteristics of patientsapplying for service, (2) ascertain factorsrelated to acceptance and rejection, (3) ob-tain information about factors associatedwith patient drop-out during treatment, (4)study the interrelation between class, psy-chological characteristics, patient's func-tioning and type of treatment provided, (5)study changes in the status of patients be-tween intake and follow-up a year later, and(6) determine the relationship between ex-tent and type of treatment, and change instatu s.

Methods: Data is being obtained from mentalhealth clinics in New York State concerning:(1) the status of the patient at intake andintake procedures, (2) extent and type oftreatment, and (3) the status of the patientat follow-up.

CURRENT STATUSAnalysis of data and preparation of reports

for publication. (Feb. 1962Dec. 1966)ORGANIZATION (S )Mental Health Research Unit, New York State

Dept. of Mental Hygiene

250

;

PRINCIPAL INVESTIGATOR(S)Saenger, Gerhart, Ph.D.Cumming, John, M.D.

STAFF

Full-time:1 psychologist

Part-time:1 physician1 statistician

COST

$200,000$249,999


New York State Mental Health Authority,Albany

(Federal funds administered by) United Com-munity Chest and Council of OnondagaCounty, Inc., Syracuse, N. Y.

Mental Health Research Unit, Syracuse, N. Y.

PUBLICATION PLANS


Gerhart Saenger, Ph.D., Assoc. Res. Scientist(Psychology), Mental Health Research Unit,New York State Dept. of Mental Hygiene,333 E. Washington St., Syracuse, N. Y.13202

11-39 The Prevalence of Intestinal Parasites in Six Selected Areas of PuertoRico-10 Years Afterwards (2/21/66)

ABSTRACTObjectives: To determine status of intestinal

parasitism among schcgil cq-iilltiren it S com-pared to 5 and 10 years ago when the samerepresentative areas were investigated.

Content :

Methods: All fecal samples are to be examinedunder the microscope following Beaver'sstandardized saline smear for helminths eggcounting. Particular emphasis will be placedon the propmrtion of Ascaris and Trichuris,mixed heavy infections.

CURRENT STATUS(Aug. 1965May 1966)

ORGANIZATION(,S)School of Medicine, Univ. of Puerto Rico

PRINCIPAL INVESTIGATOR(S)Maldonado, José F.

STAFF

Full-time:2 microscopists

Part-time:

COST

Under 0,000


PUBLICATION PLANS

Boletin Asoccación Médica de Puerto RicoJuly 1966


José F. Maldonado, Prof. of Parisitology,School of Medicine, Univ. of Puerto Rico,San Juan, P. R. 00905

251

11-40 Development and Maintenance of Two Population Laboratories for theStudy of the Distribution of Mental Disorders and the Determinants ofThese Distributions (12/27/65)

ABSTRACTObjectives: Development and maintenance of

two population laboratories to provide (a)data on mental disorders, (b) a base for fieldstudies, and (c) training of research work-ers. The main purpose is to develop indicesfor the evaluation of community mentalhealth and the effectiveness of mental healthprograms.

Content: Current studies include the relationof modern treatment to the incidence andprevalence of (1) the chronic severe socialbreakdown syndrome and (2) long-term hos-pitalization in mental hospitals. ;For descrip-tion of the social breakdown syndrome see"Mental Disorders: A Guide to ControlMethods," published in 1962 by the Ameri-can Public Health Association. This syn-drome is commonly caused by depersonal-ized institutionalization. It is believed to bethe major cause of mental disorder whichis preventable.

Methods: The populations studied are the resi-dents of Dutchess County, New York, andof the Washington Heights Health District,Manhattan, New York City. A register ofpatients with mental disorders is compiledfrom reports from mental hospitals. A com-munity survey of Washington Heights hasalso been utilized for case finding. The socialbreakdown syndrome is diagnosed by inter-view of the patient or attendants. Model,continual, community-oriented care wasmade available to Dutchess County residentsbeginning in 1960. The effectiveness of treat-ment can be evaluated by the trend of inci-dence and prevalence of long-term hospitali-zation and the social breakeown syndrome.

CURRENT STATUSFor Dutchess County a case register has been

compiled, and statistics of the social break-down syndrome and of long-term hospitaliza-

252

tion have been obtained for 1963. The datanee.d 't,c, be- amplified, missing informationsecured, and figures obtained for other years.In Washington Heights the case register andidentification of the social breakdown syn-drome are underway. The study began in1960.

ORGANIZATION(S)Psychiatric Epidemiology Research Unit, Dept.

of Psychiatry, College of Physicians andSurgeons, Columbia Univ.

PRINCIPAL INVESTIGATOR(S)Gruenberg, Ernest M., M.D., Dr. P.H.

STAFFFull-time:1 physician

Part-time:2 physicians1 statistician


FINANCING ORGANIZATION(S)USPHSResearch Foundation for Mental Hygiene, c/o

Mr. Emmer, Hudson River State Hospital,Poughkeepsie, N. Y.

Milbank Memorial Fund, 40 Wall St., Ne---York, N. Y.

Health Research Council of Greater New York,125 Worth St., New York, N. Y.

PUBLICATION PLANSThe most recent publications are "Mental Hos-

pitals Join the Community," The MilbankMemorial Fund Quarterly, Vol. XLIII, Num-ber 3, July 1964, Part 2 ; and "EvaluatingCommunity Treatment Programs" by E. M.Gruenberg and Sydney Brandon, MentalHospitals, pp. 617-19, November 1964. A

report by Brandon and Gruenberg on theeffect of the Dutchess County Service on theincidence of chronic severe social breakdownsyndrome will be published by the MilbankMemorial Fund sometime in 1966.

FOR FURTHER INFORMATIONErnest M. Gruenberg, M.D., Dept. of Psychia-

try, College of Physicians and Surgeons, Co-lumbia Univ., 630 West 168th St., New Y ork,N. Y. 10032

11-41 Fluoride Supplements for Elementary School Children (5/12/66)ABSTRACTObjectives: To study the effectiveness of in-

gested fluorides (tablets) for preventingdental caries in elementary school children;to assess the acceptability of this preventiveprocedure in rural areas; to explore methodsof organization, operation and administra-tion; and to arrive at cost estimates applic-able to local school programs.

Content: To study sites at elementary schoolsin North Carolina, Pennsylvania am. WestVirginia; age, race, and sex differentials;variable dosage and times and frequency oftablet administration; residence historiesand parental consent to participate in proj-ect ; baseline examinations completed priorto initiation of tablet administration.

Methods: Tablets are administered by classroom teachers daily in school. Beginning ingrades one, two and three, children receivefluoride tablets only on days in school. Thesechildiz-,n will receive tablets each day inschool through the sixth grade. Dental ex-aminations will be conducted periodically.

CURRENT STATUSThird year at three study sites, second year at

two study sites. (Sept. 1963-1970)ORGANIZATION(S)Dept. of Public Health Admin., School of Pub-

lic Health, Univ. of North Carolina

254


Law, Frank E., D.D.S., M.P.H.Coker, Robert E., Jr., M.D., M.P.1-1.Hughes, John T., D.D.S., Dr. P.H.Dudney, George E., D.D.S., M.P.H.

STAFF

Full-time:

Part-time:

1 physician1 statistician3 dentists

COST

$150,000$199,999


USPHSSchool of Public Health, Univ. of North Caro-

lina


Frank E. Law, D.D.S., Visiting Prof. of PublicHealth Admin., Dept. of Public Health Ad-min., School of Public Health, Univ. of NorthCarolina, Chapel Hill, N. C. 27514

1

-

( i

II-42 Infant and Maternal Morbidity Relative to Care in High Risk, LowSocioeconomic Pregnancy (12/8/65)

ABSTRACTObjectives: k 1.) Reduce maternal and child

wastage ; (2) identify high risk pregnancies;(3) devise new ways of using paramedicalpersonnel for medical care; (4) provide com-munity centered health facilities.

Content:

Methods: (1) Establishment of target areaclinics; (2) intensive community health edu-cation; (3) use of public health nursestrained in obstetrics ; (4) extensive socialservices; (5) devise and implement newmethods of data collection.

CURRENT STATUSClinics about to begin. (July 1965unknown)

ORGANIZATION(S)Maternal and Child Health Project 512, Erie

County Dept. of Health, Buffalo, Depts. ofObstetrics and Gynecology and of Nursing,State Univ. of New York at Buffalo, 100High St., Buffalo, N. Y.

PRINCIPAL INVESTIGATOR(S)Mosher, W. E., M.D.

Anderson, U. M., Ma_Randall, C. L., TvI.D.Foote, R. J., M.D.Young, F. M., R.N.STAFFFull-time:1 physician1 registered nurse2 social workers, counselors1 health educatorPart-tive :2 physicans4 registered nursesCOST

$150,000-$199,999

FINANCING ORGANIZATION(S)U.S. Children's Bureau, Washington, D.C.PUBLICATION PLANS'

FOR FURTHER INFORMATIONRonald J. Foote, M.D. Proj. Dir., Maternal and

Child Health Project 512, 2211 Main St.,Buffalo, N. Y. 14214

H-43 The Dental Status of Mentally Retarded Children in Georgia (5123/66)ABSTRACT

Objectives: (1) To determine through the useof available dental indices, the dental healthstatus of a random sample of mentally re-tarded children in Georgia , (2) to determinethe blocks that interfere with the renderingof dental care to mentally retarded childrenin Georgia, inherent in the dental professionof Georgia.

Content: (1) DMF, def, OHIS, and RPI de-terminations of some 2,000 randomly se-lected children , (2) survey of dentists, 101,who were randomly selected and inter-viewed.

Methods: Covered above.

CURRENT STATUS

Final stages of writing. (July 1965June 1966)

ORGANIZATION(S)

Georgia Dept. of Public Health


Butts, John E., B.S., D.M.D., M.P.H.

256

STAFFFull-time:1 dentist (Public Health)Part-time:

1 sociologist3 statisticians

10 dentistsCOST$10,000$14,999

FINANCING ORGANIZATION(S)Georgia Dept. of Public HealthUSPHS

PUBLICATION PLANSJournal of Georgia Dental AssociationApril

1966Journal of Public Health Dentistry (2 articles)

not determined, probably fall and winter1966

FOR FURTHER INFORMATIONDr. John E. Butts, Resident, Dental Public

Health, Georgia Dept. of Public Health, 47Trinity Avenue, Atlanta, Ga. 30334

(

(\ow,'

,

H-44 Psychosociological and Cultural Factors in the Seeking of Medical Aid(5/5/66)

ABSTRACT

Objectives:

Content: A study of the context of decisionmaking in regard to seeing a doctor. An in-tensive investigation via a panel of Italianand Irish women to determine relationshipsbetween such factors as health attitudes,general physical health, past illness be-havior, personality traits, family back-ground, and ethnicity.

Methods: Series of open-ended and closed-ended interviews with standardized psycho-logical instruments done by trained inter-viewers, mostly social workers.

CURRENT STATUS

In data analysis phase. (Sept. 1963-66)

ORGANIZATION(S)

"Brandeis Health Project," Dept. of Sociology,Brandeis Univ.

PRINCIPAL INVESTIGATOR(S)Zola, Irving KennethSpivak, MarkSTAFFFull-time:1 psychologist

Part-time:1 sociologistCOST

$100,000$149,999


PUBLICATION PLANSA number of articles have already emerged in

different journalsFOR FURTHER INFORMATIONIrving Kenneth Zola, Assist. Prof. of Sociology,

Dept. of Sociology, Brandeis Univ., Waltham,Mass. 02154

,

257

11-45 Program Project to Study the

ABSTRACT

Objectives: A multifaceted multidisciplinaryapproach to study the problems associatedwith the cerebrovascular diseases.

Content: A number of studies are to be initi-ated which will attempt to: (1) elucidatethe epidemiologic features of the differentforms of cerebrovascular disease in the Bal-timore population; (2) study the naturalhistory of these diseases ; and (3) study thegamut of problems associated with the man-agement of patients with cerebrovasculardisease, ranging from early detection andearly management to the long range rehabil-itative aspects of these diseases.

Methods: A variety of different methods willbe employed, including retrospective, cross-sectional and longitudinal studies ; and in-volving clinical studies, interviews and ques-tionnaires.

CURRENT STATUS

A series of pilot studies is being initiated ; staffis being recruited and trained; protocolsarebeing designed and completed. (Nov. 1965,for a minimum of 5-7 years)

ORGANIZATION (S)

Dept. of Chronic Diseases, School of Hygieneand Public Health, Johns Hopkins Univ.

258

Cerebrovascular Diseases (11/29/65)

PRINCIPAL INVESTIGATOR(S)Lilienfeld, Abraham, M.D.Seltser, Raymond, M.D., M.P.H.STAFFFull-time:1 physician1 statisticianPart-time:5 physicians1 psychologist1 registered nurse2 sociologists2 statisticians1 human geneticistCOST$250,000 or more

FINANCING ORGANIZATION(S)National Institute of Neurological Diseases

and Blindness, Bethesda, Md.PUBLICATION PLANSNone as yetFOR FURTHER INFORMATIONAbraham Lilienfeld, M.D., Assoc. Prof. of

Chronic Diseases, Dept. of Chronic Diseases,School of Hygiene and Public Health, JohnsHopkins Univ., 615 North Wolfe St., Balti-more, Md. 21205

H-46 Determination of Relationship of Maternal Health to EconomicDependency and Family Solidarity (12/7/65)

ABSTRACT

Objectives: To determine the impact of long-term or chronic maternal illness on finan-cially depressed families. This study will alsoendeavor to determine the ways in whichthese families are able to make the necessaryadjustments in managing the family's re-sources, and caring for family members, es-pecially chitdren. Finally, the effect of thefamily concept of mother's competence toperform her role will be examined.

Contents: Maternal health and general well-being have beal considered as prime requi-sites for family solidarity. One half of thewomen with chronic or long-term illness arebetween the ages of 15-44. The variations inexisting provisions for these families par-ticularly with children, and the meager fa-cilities in poverty areas for rehabilitatingand restoring family members to their fami-les is an important area of family and com-munity life which needs investigation.

Method: The study will compile inventory ofcommunity resources and interviews withhomemakers who are suffering from chronicillness.

CURRENT STATUS

Methodology is presently being perfected. Pre-

,

testing will begin in early 1966. Interview-ing will begin in spring 1966. (Aug. 1965-67)

ORGANIZATION(S)School of Home Econorncs and Research Foun-

dation, Ohio State University

PRINCIPAL INVESTIGATOR(S)Deacon, RuthMa loch, FrancilleBardwell, Ann S. (Mrs.)STAFFF'ull-time:

Part-time:

COST

$50,000$74,999

FINANCING ORGANIZATION(S)U.S. Children's Bureau, Washington, D.C.PUBLICATION PLANSReport of study will be prepared at comple-

tionOther publication plans are indefiniteFOR FURTHER INFORMATIONRuth Deacon, School of Home Economics and

Research Foundation, Ohio State University,1787 Neil Ave., Columbus, 0., 43210

259

11-47 Report of Program of Home Care and Exploratory Study of Nursingand Related Needs and Wants among Economically Independent PersonsHaving Chronic Health Conditions (11/30/65)

ABSTRACT CURRENT STATUSObjectives: To determine, for economically in- Mimeographed final report completed August

dependent persons having chronic health 1965. It is aot expected that the report willconditions, the needs and wants with regard be published. The project was begun in 1962.to nursing and related services.

ORGANIZATION(S)Content: The following seven principal needsand wants have been identified for persons School of Nursing, Emory Universitywith chronic health problems: (1) mainte- PRINCIPAL INVESTIGATOR(S)nance of physiological functions in mobility Bischoff, Lillian M.and nutrition, (2) restoration of physiologi-cal function of ambulation, (3) modification STAFFof psychological behavior, (4) maintenance Full-time:of physiological and psychological functions 3 registered nursesMating to conditions contributing to pro-gressive deterioration, (5) prevention of po- Part-time:tential disabilities relating to defects in en- Nonevironmental settings including emotional, COSTclimate, and personal safety, (6) modification

$100,0004149,999of behavior toward attaining feasible goals,and (7) maintenance of continuing maxi- FINANCING ORGANIZATION(S)mum comfort, support, and safe environ- USPHSment.

Methods: The data for the project was col- PUBLICATION PLANSlected from a survey of persons over 60years of age in Deka lb County, Georgia. In-

FOR FURTHER INFORMATIONformation was collected pertaining both tothe nursing needs and wants of the persons Dr. Ada Fort, Dean, School of Nursing, Emoryinvolved. Univ., Atlanta, Ga, 30322

260

0

0

II-48 Demand Projections for Pharmacists and Pharmaceutical Services in theSouthern 14 Counties of California, through the Year 1980 (12/15165)

ABSTRACT ORG ANT?. AVIAN (g)Objectives: To define the nature and extent School of Pharmacy, Univ. of So. Calif.of demand for pharmacists and pharmaceuti-

cal services in the community serviced by PRINCIPAL INVESTIGATOR(S)the university in order to plan better for the Lawrence, G. D.future in respect to physical plant needs,

STAFFcurriculum needs, staff needs, and manyother factors. Full-time:

Content: A collection of secondary statistical Nonedata pertinent to all aspects of demand forpharmaceutical services, collated and ana- Part-time:lyzed to produce meaningful estimates of 1 pharmacist-instructorfuture demand.

COSTMethods: Library research for available sec-ondary data and assistance from many sta- Under $5,000tistical collections of business agencies and

FINANCING ORGANIZATION(S)government agencies. The usual statisticaltechniques were applied to the data collected, School of Pharmacy, Univ. of So. Calif.e.g., correlation and trend analysis to pro- PUBLICATION PLANSduce meaningful data.

Not yet decidedCURRENT STATUSEssentially complete except for refinement of FOR FURTHER INFORMATION

the gross projections through further cor- Dean Alvah G. Hall,.School of Pharmacy, Univ.relation studies of supporting data. (Oct. of So. Calif., University Park, Los Angeles,1965Jan. 1966) Calif. 90007

261

H-49 Area Variations in the Receipt of Hospital and Medical Care (4/22166)ABSTR ACT

Objectives: A study of factors associated withprovision and receipt of health care, withand without prepayment. The objective isto cast light on th,-; role of supply and de-mand factors in influencing or determiningarea variations in resources for care, pro-vision and receipt of care, etc.

Content: Statistical analyses of rates of uti-lization of medical, surgical and hospitalcare, with and without prepayment, andvariations among geographical areas in se-lected population groups; and correlationsbetween (a) area variations in utilizationsand (b) supply and demand factors.

Methods: Data have been compiled from vari-ous sources (Blue Cross and Blue Shield ex-periences for select or total populationgroups; U.S; Census and other sources onarea populations, economic indices, etc.).The statistical analyses are conducted by themethods of multiple regression techniques.

CURRENT STATUS

Much of the data has been compiled ; and someseries have yet to be obtained. Extensivestatistical analyses are in progress. A pre-liminary paper on the pattern of the study,methodology and partial findings is now inpreparation. (1962-1968)

262

ORGANIZATION(S)Dept. of Epidemiology and Public Health. Yale

School of Medicine

PRINCIPAL INVESTIGATOR(S)Falk, I. S.Francisco, Edward W.STAFFFull-time:1 economist

Part-time:1 medical care specialie1 statisticianCOST835,000$44,999

FINANCING ORGANIZATION(S)Yale UniversityUSPHS

PUBLICATION PLANSA preliminary paper has been offered for pre-

sentation at the American Public HealthAssociation annual meeting, 1966. Expecteddate of publication, 1967 and following

FOR FURTHER INFORMATIONI. S. Falk, Prof. of Public Health (Medical

Care) Dept. of Epidemiology and PublicHealth, Yale School of Medicine, 60 CollegeSt., New Haven, Conn. 06504

1.0.0.000.-

II-50 Cultural Factors Affecting Illness in Rural Areas of MissouriABSTRACTObjectives: To chart the ecological patterns

of health faciliites in rural areas.Content: A 20-county rural area is involved.Methods: Data collected in 1950, 1954 and

1958 will be compared with that currentlybeing obtained.

CURRENT STATUS(July 1964-67)

ORGANIZATION ( S)Agricultural Experiment Station, University

of Missouri

PRINCIPAL INVESTIGATOR(S)Hassinger, E. W.STAFFFull-time:

1 sociologist


COST

$50,000$74,999

(5/4/66)


PUBLICATION PLANS


E. W. Elssinger, Department of Rural Sod-ology, University of Missouri, Columbia, Mo.65201

11-51 Measurement of Speech-Sound Discrimination Loss (f '3/66)ABSTRACT

Objectives: The basic objective of the long-term goal is to increase our knowledge of thediagnostic-therapeutic implications of audio-logic test findings, particularly speech dis-crimination test results.

Content: The purpose of this study is to in-vestigate the relationship between PB-50word (W-22) discrimination test results andthe Fairbanks Rhyme Test results on normaland patholog.cal eors. Articulation functionsderived from these tests delivered at sevensensation levels ranging from minus 4 dBto plus 40 dB have been analyzed for normallisteners and subjects with sensori-neuralhearing loss and will be reported in thefuture.

Methods:

CURRENT STATUS(Dec. 1965-66)

ORGANIZATION(S)University of Texas

264

PRINCIPAL INVESTIGATOR(S)Kopra, Lennart L., Ph.D.Wakiron, Daryle L.STAFFFull-time:1 psychologist

Part-time:1 psychologist2 audiologistsCOST$15,000424,999

FINANCING ORGANIZATION(S)National Institute of Neurological Diseases

and Blindness, Bethesda, Md.

PUBLICATION PLANSJournal of Speech and Hearing Research or

Journal of Acoustical Society of Americalatter 1967

FOR FURTHER INFORMATIONLennart L. Kopra, Ph.D., Prof. of Speech and

Education, Dept. of Speech, Univ. of Texas,Austin, Tex. 78712

(

r

)

H-52 Admission of Older Persons to a Private(11129065)

ABSTRACT

Objectives: TG determine demographic, diag-noF.tic, and treatment characteristics of olderpersons admitted to a private psychiatricfacility in a five-year period.

Content: Analysis of data from case files whichhas previously been extracted and coded byanother research organization.

Methods: Included in Content.

CURRENT STATUS

Analysis of data in process. (Oct. 1965Aug.1966)

ORGANIZATION (S)

North Texas State Univ.

PRINCIPAL INVESTIGATOR (S)Friedsam, H. J.

Psychiatric Hospital

STAFFFull-time:None


COSTUnder $5,000

FINANCING ORGANIZATION(S)North Texas State Univ.Timberlawn Foundation, Dallas, TexasPUBLICATION PLANSNo definite plansFOR FURTHER INFORMATIONH. J. Friedsam, Dir., Dept. of Economics and

Sociology, North Texas State University,Denton, Texas 79605

265

11-53 Prices and Patent Protection in the Ethical Drug Industry (11/30/65)ABSTRACTObjectives: To determine influence of patents

upon the level and variability of prices in thedrug industry ; to determine the efficientmethod of financing and performing drugresearch.

Content:

Methods:

CURRENT STATUSIn progress. (June 1965-Sept. 1965-Sept.

1966)

ORGANIZATION (S)Dept. of Economics, Vanderbilt Univ.PRINCIPAL INVESTIGATOR (S)Walker, Hugh D.

266

1

i


Part-time:

COST

FINANCING ORGANIZATION(S)Unsponsored Research

PUBLICATION PLANSNo specific plans as yet

FOR FURTHER INFORMATIONHugh D. Walker, Instructor in Economics,

Dept. of Economics, Vandeibilt Univ., Nash-ville, Tenn. 37203

;

II-54 Age-Income Profiles for 'Whites and Negroes in the United States(7/8/66)

ABSTRACTObjectives: To derive age-income profiles on

both cross-section and cohort basis holdingconstant such important variables as race,sex, region of residence, size of city, andyears of education; then to analyze hnplica-'dons.

Content: Graphic and tabular comparisons,correlations and other useful devices ofanalysis.

Methods: The one-in-a-thousand sample of the1960 Census of Population is the principalsource although 1940, 1950, and 1960 com-plete census will also be used. By means ofelectronic computer a great many separatecompilations holding different variables con-stant are on hand.

CURRENT STATUSMost of computer runs are on hand. Analysis

is under way. (July 1965Decem 1966)

ORGANIZATION(S)Dept. of Economics, Florida State Univ.

PRINCIPAL INVESTIGATOR(S)Colberg, Marshall R., Ph.D.STAFFFull-time:1 economist (summer 1966)Part-time:1 economist (subsequently)1 sociologist (in preliminary work)1 computer programmerCOST

$10,000$14,999

FINANCING ORGANIZATION(S)U.S. Social Security Admin.

PUBLICATION PLANSNot cleara report will be prepared for SSA

by March 31, 1967.FOR FURTHER INFORMATIONDr. Marshall R. Coberg, Chairman, Dept. of

Economics, Florida State Univ., Tallahassee,Fla.

267

11-55 The Nursing Home Industry in the State of Washington (12/3/65)

ABSTRACT STAFFObjectives: To study the structure, dynamics

and potentialities of non-government estab-lished institutions which provide nursinghome care for the aged.

Content:

Methods: The techniques of analysis of indus-try study which economists have developedin the study of industries generally.

CURRENT STATUSPlanning stage.

ORGANIZATION(S)Dept. of Economics, Washington State Univ.PRINCIPAL INVESTIGATOR(S)Trainor, John F.Kottke, Frank J.

268

None


COST


PUBLICATION PLANS

FOR FURTHER INFORMATIONJohn F. Trainor, Dept. of Economics, Wash-

ington State Univ., Pullman, Wash. 99163

H-56 Incidence of Disabling IllnessABSTRACTObjectives: To present, through a continuing

study of a selected population, periodic rec-ords of changes in annual incidence ratesof disabling illness and accidents resulting indisablement of eight days or more accordingto sex, age, and cause of disability.

Content: (1) Quarterly charts comparingmonthly variation in annual incidence ratesof disability by sex for current and preced-ing year ; (2) quarterly tabulations compar-ing incidence of disability by sex, age, andcause of disability for current and precedingyears-to-date; (3) annual chart showingmonthly variation in annual incidence ratesof disability by sex for current and sevenprior years ; (4) annual article entitled "In-cidence of Disability in Year."

Methods: New cases of disabling illness areobtained monthly from clr.im records,checked to verify accuracy of the cause-of-disability code (according to the ICD), andthen tabulated according to sex, age, andcause of disability. Cumulative summariesmade for each quarter to obtain year-to-dateand yearly summaries for use as listed inContent above. Disabling illness is defined asillness absence certified by a physician andlasting at least 8 days.

(5/23/66)CURRENT STATUSStudy is now in its second year; it is antici-

pated that it will be continued indefinitely.(Jan. 1965continuing study)

ORGANIZATION(S)Metropolitan Life Ins. Co.

PRINCIPAL INVESTIGATOR(S)Eide, K. Arne

STAFFFull-time:None


COST


PUBLICATION PLANSThe Statistical Bulletin, Metropolitan Life Ins.

Co.Currently in publicationcontinuingFOR FURTHER INFORMATIONK. Arne Eide, Stat. Assoc., Metropolitan Life

Ins. Co., 1 Madison Ave., New York, N. Y.10010

269

I. Utilization of Health Services

The following projects with their major emphasis falling in thesubject matter of other categor ies also contain data on utilization:A-3; B-4; B-7; C-5 ; D-5; D-29; D-49; G-2; G-7; G-8; G-9;G-18; H-12 ; 11-15; H-26; H-32; H-38 ; J-3; K-3.

(;27j/271

1-1 Assessment of Effects of a Nationwide Nursing Home Benefit and theDevelopment of a Research Program (9/8166)

ABSTRACTObjectives: To create a reporting network on

the various components of a nursing homebenefit, including providers of care, insur-ance carriers, and beneficiaries. A firm foun-dation upon whieh a research program canbe built will also be erected.

Content: The study will provide day-to-dayhistory of the operations of a major nursinghome benefit which will be available in 77communities in 34 States and the District ofColumbia. Data shall be summarized on earlyutilization of benefits and problems asso-ciated with the new benefits. A series of re-search proposals will be developed. Theseproposals will have as their central focus thequestion, what are the components of a suc-cessful nursing home benefit?

Methods: The project shall be conducted in twoparts. The first phase will establish the re-porting network. The second phase shall ex-plore the impact of the whole program ofnursing home benefits on beneficiaries, pro-viders of: service and insurance carriers, todevelop a series of research proposals.

CURRENT STATUS(Sept. 1966Dee. 1967)

ORGANIZATION(S)

Michigan Health and Social Security ResearchInstitute, Inc.

PRINCIPAL INVESTIGATOR(S)Glasser, Melvin

STAFFFull-time:1 medical care specialist1 statistician

Part-time:None

COST

$35,000444,999


PUBLICATION PLANSNot known yet


Melvin Glasser, Michigan Health and SocialSecurity Research Institute, Inc., 8000 E.jefferson Ave., Detroit, Mich. 48214

.27073

1-2 Hospital Utilization in New England Pre-Medicare (4/30/66)

ABSTRACTObjectives: To conduct a descriptive and ana-

iytical study relating )-,o hospital utilizationin New England Pre-Medicare.

Content: The study will analyze 18,000 patientrecords to determine the patterns of utiliza-tion by age, diagnosis, hospital size, region,and payment mechanism. Analysis of suchdata will answer such questions as (1) Whatproportion of the New England patient popu-lation were potential "Medicare" benefici-aries? (2) To v::::.4t extent did the populationuse other facilities?, (3) Did the paymentmechanisms used by the population of poten-tial "Medicare" beneficiaries differ fromthose used by the rest of the population?The information when gathered will be ar-ranged to allow a before and after "Medi-care" comparison of hospital utilization. Theproject will also describe all the data collec-tion system so that the post "Medicare" partmay be collected in a way which will matchthe first collection.

Methods: All information, which is already incoded data sheets, shall be converted toforms suitable for analysis by electronicdata processing. Quarterly progress reportsas well as a final report shall be compiled.

274


El_ A WTT/7 A rfITAILX Icr1..1.11AIVCA111.1421. 1 11.U.1.1 k

Office for Research Contracts, Harvard Uni-versity

PRINCIPAL INVESTIGATOR(S)Rosenthal, Gerald, Ph. D.

STAFFFull-time:None

Part-time :1 economist1 physician

COST


USPHS

PUBLICATION PLANSNot known

FOR FURTHER INFORMATIONGerald Rosenthal, Ph. D., Harvard Univ., 1350Massachusetts Ave., Cambridge, Mass. 02138

1-3 Study of Federal Employees Health Benefits ProgramABSTRACTObjectives: To prepare a brief history of the

Federal Employees Health Benefits programfrom its inceptinn iv, 1962 through the endof September 1964.Content: The study will consist of (1) study-

ing the problems of data collection, includingstatistical tables, sampling, and adequacy ofdata on covered population ; (2) analyzingof utilization data which are available frohlthe plans participating in the Federal Em-ployees Health Benefits Program ; (3) exami-nation of the different patterns of utilizationand analyses. In summary, the study willcontain analysis of the trends in utilization ofservicea under the different plans in their aif-ferent geographic and demographic settings.

Methods: Data shall be obtained from the CivilService Commission recorls. Analyses indepth are being undertaken of published andunpublished data from four years of op-eration of the country's largest employer-employee sponsored health benefits program.

CURRENT STATUSIn progress. (July 1965Sept. 1966)

ORGANIZATION(S)

PRINCIPAL INVESTIGATOR(P.)Period, George S.

STAFF

Full-time:None


COST

$10,000$14,999


PUBLICATION PLANSProbably USPHS

FOR FURTHER INFORMATIONGeorge S. Perrott, 8905 Grant St., Bethesda,Md. 20034

275

1-4 Development of a Methodology to Differentiate Quantities of NormalNursing Services Delivered to Different Groups of Patients

ABSTRACTObjectives: To investigate the feasibility of a

method of measuring standard nursing serv-ices to different groups of patients and, ifthe test is successful, to determine the sizeof a sample for a full test that will be sta-tistically significant.

Content: This study consists of 3 phases.Phase 1 consists of review of literature, de-velopment of a methodology, and selectionof 4 hospitals for the pilot test of the study.Phase 2 consists of assigning a team ofobservers to observe the activities of thenursing staff, aides, ward clerks in the 4hospitals. Records of patients shall bechecked including age, sex, race, and in y-ment source. Phase 3 will consist of analysisof the data obtained to determine (1) feasi-bility of the methodology to differentiatebetween quantities of services delivered todifferent groups of patients, particularly inreference to the aged versus the non-aged,and (2) the sample size necessary to furnishthe results of a larger study, a statisticalbase.

Methods: Hospital nursing units will be se-lected as sites for the study. A team of ob-servers will be assigned to each unit. A total

276

of 32,000 observations will be made, and afinal report shall be compiled.

CURRENT STATUS(AprilJuly 1966)

ORGANIZATION(S)Hospital Council of Maryland

PRINCIPAL INVESTIGATOR(S)Pendall, Rudolph

STAFFFull-time:

Part-time:

COST


PUBLICATION PLANS

FOR FURTHER INFORMATIONRudolph Pendall, Hospital Council of Maryland,

10 South St., Baltimore, Md. 21202

I-5 "Modern Medicine" Poll of Medical PracticeABSTRACT

Objectives: To obtain data on incidence oftreatment of specific illnesses.

Content: The project analyzes, for variousmajor diseases, the types of practice ofphysicians treating them, methods of treat-ment by the type of practice, results oftreatment, major changes in treatment from1949 to 1966, average number of new casesseen per 30-day period by type of practice,etc.

Methods: The information for the studies iscollected from questionnaires appearing inModern Medicine and subsequently com-pleted by physicians and mailed to the pub-lication.

CURRENT STATUSTest stage. First questionnaire to all M.D.'s_

(190,000) on circulation list of Modern Medi-cine. (Nov. 1965at least into 1967)

ORGANIZATION(S)Modern Medicine Publications, Inc.

PRINCIPAL INVESTIGATOR (S)Wright, Irving, M.D.

Jacobson, Wyman, M.D.Hubbard, A. W.

STAFF

Full-time :

I mathematician2 physicians1 statistician1 research analyst

Part-time:None

COST

FINANCING ORGANIZATION(S)Modern Medicine Publications, Inc.

PUBLICATION PLANS

Afodern MedicineAug. 1966 and later issues


Irving Wright, M.D., Modern Medicine Publi-cations, Inc., 65 at Valley View Rd., South-dale Park, Minneapolis, .Minn. 55424

277

1-6 Evaluation of Out-of-Hospital Medical Care for the Indigent Aged(8/26/66)

ABSTRACT11h40.+441troct e+i, el ., t,,,, ...s.c....tev,-...10 .....-.1.seri-esA ... or1.4, sap j 16.67 IV v SAILA.), 10 GA 6 0 0 10%. loVI.A. C10

pects of medical care utilization by recipientsof Old Age Security (public assistance) inLos Angeles County, as to the extent ofservices utilized by the recipients, and theprofessional characteristics and career pat-terns of physicians in the County who servea major portion of them.

Content:

Methods: QuantitativP t regarding medicalcare received, suci. number of physicianvisits and other data, are being obtainedfrom public assistance records of a sampleof 1,000 recipients. A sample of "high" pro-vider physicians will be compared to a sam-ple of other physicians in the community onselected professional characteristics accord-ing to data from a questionnaire survey.

CURRENT STATUS

Final write-up. (Sept. 1964Dec. 1966)

278

ORGANIZATION(S)Div. of Medical and Hospital Administration,

School of Public Health, Univ. of Calif., L.A.PRINCIPAL INVESTIGATOR(S)Dowd, Ronald

STAFFFull-time:None

Part-time:1 medical care specialistCOSTUnder $5,000FINANCING ORGANIZATION(S)Rancho Los Amigos Hospital, Downey, Califor-

niaPUBLICATION PLANS

FOR FURTHER INFORMATIONRonald Dowd, School of Public Health, Univer-

sity of California, Los Angeles, Calif. 90024

1-7 Effect on Percentage of Occupancy of Adult Care Homes in Kansas, byChange in Bed Capacity Due To New Construction, Additions to andConversion of Existing Facilities and Home Closure (12127165)ABSTRACTObjectives: To analyze the effect on percentage

occupancy of adult care homes due to newconstruction and enlargement and conversionof existing facilities.

Content: The study lists, by counties, all li-censed Kansas adult care homes and in-cludes, for each, an explanation of anychanges in licensed capacity which may haveoccurred during the study. Statistics are--iven for each facility regarding the avail-.1) le bed months and the percentage occu-pancy for each of the three years of theproject. Statewide totals are also includedand separated into categories for skillednursing homes and long-term care facilities.

Methods: Information for the study was col-lected from questionnaires mailed to all li-censed Kansas adult care facilities for eachyear from 1963 to 1965.

CURRENT STATUS

ORGANIZATION(S)Kansas State Dept. of Health

PRINCIPAL INVESTIGATOR(S)Personnel of the Kansas State Dept. of HealthSTAFF

Full-time:

Part-time:1 physician1 registered nurse1 social worker, counselor

COST

Under $5,000

FINANCING ORGANIZATION(S)Kansas State Dept. of Health



Josephine P. Boam, Admin. Assist., KansasState Dept. of Health, State Office Bldg.,Topeka, Kan. 66612

279

1-8 Professional Activity Study and the Medical Audit Program

ABSTRACTObjectives: To develop and make available to

'iospitals the use of an information systemrelevant to the qual4ty of medical practiceand hospital administration, and to trainphysicians and other hospital personnel inthe use of the system.

Content : The major program is the develop-ment of a medical information system for alarge number of hospitals. The system in-volves the condensation of the patient's med-ical record into a concise abstract suitable'for computer processing. The stored data isthen made available for a variety of usesincluding the internal management of thehospital, utilization review, development ofcriteria for good practices and the like. Theproject also offers tutorial instrnction to thephysicians, hospital administrators, and med-ical record librarians concerning methods ofusing the data bank.

Methods: There are now 758 hospitals in 46States, Puerto Rico, the District of Colum-bia, and two foreign countries participatingin the information system, and the data banknow consists of approximately 17 million caseabstracts. Seven hundred and eighty-fivephysicians and other hospital personnel havetherefore been trained in the uses of thesystem.

CURRENT STATUSAs of July 1, 1966, data are handled for 6,700,-

000 discharges per year from short-termgeneral hospitals in the United States, Can-

280

ada and Australia. Data bank is 20,000,000clinical record abstracts on magnetic tape.(1953continuous)

ORGANIZATION(S)Commission on Frofessional and Hospital Ac-

tivities??RINCIPAL INVESTIGATOR(S)Slee, Vergil N., M.D.STAFF

2 accountants3 mathematicians1 medical care specialist2 physicians1 registered nurse6 statisticians

12 nosologists15 data processorsPart-time:None



PUBLICATION PLANSThe RecordIrregularly-

FOR FURTHER INFORMATIONVergil N. Slee, M.D., Dir., Commission on Pro-

fessional and Hospital Activities, First Na-tional Bldg., Ann Arbor, Mich. 48108

(........

1-9 Nationwide Collection and Utiiization of Basic Statistics on ComprehensiveMedical Care Provided through Prepaid Group Practice (114166)

ABSTRACTObjectives: To improve out-of-hospital services

particularly -for the chronically ill and agedand by helping improve and expand compre-hensive health care services, especially byprepaid group practice through nationwidecollection and analysis of basic medical carestatistics on prepail group practice compre-hensive care programs.

Content: (1) Location and general type ofcommunity and membership served, methodsof operation, staff, facilities, and scope ofservices ; (2) population enrolled by number,age, and sex, and by such other categoriesas marital and occupational status, etc., asmay be obtainable; (3) amounts of profes-sional and other personal services and ofhospital, nursing home and other facilitiesutilized, under the various situations identi-fied under (1).

Methods: It is proposed to establish in theNational Headquarters of GHAA a Researchand Statistics Division, which will consistof a Chief, assistant, statistical clerk, and sec-retary. A professonal advisory council willbe appointed from the fields of medical careadministration, statistics, education, andpublic affairs. Staff, under the supervisionof the Executive Director and the GeneralManager, will initiate and conduct a programto collect and analyze medical care statisticsfrom prepaid group practice in three cate-gories.

CURRENT STATUSThe project is in its fourth year. Progress

reports were submitted during the first threeyears and a summary of the first threeyears' work was made in September 1965.The principal investigator is conducting ad-ditional field work at this time. (Sept. 1962Aug. 1967)

ORGANIZATION ( S)Group Health Assoc. of America

PRINCIPAL INVESTIGATOR (S)Einhorn, Marilyn M., (Mrs.)

STAFFFull-time:1 statistician

Part-time:



PUBLICATION PLANS


W. P. Dearing, M.V., Group Health Assoc. ofAmerica, 1321-14th St., N.W., Washington,D.C. 20005

281

1-10 1966 Study of Individuals Cared for in Nursing Homes in Missouri(5/5/66)

ABSTRACTObjectives : To collect and store various types

of information for all nursing home residentsin Missouri.

Content : The survey will collect data for resi-dents of nursing homes regarding age,length of stay, type of nursing home, totalmonthly expenses, sources of funds, physi-cal condition, treatment and therapy activi-ties and social life, etc. The data will bestored and made available for future use.

Methods: Questionnaires for the 20,000 Mis-souri nursing home residents have beenmailed to nursing home administrators tobe completed with the assistance of publichealth nurses from the regional health offices.The information on the questionnaires willbe recorded on IBM cards.

CURRENT STATUS

The information on the approximately 20,000nursing home residents is being collectedby the Institutional Advisory Nurses. Thisinformation is gathered for the State byour own organization and is not a specialproject, but fits into the working scheduleof the nurses. Duplicates of the individualIBM card on each completed questionnaire

282

will be supplied to the group, Heaith Eco-nomics Branch, U.S. Public Health Service,at a proposed rate of 309, per card. (Mar.Sept. 1966)

ORGANIZATION (S)Missouri Division of HealthPRINCT' 4.L INVESTIGATOR (S)Institutional Advisory NursesSTAFFFull-time:

Part-time:16 registered nurses1 statisticianCOST$25,000$34,999

FINANCING ORGANIZATION (S )Missouri Division of HealthPUBLICATION PLANS

FOR FURTHER INFORMATIONMr. Jesse H. Bartlett, Dir., Nursing Home

Program. Missouri Division of Health, Jeffer-son City, Mo.

0

0

1

I-11 Duration of Materna! Postpartum Hospital StayAn EconomicMedical Problem? (11123165)

ABSTRACTObjectives: To investigate some of the factors

relating to duration of mothers' hospitalstay.

Content: The patients surveyed were patientshaving no maternal or infant complications.The cases were distributed in each hospitalin accordance with the individual doctor iden-tification. The results showed an amazingrange of variation in postpartum stay ofhealthy mothers and babies. It was foundthat the range of stay varied between 2 and9 days with 4 and 5 days postpartum stayrepresenting the majority of patients. Sev-eral factors were also found to be associatedwith postpartum stay : economic reasons,medical background, accommodations, andshortage of beds.

Methods: The duration of postpartum mater-nal stay in the data was determined fromthe length of the infant stay. Individualhospital data were studied in relation to timeof the year. It was noticed that the lowerpcstpartum stay tends to occur at certainpeaks which are definitely not uniform intiming for all hospitals.

CURRENT STATUSContinuous evaluation in conjunction with the

functioning of the Perinatal Study.

ORGANIZATION(S)Foundation fnr mpdionl Research


STAFFFO-time:

Part-time:

COST


or

PUBLICATION PLANSData published frequently as part of a general

article covering maternity or newborn care ;in addition, much information is dispensedthrough a monthly Newsletter


Sydney H. Kane, M.D., Ex. Dir., Foundationfor Medical Research, 4840 Frankford Ave.,Philadelphia, Pa: 19124

283

1-12 Use of Inpatient Facilities of a University Hospital (5/9/66)

ABSTRACTObjectives: (1) To provide information con-

cerning the utilization of medical-care facili-tes ; (2) to help develop and adapt fromother fields methods that will be helpful inmedical-care research ; (3) to emphasize theneed in medical-care research for the devel-opment of a precise and meaningful vocabu-lary and the establishment and dissemina-tion of consistent definitions ; and (4) to aidin the continuing development of techniquesfor measuring the effect on hospital utiliza-tion of changes in administrative policieswith regard to criteria for admisson, bedallocation, length of stay, etc.

Content: The role of certain characteristics ofthe patient, physician and episode of illnessas determinants of hospital utilization arebeing studied. Among these are length ofstay, the relationship between dischargediagnosis and operative procedures per-formed, various demographic and socioeco-nomic factors. Studies examining use of theancillary facilities, e.g., radiology and lab-oratory are underway. Also under investiga-tion is an evahLation on the length of stayof changes in the allocation of beds betweenservices and of changes in policies regardinglong stay patients.

Methods: The techniques of descriptive analy-tic epidemiology are being used to examinethe patterns of hospital utilization of the

284

more than 27,000 patients discharged eachyear from -61ziversity Hospitals of Cleveland.

CURRENT STATUSAn application for renewal of this grant has

been submit',ed to the USPHS (May 1964April 1967)

ORGANIZATION(S)Div. of Biometry, School of Medicine, Western

Reserve Univ.PRINCIPAL INVESTIGATOR(S)McCorkle, Lois P., M.D.

STAFF

1 physicianPart-time:None

COST$75,000$99,999


PUBLICATION PLANSHealth Services ResearchSummer 1966

FOR FURTHER INFORMATIONLois P. McCorkle, M.D., Assist. Prof. of Bio-

statistics, Div. of Biometry, School of Medi-cine, Western Reserve Univ., Cleveland, 0.44106

1-13 Health Care and The Family: A

ABSTRACTObjectives: A two-year exploratory study a

various phases of health care utilizing thefamily as the basic study unit. The use ofboth a three generational and two genera-tional family model is envisioned. Primaryfocus will be directed at the decision-makingprocess involved in the selection and use ofhospital and physician services, financialconcepts and budgeting, knovAedge and per-ception of illness and disease, health carepractices and the allocation of family roles.In addition, an attempt will be made to ex-amine family adjustment and adaptation toperiods of illness, both episodic and chronicin nature.

Content:

Methods: Field interview. Seventy three-gen-eration family units or 210 nuclear familiesresiding within 150 mile radius of the twincities area.

CURRENT STATUSPreparation of data collection instruments.

Training of iuterviewers. Drawing sample.(Mar. 1966Feb. 1968)

Three Generational Study (7120/66)

ORGANIZATION(S)

Program in Hospital Admin., School of PublicHealth, Univ. of Minn.

PRINCIPAL INVESTIGATOR (S)Litman, Theodor J., Ph.D.

STAFF

F'ull-time:None


COST

$35,000$49,999


PUBLICATION PLANSNot available at this time


Theodor J. Litman, Ph.D., Program in HospitalAdrnin., School of Public Health, Univ. ofMinn., 1260 Mayo, MinneaPolis, Minn. 55455

1-14 Analysis of Hospital Procedures

ABSTRACTObjectives: To examine certain procedures in

hnspitglq swill as admission patterns, labora-tory processing, etc., to see if they contributeto undue length of stay of patients.

Content : This is primarily a project to attemptto increase overall efficiencies in patient proc-ebsing apart from the actual treatment ofany patient.

Methods: The methods have been to analyzedata and look for patterns in various areaswith extension to producing a mathematicalmodel of admission/discharge paterns.

CURRENT STATUSNear termination. A mathematical model of

admission/discharge patterns has been de-veloped and is now being examined in a com-puter to show how modifying different ae-mission/stay /discharge parameters modi-fies bed usage. (Sept. 1964-66)

ORGANIZATION(S)Winnipeg General Hospital

286

Affecting Length of Stay (3/29/66)

PRINCIPAL INVESTIGATOR(S)Saunders, Michael G., M.D.

STAFFFull-time:None


COST

$15,000$24,999

FINANCING ORGANIZATION(S)Department of National Health and Welfare,

Ottawa, Canada

PUBLICATION PLANSUnknown at moment

FOR FURTHER INFORMATIONMichael G. Saunders, M.D., Dir. Electroenceph-

alogram Dept., Winnipeg General Hospital,700 William Ave., Winnipeg 3, Manitoba,Canada

01-15 Analysis of the Nursing Home Benefits of Medicare on the Nursing Homes

3f Wisconsin (6130166)ABSTRACTObjectives: To develop a detailed picture of the

free-standing nursing homes in Wisconsin,and to assess the effects of the nursing homebenefits of the "Medicare' law on the nurs-ing home industry.

Content: A sample of free-standing nursinghomes in Wisconsin shall be designed. Thesample shall be stratified by size, type ofownership and location. For each nursinghome in the sample the data gathered willinclude: (1) experience of nursing homeunits ; (2) financial experience in operatingunits ; (3) patient characteristics and experi-ence. The data will be collected twice, first in1966 and again in 1967; and comparisonsmade.

Methods: A sample of free-standing nursinghomes will be designed using the data above.Analyses will be made to show the differ-ences in operating pattunr, financing, pa-tient and facility characteristics for thehomes in the 1966 and 1967 collections. Com-parisons will be made between the two setsof data to show the effects of the new financ-ing milichanisms, both on those homes whichqualify as Extended Care Facilities andthose which do not.


ORGANIZATION (S)Medical Center, Univ. of Wisconsin

PRINCIPAL INVESTIGATOR(S)Connors, Edward

STAFFFull-time:None

Part-time:1 economist1 medical care specialist

COST

$75,000499,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONEdward Connors, Medical Center, Univ. of Wis-

consin, 750 University Ave., Madison, Wisc.53706

287

1-16 Hospitalization and Surgical Care of Metropolitan Employees andDependent Spouses (5/23/66)

ABSTRACTObjectives: To obtain, through an extensive

and intensive study of claim records, a per-spective of patterns of hospitalization andsurgical care in a selected population con-sisting ot employees of the Metropolitan LifeInsurance Company at working ages, and oftheir dependent spouses covered by the Com-pany's Group Comprehensive Medical Ex-pense Plan.

Content : A series of several (exact numberunknown at present) articles and tablescovering incidence rates, duration of hospi-tal stay, type of surgery, cause of hospitali-zation, according to age, sex, and separatelyfor employees rnd dependent spouses (pre-dominantly wives).

Methods: Claim records of all inpatient hos-pitalizations for the year 1963-65 inclusive,traced to June 30, 1966, will be assembled.The study will be based on episodes of hos-pitalization. Hospitalization for same cause,occurring less than three months from theend of previous period of hospitalization, willbe considered a continuation of prior episode.

CURRENT STATUSStudy is in planning stage except for a few

preliminary analyses that have been madeof 1965 data. (March 1966-1967)

288

ORGANIZATION(S)Metropolitan Life Ins. Co.

PRINCIPAL INVESTIGATOR(S)Eide, K. Arne

STAFFFull-time:None


COST


Their

PUBLICATION PLANS

The Statistical Bulletin, Metropolitan Life Ins.Co. Will be published as a series of articlesappearing monthly or bi-monthly during1966-67. Entire series will be collected andpublished as a brochure at conclusion ofstudy.

FOR FURTHER INFORM A.TION

K. Arne Eide, Stat. Assoc., Metropolitan LifeIns. Co., 1 Madison Ave., New York, N. Y.10010

-

1-17 Utilization of Health Resources by Welfare Clients (1/17/66)ABSTRIVTObjectives: The primary feature of this proj-

ect is the study of a welfare population soas to compare utilizers and non-utilizers ofhealth services as well as other relatedresources (e.g., well-baby clinics and childcare facilities), in order to determine whichpersonal, social and cultural characteristicsand community programs are related to useand lack of use of facilities.

Content: A panel sample of 1,500 publiclyassisted families in New York City will beselected and followed up over a four-yearperiod with respect to attitudes and behaviorrelevant to utilization of services.

Methods: See Content.CURRENT STATUSPilot interviews with a small sample of fami-

lies are being analyzed. The instrument forthe first wave of systematic data collectionis being constructed. (May 1965-69)

ORGANIZATION(S)Social Welfare Research Council

,

PRINCIPAL INVESTIGATOR(S)Podell, Lawrence, Ph.D.Hauxhton, James CI:, Nr.n.STAFFFull-time:1 physician1 social worker, counselor2 sociologists

Part-time:1 phyisician1 sociologist



PUBLICATION PLANS

FOR FURTHER INFORMATIONLawrence Podell, Ph.D., Ex. Dir., Social Wel-

fare Research Council, 250 Church It., NewYork, N. Y. 10013

289

1-18 Personal Health Services:

ABSTRACTObjectives: (1) To contribute to the develop-

ment of valid and reliable instruments forcompiling data about utilization of andcharges for personal health services ; (2) toestimate rates of utilization and averagecharges for specific personal health servicesof persons in an area of New York City, andof subgroups of this population.

Content: Indices of utilization of services inone year include the following: hospitalstays and hospital days ; out-of-hospitalvisits for medical and mental health serv-ices, by payment status (paid, prepaid, free)and by location (office, clinic, home). Indicesof charges in one year include costs of in-hospital care, out-of-hospital services, pre-scriptions, medicines, appliances, etc. Grosscharges, insurance benefits and net chargeswill be obtained.

Methods: Household interview survey withtwo probability samples of housing units.One interview schedule asks about specificconditions, and then asks for services andcharges for each condition. The other inter-view schedule probes for types of facilitiesused, and then asks for services and chargesof each facility. Verification of a sample ofreperted services will compare the two sched-ules as to under- and over-reporting of serv-ices, and over-reporting of facilities. Tomeasure under-reporting of facilities, per-sons in 5 samples of known users of medicalservices will randomly be assigned to beinterviewed by one of the two schedules.

290

Utilization and Charges (1/7/66)

CURRENT STATUSInterviewinv completm fnr ahmit 60 percent

of cases in all samples. Editing of schedulesand coding has started. (Jan. 1965-66)

ORGANIZATION(S)School of Public Health and Admin. Medicine,

Columbia Univ.

PRINCIPAL INVESTIGATOR(S)Loewenstein, Regina

STAFFFull-time:1 sociologist2 statisticians

Part-time:None

COST

$150,000$199,999

FINANCING ORGANIZATION(S)USPHSHealth Research Council of the City of New

York, 125 Worth St., New York, N. Y. 10013

PUBLICATION PLANSNot yet planned


Regina Loewenstein, Res. Assoc. in Admin.Medicine, School of Public Health and Ad-min. Medicine, Columbia Univ., Rm 307, 21Audubon Ave., New York, N. Y. 10032

1-19 Psychiatric Treatment and Patterns of Medical Care (519166)ABSTRACT

Oik. Ictives: To examine the impact of the in-troduction of a psychiatric the-apy serviceon patterns of medical care provided foremotional disorders. From the point of viewof the patient, the study would examine theimpact of the psychiatric service on (1)changes in patterns of medical care andother aid sought and received by those withemotional disorders, and (2) social and psy-chological characteristics of patients asthese relate to patterns of medical care foremotional disorders and changes in thesepatterns resulting from the introduction ofpsychiatric therapy.

Content: The study focuses largely on thefamily physician and the patterns of medi-cal care he provides for emotional disordersseen during his regular practice. The studywill measure (1) changes of patterns ofpatients with emotional disorders, and (2)differences in treatment provided for pa-tients referred to the psychiatrist and thoseretained for family physician care.

Methods: Interviews conducted with both fam-ily physicians and their patients among 2patient samples seen by a family physicianduring a 3-month period prior to the offeringof psychiatric services. One sample is ofpatients with a psychiatric diagnosis, theother of all other patients. New patient sam-ples are drawn and similar interviews con-ducted two years later. A sample of natientswho had received psychiatric care v Ald beinterviewed about psychiatric treatmentthey might have received subsequently.

CURRENT STATUSInterviewing among family physicians and

patients for the first phase of the studycompleted and tabulations of physician inter-views available. Coding of unstructured re-plies of both doctors and patients in process,and initial patient tabulations underway.(Jan. 1966-68)

ORGANIZATION (S)Health Insurance Plan of Greater New YorkPRINCIPAL INVESTIGATOR(S)Fink, Raymond, M.D.Goldensohn, Sidney, M.D.Shapiro, SamSTAFFFull-time:None

Part-time:1 physician1 sociologist1 statisticianCOST$150,000-$199,999


PUBLICATION PLANSNo specific publication plans at this dateFOR FURTHER INFORMATIONDr. Raymond Fink, Assoc. Dir., Div. of Re-

search and Statistics, Health Insurance Planof Greater New York, 625 Madison Ave.,New York, N. Y. 10022

-

291

I-20 Development of Standard Medical Care and Utilization MeasurementsMethodology (7/13/66)

ABSTRACTObjectives: To develop and test a methodology

for deriving comparable utilization and costdata from a wide variety of ambulatory,home, and other types of medical care pro-grams other than in-hospital.

Content: Thesis : that by developing a sensi-tive and accurate profile of the total complexof a programincisive analysis of staff pro-viding care, the range of services available,what manner of organization and setting formeeting needs of patknts, who the utilizersare, how care is utilized, and costs of provid-ing each element of caresuch a catalogueof the critical components of each programwill provide us with myriad variables bywhich specifics of one program may be com-pared with comparable specifics of anotherprogram to the exclusion of all extraneousfactors.

M3thods: Data is being collected from 9 medi-cal care programs-5 in New York City, 4in up-State New Yorkas an exercise inorganizing data consistently, developing auseful profile instrument, refining and sim-plifying data collection techniques, andidentifying types of unavailable data whosefuture availability might broaden our under-standing of the meaning of differenccs inhow programs are utilized, cost differences,and the like.

CURRENT STATUSCurrently completing model profile (for larg-

292

est, most complex of the programs in ourlist) and 6-month report briefly discussingmethods, problems, kinds of comparativetables possible with existing data. (July1964-67)

ORGANIZATION (S)Medical and Health Research Assoc. of New

York City, Inc.

PRINCIPAL INVESTIGATOR (S)Dolinsky, Edward M., M.P.H., B.S.


Part-time:None

COST

$50,000$74,999

FINANCING ORGANIZATION(S)USPHSMedical and Health Research Association of

New York City, Inc.

PUBLICATION PLANS


Edward M. Dolinsky, Assoc. for Medical CareRes Medical and Health Research Assoc.cf New York City, Inc., 40 Worth St., NewYork, N. Y. 10013

1-21 Medical Care of Infants and Preschool Children (5/6/66)

ABSTRACTObjectives: To determine the amount and kind

of medical care now being received by in-fants and preschool children; to describebarriers to further use of preient facilitiesto provide a rational basis for suggestingchanges in structure and organization forproviding medical care; and to develop anew infant and child care program if smhaction is indicated.

Content: This project is a longitudinal studyof the medical care received by infants andpreschool children in two contrasting dis-tricts, a slum and a more middle classneighborhood.

Methods: In the infant phase of the study, in-terviews have been conducted monthly forone year with a random sample of mothersliving in each district who gave birth duringparticular months of the. year. In the pre-school phase of the study, interviews wereconducted bimonthly for one year in a ran-dom sample of the households in each ofthe districts where there was at least onechild between the ages of 1 and 6 years.Attendon is also directed at the barriers tofuller use of the facilities and personnel thatare currently available.

CURRENT STATUSData collection almost completed. Analysis of

data from 11,000 questionnaires under way,(1964-1967)

ORGANIZATION(S)New York City Dept. of HealthMedical and Health Research Assoc. of New

York City, Inc.

PRINCIPAL INVESTIGATOR (S)Mindlin, Rowland L., M.D.Densen, Paul M., Sc.D.

STAFFFull-time:1 statistician

Part-time:1 physician1 statistician





Rowland L. Mindlin, M.D., Assist. Com., NewYork City Dept. of Health, 125 Worth St.,New York, N. Y. 10013

293

1-22 .The Development of Predictor Variables in the Study of PhysicianUtilization in a Variety of Countries and Cultures (11123165)

ABSTRACTObjectives: To determine both the relevance

of predictor variables and to note the natureof the relationships between each variableand the utilization of and amounts spent onphysicians.

Content:

Methods: Household data including demo-graphic, economic, and physician utilizationinformation.

CURRENT STATUSIn process. Data being collected and examined.

(1964-196'7)

ORGANIZATION(S)Dept. of Economics (Division of the Social

Sciences), and Dept. of Public Health Prac-tice, Grad. School of Public Health, Univ. ofPittsburgh

PRINCIPAL INTESTIGATOR(S)Perlman, Mark, Ph.D.

294

STAFF

-Part-time.1 economist

COST

$15,000-$24,999


Graduate School of Public Health, Univ. ofPittsburgh

PUBLICATION PLANSJohns Hopkins Press-1968 or 1969


Mark Perlman, Ph.D., Chairman, Dept. ofEconomics, Graduate School of PublicHealth, Univ. of Pittsburgh, Pittsburgh, Pa.15213

0

)

U

1-23 Utilization of Psychiatrists' Care for Children from a Metropolitan AreaA BSTRACT

Objectives: To determine the extent and dis-tribution of psychiatrists' care for children.

Content: Collation of data from all psychia-trists in metropolitan Vancouver.

Methods:

CURRENT STATUSPrepared for publication. The project was be-

gun in 1963.

ORGANIZATION(S)Dept. of Psychiatry, Univ. of British ColumbiailRINCIPAL INVESTIGATOR(S)Richman, Alex, M.D., M.P.H.Nichol, H., M.B., D.P.M.

STAFFFull-time:

MIIIIIIIONO

Part-time:

COST


Dept. of National Health and Welfare, Ottawa,Canada

PUBLICATION PLANS


Alex Richman, M.D., Head, Sec. of Social Psy-chiatry, Dept. of Psychiatry, Univ. ofBritish Columbia, 10th and Heather, Van-couver 9, B.C., Canada

295

1-24

ABSTRACT

Use of Inpatient Facilities of a University Hospital (5/9166)

nkiantives: ri N, m-,..., ....., provide information con-cerning the utilization of medical-care facili-ties; (2) to help develop and adapt fromother fields methods that will be helpful inmedical-care research; (3) to emphasize theneed in medical-care research for the de-velopment of a precise and meaningful vo-cabulary and the establishment and dissemi-nation of consistent definitions; and (4) toaid in the continuing development of tech-niques for measuring the effect on hospitalutilization of changes in administrative pol-icies with regard to criteria for admission,bed allocation, length of stay, etc.

Content: The role of certain characteristics ofthe patient, physician and episode of illnessas determinants of hospital utilization arebeing studied. Among these are length ofstay, the relationship between dischargediagnosis and operative procedures per-formed, various demographic and socioeco-nomic factors. Studies examining use of theancillary facilities e.g., radiology and lab-oratory are underway. Also under investiga-tion is an evaluation on the length of stay,of changes in the allocation of beds betweenservices and of changes in policies regardinglong stay patients.

Methods: The techniques of descriptive ana-lytic epidemiology are being used to examinethe patterns of hospital utilization of the

296

more than 27,000 patients discharged eachyear from University Hospitals of Cleveland.

CURRENT STATUSAn application for renewal of grant has been

submitted to the United States PublicHealth Service. (May 1964-67)

ORGANIZATION(S)Div. of Biometry, School of Medicine, Western

Reserve Univ.University Hospitals of ClevelandPRINCIPAL INVESTIGATOR(S)McCorkle, Lois P., M.D.STAFFFull-time:1 physicianPart-time:None

COST$75,000-$99,999


PUBLICATION PLANSHealth Services ResearchSummer 1966FOR FURTHER INFORMATIONLois P. McCorkie M.D., Assist. Prof. of Bio-

statistics, Div. of Biometry, School of Medi-cine, Western Reserve Univ., UniversityCircle, Cleveland, 0. 44106

1-25 A Motivation Study of Women Coming to a Hospital !lased CervicalCancer Detection Program (11/26/65)

ABSTRACT

Objectives: To determine which factors moti-vated and influenced women to have a pelvicexamination to detect cancer.

Content: 16,053 women.Methods: Individual determination of desired

information.CURRENT STATUSIn preparation for publication. (Feb. 1965-

Dec. 1965)

ORGANIZATION (S )Dept. of Obstetrics/Gynecology, Thomas M.

Fitzgerald Mercy HospitalPRINCIPAL INVESTIGATOR(S)McGowan, Larry, M.D.

STAFFFull-time:1 physician

D1144 44eas na We v"vvmdco

2 physicians1 psychologist3 statisticians

COST

$5,000-$9,999


Thomas M. Fitzgerald Mercy Hospital

PUBLICATION PLANS


Larry McGowan, M.D., Dir. Med. Ed. and Res.,Dept. of Obstetrics and Gynecology, ThomasM. Fitzgerald Mercy Hospital, LansdowneAve. and Baily Rd., Darby, Pa. 19023

297

1-26, Hospital Care in Canada: Trends and Development, 1948-1962(6124/66)

ABSTRACTObjectives: To supply information on recent

trends and patterns in hospital utiliz, 4.onand hospital resources :n Canada.

Content: Analysis and discussion of hospitalusage, beds and occupancy, personnel, andin-patient characteristics, featuring a com-parison of hospital experience in the year-preceding and immediately following the in-troduction 'of the 'nation-wide hospital insur-ance program with an analysis of hospitalin-patients, in terms of age, sex, residenceand diagnostic categories.

Methods: Statistical analysis of existing rec-ords and specially prepared tabulations ofdata concerning hospitals.

(3UHRENT STATUSPublished by DNHW (1962Sept. 1964)ORGANIZATION(S)Research and Statistics Directorate, Dept. of

National Health and WelfarePRINCIPAL INVESTIGATOR(S)Mennie, W. A.

298

Closs, T. SeanRiddell, Betty

STAFFFull-time:1 economist1 registered nurse


COST



PUBLICATION PLANS


J. E. Osborne, Dir., Res. and Stat. Directorate,Dept. of National Health and Welfare,Brooke Claxton Building, Ottawa 3, Ontario,Canada

1-27 Factors Influencing Quality and Quantity of Hospital Care in AtlanticProvinces (3/25166)

ABSTRACTObjectives: Study of availability of records of

existing hospital and medical care plans, andof adequacy of data on them for medical careresearch.

Content : Identification of factors affectingutilization of hospital care whose influencemight be measured, relying principally ondata collected by universal hospital insuranceplans.

Methods: Special tabulations by hospital in-surance plans ; correlations with limited ad-ditional data collected from interviews, cen-sus, etc.

CURRENT STATUSSix months behind schedule. (Apr. 1962-66)ORGANIZATION(S)Dept. of Preventive Medicine, Dalhousie Univ.,

Halifax, N.S.PRINCIPAL INVESTIGATOR(S)Hatcher, G. H., M.D., D.P.H.

s,

Wanklin, 3. M.Gordon, P. G.

STAFFFull-time:1 epidemiologist

Part-time:5 physicians1 sociologist

COST$50,000474,999



PUBLICATION PLANSUncertain


G. H. IT".trlier, M.D., Head, Dept. of PreventiveMedici Dalhousie Univ., Halifax, N.S.,Canada

299

1-28 Group and Non-Group Hospital, Utilization Experience of Blue Crops ofWestern rennsylvania, 1963 (1/12166)

ABSTRACT

Objectives: Part ITo determine the variationin admission rates, average length of stay,and patient-days for group and non-groupmembers. To "suggest possible reasOns forthe observed differences in the various uti-lization indices.

Part IISame as Part I, by diagnostic group-ings.

Part IIISame as Part I, by contract type.Content: Part IAge and sex specific and age

and sex adjusted admission rates, averagelength of stay, and patient-days for groupand non-group members.

Part IISame data by diagnostic groupings.Part IIISame data by contract type.Methods: The data for this study were ob-

tained from the inpatient hospital claimsrecords off Blue Cross. of Western Pennsyl-Nanik and relate to payments made on behalfof apProximately 97 percent of its member-ship durhig the 'calendar year, 1963. Non-contract or hospital days not covered byspecific agreements were excluded. The ageand sex composition of the Blue Cross mem-bership by group and non-group categorieswas obtained from a systematic sample ofthe appropriate files. Over-all, the sampleconsisted of 93,823 agreements or approxi-mately 12.4 percent of the agreements out-standing for the study year.Age and sex specific admission rates per1,000 members, average length of stay, andpatient-day rates per 1,000 members by diag-nostic grouping were compiled for groupand non-group members. These utilization

,300

measures were age and sex adjusted by thedirect method.

CURRENT STATUSPart ITables and analyses completed. (May

1964Aug. 1965)Parts II and IIITables completed; analyses

incomplete. (May 1964Sept. 1966)ORGANIZATION(S)Research Dept., Blue Cross of Western Penn-

sylvania

PRINCIPAL INVESTIGATOR(S)Fitzpatrick, Thomas B.Ferbc-r, BernardSTAFFFull-time:

Part-time:1 medical care specialist1 statisticianCOST


PUBLICATION PLANSPart I : Published in Blue Cross Reports, Vol.

III, No. 3, July-Sept. 1965Parts II auJ III: To be published in Blue

Cross ReportsSept. 1966FOR FURTHER INFORMATIONThomas B. Fitzpatrick, V. Pres., Blue Cross

of Western Pennsylvania, Research Dept.,One Smithfield St., Pittsburgh, Pa. 15222

1

1-29 Health Services for Recipients of Public Assistance in CanadaABSTRACTObjectives: To study trends, shifts in empha-

sis as to coverage and benefits, and in mech-anisms for cost and utilization control, inprograms that finance provision of servicesfor welfare recipients.

Content: Detailed statistical tables on cost andutilization for each program, by category ofbeneficiary and of service, for selected years,plus descriptive and interpretative narrative.

Methods: Correspondence and other communi-cation with senior administrators of pro-vincial plans.

CURRENT STATUSFinal pre-publication review. (1964-1966)ORGANIZATION(S)Research and Statistics Directorate, Dept. of

_ National Health and WelfarePRINCIPAL INVESTIGATOR(S)Williams, L. G.Plat, G. W.

,

STAFF

Full-time:None

Part-time:

2 economists

COST



PUBLICATION PLANS

DNHW-1966


J. E. Osborne, Dir., Res. and Stat. Directorate,Dept. of National Health and Welfare,Brooke Claxton Building, Ottawa 3, Ontario,Canada

301

1-30 Nursing Activity Study (3/30/66)

ABSTRACTObjectives: To examine the amount of time

spent by various classes of nursing personnelon nursing and other duties.

Content: Observed activity on nursing unitsselected by nursing department of hospital.

Methods: Sample survey, based on methoddeveloped by the Division of Nursing Re-sources, U.S. Public Health Service.

CURRENT STATUSTo date, 210 units of 67 public hospitals have

been studied; findings analyzed and reportedon an individual hospital basis. Subsequentto the presentation of the report by thenursing consultant, the nursing departmentof the hospital is requested to indicate thechanges, if any, which directly or indirectlyare attributable to the activity study. (Sept.1959continuous)

ORGANIZATION(S)Ontario Hospital Services Commission

302

PRINCIPAL INVESTIGATOR(S)Sharpe, Gladys J.

STAFFFull-time:1 psychologistPart-time:

COST


PUBLICATION PLANS

FOR FURTHER INFORMATIONMiss Gladys J. Sharpe, Senior Consultant, Hos-

pital Nursing Services, Ontario HospitalServices Commission, 2195 Yonge St., To-ronto 7, Ontario, Canada

1-31 Inpatient Hospital Utilization of Pittsburgh Residents by PatientCharacteristics and Socioeconomic Level (Census Tract Residence), 1963(1/12/66)

ABSTRACT

Objectives: The ultimate objective is to deter-mine the relationship of patient characteris-tics and socioeconomic level to hospital ad-mission and the type and extent of inpatienthospital services received. It is expe 3ted thathospital admission rates and utilization ofservices will vary among patients of differentsocioeconomic levels. Of major interest isthe study of the possible effect of hospitalcoverage in minimizing any socioeconomicdifferences in utilization practices.

Content: (1) Introduction (including signifi-cance of problem) ; (2) critical review ofliterature (including gaps in knowledge) ;

(3) hypotheses; (4) study design; (5) data(including checks on accuracy) ; (6) anal-ysis ; (7) implications of findings.

Methods: A systematic sample of approxi-mately 10,000, or one out of each 8 Pitts-burgh residents, discharged from all of the23 voluntary short-term hospitals in thePittsburgh-Allegheny County area during1963 was deemed advisable. It has been esti-mated that the hopitals designated for studyinclusion account for approximately 97 per-cent of the Pittsburgh residents utilizingshort-term hospital care.For each patient selected, the medical andbusiness office records were abstracted. Thedata collected included age, sex, race, accom-modation, residence, employment status,marital status, all diagnoses and operativeprocedures, diagnostic and therapeutic serv-ices, total hospital bill, and source of pay-ment (i.e., self-pay, Blue Cross, commercialinsurance, etc.). Patients were assigned thesocioeconomic level of the census tract inwhich they lived at time of hospital adinis-mission. The four socioeconomic classifica-tions employed, based on income, occupation,

and education data available from the 1960Census, were determined by rank correlationmethods.As population estimates are available forBlue Cross and non-Blue Cross members foreach of the socio-economic classifice;ions,the initial analyses will be concerned withdifferential hospital admission rates. Addi-tional analysis concerning the number ofservices received will be made by employingmultivariate analytical techniques.

CURRENT STATUSData from 20 of the 23 hospitals included are

currently on hand. For 12 hospitals, thedata have been completely coded and keypunched. (Apr. 1965-Oct. 1966)


sylvania

PRINCIPAL INVESTIGATOR(S)Ferber, BernardSTAFFFull-time:1 statisticianPart-time:

COST


PUBLICATION PLANSHopefully, to be published as a bookEarly

1967

FOR FURTHER INFORMATIONBernard Ferber, Research Dept., Blue Cross of

Western Pennsylvania, One Smithfield St.,Pittsburgh, Pa. 15222

303

1-32 Review of Drug Use (4/6166)

ABSTRACTObjectives: The objective of the study is to

ascertain the actual use of drugs in hospi-tals.

Content: The study includes a review of theuse of antibacterial agents in hospitalizedpatients, particularly emphasizing the drugsused, doses used, precautions taken to pre-vent adverse effects and the clinical andbacteriological indications for their use.

Methods: All charts of patients who died orwere discharged from hospital care re-viewed. Detailed information is coded foruse of a standard 80-column IBM punchcard. Cards are sorted quarterly for specificinformation.

CURRENT STATUSThe charts of 5,000 patients have been re-

viewed. Information made available from thethe two quarterly reviews has been valuablein pointing out areas of drug overuse andmisuse, and is used in an educational wayto attempt to improve standards of druguse. (Apr. 1965-67)

304

ORGANIZATION(S)Montreal General Hospital, Montreal 25, Prov-

ince of Quebec, CanadaPRINCIPAL INVESTIGATOR(S)Ruedy, John, M.D.

STAFFFull-time:None

Part-time:1 physician2 trained techniciansCOST$10,000$14,999

FINANCING ORGANIZATION(S)Dept. of National Health and WelfarePUBLICATION PLANS

FOR FURTHER INFORMATIONJohn Ruedy, M.D., Assoc. Prof. of Pharma-

cology, Faculty of Medicine, McGill Univer-sity, Montreal 2, Quebec, Canada

1-33 Provision, Distribution and Cost of Drugs in Canada (6/24/66)ABSTRACTObjectives:

Content: The general field of pharmacy inCanada ; current production of distributionmethods of drugs in Canada ; drug costs inCanada ; drugs supplied to public assistancerecipients in Canada; drug insurance pre-paid; provision of drugs under foreign Sick-ness Insurance Plans.

Methods: Compilation, collation, and analysisof existing records from many sources, andextensive correspondence.

CURRENT STATUSPublished by Royal Commission in 1965. Sta-

tistics are currently being up-dated. (July1962June 1963)

ORGANIZATION(S)Research and Statistics Directorate, Dept. of

National Health and Welfare

PRINCIPAL INVESTIGATOR(S)Lachapelle, Robert J.Williams, Lloyd G.

Smith, Arthur F.Cook, H. GeorgePugsley, L. I., M.D.STAFFFull-time:None

Part-timb:3 ecoi._Jmists1 physician1 sociologist

COST

FINANCING ORGANIZATION(S)Report published by Royal Commission on

Health Services

PUBLICATION PLANS

FOR FURTHER INFORMATIONJohn E. Osborne, Dir., Res. and Stat. Directo-

rate, Dept. of National Health and Welfare,Brooke Claxton Bldg., Ottawa 3, Ontario,Canada

1-34 International Comparative Study of Medical Care (1/6/66)

ABSTRACTObjectives: To determine the utilization and

non-utilization of medical care by socioeco-nomic group and the outcomes of care by dis-ease category, and to make certain compari-sons with studies in Sweden and England.

Content: This socioeconomic status and mor-bidity experience of individuals studied, withthe characteristics of the hospitals, physi-cians and other elements of the medical caresystem will be noted. Appropriate criteriaof the outcome of treatment, e.g., survival,relief of symptoms, return to activity, etc.,will be identified.

Methods: A separate but closely related longi-tudinal study of a Statewide populationsample in Rhode Island by Brown University.will furnish utilization and social data. In agroup of 17 hospitals providing more than90 uercent of the hospital care of the State'spopulation, all cases of patients with selectedldiagnoses will be identified, interviewed, andtfollowed by telephone for appropriate peri-ods in relation to certain criteria of outcome.Studies of some aspects of infant and adultmortality will be added.

CURRENT STATUSInvolved in pilot studies, methodological devel-

opment and recruitment of technical person-nel. (July 1965-70)

306

ORGANIZATION(S)

Dept, of Preventive Medicine, Harvard Medi-cal School

PRINCIPAL INVESTIGATOR(S)Peterson, Os ler L., M.D.Burgess, Alexander M., Jr., M.D.

STAFFFull-time:3 physicians4 registered nurses


.1 statistician

COST

$250,000 or more


USPHS

PUBLICATION PLANSNot determined at present

FOR FURTHER INFORMATIONOs ler L. Peterson, M.D. Visiting Prof. of Prey.

Med., Dept. of Preventive Medicine, HarvardMedical School, 25 Shattuck St., Boston,Mass. 02115

,

1-35 Trends in Hospital Use Under Hospital Insurance (4/22/66)ABSTRACTObjectivest: TA Aeterc av clamnb to wutun

changes in age, sex, and diagnostic patternsof inpatient care under hospital insurance,depart from trends already egtablished be-fore the Plan came into effect. Also beingstudied are the principal components of amarked increase in the volume of outpatientservices that has followed their inclusionunder the Plan.

Content: Prince Edward Island, with its lowincome levels, rural characteristics, shortageof physicians but a generous supply of hos-pital beds, represents a Province in which amarked increase in hospital utilization mighthave been expected to follow the introduc-tion of universal hospital insurance. Theproject is devoted to a better understandingof what actually did happen. Throughoutthe study particular attention will be paidto evidence of what effect the comprehensivecoverage of outpatient services has had uponinpatient use.

Methods: The comparison of inpatient trendsbefore and since the introduction of hospitalinsurance on October 1, 1959, is to be basedupon the utilization statistics of four ob-servation years-1955, 1958, 1961, and 1965.The study of outpatient utilization underhospital insurance involves comparisons ofthe -nature and volume of services in 1961and 1964. The records of all services re-ceived by an individual during a given yearhave been linked mechanically, and analysesaro being based upon 25 percent samples ofthe patient populations.

CURRENT STATUSThe project has now reached the early stages

of data analysis, with preliminary resultsexpected by June 1966. (April 1965-1967)

ORGANIZATION(S)Faculty of Medicine, Dalhousie UniversityHospital Services Commission of Prince Ed-

ward Island, Charlottetown, Prince EdwardIsland, Canada

PRINCIPAL INVESTIGATOR(S)Wanklin, James M., Ph.D.Ledgerwood, John E.

STAFFFull-time:None

Part-time:

1 statisticiati1 hospital administrator

COST

$15,000-$24,999


PUBLICATION PLAIggIndefinite


James M. Wanklin, Ph.D., Assistant Professor,Department of Preventive Medicine, Facultyof Medicine, Dalhousie University, Halifax,Nova Scotia, Canada

807

1-36 International Collaborative Study of Medical Care Utilization (12/20/65)ABSTRACT

Objectives: To ascertain the feasibility ofcomparing rates for utilization of out of hos-pital and hospital services in defined popu-lations in three different countries.

Content: Age and sex adjusted standardizedrates for visits to nurses, physicians, andother health personnel, for admissions tohospitals and other institutions, togetherwith rates for the presence of selected symp-tom complexes, disability days, bed disabilitydays, and for availability of certain serviceswill be available from all three areas.

Methods: Household surveys of about 300households (1,000 persons) in each area. Re-turn rates have been better than 98 percentin- two areas and better than 85 percent inthe third. Validation and reliability studiesare currently under way. Preliminary datahave been analyzed, are now undergoingfinal tabulation.

CURRENT STATUS

Final tabulations being completed; validationstudies being completed ; final reports willbe completed in the spring of 1966. It is ex-pected that the Feasibility Study will leadto a larger application of the method whichnow appears to be feasible. (April 19641966)

ORGANIZATION (S)

Div. of Medical Care and Hospitals, School ofHygiene and Public Health, Johns HopkinsUniversity

308

PRINCIPAL INVESTIGATOR(S)White, Kerr L., M.D.Mabry, John H., Ph. D.Cartwright, Ann, Ph. D.Logan, Robert F. L., M.D.Ross, Alan, Ph. D.Vukmanovic, Cedomir

STAFFFull-time:2 medical care specialists1 sociologist

Part-time:4 medical care specialists2 additional physicians2 statisticians2 sociologists

COST$100,0004149,999

FINANCING ORGANIZATION(S)USPHSMilbank Memorial Fund, New York CityNuffield Provincial Hospitals Trust, London,

EnglandWorld Health Organization, Geneva, Switzer-

land

PUBLICATION PLANSTo be announced laterAutumn 1966FOR FURTHER INFORMATIONKerr L. White, M.D., Prof., Div. of Medical

Care and Hospitals, School of Hygiene andPublic Health, Johns Hopkins Univ., 615N. Wolfe St., Baltimore, Md. 21205

0

1-37 Master Sample of Blue Cross Subscribers (7114/66)ABSTRACTObjectives: To expand the information and

knowledge available with regard to numberof people covered by Blue Cross and theirhospital utilization with specific concern asto age and sex of members, diagnosis, hos-pital procedures, and hospital costs as theseare accumulated over time.

Content: The data will consist of status infor-mation and hospital claims records of, a prob-ability sample of 50,000 Blue Cross sub-scribers 'taken from approximately 36 'BlueCross Plans.

Methods: The data will be collected quarterlyand various tables will be produced showingthe cumulative hospital utilization of themembers on the contracts incuded in thesample.

CURRENT STATUSWe are now n. the sampling stage of the proj-

ect. We expect to begin collecting data byJanuary 1967. (Jan. 1966CMtinuing)

ORG*N. IZATION(S)Div. of Research and Plannink; Blue 'Cross

Associatic,A

PRINCIPAL INVESTIGATOR(S)-a- Vs. IJCA. Del illttrta

STAFFFult-time:1 statistician

Part-time:1 economist1 sociologist1 statistician

COST

FINANCING ORGANIZATION (S)Div. of Research and Planning, Blue Cross

Association

PUBLICATION PLANSAt present no publication plans


Bernard Ferber, Div. of p,esearch and Plan-ning, Blue Cross Association, 840 N. LakeShore Dr., Chicago, Ill. 60611

809

--..

lf--38 Patients, Physicians, and the General Hospital: A Social SurveyDecisions and Use in Massachusetts, 1960-1961 (12/20/65)

ABSTRACT

Objectives: To determine the sequence ofevents and decisions that led to hospitaliza-tion and dischargepatterns of use of hos-pital care.

Content: RelPting hospital use patterns to pa-tients' nal and social situations andphysicia.. k,ractice patterns in addition toage, sex, and diagnosis.

Methods: Personal ink views of a representa-tive sample of patients discharged for oneyear in Massachusetts (N=2046) and theirrecommending attending physicians.

CURRENT STATUS

Final report near completion. Preliminary bul-letins have been issued. (1960-1965)

ORGANIZATION (S )

National Opinion Research Center. N720 Wood-lawn Ave., Chicago, Illinois 60637

Center for Health Admin. Studies, Grad.School of Business, Univ. of Chicago

310

PRINCIPAL INVESTIGATOR(S)Anderson, Odin W.Sheatsley, Paul B.STAFFFull-time:

of



FINANCING ORGANIZATION(S) ,

University of ChicagoUSPHSHealth Information Foundation, New York,

N. Y.

PUBLICATION PLANSProbably University of Chicago Press-1967FOR FURTHER INFORMATIONOdin W. Anderson, Prof., Center for Health

Admin. Studies, Grad. School of Business,Univ. of Chicago, Chicago, Ill. 60637

I

I

0

u

1-39 The Value of the Family Life Cycle in PredictingFacilities (7114166)

ABSTRACTObjectives: To test the relative predictive effi-

ciency of various family life cycle modelsin the prediction of use of medical care fa-cilities and to compare these with the pre-dictive efficiency of age.

Content: The complete tape history of BlueCross and Blue Shield payments on behalfof each member enrolled in the Federal Em-ployees Health Insurance Benefits programfor the entire five years that the programhas been in effect.

Methods: Several models of the family lifecycle will be constructed and each of these,in addition to age, will be examined to deter-mine how well they predict hosptial admis-sion rates, hospital length of stay, total hos-pital days, and hospital cost.

CURRENT STATUSSampling of the data has been completed and

the analysis is being undertaken. (May1966-67)

ORGANIZATION(S)Div. of Research and Planning, Blue Cross As-

sociation

Use of Medical Care

PRINCIPAL INVESTIGATOR(S)Bice, Thomas

STAFF

Full-time:1 sociologist

Part-time:Non

COST

Under $5,000

FINANCING ORGANIZATION(S)Div. of Research and Planning, Blue Cross

Association, 840 N. Lake Shore Dr., Chicago,Ill. 60611

PUBLICATION PLANSThe results will be published in Inquiry or

Blue C'ross Reports, publications of BCASummer 1967


Thomas Bice, Purdue University, Lafayette,Indiana 47905

311

1-40 Operational Statistics Related toPrograms for Employees of the Un

ABSTRACT

Objectives: To summarize the utilization ofbenefits and the resulting dollar costs of theFederal Employees Health Benefits Program.

Content: The summarized inf mation includesthe income and expenses of the insurancecarriers by level of coverage and type ofplan. The number of persons covered and thedollar cost of benefits received are shown byplan. Employee changes from plan to planare also shown.

Methods: Data is gathered by the carriers,then assembled and analyzed by the CSCfor publishing and for internal _perating use.

CURRENT STATUSContinuous, summarized yearly.ORGANIZATION (S)Office of the Actuary, Bur. of Retirement and

Insurance, U.S. Civil Service CommissionPRINCIPAL INVESTIGATOR (S)

312

the Administration of Health Insuranceited States Government (7/14166)

STAFFFull-time:

Part-time:

COST


PUBLICATION PLANS

USCSC: Civil Service Retirement, Report Fis-cal Year Ended June 30, 1965, pp. 21-48.


Joseph Zisman, Sup. Stat., Office of the Actu-ary, Bur. of Retirement and Insurance, U.S.Civil Service Commission, 1900 E. St., N.W.,Washington, D.C. 20415

1-41 The Repeated Use of Medical Care Facilities by Federal Employees, 1960to 1965 (7/14166)

ABSTRACT

Objectives: To describe the patterns of re-peated use of hospitals, nursing homes, andother health care facilities by people enrolledin Blue Cross and Blue Shield through theFederal government over the first five yearsof the program, in effect since 1960.

Content: The complete tape history of BlueCross and Blue Shield payments on behrif ofeach member enrolled in the Federal Em-ployees Health Benefits program for theentire five years that the program has beenin effect.

Methods: A sample of 50,000 contracts will bedrawn from the tape file of 950,000 con-tracts. Ages and sex of all members will beentered from hard copy files and frequencydistributions for use measures, e.g., hospitaladmissions, days, dollars, outpatient visits,etc., will be accumulated by age, sex, option,and contract status.

CURRENT STATUSSampling from the status tapes has been com-

pleted. The data is being prepared to go ontothe computers to complete the desired runs.(MayDee. 1966)

ORGANIZATION(S)Div. of Research and Planning, Blue Cross

Association

PRINCIPAL INVESTIGATOR(S)Veney, James E., Ph.D.STAFFFull-thne:1 sociologist


COSTUnder $5,000

FINANCING ORGANIZATION(S)Div. of Research and Planning, Blue Cross

Association

PUBLICATION PLANSInquiry or Blue Cross ReportsWinter 1967FOR FURTHER INFORMATIONJames E. Veney, Ph.D., Dir., Div. of Research

and Planning, Blue Cross Association, 840N. Lake Shore Dr., Chicago, Ill. 60611

313

1-42 Ecology of Employment Termination (11/29/65)ABSTRACTObjectives: To determine whether increased

utilization of health care facilities by work-ers who are subsequently to lose their jobsis primarily due to an increase in sicknessor to an increase in sick role behavior.

Content: The study will involve the collectionof health, demographic, and personality datafor a group of workers in a factory to beclosed in the future. The men will be ob-served during the period before their jobsare abolished until they have stabilized in anew situation. Analysis will be made of theco-variation of certain feelings, physiologicresponses and behaviors and also of the ex-tent to which their interaction with moreenduring properties of the person and ofthe environment produces certain specificdiseases and/or illness behavior.

Methods: The persons to be studied are maleblue-collar workers between the ages of 35and 59 who are employed in factories inSoutheast Michigan that are about to closeor to automate some of their processes. Datawill be collected by public health nurses.

CURRENT STATUS(Sept. 1964Aug. 1969)

ORGANIZATION (S)Survey Research Center, Institute for Social

Research, Univ. of Michigan

314


Cobb, Sidney, M.D., M.P.H.Brooks, Georue W.; MTH,Kasl, Stanislav V., Ph.D.Connelly, Winnifred C., R.N., M.P.H.

STAFF

Full-time:

1 physician5 registered nurses1 bio-chemist

Part-time:

1 psychologist

COST

$250,000 or more


USPHS

PUBLICATION PLANS


Sidney Cobb, M.D., Prog. Dir., Survey ResearchCenter, Institute for Social Research, TheUniversity of Michigan, P.O. Box 1248, AnnArbor, Mich. 48106

0

t

1-43 The Effects of Psychiatric Treatment on High Volume Users of ClinicalServices in a Prepaid Health Care Plan (9/9/66)

ABSTRACT

Objectives: The purpose is to study the effectsof psychiatric treatment on high volumeusers of clinical services.

Content: The study will administer a Neuro-mental Questionnaire to 100 patients in amultiphase clinic each day. Those patientsyielding positive results will be classified asexperimental patients. The names of thesepatients shall be conveyed to computers and"consider rules" for these patients shall betransmitted to the patient's physician withthe following statement: "May have signifi-cant emotional problem, consider referral topsychiatry for further evaluation." Thestudy will analyze the data accumulated, tak-ing into effect the following categories : (1)patients referred to psychiatry by the phy-sician; (2) patients who are not referred topsychiatry by the physician ; (3) controlgroup patients without a considered rule. Allpatients with positive NMQ shall be fol-lowed to the end of the study. The analysisshall include a description of the patientscategorized by age, sex, race, socio-economicfactor, residence and diagnosis, and their useof medical and psychiatric services. Theanalysis shall consider the problem ofwhether or not computer referral is feasiblein terms of a physician's acceptance or re-jection of an automated referral to psychia-try in the records of his patient and the

acceptance or rejection of the referral bythe patient.

Methods: The project will be carried outthrough the use of a Neuro-mental Ques-tionnaire. Data obtained shall be conveyedto a computer center and analyzed. A finalreport shall be compiled containing all theactivities and results of the project.


ORGANIZATION(S)Kaiser Foundation Research InstitutePRINCIPAL INVESTIGATOR (S)

STAFFFull-time:

Part-time:

COST$10,000-$14,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONKaiser Foundation Research Institute, 1924

Broadway, Oakland, Calif. 94115

315

1-44 Development of Techniques and Methodology to Assist Under-utilizedHospitals to Provide More Effective Services to the Community (6/8/66)

ABSTRACTObjectives: To investigate the problems of 22

widely scattered hospitals. This investiga-tion has two major goals : (1) to developtechniques for the analysis of hospitalswhich are under-utilized, and (2) to assistthese 22 hospitals in determining their bestcourse of action to preserve the 3,400 bedsthey contain.

Content: Records of the hospitals will be re-viewed and the following characteristics ob-tained : diagnosis, age and sex, length ofstay, review of staff (including physicians,nurses, ancillary personnel), review of thefinancial picture (including capital invest-ment, operating costs and income). A surveyteam shall also investigate the medical caresystem of the community to assess the posi-tion of the hospital.

Methods: A survey guide will be designed forthe use of the survey team for the evalua-tion of the hospitals. The hosptial reportsshall be presented to an advisory group con-sisting of hospital and medical care personsto determine the best course of action foreach hospital.

316


ORGANIZATION(S)Group Health Assoc. of AmericaPRINCIPAL INVESTIGATOR(S)Lu dwig, Thomas

STAFFFull-time:1 medical care specialistPart-time:

COST


PUBLICATION PLANSNone yet

FOR FIMUHER INFORMATIONThomas Ludwig, Group Health Assoc. of

America, 1321-14th St., N.W., Washington,D.C., 20005

0

I-45 Utilization of Professional Personnel in the New York City School HealthService (1128/66)

ABSTRACTObjectives: The primary purpose of this study

is the development of a school health teamthat will employ an optimum percentage ofprofessional time for professional purposes.It will also be used to develop methodologyfor studying public health personnel utiliza-tion patterns.

Content: Phase I data show that approxi-mately one-third of the professional nursingtime assigned to elementary and junior highschools in the New York City school healthprogram is now spent on activities thatcould be accomplished by ancillary non-pro-fessional personnel. This means a total of125,000 hours of nursing time used belowprofessional nursing skills out of an esti-mated total of 373,000 nursing hours in theschool program.

Methods: The first phase of the study con-sisted of a time utilization study designedto find out how Health Department person-nel are being used in the school health serv-ice. The second phase is an experiment witha restructured school health personnel teambased on the findings of Phase I. Informa-tion is available in respect to 83 individualactivities, 9 major program areas, and 9functional utilization levels. The informationwas based upon 3,000 activity logs collectedfrom 338 schools on 15 days during the cal-endar year of 1964.

CURRENT STATUSPhase I time utilization study was completed

in 1965. Phase II experiment, with a re-structured school health team, will be con-

ducted from January 1 to December 31,1966. (Apr. 1964-67)

ORGANIZATION(S)Medical and Health Research Assoc. of New

York City, Inc., 40 Worth St., New York,N. Y. 10013

New York City Dept. of HealthPRINCIPAL INVESTIGATOR(S)Rosner, Lester J., M.A., L.L.B.McFadden, Grace, R.N., M.A., M.P.H.Culbert, Robert, M.D.STAFPFull-time:1 registered nurse1 statistician1 researcher, personnel administrationPart-time:4 physicians4 registered nurses1 statistician1 specialist, public administrationCOST$200,000$249,999

FINANCING ORGANIZATION(S)USPHSNew York City Dept. of Health

PUBLICATION PLANS

FOR FURTHER INFORMATIONLester J. Rosner, Assist. Corn. for Adminis-

trative Services, New York City HealthDept., 125 Worth St., New York, N. Y. 10013

317

1-46 Welfare Project

ABSTRACTObjectives: To describe the use of medical care

by two samples of the indigent aged of NewYork City, and within each sample to com-pare the patients enrolled in the Health In-surance Plan with the others.

Content: Use of hospitals, nurs;ng homes,physicians and ancillary services; socialdata ; and for H.I.P. enrollees, diagnosticdata. The study covers the year ending Feb-ruary 29, 1964.

Methods: Cohort analysis of records routinelymaintained either by the Department ofWelfare of New York City or by H.I.P. Thesamples consist of 9,000 recipients of OldAge Assistance who were ambulatory at thestart of the study year and 2,800 MedicalAid to the Aged recipients who were in pro-prietary nursing homes on the same date.

CURRENT STATUSMain findings are available in mimeographed

form. Supplementary data are being proc-essed. (July 1962-66)

ORGANIZATION(S)Health Insurance Plan of Greater New YorkPRINCIPAL INVESTIGATOR(S)Shapiro, Sam

318

Yerby, Alonzo, M.D.Rosner, HenryDensen, Paul M., D.Sc.Williams, Josephine, J., Ph.D.

STAFF

Full-time:None


COST

$100,000$149,999


Health Research Council of the City of NewYork, 125 Worth St., New York, N. Y. 10013

PUBLICATION PLANS

A paper has been submitted to Hospitals forpossible publication


Sam Shapiro, Dir., Div. of Research and Sta-tistics, Health Insurance Plan of GreaterNew York, 625 Madison Ave., New York,N. Y. 10022

(

1

*I,

1-47 Utilization Patterns of Pediatric Services in a Prepaid Medical CareProgram (11/30/65)

ABSTRACTObjectives: To determine the pattern of utili-

zation of prepaid ambulatory health andmedical care services for children for a sam-ple of families covered by the Kaiser Foun-dation Health Plan.

Content: The study will attempt to determinehow social, educational, and ethnic charac-teristics influence utilization of health carefacilities by type of care (preventive, illnesscare, emergency services), stage and dura-tion of illness, time of day and day of weekcare is sought, etc.

Methods: Interviews were conducted with theadults accompanying all children who usedthe health plan to determine the relevantmedical and socio-economic information.Data was collected on an individual visitaasis and, in general, will be reported thisway. 728 visits are involved in the study.

CURRENT STATUSPilot study completed. Other aspects to follow.

(Apr. 1964-Oct. 1966, perhaps)

ORGANIZATION(S)Maternal and Child Health Research Unit,

School of Public Health, Univ. of Calif.,Berkeley

Kniclar Vniinflotinn Health Plan, Oakland, Calif.

PRINCIPAL INVESTIGATOR(S)Bierman, Jessie M., M.D.

STAFFFull-time:None

Part-time:1 medical care specialist2 physicians2 statisticians

COST$15,000-$24,999


PUBLICATION PLANSPaper read at American Public Health Associa-

tion meeting, October 1965, on findings ofPilot Study-1966


Jessie M. Bierman, M.D., Res. Physician, Ma-ternal and Child Health Research Unit,School of Public Health, Univ. of Calif., 2288Fulton St., 4302, Berkeley, Calif. 94704

319

-

7-48 Family Life Cycle and Utilization of Health Care Services (11/30/65)ABSTRACTObjectives: The major goal of this research is

to devise family life cycle models for pre-dicting hospital utilization patterns.

Content: Various models of the family lifecycle (combining elements such as familysize, age of dependents, age of head ofhousehold, etc.), will be used to predict hos-pital utilization patterns of persons insuredunder the Federal Employees Health Bene-fits Program. A sample of utilization recordswill be drawn from the more than two mil-lion persons insured by the Federal Em-ployees Health Benefit Program. The de-pendent variables will consist of such thingsas number of admissions, length of stay andtotal cost.

Methods: This will be a statistical analysis ofexisting data.

CURRENT STATUSThe problem has been conceptualized, and the

sample is being drawn. (Ju/y 1965-67)ORGANIZATION(S)Department of Sociology, Purdue University

320

PRINCIPAL INVESTIGATOR(S)Eichhorn, Robert L.Rice, Thomag



COST

$5,000$9,999


Blue Cross Association, 840 N. Lake ShoreDr., Chicago, Ill.

PUBLICATION PLANS

Will appear as articles and publications ofBCAJuly 1968


Robert L. Eichhorn, Professor of Sociology,Dept. of Sociology, Purdue University, WestLafayette, Ind. 47906

W.

0

1-49 Impact of Medicare on the Aging and on Health Institutions in SelectedSettings of the Midwest (6/27/66)

ABSTRACTObjectives: To study the impact of the Social

Security Amendments of 1965 (Medicare)on the provision and utilization of healthcare facilities and resources in the MidwestRegion of the United States.

Content: This study will investigate the rela-tionship between the increased ability to payfor health care services and (1) utilizationby the individual, (2) the provision of serv-ices in the community, and (3) the changingrelationship between utilization and pro-vision.

Methods: A household survey will be con-ducted in several midwestern communitiesranging in size from over 1 million popuk -

tion to very small towns and their surround-ing counties. At the same time, detailed in-_formation on the organization and provisionof health care facilities will be collected forthese same communities. The household sur-vey data and the community data will thenbe related. A second survey will be conductedin 1968 and the results compared with thefirst study.

CURRENT STATUS

Field work instruments are currently being

perfected. Expect to start data gatheringduring the summer of 1966. (Apr. 1966-70)

ORGANIZATION(S)Institute for Community Studies (formerly

Community Studies, Inc.), 2300 Holmes,Kansas City, Mo. 64108

PRINCIPAL INVESTIGATOR(S)Friedmann, Eugene A.Peterson, Warren A.Coe, Rodney




FINANCING ORGANIZATION(S)USPHSPUBLICATION PLANSUncertain

FOR FURTHER INFORMATIONEugene A. Friedmann, Kan. §tate Univ., Man-

hattan, Kan. 66502

321

1-50 Utilization of Health Related Services by Aged (11/30/65)

ABSTRACTObjectives: To study use and non-use of health

related services by persons 65 and over.Content: The major objective 'of thestud.y. is

to provide some understanding of the fac-tors which influence the extent of utilizationof health-related services and facilities bythe aged. Particular attention will be paidto attitudes, information, and resources asmediating between "needs for service" anduse of a service, controlling on selected so-cioeconomic and background characteristicsof the population.

Methods: Household interviews with a cross-section sample survey of Boston area usingan area probability sample.

CURRENT STATUSInterviewing and Coding. (1965-4967)ORGANIZATION(S)Long Range Planning Project of Combined

Jewish Philanthropies

322

PRINCIPAL INVESTIGATOR (S)Axelrod, MorrisFowler, Floyd J., Jr.STAFFFull-time:1 social psychologist


COST

$100,000$149,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONMorris Axelrod, Dir. Long Range Planning

Proj. of Combined Jewish Philanthropies, 72Franklin St., Boston, Mass. 02110

( )

( )

a

--

J. ContinuityAccess to Health Care

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on continuityaccess to care: D-23; 1-17; 1-21; K-2.

323

J-1 Household Activity Patterns and Community Health (1/10166)

ABSTRACTObjectives: This reseach is concerned with

01...-.........,4-.....:-.4-1,.... ...1-1-14....3"- -- -1%,..naz at. by,. to Ida;m, 4 Id b 1 b LIUVb ktuu activities ofurban residents as considerations to be takeninto account in the location of health andmedical care facilities. The wcrk seeks to de-velop an approach in which the siting offacilities in a metropolitan area takes intoaccount "user" as well as "supplier" consid-erations.

Content: It is presently funded as a "preteststudy" which aims to develop and test a sur-vey research instrument for eventual use ina full-scale study in several metropolitanareas of different size. These later studieswould focus on the utilization of medical careand health services in the context of dailyliving patterns of "users" of different socio-economic status and other characteristics.

Methods: Conventional social science methodswill be used to control for the effects of non-spatial variables such asage and socioeco-nomic status. Alternative means of studyingspatial relationships will be explored, in-cluding non-quantitative analysis of mappeddata, distance models, intervening opportu-nity models, and analysis of centers and mo-ments of distributions in space. Some suchmethod will be adopted for use in studyingthe interactions of spatial variables and timebudgets, or activity patterns.

CURRENT STATUSPretest survey of activity analysis techniques

undertaken in Minneapolis-St. Paul corn-

pleted in fall of 1965. Data being coded andprocessed for a dummy-run on analyticalprocQdlires and tent dive evaluation (samplesize insufficient for full test). (June 196567)

ORGANIZATION ( S)Center for Urban and Regional Studies, Insti-

tute for Research in Social Science, Univ. ofNorth Carolina at Chapel Hill

PRINCIPAL INVESTIGATOR (S)Chapin, F. Stuart, Jr.Hightower, Henry C.

STAFFFull-time:None

Part-time:1 sociologist1 urban planner

COST$75 ,000$99,999


PUBLICATION PLANS

Monograph issued by the CenterSpring 1967


F. Stuart Chapin, Jr., Res. Dir., Center for Ur-ban and Regional Studies, Evergreen Houst,Univ. of North Carolina, Chapel Hill, N.C.27514

2,,I, 325

J-2 Migration and Mental Disease (1/13/66)

ABSTRACTObjectives: To examine the interrelationships

between migration and mental disease andbetween socioeconomic status and mentaldisease.

Content: First admissions data for New YorkState for the years centering around the cen-suses of 1930, 1940, 1950, and 1960 are usedin connection with census data to providerates of mental disorder by age, sex, race,marital status, education, occupation, andmigration status. Studies are longitudinal aswell as cross-sectional. Materials for Ohio,Califr :nia and Norway are used in conjunc-tion with the New York State materials.

Methods: Usual methods of statistical and epi-demiological analysis.

CURRENT STATUSData have been processed and an analysis is

beiug completed. (1961-1966)

ORGANIZATION(S)Population Studies Center, Univ. of Pennsyl-

vania

326

PRINCIPAL INVESTIGATOR(S)Thomas, Dorothy S.Lee, RverPtt R.

STAFFFull-time :None

Part-time:2 demographers

COST$100,000$149,999


PUBLICATION PLANSMonograph in 1967. A number of articles have

already appeared. Others have been sub-mitted to journals and others will follow.

FOR FURTHER INFORMATIONEverett S. Lee, Population Studies Center,

Univ. of Pennsylvania, 3935 Locust St.,Philadelphia, Pa. 19104

-

J-3 Influence of Continuity of Care on Medical Care Utilization (12/20/65)

ABSTRACTnhjactives: To develop an index which reflects

continuity of the patient-physician relation-ship over extended periods of time and tostudy the association ot continuity of careindex with physician visits, hospital admis-sions, and hospital days as measures of med-ical care utilization.

Content: Examination of patient-physician as-sociations over a time in a number of differ-ent patient population groups.

Methods: Analysis of clinic records and his-tories in a computerized medical recordsystem.

CURRENT STATUSPreliminary method is being designed and pre-

tested. Currently under revision and secondpretesting. (Sept. 1965-67)

ORGANIZATION(S)Div. of Medical Care and Hospitals, School of

Hygiene and Public Health, Johns HopkinsUn iversity

PRINCIPAL INVESTIGATOR(S)1171^: 4. ,... TT ......... T v. 1-. . 111 loGIF JEW/ 1 1.1. 9 .1.11..1J.



COST

$5,000$9,999


PUBLICATION PLANSNone at presentuncertainFOR FURTHER INFORMATION

Kerr L. White, M.D., Prof., Div. of MedicalCare and Hospitals, School of Hygiene andPublic Health, Johns Hopkins University,615 N. Wolfe St., Baltimore, Md. 21205

K. Acceptability of Health Care

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on acceptabil-ity of care: D-41 ; E-5; E-22 ; F-1 ; H-38 ; 1-17; J-1 ; L-11; L-14.

3?029

U

K-1 Use of Medical Care Program by Public Assistance Recipients, JeffersonCounty, Kentucky (12/6/65)

ABSTRACT

Objectives: To find how knowledge and atti-tudes about the medical care program areassociated with use of it.

Content:

Methods: A random sample of 150 cases ofpublic assistance in Jefferson County will beinterviewed. They will fill out the CornellMedical Inventory and a short test on atti-tudes toward medical care and knowledgeabout the medical care program. Vendor pay-ment records will be checked to determinethe use they have made of the program.Those in need of medical care (as determinedby the Cornell form) will be broken downinto users of program and non-users. Theythen will be compared on attitudes andknowledge.

CURRENT STATUS

(Oct. 1965June 1966)

ORGANIZATION (S)Kent School of Social Work, Univ. of Louisville

PRINCIPAL INVESTIGATOR (S)Vicroy, Frank M.

STAFFFull-time:None


COSTUnder $5,000


PUBLICATION PLANS

FOR FURTHER INFORMATIONFrank M. Vicroy, Prof. of Sociology, Kent

School of Social Work, Univ. of Louisville,Louisville, Ky. 40208

d3 0/ 331

K-2 Social-Psychological Factors in Outpatient Attrition (3/17/66)

ABSTRACTObjectives: To study social-psychological fac-

tors as related to outpatient attrition.Content: Patient attrition is conceived as being

initially related to the nature of the diseaseand treatment, as well as being contributedto by other factors such as social and eco-nomic ones. In this study the variables stud-died are objective indices of post facto rea-sons often given for attrition.

Methods: Approximately 4,000 ambulatory in-digent patients attending a community clinicfor treatment of chronic and/or acute dis-eases were followed. The degree to whichthey missed appointments or dropped out oftreatment altogether were noted. While intreatment, social, economic, demographic andpsychological data were collected on all pa-tients. These data are analyzed in a compari-son of patients who remained continuouslyin treatment and those who did not.

CURRENT STATUSIn process. (Aug. 1965-Jan. 1967)ORGANIZATION(S)Dept. of Preventive Medicine, College of Medi-

cine, Univ. of Tenn.

332


Oakes, Charles G.

STAFF

Full-time:

None

Part-time:

1 physician1 sociologist

COST

$15,000$24,999


PUBLICATION PLANS

Not definite


Charles G. Oakes, Ph. D., Res. Medicine Soci-ologist, Dept. of Prey. Medicine, College ofMedicine, Univ. of Tenn., 62 S. Dunlap St.,Memphis, Tenn. 38103

K-3 Comparative Study of University Employee Health Insurance Optionsand Factors in Choice (8/10/66)

ABSTRACTObjectives: (1) To discover factors determin-

ing choice and change of health plan bymembers of an employed group having freechoice of 7 different plans ; (2) to determinecomparative experience, costs, and satisfac-tions under the 7 plans.

Content:

Methods: Demographic information is avail-able from payroll on 11,000 University em-ployees. Multiple discriminant analysis isbeing applied for the first objective. A sam-ple personal interview survey will be con-ducted for the second objective.

CURRENT STATUEData analysis of objective one. (Oct. 1965-67)

ORGANIZATION(S)Div. of Medical and Hospital Admin., School of

Public Health, Univ. of Calif., L.A.

PRINCIPAL INVESTIGATOR(S)Roemer, Milton I.Hopkins, Carl E., Ph. D.STAFFFull-time:None

Part-time:1 sociologist1 statisticianCOST

$5,000$9,999



FOR FURTHER INFORMATIONMilton I. Roemer, School of Public Health,

Univ. Los Angeles, Calif. 90024

338

K-4 Selfaelp Patterns in Rehabilitation: a Comparative Study (8/26/66)ABSTRACT

Objectives: A study of the effects on the self-image, motivation, role-change, and partici-pation of physically disabled adults in re-habilitation programs structured along self-help lines.

Content: Study will compare groups of reha-bilitees according to these factors in a largePolish self-help cooperative, and a conven-tionally organizr ' American rehabilitationcenter.

Methods:

CURRENT STATUS

Literature review. (July 1966June 1967)

ORGANIZATION(S)

Div. of Medical and Hospital Admin., School OfPublic Health, Univ. of Calif., L.A.

384

PRINCIPAL INV ESTIGATOR(S)Katz, Alfred H.STAFFFull-time:None

Part-time:1 social worker, counselorCOSTUnder $5,000

FINANCING ORGANIZATION(S)Ford Foundation, International and Compara-

tive Studies Grant, Univ. of Calif., L.A.PUBLICATION PLANS

FOR FURTHER INFORMATIONAlfred H. Katz, School of Public Health, Univ.


0

K-5 A Study of Motivational Factors in Nursing Home Patients (6/30/66)ABSTRACTObjectives: To identify and describe a motiva-

tional program in a nursing home and toevaluate its effectiveness.

Content: During the first phase of the studythe project will: (1) define a motivationalactivities program and the roles of each par-ticipant; (2) show how the presence of amotivational program influences the medical,social and psychological behavior of long-term care patients; (3) endeavor to deter-mine what mechanisms allow for motiva-tion, and (4) show the relationships betweenresponses to motivational activities and thedemographic and social data gathered in thepre-admission group. The second phase willir.volve a demonstration project of a motiva-tionai program in the A. Holly PattersonHome, covering expansion and intensifica-tion of the ongoing program. The third phaseof the study shall consist of data analysisand the preparation of the final report.

Methods: The study will be conducted by ob-servations and interviews by clinical person-nel. Upon completion of the study a final re-port shall be compiled.


ORGANIZATION(S)

A. Holly Patterson Home, Uniondale, L. I.,N. Y.

PRINCIPAL INVESTIGATOR(S)Mitchell, Monroe

STAFF

Full-time:2 specialists1 psychologist1 social worker, counselor

Part-time:None

COST

$75,000$99,999


PUBLICATION PLANS


Monroe Mitchell, A. Holly Patterson Home, 875Jerusalem Ave., Uniondale, L. I., N. Y. 11553

335

K-6 Perceptions of Patients' Cognitive Needs (5/10166)

ABSTRACTObjectives: To investigate the nature and ex-

tent of patients' cognitive needs.Content: This study is focusing on patients'

own expressions of the kinds of informationthat they want to be given concerning theircondition, care, etc. and the relative impor-tance they attribute to receiving these vari-ous kinds of information. An instrument formeasuring patients' information needs willbe developed to compare patients' attitudestoward receiving information with those oftheir doctors and nurses. An examination ofthe differences between and within thegroups will be made.

Methods: Interviews are being conducted inthe initial phase. Patients are being selectedto vary according to sex, education, and na-ture as well as term of illness, as there isreason to expect that these factors might in-fluence cognitive needs. All data will be proc-essed so as to be amenable to statisticalanalysis.

CURRENT STATUSInterviews complete. Analyses of data cur-

rently underway. (Dec. 1964-Nov. 1967)

336

ORGANIZATION(S)

Sloan Inst. of Hospital Admin., Cornell Univer-sity


STAFF

Full-time:1 psychologist

Part-time:1 psychologist

COST

$75,000499,999


USPHS

PUBLICATION PLANS

Not known


Joan S. Dodge, Ph. D., Res. Assoc., Sloan Inst.of Hospital Admin., Cornell University, Ith-aca, N.Y. 14850

K-7 Mothers in Mexican and Mexican. American Cultures (5112166)ABSTRACTObjectives: To provide knowledge about the

cultural beliefs and practices relating tochildbirth of Mexican-American mothers sothat nurses might plan better care of them.

Content : Interviews of fucson mothers of Mex-ican background and of mothers in Guada-lajara, Mexico, centered on childbirth beliefsand practices collected with personal dataand obstetrical data.

Methods: Interviews sufficiently structured toprovide for systematic codification. Tech-nique like toxin-antitoxin to provide forgreater depth. Numerical analysis of data.

CURRENT STATUSData analysis prior to final report (June 1965

66)

ORGANIZATION (S)St. Mary's Hospital, Old St. Mary's Rd., Tucson,

Ariz.

PRINCIPAL INVESTIGATOR(S)Kay, MargaritaSTAFFFull-time:

Part-time:1 registered nurse

COSTUnder $5,000


PUBLICATION PLANSNot yet made.

FOR FURTHER INFORMATIONMrs. Margarita Kay, Tucson Community Coun-

cil, Mayer Alameda Bldg., 100 East Alameda,Tucson, Ariz. 85701

337

K-8 Variations in Patients' Compliance with Doctors' Orders

ABSTRACTObjectives: To determine variations in pa-

tients' compliance with doctors' orders.Content: Data will be analyzed to determine

the extent and types of variations in pa-tients' compliance and how these variationsmay be influenced by such factors as ' I per-sonal characteristics of patient a(b) the structure and process oipatient relationship, (c) the regi.. pre-scribed for the patients, and (d) the influ-ence of relatives and friends.

Methods: Data collected by means of observa-tions, tape recordings, and interviews withdoctors and ambulatory patients.

CURR'SNT ST1 'PUSAnalysis of data and writing reports. (Sept.

1963Oct. 1966)

ORGANIZATION(S)Comprehensive Care and Teaching Program,

Cornell University Medical College

338

PRINCIPAL INVESTIGATOR(S)Davis, Milton S., Ph. D.


Part-time:2 physicians1. statistician

COST$75,000$99,999FINANCING ORGANIZATION(S)USPHS

PUBLICATION PLANSNot definite

FOR FURTHER INFORMATIONMilton S. Davis, Ph. D., Assist. Prof. of Sociol-

ogy, Comprehensive Care and Teaching Pro-gram, Cornell Univ. Medical College, 1300York Ave., New York, N.Y. 10021

K-9 Choice or Rejection of Group Practice Prepayment Plan ( /12/66)ABSTRACT

Objectivas: Bases of choice of alternative med-ical care plans ; test of individual cho!ze al-gorism.

Content : Medical, economic, and sociologicalcharacteristics of plans; personal attitudestoward characteristics ; social position of per-sons making choice.

Methods: Sample interview survey.

CURRENT STATUS

Final analyses and report writing. (June 196366)

ORGANIZATION (S)

Bur. of Public Health Economics, Dept. ol.Medical Care Organization, School of PublicHealth, Univ. of Mich.

PRINCIPAL INVESTIGATOR (S)

Metzner, Charles A.

STAFF

Full-time:1 sociologist


COST

$75,000$99,999FINANCING ORGANIZATION (S)USPHS

PUBLICATION PLANSBureau of Public Health Economics, Research

Series and journal articles (journal notknown)--June 1966

FOR FURTHER INFORMATIONCharles A. Metzner, Prof., Medical Care Organ-

ization, Bur. of Public Health Economics,Dept. of Medical Care Organization, Schoolof Public Health, Univ. of Mich., Ann Arbor,Mich. 48104

.

339

K-10 Interpersonal Relationship in Rehabilitation (12/8/65)

ABSTRACT ORGANIZATION(S)Objectives: To carry out a core research

program of "Interpersonal Relationships inRehabilitation," which will add to the knowl-edge of the rehabilitation process and ulti-mately will improve rehabilitation.

Content: The project is currently establishingcooperative relationships with State agencydirectors in order to discuss research needs,to communicate the implications of researchfindings, and to provide realism for the Insti-tute's research efforts.

Methods: The project is being carried cat bytesting of applicants and counselors at threesuccessive stages of the rehabilitation proc-ess by means of two scales : (1) The SocialVocabulary Index which includes self con-cept, self acceptance, ideal self concept, andconcept of others ; (2) The Interaction Scalewhich includes client expression, client per-ception, counselor expression, counselor per-ception factor analysis with soeial variables.

CURRENT STATUSWill complete all testing by June 1966. (Mar.

1964Feb. 1967)

340

IrT1-1 A TA - -! -- 'T TTY'S' TA - - - - .. -1. T......1.21...L..v nat negiun v ul nebetuun lubbiLubePRINCIPAL INVESTIGATOR(S)McPhee, William M.

STAFF

Full-time:2 psychologists


COST$50,000$74,999


Washington, D.C.Univ. of Utah, Salt Lake City

PUBLICATION PLANSUniversity of Utah PressFeb. 1967

FOR FURTHER INFORMATIONDr. William M. McPhee, Prof. of Social Work,

Rm. 214, Bldg. 105, Univ. of Utah, Salt LakeCity, Utah 84112

K-1.1 Nurse-Patient Conferences and Patterns of Compliance (515166)

ABSTRACT

Objectives: The study seeks to ascertain theeffects of different types of contact with anurse on patients' patterns of compliance,specifically regularity in filling and takingmedication, obtaining laboratory tests andappearing at scheduled visits.

Content: A sample of 240 patients will be di-vided as follows: a) category Icontrolgroup, b) category IIthe individual pa-tients will see a nurse after each visit withthe physician, and c) category IIIsmallgroups of patients will be invited over aperiod of time to regular health educationsessions. Compliance patterns between thesecategories will be compared. In addition, thisstudy tries to obtain intensive informationabout patients' views of medical authority,the impact of their life structure on theirability to submit to regular medical care, thedegree of social support wbich is availableto them during their illness and their judg-ments of clinics and methods of health care.Before- and after-interviews will compareattitudes within and between the threegroups. Congruence measures will be soughtbetween the patients' assessment of illnessand that of the physician.

Methods: The study utilizes interviews, inter-action-processes analysis, and seeks to de-velop a number of attitude scales which canbe meaningfully applied to the study of cnm-pliance. Measures of compliance include theattempt to trace through the urine the pres-ence or absence of a placebo which is givento all patients in the three groups. The va-

lidity of using a combined compliance indexwill be investigated.

CURRENT STATUSAll instruments for the study have been de-

veloped. Interviewing has begun and patientshave been assigned to the experimentalgroups. (Oct. 1965-68)

ORGANIZATION(S)Illinois Institute of TechnologyPresbyterian St. Luke's HospitalPRINCIPAL INVESTIGATOR(S)Tagliacozzo, Daisy M.

STAFFFull-time:1 sociologist1 registered nursePcurt-time:1 physician2 sociologists

COST

$150,000$199,999

FINANCING ORGANIZATION(S)National Institutes of Health, Bethesda, Md.

20014

PUBLICATION PLANSVarious sociological and medical journals-

1968-69

FOR FURTHER INFORMATIONProf. Daisy M. Tagliacozzo, Dept. of Sociology,

Illinois Institute of Technology, 3300 S. Fed-eral, Chicago, Ill. 60616

341

K-12 Deterrents to Well-child Supervision (116166)

ABSTRACT

Objectives: To examine the background, care-seeking behavior, and certain social-psycho-logical characteristics of medically indigentmothers enrolled in a well-baby clinic.

Content: The study seeks to determine if theamount of preventive child care soughtamong the medically indigent is related tosocial class stratum and to social-psychologi-cal factors, among which are the mother'sconcordance with the purposes and potentiAl-ities of well-child supervision, her feelings ofpowerlessness and social isolation, and herperceptions of her baby's well-being. Also,the study will attempt to determine if ma-ternal and child health care-seeking tends toform a consistent pattern for individualmothers.

Methods: Information for the project was gath-ered from home interviews held with 246mothers of 10-month-old children enrolled inthe North Carolina Memorial Hospital Well-Baby Clinic, a clinic caring for children bornon the staff service of the hospital and oper-ating for teaching purposes.

CURRENT STATUS

Has been presented; awaiting publication.(Jan. 1963Summer 1965)

342

ORGANIZATION(S)Dept. of Maternal and Child Health, Scho,:i of

Public Health, Univ. of North CarolinaPRINCIPAL INVESTIGATOR(S)Morris, Naomi M., M.D., M.P.H.

STAFF

1 physician

Part-time:1 physician1 sociologist1 statisticianCOST

$25,000$34,999

FINANCING ORGANIZATION(S)Univ. of North CarolinaPUBLICATION PLANSAccepted for publication by American Journal

of Public HealthSummer 1966 (two arti-cles)

FOR FURTHER INFORMATIONNaomi M. Morris, M.D., Assist. Prof. of Mater-

nal and Child Health, Dept. of Maternal andChild Health, School of Public Health, Uni-versity of North Carolina, Chapel Hill, N.C.27514

( )

(

( -

L. Professional Practice Quality of Health Care

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on profes-sional practice--quality : H-42, 1-8.

343

L.--1 Physician Orientation in a Medical Care Organization (8/26/66)ABSTRACTObjectives; To delineate a typology of orzan-

ization structures of health insurance plansand compare characteristics of physiciansserving different organization types.

Content:

Methods: (1) Sociologic analysis of health in-surance plan organization; (2) personal in-terview survey of physicians.

CURRENT STATUSFirst wave of interviewing. (Jan. 1966-67)

ORGANIZATION(S)Div. of Medical and Hospital Admin., School of

Public Health, Univ. of Calif, L.A.

PRINCIPAL INVESTIGATOR(S)Roemer, Milton I.Hetherington, Robert W.

!

Hopkins, Carl E., Ph. D.QTA.FF

Full-time :None

Part-time:1 medical care specialist1 sociologist1 statisticianCOST

$5,000$9,999FINANCING ORGA,NIZATION(S)USPHS


FOR FURTHER INFORKATIONMilton I. Roemer, School of Public Health,

Univ. of Calif., Los Angeles, Calif. 90024

-?+11/345

I

1

L-2 Evaluating the Quality of Patient Care in a Pediatric Emergency Room(5/23/66)

ABSTRACT

Objectives: T.) evaluate the quality of patientcare in a pediatric emergency room as wellas testing methods far teaching means ofimproving patient care.

Content: The pediatric emergency room isstaffed by two straight pediatric interns.Approximately 1,100 patients from infancythrough adolescence are seen monthly. Thisstudy was performed during the last twomonths of the internship and the same twointerns were on duty throughout this period.

Methods: The charts of patients who presentedto the emergency room with the chief com-plaint of cough, cold, a fever were selectedfor evaluation. Three indices, proficiency,efficiency and competence, were designed tomeasure the quality of care, and the chartswere graded on these indices.

CURRENT STATUS

(Apr. 1966June 1966)

346

ORGANIZATION(S)University of Colorado Medical Center

PRINCIPAL INVESTIGATOR (S)

STAFFFull-time:1 physicianPart-time:None

COSTUnder $5,000

FINANCING ORGANIZATION(S)University of Colorado Medical CenterPUBLICATION PLANSNone to dateFOR FURTHER INFORMATIONRay E. Helfer, M.D., Dir., Pediatric Out-patient

Dept., Univ. of Colorado Medical Center, 4200E. Ninth Ave., Denver, Colo. 80220

( )

U

U

(

1

L-3 Examine the Feasibility of a Project To Study Physicians' Care in NursingHomes (6130166)

ABSTRACTObjectives: TA a:sty minc physicians' care in

nursing homes and to develop a research pro-tocol provided the study is feasible.

Content: The study will concern itself withthree main tasks: (1) gather and organizeconcepts and background data relating tothe proposal ; (2) provide a statement as tothe types, quantity and quality of relevantdata availab's for analysis; (3) provide astatement of problems encountered and sug-gest means of solving these problems.

Methods: Experts on the field will be consultedto obtain the necessary information. A finalreport will be compiled which will describethe areas above. The report shall also con-tain estimates of time, personnel, and fi-nances needed to perform a full-scale study.


ORGANIZATION(S)

PRINCIPAL INVESTIGATOR(S)Solon, Jerry A., Ph. D.

STAFF

Full-time:

None

Part-time:

1 medical care specialist

COST

$5,000$9,999


USPHS

PUBLICATION PLANS


Jerry A. Solon, Ph. D., 1820 Wightman, Pitts-burgh, Pa. 15217

347

L-4 Doctor/Patient Contacts in General Practice (5116/66)ABSTRACT

Objectives: From evidence available from sev-ern.' Atildieq, ena is impresi,ed by the fact thatmuch of medical practice and public behaviorin terms of the utilization of medical caremay be described as "contingent doctoring"the medical services operating when cer-tain situations are brought to their notice.The initiative rests with the patient ratherthan with the doctor. if this concept of therole of family doctor (and the hospital-baseddoctor) is generalbi accepted by the medicalprofession and the public, then this mustseriously impede the introduction of a pat-tern of practice based on prevention.

Content: The specific aim of this project is todetermine the nature of contacts betweenphysician and patient and thereby to assessthe role of the G.P.; the diagnostic and ther-apeutic level at which he operates ; the pat-tern of morbidity and the related pattern ofprescribing. It is believed that an assessmentof the involvement of general practitionersin preventive medicine can be made using amethod to be described.

Method: For one day (24-hour period) duringeach week for 7 successive weeks, 12 physi-cians participating in the study will be askedto complete a questionnaire for each doctor/patient contact. Each day of the week willbe taken in rotation and in this way a com-posite picture of the work of a full week will

348

be obtained. Forms will therefore be com-pleted for contacts in the office, home, hos-pital, at work, and by telephone. A study ispresently under way.

CURRENT STATUSPilot studies. (Apr. 1966-Mar. 1967)ORGANIZATION(S)Dept. of Preventive Medicine, Queen's Univer-

sity, Kingston, Ontario, CanadaPRINCIPAL INVESTIGATOR (S)Steele, Robert, M.D.Read, John H., M.D.Delva, Peter, M.D.STAFFFull-time :

Part-time :15 physicians

COSTUnder $5,000

FINANCING ORGANIZATION(S)Federal-Provincial Health GrantPUBLICATION PLANSNot known at presentFOR FURTHER INFORMATIONRobert Steele, M.D., Assoc. Prof., Dept. of Pre-

ventive Medicine, Queen's University. Kings-ton, Ontario, Canada

L-5 The Nurse-Monitor in a Patient-Care System (12/9/65)ABSTRACTObjectives: To relate nurse-physician actions

to their patient-centered consequences in amodel which will assist in the provision ofpatient care in existing facilities, and pro-vide guidance for the development of facili-ties of the future.

Content: The nurse-patient-physician triad isviewed as an adaptive system, and cyber-netic models are being examined in terms oftheir ability to describe such a system.

Methods: Observations of patient states andconcomitant nurse and physician action arebeing made in the operating and recoveryrooms and on nursing stations. These timeseries data are being examined to de,/ elopa descriptive model which can be used tosimulate the consequences for patients em-ploying various regulatory strategies.

CURRENT STATUSTwo major efforts are currently underway: (1)

various models are being explored with re-spect to their ability to describe the datawhich has been collected in surgery ; and(2) a pilot study is being conducted to refinemeasuring instruments and techniques priorto an extension of our study to the nursingunit. (Sept. 1965-69)

ORGANIZATION (S)The Ohio State University

PRINCIPAL INVESTIGATOR (S )

umvlond, naniel, Ph. .T).Pierce, JIlian, Ph. D., R.N.

STAFFFull-time:1 registered nurse

Part-time:2 physicians1 psychologist6 registered nurses1 statistician

COST

$150,000$199,999


PUBLICATION PLANS

Various hospital and nursing journals. Publica-tions describing each phase of the study willbe prepared as rapidly as a phase is com-pleted.


Daniel Howland, Ph. D., Assoc. Prof., The OhioState Univ., 244 W. Upham Hall, Columbus,0. 43210

349

;

,

i

i

L-6 Evaluation of Community

ABSTRACTObjectives: To evaluate the Community Psy-

chiatric Services based on the Brandon Hos-.pital for Mental Diseases.

Content: This is a study of random samples ofpatients using the services. By means of aunit system assigned to each service andsocial adjustment rating, total units of serv-ice provided will be compared to improve-ment or lack of same.

Methods: 25 patients from 8 different classesof patients receiving services are to be se-lected at random and followed for 12 months.

CURRENT STATUSThe first 75 patients to be studied have been

selected and their study is v, all underway.(Apr. 1965-67)

ORGANIZATION(S)Brandon Hospital for Mental Diseases, Bran-

don, Manitoba, Canada

PRINCIPAL INVESTIGATOR(S)Bristow, M. E., M.D.

350

Psychiatric Services (12/3/65)

Henderson, A. L., B.Sc.Harris, A. A., M.E., B.Sc.

STAFFFull-time:1 social worker, counselorPart-time:1 psychiatrist1 statistician

COST$15,000$24,999

FINANCING ORGANIZ liTION(S)Federal Health Grants, Dept. of Health anil

Public Welfare, 01"-nwa 3, Ontario, Canada

PUBLICATION PLANSCanadian Psychiatric Association Journal-

1968

FOR FURTHER INFORMATIONM. E. Bristow, M.D., Brandon Hospital for

Mental Diseases, P.O. Box 420, Brandon,Manitoba, Canada

t

L-7 Psychiatric Care in Canada: Extent and Results

ABSTRACTObjectives: Description of utilization and re-

sults of psychiatric care in Canada.Content: (1) Analyses of national trends in in-

patient psychiatric care 1932-1960 ; (2) in-tensive surveys of rates of first admission,discharge, re-admission, and aggregate useof hospital days for Saskatchewan and Brit-ish Columbia ; (3) use of in-patient and out-patient psychiatric care in one metropolitanand one semi-rural area of Canada ; (4) useof psychiatric care in prepaid medical insur-ance plans.

Methods:

CURRENT STATUSIn press, Queen's Printer, Ottawa, Canada. The

project, started in January 1962, is nowcompleted.

ORGANIZATION(S)Dept. of Psychiatry, Univ. of British blumbiaRoyal Commission on Health Servka6, Ottawa,

Canada

PRINCIPAL INVESTIGATOR(S)Richman, Alex, M.D., M.P.H.

STAFFFull-time:

Part-time:

COST

FINANCING ORGANIZATION(S)Royal Commission on Health Services, Ottawa,

Canada


FOR FURTHER INFORMATIONAlex Richman, M.D., Head, Sec. of Social Psy-

chiatry, Dept, of Psychiatry, University ofBritish Columbia, Faculty of Medicine Bldg.,10th Ave. and Heather St., Vancouver 9,B.C., Canada

351

L-8 Hospital Utilizatien. Review (11/24/65)

ABSTRACTObjectives: To develop methodology for im-

proving the functioning of utilization com-mittees in individual hospitals.

Content: In the first two years of its operation,the project has : (1) devised a system of ab-stracting medical records which enablesautomatic data processing; (2) developedmethods for identifying cases of unusualhospital stay ; (3) developed criteria for ap-propriate utilization in each of 50 diseasecategories; and (4) begun to test the effec-tiveness r v r these criteria, as well as pro-duced rts of patterns of utilization on ahospital-vy-hospital basis. During the years1966-1968 the project will look forward to aperiod of introduction of the methodologyinto all area hospitals, 21 of which now par-ticipate, evaluation .of the effects of well-operating utilization committees, and thedevelopment of long-range objectives andmechanisms of financing. Specifically, thefollowing - 'Ivities are projected for theyears 196P-68: (1) continued consultationwith utilization committee ; (2) refinementand application of criteria of utilization ; (3)extension of electronic data processing; and(4) development of comparative studies ofutilization.

Methods: Visits have been made to nearly allutilization committees. A special abstractwas designed in order to supply physicianswith basic objective data. After the dataprocessing techniques had been perfected,specialty panels were established to formu-late criteria for appropriate hospital use. Anarea in which intensive work has begun isthe development of statistical reports. Thereports cover common causes of hospitaliza-tion and reveal existing utilization patterns.The data include inter-hospital comparisons

352

of variations in length of stay. The projectstaff carries out its work under direction ofa stpering enmmittee A ppninted hy the Alle-gheny County Medical Society Foundationand the Executive Committee of the HospitalCouncil of Western Pennsylvania.

CURRENT STATUSContinuing Project. (September 1962contin-

uing)

ORGANIZATION (S)Hospital Utilization Project, 3530 Forbes Ave-

nue, Pittsburgh, Pa. 15213

PRINCIPAL INVESTIGATOR (S)Shindell, Sidney, M.D.Schofield, William, CHA

STAFFFull-time:1 medical care specialist1 physician2 statisticians1 medical record librarian

Part-time :1 medical care specialist

COST$75,000499,999

FIN &DICING ORGANIZATION (S)Support obtained from 32 industrial and finan-

cial organizations in the Pittsburgh area

PUBLICATIONS PLANSUniv. of Pittsburgh Press, ."A Method of Hos-

pital Utilization Review"December 1965

FOR FURTHER INFORMATIONSidney Shindell, M.D., Assist. Prof., Dept. of

Preventive Medicine, School of Medicine,Univ. of Pitusburgh, Pittsburgh, Pa. 15213

L-9 Study of Professional Performance of Physicians (3/5166)

ABSTRACT

Objectives: To develop criteria of professionalperformance of ohysicians ; devise assess-ment techniques, and apply to a selectedsample of physicians on whom extensivebackground data are available ; to determinerelationship of level of performance to per-sonal characteristics and educational experi-ence.

Content:

Methods: Critical incident technique used togenerate dimensions of professional perform-ance.

CURRENT STATUS

Collection of critical incidents in progress.(May 1965-68)

ORGANIZATION(S)

Association of American Medical Colleges

:

PRINCIPAL INVESTIGATOR (S )Sanazaro, Paul J., M.D.STAFFFull-time:2 psychologists

Part-time:2 psychologists1 physician

COST$200,0004249,999


PUBLICATIONS PLANS

FOR FURTHER INFORMATIONPaul J. Sanazaro, M.D., Dir. Div. of Education,

Association of American Medical Colleges,2530 Ridge Ave., Evanston, Ill. 60201

353

L-10 The Content of Good Medical Care (Clinical Medicine) (narrativeaccounts, and quantitative data on services, personnel, facilities, costs,etc,) (4/25/66)

ABSTRACT

Objectives: To formulate the content of goodmedical carein narrative form and in quan-titative estimatesto provide guidelines forgood patient care, standards for evaluationof current practices, and quantitative foun-dations for national estimates of needed per-sonnel, facilities, funds, etc.

Content: (a) Narrative descriptions of the con-tent of good care for the most importantgroups of diseases ; (b) quantitative esti-mates on incidence and prevalence of diseasegroups, and on numbers of services neededfor good care according to kind, provider,p!ace, time, costs, etc.

Mei hods: (a) Compilation of available data onmorbidity ; (b) interviews by staff memberswith selected members of the Faculty ofMedicine in accordance with planned andstructured schedules.

CURRENT STATUSAbout one-half completed. (1962-1968)

ORGANIZATION(S)

Dept. of Epidemiology and Public Health, YaleSchool of Medicine

354

PRINCIPAL INVESTIGATOR(S)Falk, I. S.Schonfeld, H. K.Harris, B. R.Bondy, P. K.

STAFFFull-time:1 statisticianPart-time:1 medical care specialistabout 60 physiciansCOST$250,000 or more

FINANCING ORGANIZATION(S)Yale UniversityUSPHS(Other financing being explored)PUBLICATIONS PLANSNot yet determined-1968FOR FURTHER INFORMATIONI. S. Falk, Prof. of Public Health (Medical

Care), Dept. of Epidemiology and PublicHealth, Yale School of Medicine, 60 CollegeSt., New Haven, Conn. 06510

L 11 Role of the Family Physician in the Community (5/31/66)

ABSTRACTObjective;i: This study of medical care in

Britain under the National Health Serviceis concerned with the nature of the care pro-vided by general practitioners, and with thesatisfactions of both patients and theirmedical practitioners.

Content: A random sample of nearly 1,400adults in England and Wales has been inter-viewed, and information obtained about theextent to wbia they receive family care,personal care, preventive care and domicili-ary care from their medical practitioner.They have also been asked for their viewsabout this care.The 552 medical practitioners of these pa-tients have been asked for information aboutthe organization of their practices, theirviews on their role in the community andtheir satisfaction with their work and theconditions under which they practice. Fourhundred and twenty-two, 76 percent, haveresponded.

Methods: Data from these two sources havebeen correlated, to determine the ways inwhich patient satisfaction is related to theorganization of practices, the attitudes ofmedical practitioners and the type of carewhich they provide.

CURRENT STATUSFinal report has been drafted , is now being

revised. (Jan. 1964-66)ORGANIZATION(S)Medical Care Research Unit, Institute of Com-

munity StudiesPRINCIPAL INVEST1GATOR(S)Cartwright, AnnSTAFFFull-time:None

Part-time:1 psychologist4 sociologists

COST$50,000$74,999


PUBLICATION PLANSRoutledge and Kegan Paul-1967FOR FURTHER INFORMATIONAnn Cartwright, Res. Dir., Medical Care Re-

search Unit, Institute of Community Studies,18 Victoria Park Square, Bethanl Green,London, E. 2. England

355

L-12 Nurse Specialist Effect on Tuberculosis (5/13.166)ABSTRACTObjectives: To determine whether the use of

nurse specialists in the care of patients hav-ing a primary disease entity and commonnursing care problem was significantly re-lated to the clinical course of the patients'illness as measured by selected physiologicaland psychological indices.

Content: Quantitative data related to nursingactivities and qualitative data rela4ed toverbal interactions between nurses and pa-tients were collected and analyzed as meas-urements of the independent variable (NurseSpecialist). Patient response, the dependentvariable, was measured by data on selectedphysiological and psychological indices.

Methods:

CURRENT STATUSCompleted. (June 1963-Dec. 1965)

ORGANIZATION (S)School of Nursing, University of Washington,

Seattle, WashingtonPRINCIPAL INVESTIGATOR(S)Little, Dolores, E.

356

Tschudin, Mary S.

STAFFri,..17 Al_... ... er tut-1471W.

None

Part-time:1 mathematician3 registered nurses1 statistician

COST

$100,000--$149,999


PUBLICATION PLANS

Nursing Researchsubmitted August 1966Book: Nursing Care PlansFall 1967Implementation of Nurse Specialist RoleFall

1969 (contact is being made with variouspublishers at present)


Doris Carnevali, Proj. Dir., School of Nursing,Univ. of Washington, Seattle, Washington98105

L-13 Residency Training in Community Psychiatry (6/2166)

ABSTRACT ORGANIZATION(S)il}k7ani;ICTOIC rPA.7 prepare psychiatric residents T. o.f Community Mental Health, :Dept. 'UI

in principles and skills of community mentalhealth in order to put such experience intopractice via teaching, research; and service.

Content: Training of participants in the pro-gram is conceived of in the broadest educa-tional sense in that a process of mutualteaching and learning is planned for partici-pants and staff. Content materials consistof the cumulative professional experiences,skills, and papers related to current andprior actionresearch projects undertakenby the Division. These projects are largelyconcerned with problems and , -b.12iples ofcommunity mental health as demonstratedby case experiences and case studies in nar-cotic addiction and alcohol use. These prob-lem areas present a unique interplay of bio-logical, emotional, sociLl, and cultural forcesat work.

Methods: The New York Medical College willbe the site of the program. Methods of train-ing will include aspects of research, teach-ing, and service. The program will 73e com-mitted to interdisciplinary integration andcareful design of intervention into com-munity and group aspects of pathology, aswell as individual elements,

CURRENT STATUSFull implementation. (July 1964-69)



STAFFFull-time:3 physicians2 psychologists2 registered nurses4 social workers, counselors2 sociologists


COST

$75,000-$99,999


USPHS

PUBLICATION PLANS

FOR FURTHE1 INFORMATIONProf. Richard Brotman, Dir., Div. of Com-

munity Mental Health, Dept. of Psychiatry,New York Medical College, 105th St. andFifth Ave., New Yo, N. Y. 10029

357

L-14 Identification of Medical.Social Problem and Proposed Sol'ution, as Seenby Doctor, Caseworker, ane Patient (12129165)

ABSTRACTObjectives: To analyze, in a general hospital,

the continuous activities of doctors and case-workers for the restoration of patients totheir maximum health potential.

Content: The study will provide informationregarding the relationship between the out-come of a given medical-social problem andthe initial agreement of doctor, caseworker,and patient on the medical-social problemand the means for its solution. Three sets offactors have been examined separately andtogether in relation to case outcome: (1)problem, solution, and means, (2) patient'smotivation and capacity, and the role of hisfamily, and (3) specific patient and hospitalenvironment factors.

Methods: Data have been collected from a sam-ple of 118 cases taken from the medical-social service department of a general hos-pital over an 8-month period in 1962-63. Thesample has been limited to adult patientsfrom medical and surgical services referredfor on-going casework.

CURRENT STATUSCompleted. (July 1962June 1965)

358

/YDri A 11.T1r7 A rrvremter 1 crvaliurcall 11.4111. 111011

School of Social Service Admin., Univ. of Chi-cago, 969 East 60th Street, Chicago, Ill.60637

PRINCIPAL INVESTIGATOR(S)Heyman, Margaret Mary

STAFFFull-time :1 social worker, counselor

Part-tin, e:

COST

$5,000$9,999




Marvret Mary Heyman, School of SocialWork, Hunter College, The City Universityof New York, New York, N. Y. 10021

....1.1.,

;

L-15 The Content of Good Dental Care (4/25/66)

ABSTRACTObjectives: To formulate the content of good

dental careprevention, diagnosis and treat-mentin narrative form as well as by quan-titative estimates ; to provide guidelines forgood patient care ; to derive tentative stand-ards and indices for evaluation and clinicalaudit of current practices; to calculate quan-titative estimates of personnel, facilities,services, time and funds needed for provid-ing good dental care on a national basis;to provide baseline data against which tocompare and evaluate present day dentaleducationon an undergraduate and gradu-ate levelac well as to compare and evalu-ate the provision of good care under differ-ent organizational pattems.

Content: 1. Quantitative estimates on the in-cidence and prevalence of dental diseases arebeing collected. 2. Quantitative estimates onwhat is good dental carein terms of typesof services, time, place, personnel, equip-ment and costare being obtained by struc-tured interviews of dentists by intervie, -eeswho are also dentists.

Methods: 1. Compilation and tabulation of inci-dence and prevalence of dental diseases frompublished and unpublished data provided bysuch sources as the National Health Survey(Household Interviews and Examinations),studies reported in the literature, andthrough private correspondence. 2. Inter-views by staff dentists with selected mem-bers of the Faculty and Department ofDentistry, Yale-New Haven Hospital, usingplanned and structured interview schedules.

CURRENT STATUSInitial interviews have been started. (1963-

1968)

ORGANIZATION(S)Department of Epidemiology and Public

Health, Yale School of Medicine

PRINCIPAL INVESTIGATOR(S)Falk, I. S.Schonfeld, H. K.Johnston, W. B.Sleeper, H. R.

STAFF

Full-time:None

Part-time:1 medical care specialist1 statistician8 dentists

COST

$50,000-$74,999

FINANCING ORGANIZATION(S)Yale UniversityUSPHS

PUBLICATION PLANSNot yet determined-1968

FOR FURTHER INFORMATIONI. S. Falk, Dept. of Epidemiology and Public

Health, Yale School of Medicine, 60 CollegeSt., New Haven, Conn. 06510

359

L-16 Development of an Automated Data Retrieval System for UtilizationReview and Scheduling Hospital Admissions (9/12166)

ABSTRACT

Objectives: To develop a flexible, replicablesystem of data collection of patients andbeds which can provide major assistance insolving problems of inappropriate and poorlycoordinated use of facilities as well as sup-plying current and complete information forreview of utilizatbn in a single facility oron a commuidty-wide basis. A major part ofthe study will be the construction of a sys-tem to predict bed availability.

Content: The study consists of two phases.Phase one will develop and define the system.Criteria and information will be computedof a physician's reliability index which willbe used as a mechanism to determine theaccuracy of estimates of length of stay andadmisrrion diagnosis for physicians with staffprivileges at the Presbyterian Medical Cen-ter. Other developments in this first phaseinclude: (1) specification of output reports ;(2) development of the scheduling str egy ;(3) development of the diagnosis priorityscheme ; (4) computer program planning andflow charting; (5) orientation of the medicaland administrative personnel to the systemusage. The second phase will include a com-plete analysis of the system. During thisphase system input information will con-tinually be collected and stored. Data analy-sis and subsequent report generation shallbe conducted in a batch processing modewhen a preselected number of transactionshave been collected. The final testing shallrepresent the ulthnate community orientedsystem in which the availability of beds andfacilities with future occupancy predictionsare updated and available with each trans-action.

Methods: Computer program planning andflow charting will be used in this project.

360

In order to conduct a preliminary systemtest the contractor of this project willutilize (1) a computer of the Institute ofMedical Sciences, and (2) a time sharedcomputer available in the community on aleased basis. The contractor shall also com-pile a final report of the project which willcontain a description of the project and thecomputer programs for the system in acommon computer lanriage.

CURRENT STATUS(July 1966Jan. 1968

ORGANIZATION (S)Institute of Medical Sciences, Presbyterian

Medical Center, San Francisco

PRINCIPAL INVESTIGATOR(S)Lebo, Charles, M.D.Russell, JeromeSTAFFFull-time:None

Part-time:1 mathematician2 physicians3 registered nurses3 systems analysts1 hospital administratorCOST

3150,0004199,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONCharles Lebo, M.D., Institute of Medical Sci-

ences, Presbyterian Medical Center, Clay andWebster Sts., San Francisco, Calif. 94111

1

L-17 Delineatien of Methods for Evaluating and Appraising Medical CarePrograms through Utilization Review and Medical Audit (5/19/66)

ABSTRACTObjectives: Preparation of a monograph for

use by professional health personnel inorganized medical care programs for theeffective conduct of utilization reviews andmedical audits.

Content: Content to be determined.Methods: The project director, working with

the Association's Program Area Committeeon Medical Care Administration, will con-duct a seminar or. medical care appraisalmethods with members of the committee andwith consultants experienced in various as-pects of medical care appraisal and methods.These consultants will present papers onassigned topics and these will be discussedat the seminar. The extensive outline of thecontent of the volume will be prepared atthe seminar. Based on the seminar themanuscript will be prepared, discussed withrepresentatives of several professional asso-ciations, and subsequently edited in a formsuitable for publication.

CURRENT STATUSPlans for the seminar are proceeding. (May

1966-67)

ORGANIZATION(S)

American Public Health Association


STAFFFull-time:

Part-time:1 medical care administrative specialist1 editor

COST

$15,000$24,999


PUBLICATION PLANS


Thomas R. Hood, M.D., Dep.. Exec, Dir., Ameri-can Public Health Association, 1790 Broad-way, New York, N. Y. 10019

361

L-18 Professionalism among American, British and(5/14/66)

ABSTRACT

Objecthes: To relate levels of professionalismto the way medical services are organized.

Content: Statistical data and analysiscom-parison of indices of professionalism.

Methods: Interview with schedulesamples ofgeneral practitioners in United States(Washington and Idaho), England, andAustralia.

CURRENT STATUSFirst part "Professionalism" completed ; an-

alysis continuing. (1962-1966)

ORGANIZATION ( S )

Was:iington State University

PRINCIPAL INVESTIGATOR(S)Montague, Joel B., Jr.

862

STAFFry,...?,..- -

G.,

a' U14-41.4111.

Australian Physicians

None

Part-time:2 sociologistsCOST$10,000$14,999


PUBLICATION PLANSJournal of Health and Human BehaviorFall

1966

FOR FURTHER INFORMATIONJoel B. Montague, Jr., Prof. of Sociology,

Washington State Univ., Pullman, Wash.99163

0

L-19 Prescribing Habits of Physicians with Respect to Brand Name versusGeneric Prescription Products (12/7/65)

ABSTRACTObjectives: The objectives of this study are as

follows : (1) to determine the frequency ofBrand-Generic prescribing by physicians, bypopulation size of community, (2) to deter-mine the frequency of Brand-Generic pre-scribing by physicians, by type of pharmacyoperation (conventional or professional).

Content: This study covered 30,000 prescrip-tions which were analyzed in 30 pharmaciesthroughout the State of Oklahoma. A totalof 1,000 of the most recent prescriptionswere analyzed in each pharmacy. The datahas been collected but has not undergonefinal analysis.

Methods: The sample was stratified accordingto population density and type of pharmacy.The Brand-Generic prescription frequencieswere tabulated and will be analyzed.

CURRENT STATUSThe data has been collected and organized.

Final analysis and writing remain to bedone. (Feb.Dec. 1965)

ORGANIZATION(S)School of Pharmacy, Southwestern State Col-

lege, Weatherford, Oklahoma


Braucher, Charles L., Ph. D.

STAFF,Full-time:None

Part-time:1 pharmacist

COST

Under $5,000


PUBLICATION PLANS

This study will be presented as a paper at theApril 1966 meeting of the American Phar-maceutical Association, Dallas, Texas

FOR FURTHER ThiDRMATION

Charles L. Braucher, Ph. D., Assoc. Prof. ofPharmacy Admin., School of Pharmacy,Southwestern State College, Weatherford,Okla. 73096

363

L-20 (a) Medical Audit by Medical Students, (b) Studies in Student Education(6/28/66)

ABSTRACTObjectives: (a) Audit quality of care provided

in situation where students have patientcare responsibility. (b) Study student atti-tudes ; measure them, and if appropriate usethis information in instruction.

Content:

Methods: (a) Audit Committee of studentsand staff, use of carefully prepared criteria;(b) students' approrch to clinical problemsinvolving physical, social and psychologicaspects of disease.

CURRENT STATUSReports submitted for publication. (1963

ongoing)

ORGANIZATION (S)Comprehensive Clinic Program, University of

Minnesota Medical School

PRINCIPAL INVESTIGATOR(S)Magraw, Richard M.Beaumont, Graham

364

Qr111 A Viri64 J. AlLA:

Full-time:None

Part-time:2 medical care specialists5 physicians1 psychologist1 social worker, counselor

COST

Under $5,000

FINANCING ORGANIZATION(S)University of Minnesota Medical School

PUBLICATION PLANS(a) Journal of Medical Education-1966

TOR FURTHER INFORMATIONRichard M. Magraw, Comprehensive Clinic

Program, Univ. of Minn. Medical School,University Hospital, Minneapolis, Minn.55455

L-21 Hemolytic Disease of the Newborn (1/11/66)

ABSTRACTnhjectiv...,: To measure against pr-actice

standards the management of cases ofhemolytic disease of the newborn resultingin fatality.

Content:

Methods: Investigation of each case reportedas a &ath from HDN during the years1961-1963 as ascertained from death certifi-cate data.

CURRENT STATUSReport of findings implementation through

professional education. (Jan. 1961-66)ORGANIZATION ( S )Bur. of Maternal and Child Health, California

Dept. of Public HealthPRINCIPAL INVESTIGATOR(S)Staff of the Bureau and Subcommittee of the

Committee on Maternal and Child Care,Calif. Medical Assoc.

STAFF171-11 A!.. ,r1M-14711e.

None

Part-time:40 medical care specialists1 physician1 statistician

COST$15,000-$24,999

FINANCING ORGANIZATION(S)Jointly, State Department of Public Health

and California Medical Association

PUBLICATION PLANSCalifornia Medicine and others-4966

FOR FURTHER INFORMATIONRobert W. Day, M.D., Chief, Bur. of Maternal

and Child Health, California Department ofPublic Health, 2151 Berkeley Way, Berkeley,Calif. 94704

365

L-22 Health Perceptions

ABSTRACTObjectives: To determine the relationships be-

tween preparation and experience of teach-ers and their skill in the health observationof school children.

Content : The following subjects will be stud-ied: (1) the difference among teachers of agiven school system in the nature andextent of their preparation for health ob-servation and appraisal, and (2) the relationbetween preparation and experience ofteachers and their perception and practicesin regard to health observation and ap-praisal roles. Subsequently, instruments willbe developed and validated which may beused in any school system and readily proc-essed to determine the extent of prepara-tion of the teaching staff, their perceptionsand their practices, in regard to the healthobservation and appraisal of children.

Methods: A group of six school systems, pro-viding a wide range in size and nature ofprogram, will be utilized for the study.Correlations will be determined for eachschool between the independent and depend-ent variables.

CURRENT STATUSInstrument has been designed and pretested.

(July 1965-67)

366

of Teachers (6114166)

ORGANIZATION(S)

Maternal and Child Health, School of PublicHealth, *Univ. of Mich.

PRINCIPAL INVESTIGATOR(S)Smith, Donald C.Best, Stanley C.Jenne, Frank H.

STAFFFull-time:

1 educator

Part-time:

COST

$50,000$74,999


PUBLICATION PLANS


Donald C. Smith, Maternal and Child Health,School of Public Health, Univ. of Mich., AnnArbor, Mich. 48103

M. Professional Technology in Health Services

The following projects with their major emphasis falling in thesubject matter of other categories also contain data on profes-sional techno.!ogy : D-16; D-28; E-23; L-17.

4 ..1

1

M-1 Boston Medical Reports: The Continued Education of the PhysiciansBringing the University Teaching Hospital to the Community Doctor viaOpen Circuit Television (5/16166)

ABSTRACT

Objectives: To promote the use of broadcasttelevision as a medium for postgraduatemedical education and thereby allow theknowledge and resources of medical centersto be made available to the practicing physi-cian in his own community.

Content : The project involves the implementa-tion of an experimental plan which provides,via open circuit television, a series of pro-grams for physicians to inform them, intheir own communities, of recent, importantmedical developments. The programs arebroadcast via educational television stationsand consist of discussions of pertinent medi-cal problems by physicians at medicalcenters. Program time is also reserved forthe answering of questions submitted byviewing physicians. Audience analyses havebeen carried on to measure the effectivenessof the ?rograms.

Methods: The State of Maine has been selectedas the 6roadcast area for the series. Pro-grams are taped at Tufts-New EnglandMedical Center and are aired over fourMaine educational television stations. Twelveprograms were broadcasted in 1964 and 24in 1965. The project is being continued andmodifications suggested by the viewingphysicians are being implemented.

CURRENT STATUS

ORGANIZATION(S)Bingham Associates Fund, Tufts-New England

Medical Center

PRINCIPAL INVESTIGATOR(S)Robertson, George J., M.D.Stearns, Norman S., M.D.

STAFFFull-time:

Part-time:1 physician1 field director/ promotional directorCOST$100,000$149,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONGeorge J. Robertson, M.D., Med. Dir., Bing-

ham Association Fund, Tufts-New EnglandMedical Center, 171 Harrison Ave., Boston,Mass. 02111

349/369

M-2 Developing Teaching Material for the Training of Occupational TherapyAssistants (8/30/65)

Objectives: To plan a coarse of study thatrelates to the job tasks and one that canbe adapted in training schools throughoutthe country for training the occupationaltherapy assistant.

Content: The project will evaluate existingteaching materials, prepare new materialsas needed and design a curriculum for train-ing the occupational therapy assistant.

Methods: The project is being carried outthrough interviews with occupational thera-pists' assistants, and their supervisors atState mental hospitals, and at institutionsfor the aged and the mentally retarded.

CURRENT STATUS(Mar. 1965-69)

ORGANIZATION(S)The Medical Foundation, Inc.

PRINCIPAL INVESTIGATOR(S)Knowles, Malcolm, Ph.D.

Rituo, MarianSpiegel, Allen D., M.P.H.

STAFFFull-time:

Part-time:

COST


Washington, D.C.

PUBLICATION PLANS

FOR FURTHER INFORMATIONMalcolm Knowles, Ph.D., The Medical Founda-

tion, Inc., 227 Commonwealth Ave., Boston,Mass. 02116

M-3 Demonstration of Automated Instruction for Diabetic Self-Care(8130165)

ABSTRACT

Objectives: To enumerate the administrativemethods and techniques involved in inte-grating programmed instruction via teach-ing machines into existing educationalprograms for diabetics in various New Eng-land hospitals.

Content: Observational schedules will be usedin a before and after manner to analyze therequired steps for implementation of the useof programmed instruction in the hospitals.

Methods: Data will also be collected on about800 patients relative to their learning andtheir retention of material.

CURRENT STATUS

(Sept. 1965-67)

ORGANIZATION(S)

The Medical Foundation, Inc.

N.,.

PRINCIPAL INVESTIGATOR(S)Spiegel, Allen D., M.P.H.STAFFFull-time:

Part-time:

COST


PUBLICATION PLANS

FOR FURTHER INFORMATIONAllen D. Spiegel, The Medical Foundation, Inc.,

227 Commonwealth Ave., Boston, Mass.02116

371

M-4 Computer Systems as Related toCollege of Mcdi

Teaching and Research Programs of theeine (11/27/65)

Au°'1'11 A CT

Objectives: To establish and evaluate the use-fulness of computer systems in the teachingand research programs of a medical school.

Content: The project will research, design,and implement computer systems for var-ious activities of medical school, includingthe following: (1) laboratory data recordingand analysis; (2) medical records searchand retrieval system; (3) drug and serviceutilization; (4) menu planning and nutritionresearch; (5) student, support staff andfacilities scheduling; (6) teaching bed allo-cation and admitting system; and (7) costaccounting and analysis by department.

Methods: Prior to the purchase of computers,needs will be carefully assessed for allphases of the project. A modular approachto the program will be utilized and systemsresearch personnel will guide the implemen-tation of the project.

CURRENT STATUS

ORGANIZATION(S)College of Medicine, The Ohio State University

372

PRINCIPAL INVESTIGATOR(S)Meiling, Richard L., M.D.Lachner, Bernard J.Bergman, John H.

STAFF

Part-time:

COST

$250,000 or more


PUBLICATION PLANS


Bernard J. Lachner, Assist. Dean, College ofMedicine, Ohio State Univ., 410 W. TenthAve., Columbus, 0. 43210

(7!:

0M-5 Improved Nursing Care for the Geriatric Patient (611/66)

ABSTRACT

Objectives: Curriculum improvement in theteaching of geriatric nursing in a bacca-laureate degree program. Examine attitudesof nursing students towa...1 the older patient.

Content: (1) Identifying cf nursing needs ofhospitalized geriatric patients, (2) planningteaching content that impleinents newestresearch findings from all related sciences.

Methods: Literature survey, questionnairesand opinionnaires, consultation with experts.

CURRENT STATUSCollecting and analyzing data. Surveying lit-

erature. (Sept. 1965-68)

ORGANIZATION (S)San Diego State College FoundationNursing Department, San Diego State CollegePRINCIPAL INVESTIGATOR(S)

JMoses, Dorothy V.Laws, ElizabethNye, Neva

De Lora, JackKaplan, OscarSTAFFFull-time:1 psychologist3 registered nurses1 sociologist

Part-time:

COST

$75,000$99,999


PUBLICATION PLANSIndefinite at present

FOR FURTHER INFORMATIONDorothy V. Moses, Proj. Dir., Nursing Dept.,

San Diego State College, 5404 College Ave.,San Diego, Calif. 92115

373

M-6 Specialization in Modern Medical Care (4/22/66)

ABSTRACT

Objectives: A comparative study of specializa-tion in Great Britain and the USAto com-pare and contrast the status and role of thespecialist in two countries with many cul-tural and economic similarities but with im-portant historical and current differences;and to evaluate specialist-generalist rela-tions, in light of influences of various fac-tors in education, organization of services,role of government, etc.

Content: Historical review of background,evolution of education, private and publicpractices, role of governments and of privateagencies; summary of the current scene (or-ganizational, personnel, facilities, education,licensure, etc.).

Methods: Regarding the British state of thestudy: Historical review; compilation ofdata on the recent and current scene frompublished reports, consultations and inter-views with the Ministry of Health, theRoyal Colleges, the professional associations,representatives of practitioners, hospitals,etc.; critical analyses of data and opinions.Regarding the USA stage: Correspondingmethods, adapted to the domestic scene.

CURRENT STATUSa) The report on the British part is in the

form of a book, now in press: Medical Prac-tice in Modern EnglandThe impact ofSpecialization and State Medicine (YaleUniversity Press, July 1966).

374

b) The USA part of the study has begun;the comparative stage will come later.(1962-1968)

ORGANIZATION(S)Dept. of Epidemiology and Public Health, Yale

Schonl of Medicine

PRINCIPAL INVESTIGATOR(S)Falk, I. S.Stevens, Rosemary A.

STAFFFull-time:1 medical care specialist1 sociologist


COST

5,000-$99,999

ANANCING ORGANIZATION(S)Yale UniversityUSPHS

PUBLICATION PLANSBook. Yale Univerp;ty PressJuly 1966


I. S. Falk, 1 rof. of Public Health (MedicalCare), Dept. of Epidemiology and PublicHealth, Yale School of Medicine, 60 CollegeSt., New Haven, Conn. 06510

0

M-7 Conference on Dental Health Education Goals (8/30/65)ABSTRACTObjectives: To set specific goals for oral health

education based upon research proven facts.Content: Specific goals will be selected which

might have a high probability of success interms of getting the public to put thesegoals into action.

Methods: Experts in the areas of research,mass media implementation and small groupimplementation met and discussed the prob-lem for three days.

CURRENT STATUS(JuneOct. 1965)

ORGANIZATION(S)The Medical Foundation, Inc.

PRINCIPAL INVESTIGATOR(S)Spiegel, Allen D.

STAFFFull-time:

Part-time:

COST

FINANCING ORGANIZATION(S)General Electric Co., Ashland, Mass.Proctor and Gamble Co., Cincinnati, 0.PUBLICATION PLANS

FOR FURTHER INFORMATIONAllen D. Spiegel, The Medical Foundation, Inc.,

227 Comonwealth Ave., Boston, Mass. 02116

375

M-8 Establishing Priorities for Programs of Continuing Medical Education(1/ 10166)

ABSTRACTObjectives: To establish a systematic method

of identifying priority for programs of con-tinuing education of hospital staff physi-cians by determining and weighting healthma's of patients they see, availability ofhealth resources to meet these needs anddiscrepancies between availability and utili-zation of such resources by physicians.

Content: Determination of disease incidence,personal disability and social disruption ofhigh incidence problems with appropriateweighting to get preliminary patient needsinventory. Documentation of prognosis ofhigh need conditions with and without op-tional care. End result studies of high needconditions to establish whether discrepancyexists between what might be done andwhat is being done. Development of educa-tional programs to meet specifically identi-fied needs.

Methods: See Content.CURRENT STATUSMethods to diagnose educational needs of pro-

fessional groups and individuals are beingrefined. Educational programs and evalua-tion procedures are being developed. (1964Continuing)

ORGANIZATION(S)Rockford Memorial Hospital, Rockford, IllinoisOffice of Research in Medical Education, Col-

376

lege of Medicine, University of Illinois, 901South Wolcott Street, P. 0. Box 6998, Chi-cago, Illinois 60612

PRINCIPAL INVESTIGATOR(S)Miller, George E., M.D.Williamson, John, M.D.

STAFF

Full-time:1 physician

Part-time:9 physicians1 psychologist2 statisticians

COST

$15,000$24,999


USPHS

PUBLICATION PLANS

Not formulated


George E. Miller, M.D., Dir., Office of Researchin Medical Education, College of Medicine,Univ. of III., 901 South Wolcott St., P.O. Box6998, Chicago, Ill. 60612

(

,

M-9 The Association of American Medical Colleges Study of Medical StudentAttrition (2/ 15/66)

A TISTR A (IT

Objectives: To determine the factors whichlead to student attrition in medical schooland to formulate a set of admissions criteriawhich would result in lower attrition rates.

Content: The study analyzes the characteris-tics of both the students who drop out andthe schools from which they leave. The fol-lowing qualities of students are comparedfor non-dropouts, academic dropouts, andnon-academic dropouts : MCAT scores, pre-medical school grades, sex, and age. Attri-tion rates of medical schools are correlatedwith the following characteristics of theschool: location, research emphasis, propor-tion of out-of-State students, etc. Conclu-sions are drawn as to possible ways oflowering attrition rates.

Methods: Information for the study was gath-ered by questionnaires mailed to studentdropouts and medical school administrators,by computer analysis of the Association ofAmerican Medical Colleges' student records,and by interviews with students andadministrators.

CURRENT STATUSIn final editing stage prior to submission for

publication. (July 1962-66)

ORGANIZATION(S)Association of American Medical Colleges

PRINCIPAL INVESTIGATOR(S)Johnson, Davis G., Ph.D.Hutchins, Edwin B., Ph.D.

STAFFFull-time:None

Part-time:2 psychologists

COST

$35,000$44,999

FINANCING ORGANIZATION(S)Maurice Falk Medical Fund, 3315 Grant Bldg.,

Pittsburgh, Pa. 15219

PUBLICATION PLANSJournal of Medical EducationSummer of

1966

FOR FURTHER INFORMATIONDavis G. Johnson, Ph.D., Assist. Dir. (Student

Studies and Services), Div. of Education,Assoc. of American Medical Colleges, 2530Ridge Ave., Evanston, III. 60201

377

I

M-10 A Longitudinal Study of the Students Entering Medical School in 1956(2/15/66)

ABSTRACT

Objectives: To assess, covering the time be-fore, during, and after medical school, thechanges in personality characteristics, inter-ests, career patterns, and performance offuture physicians.

Content: The study makes a detailed analysisof the development of the medical studentthrough his medical education, correlating,among other things, the following informa-tion: (1) .personality traits of enteringmedical students vs. all college males, (2)personality traits of entering medical stu-dents vs. graduating medical students, (3)personality traits of students at research-oriented medical schools vs. students atschools whose graduates usually becomeprivate practitioners, (4) school bueget vs.the Medical College Admission Test (MCAT)scores of students, and (5) school budget vs.student career choice.

Methods: Beginning in 1956, 2,800 studentsentering 28 medical schools were studieduntil their graduation. Each student com-pleted tests designed to measure personalityand occupational interest patterns. MCATscores, rank in class, and eventual careerchoice were also obtained for the students.In conjunction with the data collected on thestudents, information was also obtained re-

garding the various characteristics of theirmedical school environment.

CURRENT STATUSMiscellaneous reprints of specific aspects of

the study available on request. (1955-1967)ORGANIZATION(S)Association of American Medical Colleges

PRINCIPAL INVESTIGATOR(S)Hutchins, Edwin B., Ph.D.STAFFFull-time:1 psychologist

Part-time:

COST$15,000$24,999FINANCING ORGANIZATION(S)Association of American Medical Colleges

PUBLICATION PLANSJournal of Medical Education and the psy-

chological journals-1968FOR FURTHER INFORMATIONEdwin B. Hutchins, Ph.D., Assist. Dir. (Basic

Research), Div. of Ed., Assoc. of AmericanMedical Colleges, 2530 Ridge Ave., Evanston,III. 60201

M-11 Training in Community Mental Health (6/2/66)

..A.rioTit A CT

Objectives: To train groups composed of sixprofessional Persons, each from a variety ofdisciplines, in principles and skills of com-munity mental health as they apply to prob-lems of social deviation such as narcoticaddiction and alcohol abuse. The ultimategoal is to encourage and prepare such pro-fessional personnel to put this experienceinto practice in research, teaching and serv-ice programs in local community agencies,institutions and planning bodies.

Content: The Pilot Project is committed tointerdisciplinary integration of psychiatriccasework, public health nursing, psychology,sociology, community organization and psy-chiatry, and is carefully designed to provideresearch, education and service content inindividual, group and community aspects ofpathology in addictions.

Methods: Curriculum will be based on thecumulative experiences of the Division ofCommunity Mental Health, New York Col-lege of Medicine, and will present the sixperson group with, a broad grounding in theprinciples and skills of community mentalhealth practice.

CURRENT STATUS

Active. (July 1965-68)

AT)" ILTIMI PrIltirmT ei111,W11.1 11411 1 J11111 (0)

Div. of Community Mental Health, Dept. ofPsychiatry, New York Medical College

PRINCIPAL INVESTIGATOR(S)Brotman, RichardSTAFFFull-time:3 physicians2 psychologists2 registered nurses4 social workers, counselors2 sociologistsPart-time:2 social workers, counselors1 teacherCOST$150,000$199,999

FINANCING ORGANIZATION(S)National Institute of Mental Health, Bethesda,

Md. 20014

PUBLICATION PLANS

FOR FURTHER INFORMATIONProf. Richard Brotman, Div. of Community

Mental Health, Dept. of Psychiatry, NewYork Medical College, 105th St, and FifthAve., New York, N. Y. 10029

879

M-12 A New Training Program for Nurses Which Will Prepare Them to GiveImproved Health Care to Children in Medically Depressed Areas (12/6/65)

ABSTRACT

Objectives: To establish a new training pro-gram in pediatrics for public health nurseswhich will increase their knowledge andskills so that they can fill an expanded rolein maternal and child health as independentpractitioners ef nursing; and to train nuaesso that they may act as more effective asso,dates of physicians to allow conservation ofpresently existing medical resources in medi-cally depressed areas.

Content: In the first phase, each nurse willreceive about four months of intensivetheory and practice in pediatrics. This phaseis a clinically-oriented educational programand incudes management of the wel! child,identification and care of acute and chronicconditions in childhood, and care of emer-gency situations. The second phase of theproject is the application of the nurse'snewly acquired knowledge and skills in amedically depressed area.

Methods: The first (training) phase of theprogram will be conducted at the Universityof Colorado Medical Center and will be fourto six months in length. The second phase(18 to 20 months in length) will be per-formed at the family health service at Trini-dad, Colorado, an area with limited medicalresources.

380

CURRENT STATUS(Oct. 1965-68)

ORGANIZATION(S)University of Colorado Medical CenterPRINCIPAL INVESTIGATOR(S)Silver, Henr, K., M.D.Ford, Loretta C., Ed. D., R.N.STAFFFull-time:13 registered nursesPart-time:

4 medical care specialists14 physiciansCOST$50,000$74,999

(first year)FINANCING ORGANIZATION(S)Initial partial support from Research Commit-

tee of the Univ. of Colorado School ofMedicine

PUBLICATION PLANS

FOR FURTHER INFORMATIONHenry K. Silver, M.D., Prof. of Pediatrics,

Univ. of Colorado Medical Center, 4200 E.Ninth Ave., Denver, Colo. 80220

M-13 StudylThe Use of Dental Assistant in Dental Practice; Study IIDental Treatment of Handicapped Persons (1/27/66)

ABSTRACTObjectives: Study IA continuing study and

training program on the use of dental assist-ants in dental practice. Study IIThe treat-ment of handicapped children and aged inpractice.

Content: Study IRecords kept of accomplish-ments of senior students with and withoutdental assistants. Study IIMethods oftreating handicapped persons in practice.

Methods: Practical demonstrations.CURRENT STATUSBoth progressing with good results showing

need and benefits of both training programs.(Study I:1960-continuous) (Study 11:1962-Aug. 1966)

ORGANIZATION(S)School of Dentistry, Fairleigh Dickinson

UniversityPRINCIPAL INVESTIGATOR(S)Study ILevitz, Victor, D.D.S.

Study IIKolm, Sidney, D.D.S.Thomas, Robert, D.D.S.

STAFFFull-time:1-12 dental assistants

Part-time:4 dentist.;

COST


The

PUBLICATION PLANSNot announced


Study IVictor Levitz, D.D.S.; Study II-4Sidney Kohn, D.D.S., School of Dentistry,Fairleigh Dickinson Univ Teaneck, N. J.07666

381

M-14 Test of Use of Programmed Instruction in Rehabilitation Aspects ofNursing (6/22/66)

ABSTRACTObjectives: To develop programmd units of

instruction in rehabilitative aspects of nurs-ing and to test their effectiveness.

Content: Rehabilitative aspects of nursing in-cluding concepts and goals, muscle condi-tioning, body positioning, range of motions,and clinical application.

Methods: Content and objectives are validatedby subject-matter specialists. T-aching proc-ess is analyzed and items written. Testingof experimental forms until 90 percent oftest population achieves 95 percent success.Preparation of final copy.

CURRENT STATUSUnit I on Concepts and Goals is completed.

Other units in process. Should be completedby September 1967. (June 1963Sept. 1967)

ORGANIZATION(S)National League for Nursing

PRINCIPAL INVESTIGATOR(S)Flitter, Hessel H.

382

STAFFFull-time:3 registered nurses1 artist1 editorPart-time:3 psychologists3 registered nurses1 statisticianCOST$200,000$249,999


Washington, D.C.

PUBLICATION PLANSNational League for NtirsingUnit I, 1966;

Units II, III, IV, V, September 1967FOR FURTHER INFORMATIONHessel H. Flitter, Dir., Res. and Studies Serv-

ice, National League for Nursing, 10 Colum-bus Circle, New York, N. Y. 10019

0

M-15 Neighborhood Health Aid Program (1/3/66)

ABSTRACTObjectives: To strengthen motivation for the

increased use of health facilities and serv-ices existing in the city and to channelsimple health information into the formaland informal communications network ofthe neighborhood.

Content: Health aid personnel go into homesand initially help families to solve immediatehealth problems. After rapport has been es-tablished, an inventory of health needs forthe families is taken. Health need prioritiesare established during conferences withhealth aide personnel and public healthnurse supervisors. Functions of the healthaide include: teaching the importance ofseeking health care, informing persons ofthe available health facilities, caring forchildren in the home while others attendclinics, providing transportation, healthteaching in various areas, etc.

Methods: A neighborhood, with a populationof about 100,000, in Washington, D. C., hasbeen selected for the program. The neigh-borhood health aid personnel are selectedfrom people who are well respected in thecommunity and have demonstrated interestin community problems. Families becomeknown to the Neighborhood Health Aid Pro-gram through casefinding activities andreferrals.

CURRENT STATUSLast six months of 3-year demonstration grant.

The project was transferred from the Health

and Welfare Council to the D. C. Depart-ment of Public Health, July 1965. We hopethat the project will continue under theauspices of the D. C. Department of PublicHealth.

ORGANIZATION ( S)Neighborhood Health Aid Program, Bur. of

Nursing, D. C. Dept. of Public Health

PRINCIPAL INVESTIGATOR(S)Hicks, Florence J. (Mrs.)

STAFFFull-time:1 registered nurse

Part-time:None

COST$100,000--$149,999

FINANCING ORGANIZATION(S)U.S. Public Health Service, Region DI, Char-

lottesville, Virginia

PUBLICATION PLANSAmerican Journal of Nursing, "Training

Neighborhood Health Aides," April 1965Public Health Reports (in process of writingarticle) date unknown

FOR FURTHER INFORMATIONMrs. Florence J. Hicks, Sup. Public Health

Nurse, D. C. Department of Public Health,400 L Street, S.E., Washington, D.C. 20003

383

M-16 Readings in Health

ABSTRACTObjectives: To assemble pertinent readings on

health care economics as a teaching aid.Content: Collected readings with appropriate

introductions.Methods: Search of literature (emphasis on

historical iteros out of print).CURRENT STATUSApproximately one-third complete. (July

1965Jan. 1967)ORGANIZATION (S)Dept. of Health Care Admin., George Wash-

ington Univ.

PRINCIPAL INVESTIGATOR (S)Camp, Elwood W.

STAFFFull-time:None

384

Care Economics (5/23/66)

Part-time:

1 hospital administrative educator

COST

Under $5,000


W. K. Kellogg Foundation, Battle Creek,Michigan

PUBLICATION PLANS


Elwood W. Camp, Assoc. Prof., Dept. of HealthCare Admin., The George Washington Uni-versity, 816 21st St., N.W., Washington, D.C.20006

1

(4)

M-17 Mental Health Integrator (4/28/66)

ABSTRACTObjectives: To carry the strand of psychiatric

nursing throughout the curriculum, initiatedat the point of first patient contact and pro-gressing as a continuum until graduation.

Content: Planning emotional support for pa-tients in the general hospital and publichealth agency. Implementing this plan atthe time of student experience, and eval-uating the effectiveness of having a psychi-atric nursing specialist on the wards.Hopei lly the Medical-Surgical and PublicHealth faculty would eventually assume thisresponsibility.

Methods: A psychiatric nurse specialist who isacting as a resource person in hospitals andpublic health agency in order to assist stu-dents to recognize anxiety states and insti-tuting nursing therapy so that the patient'sanxiety may be diluted. Evaluation of theemotional support given these patients is apart of the planned program.

CURRENT STAT"3Program is operational. (July 1966-70)

ORGANIZATION(S)University of Delaware

PRINCIPAL INVESTIGATOR(S)Cloud, Elizabeth D.

STAFFFull-time:None

Part-time:1 registered nurse

COST

$35,000-$44,999


PUBLICATION PLANS

FOR FURTHER INFORMATIONMadeline McDowell, Chairman, Dept. of Nurs-

ing, Univ. of Delaware, Newark, Delaware19711

385

M-18 Development of a Program of Research in Health Economics and Impactof Medical Research (12/28/65)

ABSTRACTObjectives: To develop an agenda of research

in health economics and the impact of medi-cal research.

Content: The Economic and Public Policy Im-portance of Health Care. The Use of Eco-nomics in Evaluating Health Care. SomeBroad Areas for Investigation. The Role ofan Independent Institute in Health PolicyResearch.

Methods: The principal investigators prepareda background paper for a conference of ex-perts held at the Brookings Institution onOctober 29, 1965. A summary of the confer-ence is now being prepared.

CURRENT STATUSOn schedule. (July 1965Jan. 1966)ORGANIZATION(S)Economic Studies Division, The Brookings In-

stitution, 1775 Massachusetts Ave., N. W.,Washington, D.C.

PRINCIPAL INVESTIGATOR(S)Somers; HermAn

STAFFFull-time:None


M. PrId Anne R.

COST

$5,000$9,999


The National Institutes of Health, Washing-ton, D.C.

PUBLICATION PLANSNot yet known


Herman M. Somers, Princeton Univ., Prince-ton, N. J. 08540

M-19 Accident Prevention, Brown County (5/5/66)

ABSTRACT

Objectives: To study the role of accidents thatoccur daily.

Content: Then, after studying accidents, therewill be a period of educating the public andif possible resume a new survey to deter-mine if they. is a reduction in accidents.

Methods: Doctors reported every accident giv-ing all the details of the accident: person,place, time, prevention and guilty party.

CURRENT STATUS

Latent. (October 1962-1967 or 1968)

ORGANIZATION (S)

Brown County A' -dical Society, New Ulm,Minnesota


Doctors of the Medical Society

i

STAFFFull-time:

Part-time:30 physicians4 social workers, counselors2 statisticians

COSTUnder $5,000

FINANCING ORGANIZATION(S)Minnesota Department of Health, Minneapolis,

Minnesota

PUBLICATION PLANS

FOR FURTHER INFORMATION0. B. Fesenmaier, M.D., New Ulm, Minneso:a

56073

387

M-20 The Wisconsin Pharmacist-Preceptor as a Teacher A PreliminaryStudy of Role Effectiveness (116166)

ABSTRACTObjectives: To illuminate the function of the

pharmacist-preceptor as a practical teacher,and to characterize the circumstances of pre-ceptorship rated as superior by a sample ofinterns after completion of their legally re-quired period of training.

Content: Traditional importance of the pre-ceptor in pharmacy ; purposes and method-ology ; rated effectiveness of preceptorialteaching (intern's view in relation to thepreceptor's view) ; instructional setting ofthe preceptor; attitudes toward some aspectsof the preceptorship; suggestions from thefield for improving the educational value ofthe preceptorship ; bibliography.

Methods: Selected sample represents 17 per-cent of Wisconsin preceptors. Questionnairedevised for self-rating and for rating byformer pharmacy interns. Field study to de-termine attitudes and temperamental quali-ties of preceptor-sample (Guilford-Zimmer-man TS utilized), and resources of worksetting evaluated. Comparative study in an-other State projected.

ORGANIZATION(S)

School of Pharmacy, University of Wisconsin

PRINCIPAL INVESTIGATOR(S)Sonnedecker, GlennDes Roches, Bernard

STAFFFull-time:None


COST

$5,000-$9,999


State Legislature, through Research Commit-tee of Graduate School, University ofWisconsin

PUBLICATION PLANS

Expected date of publication unknown

FOR FURTHER INFORMATIONCURRENT STATUS Glenn Sonnedecker, Ph.D., Prof., School ofPartially completed doctor of philosophy dis- Pharmacy, Univ. of Wisconsin, Pharmacy

sertation. (Spring 1964-1967) Building, Madison, Wisconsin 53706

388

M-21 Appraisal of Extension of Graduate Instruction for Psychiatric NurseTherapists (5112/66)

ABSTRACT

Objectives: To make a critical appraisal of theextension of graduate instruction in psychi-atric nursing which is designed to enhancethe competence of clinical specialists in psy-chiatric nursing in establishing and main-taining an ongoing program of therapy in adesignated psychiatric clinical area.

Content: For the pilot project, nurses will begiven special training in various aspects ofpsychiatric nursing with actual supervisedexperience with patients and methods andpractice in teaching and supervision. Thestudents, after completing the instruction,will be assigned to groups of patients inpsychiatric hospitals and will evaluate pa-tients in psychiatric hospitals and will eval-uate patient status and proceed to developan ongoing plan for patient care. Subse-quent analysis will be made over a five-yearperiod to determine the effectiveness of theprogram.

Methods: Nurses participating in the projectwill have had three semesters of full-timestudy in psychiatric nursing at the Master'slevel at the University of Maryland. Theywill then be assigned to a unit of about 25patients in a selected Maryland State mental

hospital for the extended training. The ap-praisal of the program will be based on fiveyears' experience of the pilot program.

CURRENT STATUSSecond year of study. (1965-1967)ORGANIZATION(S)School of Nursing, University of MarylandPRINCIPAL INVESTIGATOR(S)Carl, Mary K., Ph.D., B.S.

STAFFFull-time:11 registered nursesPart-time:

COST$50,000$74,999FINANCING ORGANIZATION(S)National Institutes of Health, Bethesda, Md.PUBLICATION PLANSUniversity of Maryland-1967FOR FURTHER INFORMATIONDr. Mary K. Carl, Prof. of Nursing, S&ool of

Nursing, Univ. of Maryland, 624 W. Lom-bard St., Baltimore, Md. 21201

389

Index of Principal Investigators

Index of Organizations

0INDEX OF PRINCIPAL INVESTIGATORS

Abel-Smith, Brian A-20Alexander, Jean H-21Andersen, Ronald M. B-5; C-7Anderson, A. M. E-15Anderson, Odin W. B-4; B-5; C-8; 1-38Anderson, U. M. H-42Anzel, Daniel M. D-1Atkins, Walter D. G-7Atwater, John B. E-32Axelrod, Morris 1-50

Babow, Irving D-39Bailey, J. Harold A-24Baker, Katherine (Mrs.) D-13Baldwin, William R. G-12Balintfy, Joseph L. E-27Bang, Haakon E-21Barbaccia, Joseph C. G-22Bardwell, Ann S. (Mrs.) H-46Barrett, Harold S. E-23Barsky, Percy E-20Bauman, William A. A-26Baumgarten, Harold E-8Beaumont, Graham L-20Beloff, J. S. D-28Benson, S. Bruce E-44Bergman, John H. M-4Best, Stanley C. L-22Bice, Thomas 1-39; 1-48Bierman, Jessie M. 1-47Bischoff, Lillian M. 11-47Blodgett, Frederic M. D-31Blomquist, Robert H. D-23Bodine, Roy L.. II-33Bondy, P. K. L-10Bonn, Jane E-18Bordua, David D-32Borish, Albert L. H-19Branton, A. F. D-44Braucher, Charles L. E-25; L-19Brauer, John C. A-29Bridgman, R. F. A-20Bristow, M. E. L-6Brodie, Dorothy A-10Bronstein, Edward H-19Brooks, George W. 1-42Brotman, Richard D-16; E-24; L-13; M-11Brown, B. Isabel (Mrs.) A-13; G-3; G-4; G-5Bryant, W. D. B-7Buatti, Anthony T. B-10Burditt, Russell D-34Burgess, Alexander M. 1-34Burnight, Robert G. H-6Butts, John E. H-43

Cabanas, R. 11-33Cadmus; Robert R. E-53Calisti, Louis J. P. F-1Callahan, Patricia G-19Callahan, Patrick E-42Camp, Elwood W. M-16Cape, William H. D-45Caplan, Gerald D-3Carl, Mary K. M-21Carter, H. W. D-8Cartwright, Ann 1-36; L-11Cave, Helen (Mrs.) H-21Chapin, F. Stuart, Jr. J-1Chase, Charles L. A-29Childs, Alfred W. D-47Clark, Eleanor A-8Clayton, Lewis B. D-41Closs, T. Sean D-20; D-33; 1-26Cloud, Elizabeth D. M-17Cobb, Sidney 1-42Coe, Rodney 1-49Cohen, Harold A. A-27Coker, Robert E., Jr. H-41Colberg, Marshall R. H-54Colfiesh, Virginia (Mrs.) H-15Cohen, M. F. E-2Connelly, Winnifred 1-42Connors, Edward 1-15Cook, H. G. C-3; 1-33Culbert, Robert 1-45Cumming, Elaine D-17Cumming, John 11-38

Dauphinais, Raymond J. D-6Davies, A. Michael H-29Davis, Milton S. K-8Deacon, Ruth H-46Dee, Donald A. D-6DeLora, Jack M-5Delva, P. L. II-21; L-4Dennis, James L. D-5Densen, Paul M. 1-21; 1-46Derry, John A-7; E-52Des Roches, Bernard M-20Diamond, Fred A-6Dick, H. R. E-50Dickerson, 0. D. C-2Dodge, David E-45Doff, Simon D. C-9Dolinsky, Edward M. 1-20Dornblaser, Bright M. D-2Douglas, Bruce L. H-35Dowd, Ronald 1-6Dowd, Ronald P. G-8

JP/393

Dubois, Donald G-16Dudney, George E. H-41Duff, Raymond S. E-22; E-26Dupont, Annalise H-24Durham, Floyd A-28

Ehinger, Robert F. D-51Eichhorn, Robert L. D-38; 1-48Eide, K. Arne 1-16; G-24; H-56Einhorn, Marilyn M. (Mrs.) 1-9Eisenberg, Arthur G-18Elsea, William R. D-27Esposito, tonigEvanson, Robert V. E-47

Falk, I. S. C-14; D-24; H-49; L-10;Fecher, Con J. H-8; H-9; H-30Feldstein, Paul J. G-20Fellers, John D. E-7Ferber, Bernard 1-28; 1-31; I-37Field, Mark G. D-10Fink, Raymond 1-19Fitzgerald, H. K. G-18Fitzpatrick, Thomas B. A-3; A-10; 1-28Flitter, Hessel H. M-14Foote, R. J. E-15; H-42Ford, Amasa B. E-16Ford, Loretta C. M-12Fowler, Floyd J., Jr. 1-50Fowler, Irving A. E-34Foyle, William R. A-18Francisco, Edward W. 11-49Friedmann, Eugene A. 1-49Friedsam, H. J. E-50; 11-52Fuchs, Victor R. E-40

Hatcher, G. H. 1-27Haughton, James G. I-17Hebb, Adele (Mrs.) D-19Heggtveit, C. R. (Mrs.) D-20; D-33Henderson, A. L. L-6Hetherington, Robert W. L-1Heyman, Margaret Mary L-14Hicks, Florence J. (Mrs.) M-15Higgins, A. C. E-11Hightower, Henry C. J-1Hill, Percy H. F-1Hilling, Helen Clark E-12IIinchey, Brackaton C-12Hiss, J. G. Fred G-14Hofstetter, H. W. A-24

L-15; M-6 Hogan, Michael G-23Hollingshead, August B. E-22; E-26Hopkins, Carl E. A-4; C-6; K-3; L-1Howland, Daniel L-5Hubbard, A. W. 1-5Hughes, John T. H-41Hummer, Paul A. G-6Huntley, R. R. G-23Hutcheson, B. R. D-34Hutchins, Edwin B. M-9; M-10

Gadzikowski, Gilbert C-13Gearing, Frances R. G-10Gendel, Evalyn S. D-25Gesche, Me lita D-49Getting, Vlado A. E-1Gilchrist, Sarah G-2Gish, Charles W. E-36Glasser, Melvin I-1Goldensohn, Sidney 1-19Goldstein, Sidney B-2Gordon, Gerald E-28Gordon, P. G. 1-27Gottlieb, Symond R. A-3Gough, Anna D-20; D-33Griffith, John R. E-38Griswold, Robert L. H-1Gruenberg, Ernest M. H-40Gue, Ronald L. E-7Gynn, Thomas N. H-34

Hanlon, John J. D-19Hardyment, A. F. E-30Harris, A. A. L-6Harris, B. R. L-10Harris, N. H-33Harro, Dale E. D-49Hassinger, E. W. H-50

Ingalls, Theodore H. 11-17Ingbar, Mary Lee A-16Inghe, Gunnar H-27

Jackson, Robert C. C-9Jaco, E. Gartly A-21; D-4Jacobson, Wyman 1-5Janavitz, Mary B. G-6Jenne, Frank H. L-22Johnson, Albert L. D-41Johnson, Cyrus M. H-28Johnson, Davis G. M-9Johnson, Helen (Mrs.) 11-24Johnston, W. B. L-15Jones, Michael G-19

Kabat, Hugh F. D-46; E-41; E-42; E-43; E-44; F-6Kaitz, Edward M. A-1Kaplan, Oscar M-5Kasl, Stanislav 1-42Katona, George E-48Katz, Alfred H. C-1; D-40; K-4Katz, Selig H. D-49Kaufman, Harold F. E-3Kay, Margarita K-7Keeny, Roy F-7Kellerman, Bert G-11Kirby, Glenn, Jr. A-15Kisch, Arnold I. H-17Kitinoja, John C-10Kleiner, Robert J.Klutch, Murray G-lvKnapp, David A E-9Knowles, Malcoin; M-2Kohn, Sidney M-13Kopra, Lennart L. H-51

Korney, Betty Jo G-16Kottke, Frank J. 11-55

Lachapelle, Robert J. B-1; 1-33Lachner, Bernard J. M-4Lambert, Camille, Jr. E-18; 11-20Law, Frank E. H-41Lawrence, G. D. 11-48Laws, Elizabeth M-5Lebo, Charles L-16Ledgerwood, John E. 1-35Lee, Everett S. J-2Talvi 11, Merris n-18Levine, Sol D-4ILevitz, Victor M-13Levy, Sam A-9Lieberman, Marvin A-25Lilienfeld, Abraham 11-45Lillick, Lois C. G-2Litman, Theodor J. 1-13Little, Dolores E. L-12Lively, C. E. G-11Loewenstein, Regina 1-18Logan, Robert F. L. 1-36Loyola, Maria (Sister) D-21Ludwig, Thomas 1-44

McCafffree, Kenneth M. A-14;McCamman, Dorothy H-12McCorkle, Lois P. 1-12; 1-24McCormick, John E-18; H-20McEvilla, Joseph D. E-19McFadden, Grace 1-45McGowan, Larry 1-25McGrath, Marck D-34McKelvey, Lowell E. H-33McKenna, Joseph V. F-5McKenzie, A. C. H-23McKerracher, D. G. 11-22McPhee, William M. K-10

Mitchell, Monroe K-5Mobley, Eugenia L. D-22Moen, J. B. C-4Montague, Joel B., Jr. L-18Montoya, Carlos B-8Moor, Pauline M. G-18Morgan, James E-48Morison, James B. E-20Morris, Naomi M. K-12Morse, Richard L. D. A-2Moses, Dorothy V. M-5Moses, Evelyn B. A-22; A-23; 0-17Mosher, W E E-15; II. -42Mosley, Mary L. (Mrs.) D-35Muhler, Joseph E-36Muldaven, Michael A-7Muller, Charlotte B-9Muller, Jonas N. E-I4; 11-13Munoz, Raul, A. 11-26Munzenrider, Robert J. G-15Murphy, J. Carter A-15Muth, Riman A-29Myers, Bever lee A. (Mrs.) D-35

Nagi, Saad Z. E-31Nauen, Richard E-14; H-13Neuhauser, Duncan E-49

E-10 Newport, John F. D-35Nichol, H. 1-23Nix, J. T. H-8; 11-30Norwood, George M., Jr. A-29Nye, Neva M-5

Mabry, John H. 1-36Macduff, Susan G-8Macleod, K. I. E. D-29MacRae, P. D. E-5Magraw, Richard M. L-20Maldonado, Jose F. 11-39Maloch, Francille H-46Marquis, Sue E-28Marra, E. E-I5Marshall, Eleanor D. (Mrs.) C-11;Martel, Martin U. H-6Martin, Cora D-50Martin, Leonard W. B-3Martin, Walter T. E-45Meiling, Richard L. M-4Mennie, W. A. D-20; D-33; 1-26Mercer, Victor E-36Metzner, Charles A. K-9Miller, George E. M-8Miller, Winston R. D-30Milliken, Sewall D-29Mind lin, Rowland L. 1-21

Oakes, Charles G. K-2Ogawa, George B-4Olson, Stanley W. D-7

Palumbo, Dennis J. D-19Parker, Seymour H-2Penchansky, Roy E-37Pendall, Rudolph 1-4Pepper, Anita C-14Perez, Salvador Diaz B-8; 11-3Perlman, Mark 1-22Perrott, George S. 1-3Peterson, Os ler L. 1-34Peterson, Warren A. 1-49Phillips, Derek L. H-37Phillips, Harry T. H-5Pierce, Lillian L-5

G-17 Piore, Nora B-11Plet, G. W. A-11; 1-29Podell, Lawrence 1-17Points, Thomas C. D-5Polk, Lewis D-19Pugs ley, L. I. 1-33

Quay, Herbert D-32

Raghuran, N. V. D-20; D-33Randall, C. L. E-15; H-42Ransohoff, Jerry D-29Rasmussen, Albie (Mrs.) A-2

395

Read, John H. L-4; H-21Reichman, Leonard H-19Reider, Fred F-7Reynolds, Harry D-50Richards, Charles F. F-6Richardson, William C. C-8Richart, R. H. D-43Richman, Alex C-5; II-10; H-18; 11-32; 1-23; L-7Riddell, Betty 1-26Rigby, Paul H. E-33Rising, Edward J. D-2Rituo, Marian M-2Rivero-aenzalez, Randolfo t, A

Ro, K. K. A-12Roberts, Arthur T. E-51Robertson, George J. M-1Robertson, Robert L. A-5Robinson, Norma F-7Rodowskas, Christopher A. E-47Roemer, Milton I. C -6 ; D-9; F-8 ; G 13; H-7 ; K-3 ;L-1Rosenthal, Gerald H-31; 1-2Rosenthal, Julian E. E-14; H-13Rosner, Henry 1-46Rosner, Lester J. I-45Ross, Alan 1-36Rossman, John E-4Roth, Mitchell E. D-51Rothenbuhler, Ervin F-7Rottenberg, Simon F-2Ruderman, A. P. G-9Ruedy, John 1-32Russell, Jerome L-16

Saenger, Gerhart H-38Sanazaro, Paul J. L-9Sartorelli, Camillo 11-24Saunders, Michael G. 1-14Sayers, Allison H-25Schloesser, Patricia T. D-25Schlorff, Velma G-22Schofield, William L-8Schonfeld, H. K. L-10; L-15School, Geraldine T. G-18Schooler, Kermit K. D-11Schroeder, Roger D. E-43Schulberg, Herbert C. D-3Schweitzer, Morton D. G-10Schwenger, Cope W. 11-25Segal, Bernard E. 11-37Seim, Harold C. E-41.Seltser, Raymond H-45Shapiro, Sam 1-19; 1-46Sharpe, Gladya J. 1-30Shaughneasy, Mary D-14Sheatsley, Paul B. I-35Shindell, Sidney L-8Silver, Henry K. M-12Slee, Virgil N. 1-8Sleeper, H. R. L-15Smith, Arthur F. B-1; 1-33Smith, Colin M. D-15; H-22Smith, Donald C. D-36; L-22

396

Snyder, Eleanor M. B-11Sojo Morales, L. H-33Solon, Jerry A. L-3Somers, Anne R. G-13; M-18Somers, Herman M. M-18Sonnedecker, Glenn. B-46; M-20Sonquist, John E-48Soricelli, David A. H-19Spangler, Huston F-7Spellman, A. B-7Spencer, F. J. D-48Spiegel, Allen D. M-2; M-3; M-7Spivack, Mayer D-34Spivak, Mark H-44Staack, H. Frederick, Jr. H-34Stark, Harry 8-6Stearns, Norman S. M-1Steele, Robert II-21; L-4Stein, Samuel C. H-17Stevens, Carl M. F-4Stevens, Rosemary A. M-6Stewart, William M. G-21Strauss, Anselm D-41Strick, Frances (Mrs.) H-21Stuckey, Ronald E-35Sultz, Harry A. 11-4; H-36

Taber, Merlin D-32Tagliacozzo, Daisy M. K-11Taylor, J. K. D-44Taylor, Robert D-41Tester, William W. B-39Thellwell, Raymond F-7Thomas, Dcrothy S. J-2Thomas, Robert M-13Thompson, Charles E. 11-34Topiol, Jack B-6; C-10Torrens, Paul R. H-14Trainor, John F. 11-55Tschudin, Mary S. L-12

Vahey, Virginia V. A-9Vandow, Jules E. D-42Veney, James E. E-29; I-41Vera, Mario B-8Vicroy, Frank M. K-1Vlasak, George J. H-5Voorhees, Arthur L. 0-18Voors, A. Wouter E-13Vukmanovic, Cedomir 1-36

Wakeley, Ray E. 0-11Walden, Daniel C. E-12Waldron, Daryle L. 11-51Walker, Hugh D. H-53Wallace, Donald A. H-35Wanklin, J. M. 1-27; 1-35Ward, Morton F-3Ward, Robert G-21Warren, Richard M. D-23Watts, K. H. H-11Webber, Irving L. D-8

Weckwerth, Vernon E. E-6Weeks, Lewis E. E-38Weinerman, E. R. D-28Wessler, Richard D-43

O White, Kerr L. 1-36; 3-3Whittier, Peter B-6Wilkinson, Kenneth P. E-3Williams, Josephine J. I-46Williams, L. G. A-11; B-1; C-3; C-4; 1-29; 1-33Williams, R. C. D-44Williamson, John M-8Winship, Henry W., III 0-46Wiriek, Grover C., 3r. A-3Wood, Donald G-19

Wood, Ralph B. G-8Wortham, John L. A-28Wright, Irving 1-5Wysong, Jere A. D-38

Yaffe, Silvia F. F-3Yerby, Alonzo 1-46Yett, Donald E. A-4Young, F. M. 11-42

Zaus, Earl A. 11-34Ziegler, Arthur D. E-1Zola, Irving Kenneth 11-44Zolik, Edwin S. F-9

397

INDEX OF ORGANIZATIONS AND INSTITUTIONS

State and Local

Organization or institution Reference No.

Tucson, St. Mary's Hospital K-7California:

Alameda County Welfare Department G-8Los Angeles County Bureau of Public Assistance G-8Napa State Hospital D-39Oakland, Kaiser Foundation Health Plan 1-43; 1-47Oakland, Permanente Medical Group E-2Presbyterian Medical Center L-16San Diego State College Foundation M-5San Diego State College, Nursing Department. M-6State Department of Public Health A-7; E-52; G-2; L-21Statk Department of Social Welfare G-8State Medicr' ,Association G-19Stockton Stato Hospital H-1University of California, Institute of Business and Economic Research D-47University of California, School of Public Health A-4;

0-1; C-0; D-1; D-9; D-40; E -4; F-8; G-16; H-7; 1-6; 1-47; K-3; K-4; L-1University of Southern California, School of Pharmacy H-48

Colorado:University of Colorado School of Medicine L-2; M-12

Connecticut:New Haven Health Department E-32New Haven, Yale-New Haven Hospital E-26State Department of Health E-23Yale Univin.sity E-22; E-26Yale University, School of Medicine C-14;

D-24; D-28; D-31; H-49; L-10; L-15; M-6Delaware:

University of Delaware M47District of Columbia:

Department of Public Health M-15George Washington University M-16

Florida:Pinellas County Health Department D-8State Board of Health C-9State University C-2; H-54University of Florida, Center for Health and Hospital Administration .......... E-7

Georgia:Atlanta, Community Council of the Atlanta Area, Inc. D-44Emery University, School of Nursing H-47State Department of Public Health II-43University of Georgia A-27

Hawaii:State Medical Association .......... ..... . ........ ..... A-10

3?V399

Organization or institution Reference No.

Illinois:Chicago, Charles Edward Thompson and Associates... H-34Chicago, Presbyterian-St. Luke's Hospital K-11De Paul University F-9Illinois Institute of Technology K-11Loyola University B-3Rockford Memorial Hospital M-8Southern Illinois University G-11State Department of Public Health A-17University of Chicago E-28University of Chicago, Graduate School of Business B-4;

B-5; C-8; E-49; 1-38University of Chicago, Health Information Foundation C-7University of Chicago, National Opinion Research Center B-4; B-5; C-7; 1-38Uriversi4 of Chicago, School of Social Service Administration L-14University of Illinois, College of Dentistry H-35University of Illinois, College of Medicine M-8University of Illinois, Jane Addams Graduate School of Social Work D-32

Indiana:Indiana University A-24Indiana University, School of Dentistry E-36Purdue University 1-48Purdue University, Department of Sociology D-38Purdue University, School of Pharmacy and Phartnacal Sciences E-47State Board of Health E-36

Iowa:University of Iowa, College of Medicine E-39University of Iowa, College of Pharmacy E-39

Kansas:State Department of Health D-25; 1-7State University A-2University of Kansas, Governmental Research Center D-45

Kentucky:University of Kentucky H-28University of Louisville, Kent School of Social Work K-1

Louisiana:Tulane University E-31Tulane University, School of Business Administration E-27Tulane University, School of Medicine G-22

Maryland:Baltimore, Hospital Council of Maryland 1-4Johns Hopkins University, School of Hygiene and Public Health H-45; 1-36; J-3University of Maryland, School of Nursing ..... .......... ................ M-21

Massachusetts:Boston, Bingham Associates Fund. M-1Boston Citir Hospital A-1Boston College G-1Boston College, School of Nursing D-14Boston, Health Research Institute, Inc. A-9; H-5Boston, Long Range Planning Project of Combined Jewish Philanthropies 1-50Boston, Massachusetts General Hospital A-8Boston, Medical Foundation, Inc. D-34; M-2; M-3; M-7Boston University D-10Brandeis University H-44Brandeis University, Florence Heller Graduate School for Advanced

Studies in Social Welfare D-11Greenfield, Franklin County Public Hospital D-2Harvard University, Department of Economics A-16; F-4; H-31Harvard University, Graduate School of Public Administration A-16; H-31

400

Owanization or institution Reference No.Harvard University Medical School D-3; 1-34Harvard University, Office for Research Contracts. 1-2Harvard University, School of Public Health E-37Lowell Technological Institute C-12Mount Holyoke College A:5State Department of Public Health H-5Tufts University F-1University of Massachusetts, School of Engineering D-2

Michigan:Ann Arbor, Commission on Professional and Hospital Activities 1-8Detroit, Michigan Health and Social Security Research Institute I-1Lansing, Michigan Health Officers Association E-1State Department of Public Health E-1University of Michigan, Graduate School of Business Administration A-3;

A-18; E-38; G-20University of Michigan, Institute of Science and Technology.. D-12University of Michigan, Region V Research Program D-36University of Michigan, School of Public Health D-36; E-1; K-9; L-22University of Michigan, Survey Research Center E-48; 1-42Wayne State University C-13Wayne State University, College of Pharmacy D-6

Minnesota:Brown County Medical Society M-19Minneapolis, Modern Medicine Publications, Inc. 1-5Saint Paul Medical Center D-30University of Minnesota E-6University of Minnesota, College of Pharmacy. E-41;

E-42; E-43; E-44; F-6University of Minnesota Meaical School L-20University of Minnesota, School of Public Health A-21; D-4; 1-13

Mississippi:State University, Social Science Research Center.... ..... ... ..... . .. .. ....... ... .. . E-3

Missouri:Kansas City, Institute for Community Studies, Inc.. ...... . .... 1-49St. Louis, Barnes Hospital Medical Center F-5St. Louis University D-43St. Louis University, Health Organization Research Program D-43St. Louis University, Institute of Technology. F-5State Department of Public Health and Welfare 1-10University of Missouri, Agricultural Experiment Station .. H-50University of Missouri, School of Medicine B-7

Montana:State Board of Health .. . . G-15

Nebraska:University of Omaiiii, Center for Urban Studies

New Hampshire:Dartmouth Medical School . H-37

New Jersey:Fairleigh Dickinson University, School of Dentistry M-13Princeton University G-13Rutgers, The State University B-6; C-10

New Mexico:Stlte Department of Public Health. G-7

New York:Buffalo, Maternal and Child Health Project . H-42City University of New York, Hunter College Graduate Division B-11Columbia University E-8Columbia University, College of Physicians and Surgeons ..... 11-40

401

Ovanization or institution Reference No.Columbia University, Presbyterian Medical Center A-26Columbia University, School of Public Health and Admin!-+tative Medicine B-9;

G-10; 1-18Cornell University Medical College K-8Cornell University, Sloan Institute of Hospital Administration K-6Erie County Department of Health D-27; D-37; D-51; E-15; II-42Health Insurance Plan of Greater New York 1-19; 1-46Hospital Service Corporation of Western New York (Blue Cross) D-51Medical and Health Reftarch Association of

New York City, Inc. D-42; 1-20; 1-21; 1-45Monroe County Department of Health D-26New York Aeae.enly of Medicine A-25New York City, Babies Hospital A-26New York City Department of Health B-11; D-42; G-10; 1-21; 1-45New York City, St. Luke's Hospital Center II-14New York City, Social Welfare Research Council 1-17New York City, Urban Medical Economics Research Project B-11New York Medical College, Department of Physical Medicine and

Rehabilitation E-14; H-13New York Medical College, Department of Psychiatry. D-16; E-24; L-13; M-11New York University, Graduate School of Public Administration.. ........ ............. . E-12St. John's University, College of Pharmacy B-10State Department of Health D-49; D-51; E-13; G-14State Department of Health, Buffalo Regional Office G-14State Department of Mental Hygiene, Mental Health Research Unit D-17; H-38State University of New York, Research Foundation E-34State University of New York, Upstate Medical Center E-11State University of New York at Buffalo, School of

Medicine E-15; G-14; H-4; 11-36; 11-42State University of New York at Buffalo, School of Nursing H-42State University of New York at Buffalo, School of Social Welfare E-34Uniondale, A. Holly Patterson Home K-5

North Carolina:Duke University F-2University of North Carolina at Chapel Hill, Center for Urban and

Regional Studies, Institute for Research in Social Science J-1University of North Carolina at Chapel Hill, School of Dentistry A-29University of North Carolina at Chapel Hill, School of Medicine ... E-53; G-23University of North Carolina at Chapel Hill, School of

Public Health D-41; II-41; K-12

Ohio:Cincinnati, Greater Cincinnati Hospital Council.. . .... . D-29Cincinnati Health Department D-29Cincinnati, Public Health Federation D-29Cleveland, Benjamin Rose Hospital F-16Cleveland, Community Health Foundation D-18Cleveland, Visiting Nurse Association. ....... .. ..... .. E-16Frances Payne Bolton School of Nursing E-16Lorain City Health Department H-16Ohio State University E-31; L-5Ohio State University, College of Medicine M-4Ohio State 'University, College of Pharmacy E-9Ohio State University, Research Foundation H-46Ohio State University, School of Home Economics H-46Toledo District Board of Health E-17University of Dayton, Committee on Medical Care of Clergy

and Religious H-8University of Dayton, Research Department H-8University Hospitals of Cleveland 1-24Western Reserve University, School of Medicine... .. ..... E-16; 1-12; 1-24

402

Organization or institution Reference No.Oklahoma:

Oklahoma City, Oklahoma Health Sciences Foundation D-5Southwestern State College, School of Pharmacy E-25; L-19University of Oklahoma School of Medicine D-E

Oregon:Pacific University, College of Optometry G-12University of Oregon, Department of Sociology E-45

Pennsylvania:Darby, Thomas IVI. Fitzgerald Mercy Hospital 1-25Philadelnhia County Dental Society 11-19Philadelphia Department of Public Health, Community Health Services 11-19Philadelphia Department of Public Health, Division of Dental Health 11-19Philadelphia, Foundation for Medical Research... ....... .. .............. ........ I-11Philadelphia, Geriatric Institute F-3Philadelphia, Public Health Systems Research Project D-19Pittsburgh, Blue Cross of Western Pennsylvania A-10; A-12; 1-28; 1-31Pittsburgh, Health and Welfare Association of Allegheny County

G-6;E-18;H-20

Pittsburgh, Hospital Utilization Project L-8State Department of Health H-15State University, College of Business Administration E-33Temple University H-2University of Pennsylvania, Population Studies Center J-2University of Pennsylvania, School of Medicine H-17University of Pittsburgh, Graduate School of Public Health 1-22University of Pittsburgh, School of Pharmacy E-19

Puerto Rico:Department of Health H-26University of Puerto Rico School of Dentistry .. ........ .... H-33University of Puerto Rico School of Medicine II-39

Rhode Island:Brown University B-2Brown University, Population Studies and Training Center H-6

Tennessee:Meharry Medical College, School of Dentistry D-22University of Tennessee

K-2Vanderbilt University11-53

Texas:Baylor University, College of Medicine D-7North Texas State University E-50; H-52Southern Methodist University, Department of Economics A-15Texas Christian University A-28Texas Technological College

.. ........ ..... E-51University of TexasH-51

Utah;Salt Lake City, Community Services Council G-21University of Utah, College of Business G-21University of Utah, VRA Region VIII Research Institute K-10

Virginia:Medical College of Virginia

D-48Washington:

Seattle, King County Hospital . D-23State Department of Public Assistance D-13Takoma, Hillhaven, Inc. - A-6University of WashingtonA-14University of Washington, School of Nursing L-12Washington State University H-55; L-18Washington State University, College of Pharmacy. E-21

403

Onganization or institution

Wisconsin:University of Wisconsin Medical CenterUniversity of Wisconsin School of Pharmacy

National GovernmentalDepartment of Health, Education, and WelfarePublic

Health Service. A-15;Executive Office of the President, Bureau of the Budget

A-25;

Reference No.

1-15E-46; M-20

D-35; F-7; G-14F-7

United States Civil Service Commission 1-40

National PrivateAmerican Association of Dental Schools A-29American Foundation for the Blind G-18American Hosp:ttal Association E-49American Nurses Association A-22; A-23; C-11; E-35; G-17American Optometric Association A-24American Public Health Association L-17Association of American Medical Colleges L-9; M-9; M-10Blue Cross Association E-29; 1-37; 1-39; 1-41Brookings Institution M-18Group Health Association of America H-12; 1-9; 1-44K...nny Foundation E-31Metropolitan Life Insurance Company G-24; H-56; I-16National Bureau of Economic Research E-40National League for Nursing M-14National Tuberculosis Association D-41Pan American Health Organization G-9

CanadianAntigonish (N.S.), St. Martha's Hospital D-21Brandon (Man.) Hospital for Mental Diseases L-6British Columbia Department of Health Services and Hospital Insurance H-11Canadian Dental Association A-13; G-3; G-4; G-5Charlottetown (P.E.Is.), Hospital Services Commission of Prince

Edward Island. 1-35College of Physicians and Surgeons of British Columbia E-30Dalhousie University 1-27Dalhousie University, Faculty of Medicine ...... . 1-35Manitoba Department of Health and Public Welfare E-20Montreal (Quebec) General Hospital 1-32National Health and Welfare, Department of A-11;

B-1; C-3; C-4; D-20; D-33; H-23; 1-26; 1-29; 1-33Queen's University H-21; L-4Royal Commission on Health Services L-7St. Francis Xavier University D-21Toronto (Ont.), Ontario Hospital Services Commission 1-30University of Alberta E-5University of British Columbia H-32University of British Columbia, Faculty of Medicine C-5;

H-10; H-18; 1-23; L-7D-15; H-22University of Saskatchewan

University of TorontoUniversity of Toronto, School of HygieneWinnipeg (Man.) General Hospital

H-24H-251-14

Other ForeignChile, Centro de Estudios Sociales de la Facultad de Economia de la

Universidad de Chile H-3Chile, Departamento de Salud del Colegio Medico B-8; H-3England, Institute of Community Studies L-11Israel, Hebrew University, Hadassah Medical School H-29Sweden, Karolinska Institutets, Social Medicinska Institution H-27Switzerland, World Health Organization.. ...... ............... . ... A-20

404

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