Abstract: A sample population of some two hundred subjects in Vancouver was surveyed to determine the physician/patient role orientations preferred by patients in clinical decision making. Eight dimensions of role orientations were identified, and indexes measuring these were defined. Index scores obtained for the population studied indicate that they wished to employ physicians as information sources and to a certain extent as decision makers, but that they also wished to have some input into the decision process. Analysis of sociodemographic and experiential variables did not identify any single variable that could predict role preferences.

Abstract: The arrangements comprising the health care delivery system are analyzed in terms of social organization, and selected characteristics of the system are discussed that are pertinent to the study of diffusion and adoption of various types of innovations. Research currently under way or completed is then reviewed in terms of its contribution to overall understanding of the phenomenon of innovation, on both the individual practitioner and the organizational levels. The analysis is then used to delineate problem areas needing further study. The article provides a useful context in which to consider substantive findings of future empirical research.

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Abstract: A methodological framework for the cost-effectiveness evaluation of diagnostic tests for mass screening is presented. The decision rule is based on disease incidence, probabilities of test error, the cost of the test and of treatment for found cases, and the economic value (expected lifetime earnings or equivalent) of additional length or quality of life for those cured of the disease. The decision rule is applied to the Pap test for cervical cancer, with results showing that as a one-time screening device the test is cost-effective from society's standpoint. Extensions of the method would permit estimation of the disease incidence at which a given test or treatment would be cost-effective; would permit estimation of the breakeven price of test and treatment with given disease incidence; and would allow determination of optimal testing frequency.

Abstract: A selectable dual ratio connection between the rudder pedals and the control elements of an aircraft for steering the aircraft by means of the nose mounted landing gear wheel thereof. The connection includes a control arm and a control segment selectively related either by a link, walking beam and bungee or by means of a pivoting link mechanism. The arm and segment are rotatably mounted upon axes that coincide with the pivoting link mechanism which in one position locks the arm and the segment together while in another position enables differential motion therebetween.

Abstract: Recent research on physician distribution using the structural approach is briefly reviewed and its theoretical and methodological limitations outlined in detail. On the basis of this critical evaluation, some possible directions for future research are suggested within a human ecology framework, which views the health care subsystem as one aspect of the way in which populations organize to deal with their environment.

Abstract: The first phase of a cooperative project to develop and pilot-test an improved system for monitoring the quality of nursing care is described. Evaluation criteria from existing methodologies were grouped in a comprehensive framework of nursing objectives and subobjectives, and both the framework and the criteria developed were tested statistically. The master criteria list was placed in a computer file, from which criteria subsets are systematically selected for actual quality monitoring. The methodology has been used in two pilot hospitals; in the second phase of the project, now under way, the system is being implemented in a wider sample of hospitals to further test the validity of the conceptual framework and the reliability of individual criteria.

Abstract: This study presents a comprehensive method for quantifying hospital output and estimating hospital productivity. A number of less comprehensive productivity measures that can be quantified from data available from regional third-party payers and from the American Hospital Association are also developed and evaluated as proxies for the comprehensive measure, which is based on local area data. Methods are discussed for estimating the necessary variables on a regional or national level.

Abstract: This article outlines a broad theoretical approach to measuring real cost-per-case differences resulting from differences in case mix, service intensity, and input productivity. Modifying the method in the interests of accommodating current lack of access to hospital data pertaining to diagnostic case mix, the authors apply the method to data from three Connecticut hospitals for the 1960-69 period and find both nominal and real changes in cost per case due to changes in factor input prices, gross service intensity, and factor input productivity.

Abstract: Interestingly, politics medicine and social science that you really wait for now is coming. It's significant to wait for the representative and beneficial books to read. Every book that is provided in better way and utterance will be expected by many peoples. Even you are a good reader or not, feeling to read this book will always appear when you find it. But, when you feel hard to find it as yours, what to do? Borrow to your friends and don't know when to give back it to her or him.

Abstract: A financial model of a hospital is used to analyze the relationships among service intensity, productivity, and per diem cost growth rates at various input cost growth rates. The model duplicates the hospital's cost-finding procedure given estimates of service volumes, hours, and direct costs. Results of the analysis indicate that large increases in labor productivity and/or decreases in service intensity would be necessary in order to limit the growth rate of per diem costs to 8 percent per year.

Abstract: The Trilevel Classification System described adapts the useful features of existing classification systems for convenient use in health manpower analysis. A computer program links the Kaiser Clinical-Behavioral Classification system, oriented to the demographic and socioeconomic characteristics of patient populations using ambulatory-care services, with the Geomet Specifications of Care, which in turn utilizes ICDA-coded records and Current Procedural Terminology—coded elements of care. An extensive case study is discussed in which the system is used in an HMO to predict the differential effects of various delegation policies for physician assistants.