Medical care
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To examine the association of primary care availability, HMO enrollment, and other person and location variables with potentially preventable hospitalization for adults in New York State, compared with other types of hospitalization. ⋯ A key policy-relevant result is the negative association of primary care physicians per capita with the likelihood of ACS admissions, without an offsetting association with resource costs via referral-sensitive admissions. The method allowed for examining the possible effects of personal and area variables on one type of hospital admission (ACS) by contrast with other specific types of admissions. This type of analysis could be strengthened in several ways for a defined population when better data on individual patients and several time periods are used.
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To identify factors related to elderly consumers' choice of pharmacy types and their overall satisfaction with pharmacy services provided by: a single community pharmacy, multiple pharmacies with a primary community pharmacy, a single mail order pharmacy, and multiple pharmacies with a primary mail order pharmacy. ⋯ Although using a single community pharmacy may create close patient-pharmacist relationships and improve health outcomes, consumers may be diverted from this choice because of price concerns and insurance diversification.
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With an aging population and public policies that limit accessible and affordable formal care services, informal caregivers, largely women, will continue bearing the overwhelming responsibility for home and long-term care services provision. ⋯ Informal caregivers, particularly women, are under considerable stress to provide a large volume of care with little support from formal caregivers. Program planners, policy makers, and formal care providers must act together to provide accessible, affordable, and innovative support services and programs that reduce family caregiving strain.
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The economic evaluation of health interventions for older people is complicated by the difficulty in obtaining self-reports of quality of life from persons with cognitive impairments, physical impairments, or both. ⋯ Proxy EQ-5D responses, either for a specific point in time or for assessing change over time, may not be valid measures of self-reported quality of life among older medically-ill patients.