American journal of public health
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We assessed the frequency of hospitalized burn injuries in Massachusetts, and product involvement in causing burns, by reviewing the hospital inpatient records and emergency room logbooks for 240 of New England's 256 acute-care hospitals. Children less than two years of age, males, and Blacks experienced higher burns rates than did older individuals, females, or Whites. Products frequently associated with burn injuries included those involved in food preparation and consumption, flammable liquids, and clothing.
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This study assessed the need for physician services among a group of institutionalized mentally retarded individuals in anticipation of their transfer to community residential facilities and subsequent management of their care by community-based physicians. The clients' personal physicians in the institution identified every chronic condition which required physician services, and recommended the kind of physician and frequency of visits for the management of each condition. Key informants reviewed these estimates and determined if there were sufficient physicians in their communities to provide this care. ⋯ These included orthopedics for the multiply-handicapped, neurology including behavioral neurology, and psychiatry. Deinstitutionalization policies which rely solely upon community physician services will lead to inadequate medical care in the community for some mentally retarded individuals. In these situations, alternative approaches to care must be developed.
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All accidental gunshot fatalities in North Carolina were reviewed for the years 1976-80. There were 210 cases, of which 94 were self-inflicted and 116 were inflicted by others. Young white males predominated as victims, 31 per cent under the age of 15. ⋯ Sixteen per cent of the accidents involved children playing with guns and 14 per cent involved dropped or mishandled weapons. During the same period, there were 2,553 suicides and 2,509 homicides by firearm. Gunshot fatalities are an important American public health problem.
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We studied all admissions to the 11 acute care hospitals of the New York City Health and Hospitals Corporation (April 1983-September 1984) matching emergency room (ER) admitted diagnostic related group (DRG) subgroups in each hospital with at least five non-ER admitted patients (N = 222,961). Mean cost per ER patient ($8,385) was greater than non-ER mean cost per patient ($4,386) for Medicare and non-Medicare. Our data suggest that public hospitals with a high proportion of ER admissions may be at a financial disadvantage under DRG reimbursement.
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Comparative Study
Longitudinal patterns of cigarette smoking and smokeless tobacco use in youth: the Bogalusa Heart Study.
Tobacco use was studied during 1977-76 (n = 2880) and 1981-82 (n = 2158) in a total biracial community of children, aged 8-17 years, in Bogalusa, Louisiana. White males were the early adopters of tobacco products in both surveys. Cigarette smoking decreased in all race and gender groups while smokeless tobacco use increased in White males. Studies which find a decline in male adolescent smoking should investigate a possible concurrent increase in smokeless tobacco.