Health affairs
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Firearm-related injuries are a substantial public health problem. A wide array of policies designed to prevent these injuries have been discussed, but few are enacted into legislation. ⋯ We offer a nosology for categorizing existing and future gun policies. A brief review of the effectiveness of existing gun policies is presented, and an argument is made for redirecting gun policy.
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While much research has been conducted into physician supply in rural areas, very little is known about physician supply in areas with heavy populations of ethnic minorities. This study finds that in 1990 the number of physicians per thousand residents was lower than the national average in counties with predominantly black and Hispanic populations. For counties largely populated by Native Americans, the mean number of physicians was slightly higher than the national average.
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Hospitals with chronic losses might respond by closing, by drastically changing their services and patient mix, or by increasing efficiency. These possible responses are examined by studying a cohort of hospitals that were losing money between 1980 and 1984 as measured by their five-year average total revenue margins. ⋯ The remainder did not alter their service mix or select in favor of easier, better-paying patients. However, there was a reduced rate of investment in new technologies.
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The United States spent $751.8 billion on health in 1991, an increase of 11.4 percent over 1990 levels. National health expenditures consumed 13.2 percent of gross domestic product (GDP). ⋯ Consumers' out-of-pocket payments grew only 5.7 percent to a total of $144.3 billion, accounting for 19.2 percent of national health expenditures (the lowest share ever reported). Economywide price inflation accounted for 36 percent of health spending growth in 1991; increases in use and intensity of health services accounted for 30 percent of total spending growth; excess medical price inflation accounted for 25 percent, an amount that is consistent with its share throughout the 1980s.