Revista panamericana de salud pública = Pan American journal of public health
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Rev. Panam. Salud Publica · Jul 2001
Randomized Controlled Trial Clinical TrialAre routine preoperative medical tests needed with cataract surgery?
The objective of this study was to investigate whether routine medical testing before cataract surgery reduces the rate of complications during the perioperative period in adults. ⋯ The results of this study suggest that routine medical testing before cataract surgery does not reduce the rate of complications during the perioperative period. The results also suggest it would be more efficient not to request routine preoperative tests unless indicated by patient history or physical examination.
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Rev. Panam. Salud Publica · Jul 2001
Comparative Study[Availability, accessibility, and acceptability in the evolving health care system for older adults un the United States].
This study examined three dimensions of access to medical services that contribute to social equity in distribution--availability, accessibility, and acceptability--in order to examine the equity of two medical system arrangements in the United States of America: the traditional fee-for-services scheme and the newer, health maintenance organization (HMO) approach. Equity was compared among three racial/ethnic groups of older adults in the country: European-Americans (the majority in the United States), African-Americans, and Latin Americans (Latinos). ⋯ The HMO approach increases access to medical care but does not necessarily improve the quality of the patient-physician interpersonal relationship for older minority persons in the United States. This study demonstrates that in health systems that are going through a reform process it is possible to monitor equity in medical care, and that an accurate assessment needs to focus on vulnerable populations as well as to distinguish between different dimensions of access.