Differences in treatment of ischemic heart disease at a public and a voluntary hospital: sources and consequences.
A study of hospital patients with ischemic heart disease reports that patients in a public hospital received fewer needed diagnostic tests, surgeries, and follow-up visits for their conditions than their private hospital counterparts. Factors in the hospitals' organizational environments and the patients' social backgrounds were observed to have an impact on content of treatment and to affect patient as well as provider perspectives on the quality of care. To facilitate the analysis, data were collected from four sources: direct observation of the care of each patient on rounds and at the bedside; interviews with physicians concerning the rationale for their decisions; a process-oriented chart audit assessing the appropriateness of care; and an extensive home interview with each patient three months following hospital discharge to establish further use of health services, health status, and satisfaction with care.
Yedidia
M J
MJ
Health Research Program, Robert F. Wagner Graduate School of Public Service, New York University, NY 10003.
D000552:Ambulances; D003625:Data Collection; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006779:Hospitals, Public / Q000592:standards* / Q000706:statistics & numerical data; D006788:Hospitals, Voluntary / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007350:Insurance, Hospitalization; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000191:economics* / Q000628:therapy*; D009519:New York City; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D018579:Patient Selection; D011787:Quality of Health Care / Q000706:statistics & numerical data; D040841:Resource Allocation; D016896:Treatment Outcome; D035862:Vulnerable Populations