Abstract:
:Public outcry regarding unsafe interhospital patient transfers led to the passage of the COBRA Law of 1985. Since its implementation in 1986, the law has been sharply criticized for its sporadic enforcement, narrow focus, and lack of care provisions for the poor. We reviewed retrospectively the charts of all emergency department patients transferred from two Milwaukee private hospitals during two identical 6-month periods in 1985-1986 and 1988-1989. We compared demographic and clinical characteristics of the patients transferred during the two periods. The emergency departments cared for 15% of Milwaukee's emergency patient population and transferred 216 and 200 patients during each respective period. Uninsured transfers fell from 32% to 17% of the study populations. Although the proportion of the local population belonging to a health maintenance organization (HMO) did not change, transfer of HMO patients increased from 14% to 27%. Transfers to the area's various tertiary care centers made up 21% and 35% of all transfers and were conducted without regard to insurance status. There was a fourfold increase in the use of the county's public assistance plan for emergency hospitalization of indigent patients at local hospitals. Although the number of uninsured patients transferred from the study hospitals decreased markedly, this decrease was counterbalanced by increased private hospital use of the county's emergency hospitalization plan for indigent patients. This successful plan bears further examination by health policy planners as an important model for the provision of emergency hospitalization for the indigent.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Kerr HD,Byrd JC,Stuart RW,Whitcomb Jdoi
10.1097/00007611-199311000-00004subject
Has Abstractpub_date
1993-11-01 00:00:00pages
1210-4issue
11eissn
0038-4348issn
1541-8243journal_volume
86pub_type
杂志文章abstract:OBJECTIVE:Satiety is the perception of satisfied fullness and represents a summation of neural and hormonal influences. Satiety can be assessed by drink tests, including water load. The objective of our study was to confirm the difference in water load volume between nonobese control children and children with function...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000612
更新日期:2017-03-01 00:00:00
abstract::Twelve cases of Shigella sonnei infection, with two deaths, occurred at a custodial institution in Donelson, Tennessee, in April and May 1973. Nine of the cases and both deaths were in patients hospitalized at the institution's infirmary. The patients with nosocomial shigellosis were significantly younger and had been...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197610000-00026
更新日期:1976-10-01 00:00:00
abstract:OBJECTIVES:Patients with cirrhosis have a high rate of 30-day hospital readmission that affects their quality of life and contributes to increased healthcare-related costs. The aim of our study was to identify frequency, predictors, and preventable causes of hospital readmissions among patients with decompensated cirrh...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000371
更新日期:2015-11-01 00:00:00
abstract::Lyme disease, now the most common tick-borne illness in the United States, has recently received much media attention, due in part to its potentially serious sequelae in untreated patients. Because a rare patient with late illness may lack antibodies to the etiologic agent, Borrelia burgdorferi, physicians may be temp...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199110000-00024
更新日期:1991-10-01 00:00:00
abstract::The comparative value of palpation, light percussion, and auscultatory percussion for detecting the liver below costal margin was studied in 45 normal subjects and 20 patients. The presence of the liver 2 cm or more below the costal margin was considered abnormal, since this organ was found no more than 1 cm below in ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199402000-00006
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVES:To explore temporal trends and geographic variations in mortality from prescription opioids from 1999 to 2016. METHODS:Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death files were used to calculate age-adjusted rates and 95% confidence int...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000001074
更新日期:2020-03-01 00:00:00
abstract::To determine the prevalence of frequently occurring neurologic disorders in a biracial population, a survey of households and chronic care institutions was carried out for all residents of Copiah County, Mississippi. Along with a complete census, interviews were held using extensive questions about diagnoses, signs, a...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198703000-00016
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:This study was done to determine the safety, efficacy, dosing requirements, and spontaneous recovery profiles of prolonged infusions of rocuronium bromide in the critically ill. METHODS:This multicenter, prospective, nonrandomized, open label trial enrolled 32 patients at two university-based medical center...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:This study was performed to examine the effect of stress on pregnancy outcome in women who underwent assisted reproductive technology (ART) procedures. METHODS:In a controlled clinical study of healthy volunteers in an academic research environment, stress was measured subjectively by administering patient ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000054567.79881.E9
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Chlamydia is the most commonly reported infectious disease in the United States, yet many women at risk for chlamydia infection are not being tested. METHODS:We conducted a chlamydia screening study (Phase I) and retrospective medical chart review (Phase II) of 199 women from 16 to 40 years of age attending...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000053673.13882.00
更新日期:2003-09-01 00:00:00
abstract::Supplemental digital content is available in the text. ...
journal_title:Southern medical journal
pub_type: 评论,杂志文章
doi:10.14423/SMJ.0000000000000716
更新日期:2017-11-01 00:00:00
abstract::In the past 30 years there has been no improvement in the five-year survival rate for endometrial carcinoma. Any change comparable to improved survival in cervical carcinoma will be accomplished only by similar detection of the early asymptomatic and precursor lesions of endometrial carcinoma. Reasons why the conventi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198004000-00022
更新日期:1980-04-01 00:00:00
abstract::Liver amyloidosis is very rare but is relatively common within the group of amyloid diseases. Jaundice seldom accompanies this condition. Since the results of liver tests are often abnormal, liver amyloidosis cannot be diagnosed by symptoms alone. Diagnosis is provided only by liver or rectal biopsy. We have described...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197907000-00041
更新日期:1979-07-01 00:00:00
abstract::There are an estimated 22 million users of smokeless tobacco in the United States, 3 million of them under age 21. We surveyed physicians and patients to determine whether the health hazard of smokeless tobacco was recognized and whether preventive measures were being implemented. Although more than 80% of physicians ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::This paper discusses the pathology produced by pit viper venom and the pharmacologically active substances released by the action of venom on human tissue. The risks of many of the popular methods of treatment such as tourniquets, cryotherapy, incisions, excisions, and cortisone are also discussed. A prospective treat...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197908000-00002
更新日期:1979-08-01 00:00:00
abstract::Obstructive biliary disease in childhood is not common, but should be considered in the differential diagnosis of a child with jaundice, abdominal pain, or an abdominal mass. We have reviewed the experience at Vanderbilt Children's Hospital from 1970 to 1985, during which 87 children 18 years of age or younger with bi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198611000-00007
更新日期:1986-11-01 00:00:00
abstract::Massive bleeding from a pharyngoesophageal diverticulum is a rarely reported condition, with only two reported cases in the literature. This report describes a patient who had massive bleeding due to ulceration in the base of a pharyngoesophageal diverticulum, presumed to have been caused by chronic aspirin ingestion....
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199003000-00033
更新日期:1990-03-01 00:00:00
abstract::Mesenteric lipodystrophy (ML) is a rare condition characterized by a nonspecific inflammatory process that involves the root of the mesentery in a lipoma-like lesion. Presenting features of ML include abdominal pain, weight loss, nausea, vomiting, diarrhea, and constipation. This case illustrates that ML should be inc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199905000-00013
更新日期:1999-05-01 00:00:00
abstract::More than a century ago, Courvoisier published his observation on the significance of a palpable gallbladder in the differential diagnosis of obstructive jaundice. We have described two patients with newly described conditions--AIDS-associated cholangiopathy and diet-induced cholecystitis--who had a palpable gallbladd...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199205000-00018
更新日期:1992-05-01 00:00:00
abstract::Nonspherocytic hemolytic anemia was diagnosed in a 34-year-old man with jaundice since childhood. Splenectomy at the age of 8 had no influence on the anemia. Bronze diabetes was diagnosed at age 31, presumably due to hemosiderosis and secondary hemochromatosis. Iron chelation was unsuccessful in controlling iron overl...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198505000-00027
更新日期:1985-05-01 00:00:00
abstract::We have reported a case of septicemia and meningitis due to alpha-hemolytic Streptococcus in a 5-day-old infant. The microbiologic and clinical characteristics of neonatal infection with this organism lead us to conclude that this bacterium can be pathogenic in the newborn and should not be dismissed as a contaminant....
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198303000-00032
更新日期:1983-03-01 00:00:00
abstract::Safety restraints have proven effective in the prevention of serious automobile injuries and deaths, but safety education has been ineffective in getting consumers to use restraints. We surveyed the personal and counseling practices of a group of pediatricians over a one-year period to determine whether prenatal and p...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198110000-00003
更新日期:1981-10-01 00:00:00
abstract::The objective of this study was to determine the effect(s) of pregnancy and of advancing gestation on maternal serum amylase and lipase levels. Thus, serum amylase and lipase concentrations were quantitated in three groups of women. Groups included (1) 118 pregnant women whose serum amylase and lipase levels were meas...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007611-199602000-00008
更新日期:1996-02-01 00:00:00
abstract::Penetrating neck trauma may be managed operatively or nonoperatively, depending on precise anatomic location. Conservative management of zone II injuries is currently an issue under debate. We present a brief case report followed by a description of the current strategies for operative exploration and diagnostic maneu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2000-06-01 00:00:00
abstract::This article documents distributional patterns of allopathic family practice physicians (including general practitioners) in Texas as compared with allopathic physicians in all other medical specialties in the state during the period 1969-1973, for which there are reliable data. Statistical analysis of this informatio...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197709000-00007
更新日期:1977-09-01 00:00:00
abstract::A rare case of alveolar rhabdomyosarcoma of the urinary bladder, manifested as a systemic disease in a 51-year-old woman, was diagnosed at necropsy. Diffuse lytic bone lesions and extensive bone marrow involvement with a leukoerythroblastic blood picture led to an initial clinical diagnosis of a hematologic malignancy...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198704000-00031
更新日期:1987-04-01 00:00:00
abstract::Interaction of allergen with T-cells is associated with patterns of cytokine release by immunocompetent cells characterized as T-helper Th1 or Th2 T-immune responses. The Th2 pattern of inflammation induced by this cytokine release is associated with allergic diseases. The molecular mechanisms underlying allergic infl...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000097887.04639.39
更新日期:2003-11-01 00:00:00
abstract::The cost of managing chronic ulcers, both venous leg and decubiti (sacral pressure), was reviewed using 36 randomized, controlled studies with a focus on saline, hydrocolloid, and a human skin construct. When one includes the labor intensiveness of dressing changes three to four times per day, the application of hydro...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.SMJ.0000082011.70728.8C
更新日期:2004-02-01 00:00:00
abstract::A patient ingested a massive amount of an oral theophylline preparation and recovered. The paucity of central nervous system manifestations may have been related to the presence of fulminant diarrhea with expulsion of the tablets per rectum. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197808000-00027
更新日期:1978-08-01 00:00:00
abstract::Castleman disease (CD) is a rare lymphoproliferative disorder that occurs in adults and rarely in the pediatric population. The disease is characterized by slowly enlarging masses that can form anywhere within the lymphatic system. It is an uncommon cause of a neck mass in both children and adults that presents insidi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000406
更新日期:2016-02-01 00:00:00