Rural, urban and suburban comparisons of preventive services in family practice clinics.

Numerous studies have compared health services provided in rural and urban areas, and overall they have found that utilization is lower in rural areas. A significant factor in lower utilization is that rural residents have less access to health services. Much less is known about rural and urban utilization differences once a patient has access to a service provider. This paper focuses on preventive services received when a patient is already in a clinic. Using data from an in-depth qualitative study of 16 family practice clinics in Nebraska, comparisons of physician-specific preventive service rates are made across three geographic categories: rural, urban and suburban. Results from a one-way multivariate analysis of variance show that preventive services rates for nine services examined were as high or higher in rural areas, suggesting that rural health services do not lag for patients with access.

The undiscovered Argentine pharmaceutical market.

The Argentine health care system is more highly developed than most systems in Latin America and gives most of its citizens access to a reasonable level of care. Now after 50 years of government control the system is becoming privatized, which provides new possibilities for health care marketers. One company developed an innovative approach to pharmaceutical marketing in Argentina that, while perhaps not appropriate for the U.S. market, may reap rewards in certain cultures and provide lessons for others.

Assessing quality. As pressure mounts for clinics to deliver quality, medical practice blueprints and genograms serve as useful tools.

Increasingly, medical practices feel pressure to provide and communicate high quality patient care. Offering their insight on how a medical practice can improve quality, the authors describe the process of delivering medical care during patient encounters. Specifically, they present two methods that can be used to understand, evaluate, and improve interactions between patients and providers: medical practice blue prints and medical practice genograms.

Childlessness: a panel study of expressed intentions and reported fertility.

PIP: This study used data from the 1970 and 1975 National Fertility Surveys to ascertain the consistency between childlessness intentions and subsequent behavior and intentions. Of the 274 white US women who were childless and not pregnant at the time of the 1970 survey, 234 (85%) intended to have children at some point. However, by the time the 1975 re-interview, only 169 women (62%) had followed through with their intentions. In contrast, 38 (95%) of the 40 women who in 1970 intended no children had no children in 1975. Of the 65 women who expressed an expectation for children in 1970, but had no children by 1975, 22 had changed their intentions by 1975. These findings indicate that childless behavior exceeds childless intentions, with a significant proportion of women changing their intentions from expecting as least 1 child to intending zero parity over a relatively brief time span. Further analysis revealed that changing intentions from more than zero to zero parity is associated with high levels of education, a slightly higher income, a lesser degree of importance awarded to religion, and labor force participation. It is recommended that future studies focus on multiple correlations of childlessness.^ieng

The structural correlates of metropolitan migration: 1970-1975.

This study is concerned with the debate over the supremacy of organizational versus environmental models for explaining population change within the context of metropolitan-nonmetropolitan turnaround migration. A sample of U.S. metropolitan areas is classified by a migration typology that considers sign changes or consistencies in rates of net migration between the 1960s and 1970s. "Four categories result and organizational, environmental and technological data are analyzed utilizing ridge regression with interaction terms to ascertain whether structural differences among migration categories exist." The study shows that organizational factors are more relevant for urban areas experiencing in-migration, and environmental factors are more relevant for those experiencing out-migration.

Demographic methods in applied demography: an American perspective.

PIP: "The purpose of this paper is to explore the usage of demographic methods in applied demography [in the United States]. The reason for the exploration is to document the range of methods being used to help address a wide range of public and private sector opportunities and problems. A limited content analysis of applied studies is performed." (EXCERPT)^ieng

Health demography comes of age.

The U.S. health care industry has been hampered in the development of a mature marketing function in part due to characteristics unique to the industry. These characteristics include a lack of market data, poorly developed market research techniques, and a poor understanding of consumer behavior within the industry. Some of the deficiencies are being addressed through the development of an emerging field that is being referred to as "health demography." Health demography and those who have begun to refer to themselves as health demographers are drawing from the fields of demography, epidemiology, biostatistics, and the social sciences to formulate a new discipline uniquely related to the needs of today's health care marketers and planners. Those involved with health demography are developing databases and models for application to concrete problems in health care delivery. The development of this field is contributing to the advancement of the state of marketing in health care and serving to reduce many of the barriers that have retarded the development of a mature marketing function within the health care industry.

Demographic change and the supply of physicians, hospitals, and hospital beds: marketing implications.

Demographic conditions are a major component of the business environment in which health care marketers must compete. The following study assesses the impact of demographic factors on health care supply and finds that population size, population change, age structure, and income are important predictors of physician, hospital, and hospital bed supply. The results are discussed in the context of marketing implications.

The marketing implications of migration on hospital and physician supply and demand in the United States.

Physician and hospital service supply and demand issues lie at the forefront of healthcare policy today. Among the factors affecting state and local supply and demand is the often times overlooked impact that migration has had on interarea population size and composition. This paper discusses the role of migration in the restructuring of population in the context of health care needs. Significant in- or out-migration is shown to be strongly related to a discrepancy between physician and hospital supply and demand. The marketing implications of these imbalances are discussed.

Beyond patient satisfaction. Broaden the scope of quality measurement by integrating the marketing view with other perspectives.

The patient satisfaction perspective has dominated recent marketing efforts to measure and understand health care quality. The authors propose a broader health care quality model that includes medical outcomes, access to health care services, and personnel dimensions along with patient satisfaction concerns as the foci of quality measurement. The model also encompasses important contextual factors that clearly affect the level of health care quality.

Segmenting the senior health care market.

This paper addresses the issue of health market segment comparisons for the senior population. The analysis demonstrates how initial self-assessed health comparisons among three racial/ethnic categories can be adjusted to reflect compositional (age and income) differences among the three groups. The adjustments provide additional insight into the nature of these segments.