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The article examines abstracts of papers submitted but not included in the program of the annual meeting of the American Public Health Association, Medical Care Section, 1962. Some of these are "Experiences and Activities at a Medical Computing Center," by L.D. Cady, M.A. Woodbury, and L.J. Tich and "An Internist's Experiences With Medical Care of Welfare Patients in Proprietary Nursing Homes," by Sidney M. Greenberg. The first abstract focuses on the center that is cooperating with investigators in the area of mathematical and theoretical analysis and statistical data handling and analysis, information coding, keypunching and storage of medical data for further study and retrieval. The second abstract contains observations of the medical, nursing, and administrative practices in four nursing homes as made by an internist responsible for the medical Scare of welfare patients in these homes. In evaluating these activities the recognition and meeting of the patient's total needs was utilized as the criterion of quality of performance.

The article presents abstracts of various research papers published in the June 1961 issue of "Journal of Health and Human Behavior." One of the abstract discusses the relationship between and intrapsychic processes. Another abstract presents a study which attempts to ascertain, and account for, the presence of significant differences in knowledge of attitudes toward mental disease between a sample of high school boys and one from a boys' reformatory. The purpose of one of the papers on hospital-patient relationships is to clarify the precise nature of the relationship between mental hospitals and patients and to compare and contrast it with the relationship between medical hospitals and patients. Another paper on mental hospitals presents information about four types of "pathway" organizations which seek to assist in the transitional period between the discharge of a mental patient from a hospital and his re-entry into community life. The four general types considered are day hospitals, halfway houses, sheltered workshops, and ex-patient organizations.

The community health center has been viewed by many Americans as an important mechanism for the improvement of health of the urban poor. The millions of dollars allocated for a relatively small percentage of the population, however, has led to some criticisms of the concept. This paper deals with factors influencing the cost of dental services in a community health center and an analysis of several existing programs. The major factors affecting the cost effectiveness of the clinics appear to be the (1) broken appointment rate, (2) age distribution of the population served, (3) mixture of services rendered, and (4) additional community services rendered. Programs which have low broken appointment rates and which treat both adults and children seem to maintain a higher revenue-cost ratio. This ratio was in the range of 0.78 to 1.10 for the three dental programs studied. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to evaluate the relative efficiency of several basically different health care systems by considering their market structure and its implication on the price and output of health care services.
The present article evaluates relative efficiency of four alternative health care systems; namely, the physician controlled non-profit hospital, the proprietary hospital, consumer controlled hospital and the government controlled hospitals. The analysis used in the study utilizes the theories of economics of cooperation. The scope of the study is limited only to the analysis of the nature of the market structure and its implications on the price and output of health care services and the costs and benefits associated with the zero individual user costs. Our conclusions are that: 1. The price and output tends to be close to the socially optimum level under the open-member consumers' coop hospitals; whereas the de facto closed-member producers' coop for the staff physician (as in the U.S.), output tends to be suboptimal and the price tends to be supra optimal. The equilibrium output and price for the proprietary hospitals and the hospitals under the British-Swedish systems can be shown to fall somewhere between these two extremes. 2. Furthermore, if the individual user cost is reduced to zero through the government finance or insurance coverage, the social cost of providing health care and the waste of resources tends to be larger under the proposed U.S. plans than under the hypothetical model and British-Swedish system, largely due to the inelastic supply response of the existing health care industry in the U. S. [ABSTRACT FROM AUTHOR]

Ageing population and consequent high dependency ratios are features common to all European countries. However, the specific problems of the elderly in rural areas have not been the subject of systematic research, despite growing preoccupation with the obstacle this group may constitute to modernization and restructuring of agriculture. In default of hypotheses based on properly weighted data on rural populations, the paper examines the type of alteration in the situation of old people which is reported as occurring as agriculture becomes increasingly focused on highly organized market production. It then discusses the possible impact of this change of situation on the basic needs of the old in rural areas, as identified in general studies of old age. These basic needs-for economic security, housing, health care, and continued activity -- are briefly reviewed in the context of rural life. The question is put as to whether it is feasible to solve the old-age problems so presented on lines consonant with the general principles to be observed in treatment of the old, which have emerged in these last few years as a consensus of informed opinion. In view of the lack of precise facts, a long-term research strategy is suggested. As a first approach, some global studies of all factors involved within some limited and clearly defined areas would seem essential. Specific problems could then be selected for more thorough study, perhaps on parallel multi-national lines, to ascertain which practical solutions are most likely to be of help in evolving new human patterns of living in integrated rural communities. [ABSTRACT FROM AUTHOR]

The paper deals with the prognosis of teeth positioned in fracture lines. The clinical and radiographic findings are based on 68 patients with 84 fractures involving 110 permanent teeth. The observation period varies from 1 to 7 years. By means of a multivariate analysis it has been found that pulp necrosis was present in 25 % of the involved teeth and was significantly related to the course of the fracture line in regard to the apical area and the time interval from injury to permanent fixation. Loss of marginal bone support was registered in 12 % of the involved teeth and found significantly related to tooth location and to dislocation of fragments after reduction. Pulp obliteration was recorded in only 5 % of the involved teeth. Root resorption was not found at follow-up. [ABSTRACT FROM AUTHOR]

There is a significant lack of patient-centered studies in current socio-medical research, and also very little use made of experimental designs. As a departure from this trend, this paper presents the design and result s of a clinical experiment indica-. ting greater effectiveness of a patient-centered nursing approach used to administer a standard nursing procedure. [ABSTRACT FROM AUTHOR]

Previous theory and research in role conflict provided empirical tools and hypotheses regarding conflict resolution. A pencil-and-paper conflict situation was administered to workers in a mental hospital, a setting previously described as conflict- ridden. A positive association was found between mode of conflict resolution, ideology and worker's effectiveness as a hospital employee. [ABSTRACT FROM AUTHOR]

This paper examines the internal and external stresses which accompany the gradual shift of responsibility from local boards of health to a possible eventual domination by the state health department. Fifty seven members of boards of health in 14 communities in one county in Eastern Pennsylvania were interviewed on the present functions of the local boards of health. Our finding suggests that the local board of health is not simply an organization. It is symbolic of a way of life in a community and it represents many things-a part of town, individualism, self-rule. [ABSTRACT FROM AUTHOR]

In the health insurance movement, the provision of drugs has been one of the medical needs least well met. One prepaid medical care plan has pioneered in an effort to meet this need, and its precise experience is reported in this paper. [ABSTRACT FROM AUTHOR]

The article discusses the validity of clinical judgments of schizophrenic pathology-based on verbal responses to intelligence test items. The reliability of clinical judgment has been the subject of a series of studies using single responses to intelligence test items obtained from psychiatric patients and judgments by trained clinicians based on a seven-point rating scale. It has been possible to demonstrate reliability in judgments of disorganization in schizophrenic thinking, as well as more specific aspects of schizophrenic thinking. The question now arises whether clinicians can make global appraisals of complete test protocols with as great reliability as they can judge single test items. This paper extends the study of reliability, defined as interjudge agreement, to global judgments in which whole protocols are ranked according to severity of schizophrenic pathology.

The article reports on psychological research in the community mental health service in the United States. The need is obvious for the development of public health practices which will control the causes of mental ill health as effectively as is now done with many other diseases. It is the purpose of this paper to discuss the opportunities and the methodological problems for the psychologist doing research in the field of community mental hygiene. Research on community mental hygiene, it seems to the author, can best be attacked by studying those factors in total community life which prevent or promote the development of healthy patterns of adjustment by individuals or groups. Stating this a little differently, research in community mental hygiene might best be concerned with the nature and the origin of conflicts, frustrations, or confusions for persons or groups which are part of the community way of life.

In many scientific investigations, it is desired to bring together, or link, two or more documents which represent the same individual, even though these documents do not contain a unique identifier and were derived from different sources. In medical and public health research and elsewhere, this problem is known as the document linkage problem. This paper considers some aspects of classifying pairs of documents into one of two populations when their items are identifying information, where each item of information can take on three distinct values correct, incorrect or missing. Section I identifies three document linkage problems. Sections 2 and 3 deal with the mathematical formulation of the multivariate document linkage problem. Section 4 gives the classification procedure and Section 5 deals with the application of the theory to a problem in the field of public health. [ABSTRACT FROM AUTHOR]

The article reports on a self-directed approach to the treatment of a complex neurosis with implosive therapy (IT). It demonstrates or investigates the effectiveness of IT in the treatment of psychological disorders typically have dealt with relatively simple, identifiable fears. This paper describes the self-directed treatment of a "complex" and debilitating neurosis, in which identification of the conditioned stimuli was based upon dynamic inferences. The results of the study support the use of dynamic formulations to develop a behaviorally oriented treatment program.

The article presents information about this special "Medical Care Issue," which presents reports of several specific programs that illustrate contributory streams in this larger movement of medical care organization. The variety in the movement derives from locality as well as content. One report in this issue comes from the Appalachian coalfields, where new forms of consumer-sponsored prepaid group medical practice are evolving. Another comes from the nation's capital, where a long established health insurance plan has added drugs to its benefits. Another comes from New York City, where organized "home care" has been explored, for the first time as a feature of hospitalization insurance. Another comes from Southern California, where efforts are being made to up-grade the quality of nursing homes. Another comes from a college town in Kentucky, where a great new medical center is being established. Two papers of generic orientation are then presented: one is on the economic characteristics of health services and how they differ from other services or commodities. The final paper offers a review of sociological research conducted on the organization of medical care over the years.

The article comments on the paper "First aid training and accidents," by Gary Miller and Neil Agnew in this issue. Miller and Agnew tested the hypothesis that the probability that people trained in first aid will be involved in accidents is less than those who have not been trained. However, the data used were all obtained from the company for which the victim worked. This is erroneous because the number of accidents is not the same as the number of recorded accidents, particularly in British firms. Moreover, the authors failed to consider the fact that first-aiders are not exposed to the same risks for the same time as the other workers.

This article presents discussion related to psychoses. The reader should be reminded that the system was developed on inpatients in public mental health facilities and therefore should work most effectively with such patients. The correlates also may be applicable to outpatients from such facilities, especially if they have become outpatients after having been inpatients, which frequently is the case, or readers familiar with computerized printouts of MMPI interpretations or with skillful clinical interpretations, the interpretive summaries given in this paper may be disappointing on several grounds: Prognostic statements are not included, the reports often are brief, the language in which the reports are cast lacks elegance, scales L, F, and K are not interpreted in terms of validity, and dynamic explanations of behavior are not attempted.