Relationship marketing in health care.

Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.

Adapting the SERVQUAL scale to hospital services: an empirical investigation.

Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified.

Race of parents and infant birthweight in the United States.

Detailed 1977 national natality data are used to investigate social, demographic, and genetic effects on birthweight differentials. Analysis of birthweight differences among infants with white, black, and mixed black-white parents indicates that a portion of the observed weight differentials appear to be due to biologic factors. Infants with a black mother and father have the lowest mean birthweights, while infants with two white parents have the highest weights. Newborns with mixed-race parents have intermediate birthweight distributions. Multivariate analysis suggests that the effects of parental race on birthweight are not the result of maternal/obstetric differences among parents of the same or mixed race.

Organ-specific autoantibodies in non-organ-specific autoimmune diseases with special reference to rheumatoid arthritis.

Sera from 367 patients with rheumatoid arthritis (RA) and from 102 patients with other non-organ-specific (NOS) autoimmune diseases were examined for the presence of organ-specific (OS) autoantibodies. The incidence of these OS autoantibodies was not increased in patients with NOS autoimmune diseases with the exception of thyroglobulin antibodies, which were significantly more frequent in RA (P less than 0.001) and in Sjögren's syndrome (P less than 0.05) patients than in normal controls. Investigation of 169 patients with OS autoimmune diseases did not reveal an increased prevalence of NOS autoantibodies. In RA patients, OS autoantibodies correlated with NOS autoantibodies (P less than 0.04) and with HLA-DR3 antigen (P less than 0.01).

New community residents' preferences for dental service information.

New residents of a community who wish to select a dentist need information about the dental services that are available. Dentists who wish to expand their practices may want to stimulate the flow of information that new residents consider important but are unable to find. A survey of 679 new residents of a metropolitan area disclosed that the greatest need appears to be for information that relates to quality of work, concern for patients, personal appearance, price, location, waiting time, and insurance form preparation.

Age of mother and pregnancy outcome in the 1981 Arkansas birth cohort.

PIP: Higher levels of obstetric risk observed among teenage mothers seem to be an artifact of lower socioeconomic status and inferior access to health care rather than biological immaturity. In a study of matched Arkansas birth-infant death records for 1978, the proxy variables for health access (month care started and number of visits) have the strongest association with each of the dependent variables. The indicators of social status (education, race, and marital status) have a weaker association, and there is virtually no age effect observable once the affects of socioeconomic status and health access have been controlled for. A series of stepwise regression analyses shows that the multiple partial for health access indicators and mortality is 0.036, while the same coefficients for social status indicators and age are 0.001 and 0.006, respectively. Similar results are obtained using the other dependent variables. Health consequences of adolescent pregnancy usually include higher rates of malnutrition and prematurity and lower birth weight. It seems that the elevated morbidity and mortality among newborns delivered by teenagers are not a result of biologic factors. After the effects of lower status and health care access have been removed, the apparent biological disadvantages attributed to teenagers disappear, and, in the case of mortality and birth weight, are replaced by a slight advantage. This advantage is observed through the use of statisitical controls and will not be observed in the population at large unless there are changes in the policies governing access to contraception, abortion, and health care by adolescents, especially those at the youngest ages.^ieng

Neonatal mortality by the day of the week in the 1974-75 Arkansas live birth cohort.

This study is an analysis of daily variations in neonatal mortality among 66,049 live births in the 1974-75 Arkansas live birth cohort. Weekends and holidays in general, and Sundays in particular, were found to have the fewest number of deliveries. Variations in deliveries by the day of the week were attributed to obstetric practices. Births weighing less than 2500 gms. were over-represented among weekend deliveries as were infants experiencing a birth-related injury. Neonatal mortality was found to be higher among weekend deliveries with a Sunday rate that was 27 per cent above the weekly average. Separate analysis by race and birth weight revealed the weekend peak to be more pronounced among non-whites. Analysis of daily variations by cause of death showed that Sundays exceeded the overall average for seven of the eight cause of death categories examined. (Am J Public Health 1981;71:601-605.)

Informed consent and its implications in family practice.

The doctrine of informed consent has had its practical introduction to medical malpractice litigation in the past five years. Its definition has not changed since the days when its definitive application was only a fond dream of the malpractice plaintiffs attorneys. However, with neh new methods of presenting this theory to the courts, and with the newly emerging practice fo having rulings on matters of law substituted by judges for prevailing standards of medical practice, the implications for family physicians have become tremendous. Hopefullum by understanding the principles involved in its application in the pertinent landmark cases, family physicians will be better able to abid the pitfalls engendered by the doctrine of informed consent.