A cost and production analysis of hospital dental care programs.

To provide hospital dental programs with useful information about the expansion of dental services and the identification of pertinent financial information, a production function and cost function analysis was performed. Results showed that hospital ownership (public or private) and size of the dental clinics were associated with the cost of providing dental services and the volume of services provided. Among 23 hospitals studied, private hospitals had a much lower cost per visit, had more paid attending dentist staff, paid their resident dentists less, and had significantly more billings paid by Medicaid and by patients than public hospitals. When stratified by ownership and size, these basic differences were accentuated for the small clinics. Except for primarily the Medicaid and self-pay billings, the characteristics of large public and private hospital dental clinics were extremely similar. Multiple regression analysis found that a decrease in cost per visit was associated with more visits to dentists and more to hygienists. Production of dental services could be increased by increasing the number of attending dentists, hygienists, and residents. Preliminary econometric analysis reveals that the optimal mix of attending dentists to resident dentists should be approximately 1.8 full-time equivalent (FTE) resident for every 1 attending FTE dentist to produce the most dental services at the lowest cost.

2,3-dihydro and carbocyclic analogues of tryptamines: interaction with serotonin receptors.

Several dihydro and carbocyclic analogues of tryptamine were evaluated in order to determine the role of the heterocyclic portion of the indole nucleus on the interaction of indolealkylamines with the serotonin receptors of the rat fundus. Reduction of the C2--C3 double bond or replacement of the indole nitrogen with an sp3-hybridized carbon atom results in a 50% decrease in receptor affinity. Complete removal of the five-membered ring of N,N-dimethyltryptamine reduces affinity by an order of magnitude. It appears that an intact indole nucleus, though not entirely necessary, results in an optimal receptor interaction for the indolealkylamines examined.

Synthesis and evaluation of novel alkylpiperazines as potential dopamine antagonists.

Several alkylpiperazines, monocyclic subfragments of known tricyclic neuroleptic agents, were evaluated as dopamine antagonists in the isolated rabbit ear artery preparation. Compound prepared and evaluated are of the general structure Ar-X-(CH2)n-Y, where X = C, O, and N, n = 1-3, and Y, for the most part, was 4-methylpiperazine. Those compounds where X - NH, n = 3, and X = (Z)-CH - CH, n = 2, with an electron-withdrawing group meta to the side chain, possess dopamine antagonist activity comparable to that of clozapine. It is concluded that the entire tricyclic structure of phenothiazine-like agents (or at least more than a monocyclic ring system) is necessary for optimal activity as a dopamine antagonist in the receptor preparation used in this study.