RESUMEN

Practice location may have greater economic importance today for dental students and dentists who are considering relocation and/or expansion to new sites than in the past. Yet, a literature review easily leads to the inference that practice location decisions are far too complicated and individualistic for there to be any systematic pattern of dentists' geographic distribution. This paper specifies and estimates an economic model that attempts to explain the distribution of dentists in particular market areas in the state of Connecticut and to test the hypothesis that the distribution, rather than exhibiting randomness, adheres to the prediction of theory. The findings show that the geographic distribution of dentists is significantly related to a few key variables. Given these results, and because this model can be applied to other areas and uses data that are readily available for any market area, it may be useful for educators involved in helping dental students with their practice location decisions.

Asunto(s)

RESUMEN

Previous research has established dentistry as a growth sector of the U.S. economy. This study examines the economic relationship between dentistry's growth and factors operating on the demand and supply sides of the dental market. Output, defined as real per capita dental expenditures, was hypothesized to be a function of consumer income, dental insurance and the supply of dentists. Data for the period 1950-89, were analyzed using a generalized least squares approach. The analysis supported the hypothesis, indicating a significant relationship between growth in the dental sector and economic market factors. The study concludes that dentistry's real growth since 1950 was: (1) induced by increases in demand, mainly attributable to insurance and to a lesser extent consumer incomes; and (2) supported by increases in supply. The findings provide support for the insurance hypothesis, which suggests that growth in dental insurance has had a significant impact on the dental economy in recent years.

Asunto(s)

RESUMEN

The viability of community dental programs is influenced by various factors, including costs and effectiveness. Costs, in turn, are influenced by the prices and productivity of resources, and variations in these will influence not only comparisons among programs providing a homogeneous service but also any conclusions that can be drawn about cost-effectiveness. This paper eliminates wage effects and examines resource productivity and returns to scale in relationship to the size of a group of school-based mouthrinsing programs. The research questions were to determine: 1) whether the programs exhibit increasing, decreasing, or constant returns to scale, and 2) the productivity of labor and capital. Data from 14 programs in the US were pooled for 2 yr to yield 28 observations. The production relationship between output (numbers of participants) and inputs (labor and capital) was specified in a Cobb-Douglas model. Findings were that 1) the programs exhibited decreasing returns to scale (P less than 0.01); and 2) the average and marginal productivities of labor and capital declined (P less than 0.001). The implications of these findings are that, with equal wages and homogeneous labor, the average cost of mouthrinsing per participant would have increased as a function of the size of these programs. To the extent that the economics of community dental programs are influenced not only by the costs and productivity of the resources they use but also by their size, there may be some value in research on the economics of optimum program size and the role of management in program organization.

Asunto(s)

RESUMEN

Previous research has shown that over the period 1950 through 1977 the dental sector experienced a faster rate of economic growth than did the economy at large. This study extends the period of analysis through 1986. The findings show that dentistry maintained its economic strength relative to the economy. The annual growth rate for dentistry of 4.8 percent was significantly greater (p less than 0.001) than the 3.3 percent rate for the economy. In addition, inflation has been less in dentistry, and growth in the dental sector was not adversely affected by the economic recession of 1978-1984.

Asunto(s)

RESUMEN

The term ermine phenotype has been chosen to describe patients with white hair with black tufts. The patients also have sensorineural hearing loss. This rare phenotype may come about either by failure of migration of melanocytes or by an autoimmune mechanism. Examples of each are cited. The authors describe a possible third type. Comparison with other pigment loss-sensorineural hearing loss syndromes is made.

Asunto(s)

RESUMEN

Studies of school-based mouthrinsing programs show variations in costs. In earlier work per subject costs in 14 programs were shown to increase with program size. Theoretical explanations for this finding, pertinent to these programs, include 1) wage differentials and 2) scale effects--differences in labor productivity attributable to organizational differences. To test the hypotheses implicit in these explanations a log-linear model was specified with average costs (in constant dollars) expressed as a function of wages and scale. Data were pooled for two complete years, yielding 28 observations. Regression analysis showed that 68% of the variation in average costs was explained by wages and scale, and that with wages held constant, a 1.0% increase in program size correlated with a 0.33% increase in per subject costs. The result is attributable to decreasing labor productivity. The findings of diseconomies of scale in mouthrinse programs have potential implications for the planning and evaluation of community dental programs.

Asunto(s)

Asunto(s)

RESUMEN

Previous research on a group of school-based mouthrinsing programs showed costs per participant to increase with program size. This paper examines the behavior of average costs as they relate to wages and labor productivity. Costs are found to increase because of differences in the mix of voluntary and paid labor. As program size increased, administrators substituted relatively high priced paid labor for low priced voluntary labor.

Asunto(s)

RESUMEN

This paper compares two approaches to the estimation of costs in dental care programs: a conventional approach and an approach based on theoretical expectations. The conventional approach typically uses a linear extrapolation of an average figure - e.g., cost per visit - over various program sizes and thus predicts constant costs. Constant costs are, however, theoretically implausible, and it should be anticipated that their use in program planning or analysis would generate biased estimates. This hypothesis is examined using annual costs and visits from a group of uniform clinics over a five-year period. Results show that costs calculated by the conventional method are underestimated at low volumes and increasingly over-estimated at higher volumes. The findings, which illustrate how in-efficiency can inadvertently be incorporated into program design, have implications for cost-effectiveness of dental care delivery in the public sector.

Asunto(s)

RESUMEN

The purpose of this study was to determine the economic costs of school-based mouthrinsing in the demonstration programs. Costs for two complete years were expressed in 1978 dollars, and divided into explicit and implicit categories. Costs per participant were found to vary among programs (ranges of average total costs - period I: $2.35-$8.05, period II: $1.46-$7.94), and a tendency for some average costs to increase with size was identified. That costs were higher than the conventionally reported $0.50-$1.00 reflects 1) the organization of these federally funded programs and, 2) the use of an accounting method which describes the real economic costs of public programs.

Asunto(s)

RESUMEN

Conventional analyses of the cost-effectiveness of preventive regimens fail to account for the impact of attrition on reported costs. Using an economic model in which costs are allocated to fixed and variable components, and data from a recently completed clinical field trial, costs per participant are shown to vary with the rate of attrition. That this variation is usually obscured in reported studies results from methods conventionally used to measure the participants in calculating average costs. This paper proposes a method for resolving this dilemma by allocating costs among the number of beneficiaries in terms of resource utilization.

Asunto(s)

Asunto(s)

RESUMEN

Successful treatment with cimetidine of a case of severe metabolic alkalosis secondary to gastric hypersecretion in the short bowel syndrome has been presented.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)