R Paul Duncan
Datos Biográficos
| ID | 259268 |
|---|---|
| NOMBRE | R Paul Duncan |
| NOMBRES | R Paul |
| APELLIDO | Duncan |
| FIRMA | DUNCAN R P |
| AFILIACIONES | University of Florida |
| ORCID | 0000-0003-2295-449X |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 37 |
| TOTAL DE CITAS | 98 |
| TOTAL COMO AUTOR | 37 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1976 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2023 |
| ÍNDICE H | 3 |
The Impact of State Policy on Adverse Teen Sexual Health Outcomes in the United States
The health care utilization model
Children may receive dental services that eliminate acute dental problems, probably as a result of the ACA and CHIP coverage. The patterns of findings suggest the need for policy changes to improve pediatric dental coverage and promote professional recommendations for effective dental hygiene
Early Performance of Hospital Value-based Purchasing Program in Medicare
BACKGROUND: Under the Affordable Care Act, the Centers for Medicare and Medicaid Services has greatly expanded inpatient fee-for-value programs including the Hospital Value-based Purchasing (HVBP) program. Existing evidence from the HVBP program is mixed. There is a need for a systematic review of the HVBP program to inform discussions on how to improve the program's effectiveness. OBJECTIVE: To review and summarize studies that evaluated the HVB…
Reported Experiences with Medicaid Managed Care Models Among Parents of Children
A New Global Depression
Interview with the author of The Dollar Crisis, one of the few analyses to predict the 2008 financial meltdown. Richard Duncan tracks its causes to the credit explosion unleashed by the fiat-dollar system, in toxic symbiosis with the global wage deflation caused by manufacturing’s shift to the East
Are treelines advancing? A global meta‐analysis of treeline response to climate warming
Treelines are temperature sensitive transition zones that are expected to respond to climate warming by advancing beyond their current position. Response to climate warming over the last century, however, has been mixed, with some treelines showing evidence of recruitment at higher altitudes and/or latitudes (advance) whereas others reveal no marked change in the upper limit of tree establishment. To explore this variation, we analysed a global d…
The Pivotal Impact of Center Characteristics on Survival of Candidates Listed for Deceased Donor Kidney Transplantation
BACKGROUND: There are currently over half a million end-stage renal disease patients and >70,000 patients listed to receive a deceased donor kidney transplant in the United States. To receive a deceased donor transplant, patients are placed on a waiting list at one of approximately 240 centers. Although candidate decisions to list at a particular center may often be made passively (based on proximity or physician referral), the important question…
Patient‐Level and Practice‐Level Characteristics Associated with Receipt of Preventive Dental Services
One preventive procedure was common; the other was uncommon. However, practices did not effectively target high-risk patients for either procedure. Instead, both services were typically received by persons with the least need for them. These findings are consistent with the conclusion that practitioners greatly influenced the delivery of fluoride services, with substantial contributions also made by patient-level predisposing and enabling factors…
Satisfaction With Dental Appearance Among Diverse Groups of Dentate Adults
Dissatisfaction with dental appearance was common in this population-based sample of middle-aged and older adults, and was significantly associated with key sociodemographic and oral health factors
Variations in Health Insurance Coverage for Rural and Urban Nonelderly Adult Residents of Florida, Indiana, and Kansas
Context: Evidence exists for differences in health insurance coverage among states, but less is known about variations across different kinds of communities within states. Purpose: This article assesses the role of residential setting (metropolitan county, rural adjacent, and rural nonadjacent) in health insurance coverage for adult residents, under age 65, using data from large‐scale surveys collected in 3 diverse states (Florida, Indiana, and K…
Pain and the Use of Outpatient Services Among Persons With HIV
BACKGROUND: The negative impact of pain on health-related quality of life has been documented for persons with human immunodeficiency virus (HIV). Furthermore, pain could be an important factor in seeking medical care. However, the relationship between pain and health service utilization is poorly understood. OBJECTIVES: The objective of this study was to investigate the effect of pain on use of outpatient services among a nationally representati…
The Dynamics of Toothache Pain and Dental Services Utilization
In this diverse sample of adults, toothache pain occurs frequently and is quite variable overtime. Toothache occurs in conjunction with various forms of self-reported oral disease (e.g., abscess, cavities) or tissue damage (e.g., loose tooth, broken tooth, bleeding gums). Subjects who experience toothache are slightly more likely than others to utilize dental services in the time period proximate to the toothache pain
Predictors of Chewing Difficulty Onset Among Dentate Adults
Self-reported oral disease and tissue damage and toothache pain were strong predictors of decline in chewing ability. Additionally, women were identified as a high-risk group for incident chewing difficulty. Future research should elaborate further the pathways through which these factors affect oral function
Patterns of Change in Self-Reported Oral Health Among Dentate Adults
BACKGROUND: Although self-assessments of oral health have become useful tools in dental research, the use of self-reports to study changes in oral health over time has been limited. The aim of this investigation was to describe how oral disease and tissue damage, pain, functional limitation, disadvantage, and self-rated oral health change over time. METHODS: The Florida Dental Care Study (FDCS) (n = 873) is a longitudinal study of oral health amo…
Taking Dental Self‐care to the Extreme
The phenomenon of dental self-extraction is real and is not limited to residents of developing nations or geographically isolated areas. Because of the potential for prolonged bleeding or bacterial endocarditis in certain population groups, community health clinicians and officials should be cognizant of this behavior
Oral Functional Limitation among Dentate Adults
The findings in this study suggest a significant prevalence of oral functional limitation in dentate adults. Certain clinical and sociodemographic factors were strongly and independently associated with its presence
Multidimensionality of Oral Health in Dentate Adults
OBJECTIVES: An understanding of the validity and usefulness of self-reported measures (as distinct from clinically determined measures) of oral health is emerging. These self-reported measures include self-rated oral health (SROH). Three objectives were to: (1) describe self-rated oral health in dentate adults, (2) quantify associations between self-rated oral health and other measures of oral health (oral disease and tissue damage, pain and disc…
Determinants of dental care use in dentate adults
Rural‐Urban Comparisons of Age and Health at the Time of Nursing Home Admission
This study re‐examines the contention that rural elders admitted to nursing homes are younger and healthier than their counterparts who enter urban facilities. The analysis uses interview data gathered in both urban and rural nursing homes. Residents were inter‐viewed at or near the time of admission regarding their health and circumstances immediately prior to entering the nursing home. The findings indicate few and modest differences between ur…
Evaluation of Bias and Logistics in a Survey of Adults at Increased Risk for Oral Health Decrements
This method of sampling persons at high risk for oral health decrements resulted in only modest bias with respect to the population of interest
Validity of Self‐reported Tooth Counts During a Telephone Screening Interview
When the unit of analysis is the overall sample, these results suggest that self-reported tooth counts during a telephone interview are sufficiently valid to meet all but the most stringent data requirements. When the unit of analysis is the individual subject, these tooth counts may not be valid, depending upon the degree of specificity required and subject characteristics
Race Differences in the Health of Elders who Live Alone
This investigation was initiated to determine whether older African Americans who live alone are in poorer health than their White counterparts who live under the same circumstances. Data on 5 measures of health were collected in telephone interviews with a stratified random sample of community-dwelling elders (n = 1,189). Analysis of weighted data indicate that there were fewer differences in health by race among older persons who lived alone co…
Dental Health Attitudes Among Dentate Black and White Adults
OBJECTIVES: Blacks and poor persons share a greater burden of oral disease and are less likely to seek dental care on a regular basis. The role of dental attitudes and knowledge of services on this circumstance is unclear. The authors quantified group differences in dental attitudes and knowledge of services and related them to regularity of dental care use. METHODS: As part of the baseline phase of The Florida Dental Care Study, a longitudinal s…
Differences by Race in the Decline of Health Over Time
Previous research on race differences in health, we believe, has failed to take into account the initial state of health of the respondents. Other research has demonstrated that elders in poor health are more likely to experience a change in their health over time. It is unclear if the greater probability of decline in health observed among African Americans is a result of being more likely to begin such observations in health states that are wor…
The influence of community context on the decision to enter a nursing home
Dual Occupation Families and Migration
Determinants of dental care use in dentate adults
Differences by Race in the Decline of Health Over Time
Previous research on race differences in health, we believe, has failed to take into account the initial state of health of the respondents. Other research has demonstrated that elders in poor health are more likely to experience a change in their health over time. It is unclear if the greater probability of decline in health observed among African Americans is a result of being more likely to begin such observations in health states that are wor…
The influence of community context on the decision to enter a nursing home
Race Differences in the Health of Elders who Live Alone
This investigation was initiated to determine whether older African Americans who live alone are in poorer health than their White counterparts who live under the same circumstances. Data on 5 measures of health were collected in telephone interviews with a stratified random sample of community-dwelling elders (n = 1,189). Analysis of weighted data indicate that there were fewer differences in health by race among older persons who lived alone co…
Older Floridians' Attitudes toward and Use of Dental Care
Older Floridians (mean age 78 years) were interviewed regarding their use of dental care, attitudes toward dental care, and other characteristics hypothesized as being explanatory of dental care use. Fifty-two percent of respondents reported having been to a dentist within the past year, and 31% had not been within the previous 5 years. Five constructs measured attitudes toward dental care and dental health: (a) the importance placed on regular d…
Health Insurance Coverage of Mexican American Families in the U.S
This article examines the impact of the employment context and family structure on the health insurance status of Mexican families. Data from the 1987 National Medical Expenditure Survey were used to (a) examine the differences in the extent of family coverage among Latino families in the U.S., (b) determine whether differences in the residential distribution of these families is responsible for these differences, and (c) assess the impact of fam…
Attitudinal and Situational Factors in the Use of Physician Services by Low-Income Persons
Lee A. Crandall, R. Paul Duncan, Attitudinal and Situational Factors in the Use of Physician Services by Low-Income Persons, Journal of Health and Social Behavior, Vol. 22, No. 1 (Mar., 1981), pp. 64-74+75-77
Dual Occupation Families and Migration
Attitudinal and Situational Factors in the Use of Physician Services by Low-Income Persons
Lee A. Crandall, R. Paul Duncan, Attitudinal and Situational Factors in the Use of Physician Services by Low-Income Persons, Journal of Health and Social Behavior, Vol. 22, No. 1 (Mar., 1981), pp. 64-74+75-77
Faculty Time Allocation in Rural Primary Care Training Sites
This investigation examined the allocation of time by medical school faculty who served as attending physicians on a rotating basis in rural primary care centers where medical students and house staff were trained. Two quite different methods of studying faculty time allocation produced relatively consistent results. Travel and direct care of patients (with no medical students present) accounted for the largest share of faculty time. Much of the …
Determinants of the Uncompensated Care Burden of Rural and Urban Hospitals in Florida
It has been projected that over the next decade as many as 700 hospitals will close due to financial pressures created at least in part by the problem of uncompensated care. Many analysts contend that smaller, rural hospitals will be disproportionately represented among those which close. This investigation uses data collected from over 14,000 inpatient records from 130 representative hospitals in Florida to examine the degree to which rural hosp…
Recruitment and Retention of Rural Physicians
This paper briefly describes a number of structural and economic changes in the profession of medicine and in the rural medical care delivery system that have occurred since about 1970. Changes in the national physician supply; in the training, work, and practice characteristics of physicians; in the demographic characteristics of physicians; in the medical resources available in rural communities; and in federal and state support for the provisi…
Education for Rural Health Services Administration
This section briefly describes the administrative needs of rural health services delivery entities, especially hospitals. It then reviews the educational processes in which health administrators are trained, with a focus on changes that have emerged during the 1980s. The final section examines the extent to which the educational programs are consistent with the needs of rural environments, and provides some suggested strategies for the coming dec…
Job Satisfaction Among Hospital Nurses
Despite recent declines in turnover and vacancy rates, maintaining a stable nursing staff continues to be critical to the effective operation of American hospitals, fob satisfaction is a pivotal element in nurse retention, and organizational theory suggests that some of the factors that influence job satisfaction vary by facility size. This is a study of job satisfaction among a sample of 731 nurses providing direct patient care in 22 hospitals. …
Oral Signs, Symptoms, and Behaviors in Older Floridians
Six hundred community-dwelling older Floridians were interviewed regarding the presence of reported signs of dental conditions, dental and oral symptoms, behavioral impact from dental conditions, and orofacial sensory changes. The prevalence of any single oral sign, symptom, or behavioral impact was generally low. A notable exception was the 39 percent prevalence of dry mouth. However, from 10 percent to 29 percent of persons had at least one of …
Older Floridians' Attitudes toward and Use of Dental Care
Older Floridians (mean age 78 years) were interviewed regarding their use of dental care, attitudes toward dental care, and other characteristics hypothesized as being explanatory of dental care use. Fifty-two percent of respondents reported having been to a dentist within the past year, and 31% had not been within the previous 5 years. Five constructs measured attitudes toward dental care and dental health: (a) the importance placed on regular d…
Changes in Health Insurance Coverage Within Rural and Urban Environments—1977 to 1987
This study examines changes in the health insurance coverage of the nonelderly population in rural and urban areas between 1977 and 1987, using data from the National Medical Care Expenditure Survey (NMCES) and the National Medical Expenditure Survey (NMES). It was designed to test the hypothesis that differences in the rates of health insurance coverage in rural and urban areas have diminished over time, and to explore the composition of changes…
Rural Health Networks in Florida
This article describes the development of rural health networks in Florida, which has adopted formal policies to support these networks. First, the history and content of the relevant legislation are described. The current networks are identified and their development to date summarized. Finally, a detailed case study is employed to outline the steps taken to establish one network
Health Insurance Coverage of Mexican American Families in the U.S
This article examines the impact of the employment context and family structure on the health insurance status of Mexican families. Data from the 1987 National Medical Expenditure Survey were used to (a) examine the differences in the extent of family coverage among Latino families in the U.S., (b) determine whether differences in the residential distribution of these families is responsible for these differences, and (c) assess the impact of fam…
The influence of community context on the decision to enter a nursing home
Rural‐Urban Comparisons of Age and Health at the Time of Nursing Home Admission
This study re‐examines the contention that rural elders admitted to nursing homes are younger and healthier than their counterparts who enter urban facilities. The analysis uses interview data gathered in both urban and rural nursing homes. Residents were inter‐viewed at or near the time of admission regarding their health and circumstances immediately prior to entering the nursing home. The findings indicate few and modest differences between ur…
Evaluation of Bias and Logistics in a Survey of Adults at Increased Risk for Oral Health Decrements
This method of sampling persons at high risk for oral health decrements resulted in only modest bias with respect to the population of interest
Validity of Self‐reported Tooth Counts During a Telephone Screening Interview
When the unit of analysis is the overall sample, these results suggest that self-reported tooth counts during a telephone interview are sufficiently valid to meet all but the most stringent data requirements. When the unit of analysis is the individual subject, these tooth counts may not be valid, depending upon the degree of specificity required and subject characteristics
Race Differences in the Health of Elders who Live Alone
This investigation was initiated to determine whether older African Americans who live alone are in poorer health than their White counterparts who live under the same circumstances. Data on 5 measures of health were collected in telephone interviews with a stratified random sample of community-dwelling elders (n = 1,189). Analysis of weighted data indicate that there were fewer differences in health by race among older persons who lived alone co…
Dental Health Attitudes Among Dentate Black and White Adults
OBJECTIVES: Blacks and poor persons share a greater burden of oral disease and are less likely to seek dental care on a regular basis. The role of dental attitudes and knowledge of services on this circumstance is unclear. The authors quantified group differences in dental attitudes and knowledge of services and related them to regularity of dental care use. METHODS: As part of the baseline phase of The Florida Dental Care Study, a longitudinal s…
Differences by Race in the Decline of Health Over Time
Previous research on race differences in health, we believe, has failed to take into account the initial state of health of the respondents. Other research has demonstrated that elders in poor health are more likely to experience a change in their health over time. It is unclear if the greater probability of decline in health observed among African Americans is a result of being more likely to begin such observations in health states that are wor…
Taking Dental Self‐care to the Extreme
The phenomenon of dental self-extraction is real and is not limited to residents of developing nations or geographically isolated areas. Because of the potential for prolonged bleeding or bacterial endocarditis in certain population groups, community health clinicians and officials should be cognizant of this behavior
Oral Functional Limitation among Dentate Adults
The findings in this study suggest a significant prevalence of oral functional limitation in dentate adults. Certain clinical and sociodemographic factors were strongly and independently associated with its presence
Multidimensionality of Oral Health in Dentate Adults
OBJECTIVES: An understanding of the validity and usefulness of self-reported measures (as distinct from clinically determined measures) of oral health is emerging. These self-reported measures include self-rated oral health (SROH). Three objectives were to: (1) describe self-rated oral health in dentate adults, (2) quantify associations between self-rated oral health and other measures of oral health (oral disease and tissue damage, pain and disc…
Determinants of dental care use in dentate adults
Patterns of Change in Self-Reported Oral Health Among Dentate Adults
BACKGROUND: Although self-assessments of oral health have become useful tools in dental research, the use of self-reports to study changes in oral health over time has been limited. The aim of this investigation was to describe how oral disease and tissue damage, pain, functional limitation, disadvantage, and self-rated oral health change over time. METHODS: The Florida Dental Care Study (FDCS) (n = 873) is a longitudinal study of oral health amo…
Predictors of Chewing Difficulty Onset Among Dentate Adults
Self-reported oral disease and tissue damage and toothache pain were strong predictors of decline in chewing ability. Additionally, women were identified as a high-risk group for incident chewing difficulty. Future research should elaborate further the pathways through which these factors affect oral function
Medicine (33 obras) · Dental Health and Care Utilization (15 obras) · Gerontology (15 obras) · Family medicine (14 obras) · Health care (12 obras) · Environmental health (11 obras) · Psychology (11 obras) · Population (10 obras) · Dentistry (9 obras) · Healthcare Policy and Management (9 obras)