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Presents a novel semiconductor quantum well (QW) structure consisting of alternating (In,Ga)As and Ga(P,As,Sb0 layers grown pseudomorphically on a GaAs substrate by all-solid-source molecular beam epitaxy. Determination of the band gap of the QW by the thickness and composition of both types of layers; Explanation for the strong room-temperature photoluminescence.

We studied the effect of scheduled intern rotations on the cost and quality of inpatient care at one teaching hospital. For all discharges from the internal medicine service between 1980 and 1986, we identified 1,705 rotation patients and 3,141 no-rotation patients. Using linear or logistic regression analysis to control for baseline differences, we evaluated for the effect of rotation. We found that rotation was significantly related to longer length of hospital stay, b = 0.341 days, p = 0.001, and higher hospital charges (for log charges, b = 0.053, p = 0.016. Hospital deaths, nursing home placements, and 30-day readmissions were not significantly related to rotation, p > 0.1. These results suggest that the systematic discontinuity induced by scheduled intern rotations may be another source of increased health care costs experienced at teaching hospitals. [ABSTRACT FROM AUTHOR]

Objective: To determine whether the timing and number of patients admitted by internal medicine housestaff under a traditional call schedule affect the resource utilization and outcome of care for those patients.Design: Retrospective cohort study, using existing computerized records.Setting: University-affiliated 340-bed city/county teaching hospital.Patients/participants: 22,112 patients discharged from the internal medicine service who had been admitted by an on-call first-year resident between January 1, 1980, and December 31, 1987.Measurements and Main Results: Admission after 5:00 PM was associated with decreased hospital length of stay (8.1%, p less than 0.0001), but increased total charges (3.1%, p = 0.007). The relative risk of inpatient mortality for patients admitted at night was 1.21 (p = 0.03). Patients of busier housestaff, as indicated by a larger number of on-call admissions, had lower total charges (1.7% decreased per admission) and no change in risk of inpatient mortality. While no linear relation was found between number of admissions and length of stay, analysis of nonlinear effects revealed that length of stay first rises, then falls as interns receive more on-call admissions.Conclusions: The number and timing of admissions by on-call internal medicine housestaff are significantly related to length of hospital stay, total charges, and likelihood of inpatient mortality at one teaching hospital. These variations should be considered in planning the reform of residency training programs. [ABSTRACT FROM AUTHOR]

The inexperience of house staff has been offered as one explanation for the increased cost of care at teaching hospitals, but conclusive evidence for this has been lacking. We studied the relationship of house staff experience to the cost and quality of inpatient care in a large series of internal medicine patients at one teaching hospital. We defined house staff experience by the month of academic year during which the patient received care. Our measures of cost were length of hospital stay and total hospital charges, while our measures of quality were hospital deaths, hospital readmissions, and nursing home placement. Multiple linear regression analysis on 21,679 hospital discharges revealed increasing house staff experience to be associated with a significant decline in length of stay (95% confidence interval for b, -0.006 to -0.066 days per discharge per month of house staff experience) and total hospital charges (95% confidence interval for b, -0.002 to -0.017 log dollars per discharge per month of house staff experience). These findings constitute an estimated average decline of 0.43 days per discharge and +370 per discharge over the academic year. Logistic regression analysis found no relationship of house staff experience to hospital deaths, readmissions, or nursing home placement. These findings suggest that the process of training inexperienced physicians may represent an important source of inefficiency for teaching hospitals struggling in a competitive environment. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of a voucher for free mammography on compliance with recommended mammography screening guidelines.Study Design: Vouchers for free mammography distributed to a random sample of women over the age of 50 in two rural southern Minnesota counties. The vouchers were good for one year. Baseline and follow-up data were collected and rates of compliance with current mammography guidelines were observed for the voucher group and a control group of women living in the same counties.Methods: Logistic regression models were used to estimate the effect of the voucher on compliance with mammography guidelines and the impact of factors potentially influencing the effectiveness of the voucher.Principal Findings: The voucher improved mammography rates primarily through increasing screening among women who were out of compliance at baseline.Conclusions: Vouchers, even when distributed randomly within a population of rural Midwestern women, can significantly improve compliance rates. Vouchers are no less effective a means of increasing screening among vulnerable women than among other women. [ABSTRACT FROM AUTHOR]

Utilization of preventive health care services is lower in rural populations than in urban populations, possibly as a result of barriers to preventive health care that are characteristic of rural settings. This study was conducted to identify factors associated with mammogram utilization among farm women. Mammogram utilization among farm women from six southern Minnesota counties was examined as part of a larger community-based cancer intervention study. Farm women aged 40 and older were randomly selected from a list of farm households and interviewed by telephone to determine mammogram utilization and factors related to utilization. Of the 606 respondents, 78 percent reported ever having a mammogram and 49 percent reported a mammogram within the past year. Physician recommendation for a screening mammogram and family history of breast cancer were found to be associated with ever having a mammogram. Correct knowledge of mammogram screening guidelines was associated with a mammogram within the past 12 months. Overall, physician recommendation was the most influential determinant of utilization. As more emphasis is placed on prevention, patient education by physicians can have the greatest impact on mammogram utilization. [ABSTRACT FROM AUTHOR]