Impact on patient satisfaction and importance of medical intake and office staff in a multidisciplinary, one-stop shop transgender program in Indianapolis, Indiana

Background: Historically, the transgender population has postponed seeking primary care due to discrimination within social and medical settings. Very few studies have considered patient satisfaction with transgender care and whether there are differences in staff satisfaction. This cross-sectional study focuses on the satisfaction of transgender patients who receive primary care at a comprehensive, “one-stop shop” program in Indianapolis, IN, USA. Methods: Sixty-two patients completed a patient satisfaction survey. Items consisted of 5-point Likert scales with anchors of satisfaction, caring, competence, and doctor recommendation. Results: Overall, there were positive responses to all items, ranging from moderately high to very high. There was high overall satisfaction in the program’s trans-friendliness, office visits, and “one-stop shop” model. Lower scoring items concerned medical intake with appointment making and timing. There were no statistical differences across age, gender, education, duration at the program, and number of visits in the past 12 months. There were clear differences between how respondents viewed the care and competence of the program’s staff. In particular, the doctor was viewed most positively and office staff least positively with medical staff rated in-between. Conclusion: There is high patient satisfaction with this comprehensive, “one-stop shop” care model among the transgender population. We recommend that transgender programs routinely conduct quality improvement measures, maintain sufficient workforce coverage, and provide cultural competency training which should include appropriate care standards and patient-centered concerns regarding appointment making and burdens associated with timing, traveling, and cost

Secular Trends in Physiological Capital: Implications for Equity in Health Care

Over the past three centuries there has been a rapid accumulation of physiological capital in OECD countries. Enhanced physiological capital is tied to long-term reduction in environmental hazards and to the conquest of chronic malnutrition. Data on heights and birth weights suggests that physiological capital has become more equally distributed, thereby reducing socioeconomic disparities in the burden of disease. Implications for health care policy are: (1) enhanced physiological capital has done more to reduce inequities in health status than has wider access to health care; (2) the main contribution of more advanced medical treatment so far has been to retard depreciation in individuals' physiological capital; (3) prenatal and early childhood care and environmental issues are key for interventions aimed at enhancing physiological capital and at affecting its rate of depreciation; (4) lifestyle change is the most important issue affecting health equity in rich countries; and (5) greater access to clinical care should be promoted through aggressive outreach, since expanded insurance coverage by itself is inadequate.

Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy

Prize Lecture to the memory of Alfred Nobel, December 9, 1993Economics History;

Why China is Likely to Achieve its Growth Objectives

In 2002, the Chinese Communist Party announced a goal of quadrupling per capita income by the year 2020. Starting at income levels of the year 2000, this would require a growth rate of 7.2 percent per annum in per capita income or close to 8.0 percent in GDP. Such unresolved and emerging problems as growing income disparities, increasing pollution, pressures on infrastructure, the inefficiency of state owned enterprises, and political instability are often cited as reasons to doubt the attainability of the CCP%u2019s goal. However, China%u2019s progress in addressing fundamental constraints that might limit rapid economic growth augurs well for the success of its economic goals. Although there are disagreements about economic policy among top leaders, the continued transformation into a market economy and the promotion of increasing local autonomy in economic matters are not in doubt. In education, China has substantially increased the percentage of its workforce receiving a college education, and continuing growth in this investment in human capital could account for a large portion of the desired growth rate. In addition, the value of improvements in the quality of economic output unmeasured by GDP, such as advances in the quality of health care and education, could raise reported growth rates by as much as 60 percent. Finally, the government%u2019s increasing sensitivity to public opinion and issues of inequality and corruption, combined with improving living conditions, have resulted in a level of popular confidence in the government that makes political instability unlikely.

Simon S. Kuznets: April 30, 1901-July 9, 1985

This paper, prepared for the Biographical Memoirs of the National Academy of Sciences, presents an account of the scholarly career of Simon S. Kuznets. Among the issues considered are his contribution to the development of the empirical tradition in economics, his transformation of the field of national income accounting, his use of national income accounting during World War II to set production targets for both the military and civilian sectors of the economy, and to guide the implementation of those targets; his development of a theory of economic growth, his investigation of the interrelationship between economic growth and population growth, his contribution to methods of measurement in economics, and his legacy to the economics profession.

Reconsidering Expectations of Economic Growth After World War II from the Perspective of 2004

At the close of World War II, the future of economic development was the subject of wide-ranging debates. Historical experience has since shown that these forecasts were uniformly too pessimistic. Expectations for the American economy focused on the likelihood of secular stagnation, which continued to be debated throughout the post-war period. Concerns raised during the late 1960s and early 1970s about rapid population growth smothering the potential for economic growth in developing countries were contradicted when, during the mid- and late-1970s, fertility rates began to decline rapidly. Predictions that food production would not keep up with population growth have also been proven wrong: between 1961 and 2000, calories per capita worldwide have increased by 24 percent, despite a doubling of the global population. The high rates of economic growth in East and Southeast Asia were also unforeseen by economists. Copyright 2005, International Monetary Fund

Some Notes on the Scientific Methods of Simon Kuznets

This paper discusses the scientific methods that guided the economic research of Simon Kuznets, with particular stress on his approach to measurement and theory. The paper closes with the transcription of a brief autobiographical talk by Kuznets at a dinner in honor of his eightieth birthday.