Economic barriers to the use of oral rehydration therapy: a case report

Article Abstract:

Diarrhea leading to dehydration results in more than 200,000 hospital admissions in the United States each year among children less than five years old. One study reported that diarrhea caused 500 deaths each year between 1973 and 1988 in the United States among children aged one month to four years. These deaths can easily be prevented by the appropriate use of oral rehydration therapy (ORT), the oral administration of solutions containing glucose (sugar) and electrolytes such as sodium and potassium. The National ORT Project was developed to promote the use of ORT by parents and health professionals. The objectives of the project are to prevent dehydration by starting ORT at home at the onset of diarrhea, and to encourage use of ORT rather than intravenous treatment for children with dehydration who must be hospitalized. The project has focused on educating health professionals and the public about the effectiveness of ORT. A case is described of a nine-month-old infant who developed rotavirus infection resulting in diarrhea. The child's mother tried to buy the oral glucose-electrolyte solution in a pharmacy but was unable to afford the product. The child's condition worsened but she did not seek medical attention for him until his condition was critical; in the hospital, he ultimately died of complications from the dehydration. This case shows that children living in poverty may not receive the benefits of ORT unless economic barriers to the use of ORT are eliminated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Economic aspects, Complications and side effects, Diarrhea in children, Oral rehydration therapy, Childhood diarrhea

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Career choice in one general pediatric Title VII-supported residency

Article Abstract:

Title VII funds can be successfully used to fund programs to educate generalist physicians. Congress allocated funds in 1976 to support residency training for generalists in family practice, pediatrics, and internal medicine. The Boston University School of Medicine and Boston City Hospital have been training generalist pediatricians in urban pediatrics since 1976. Every year since 1978, graduates have responded to questionnaires about their current career. In 1987, 79% of doctors who completed training between 1983 and 1987 were generalist pediatricians. In 1992, two-thirds of those responding were generalist pediatricians. Overall, from 1983 through 1992, two-thirds of all graduates were in primary care. Among the 78 doctors who responded to both the 1987 and 1992 surveys, 83% were still practicing general pediatrics. Moreover, in 1992, 73% of the doctors had 10% or more Medicaid patients and 28% reported that more than half their patients were on Medicaid.

Education, Curricula, Residents (Medicine), Pediatricians, Physicians (General practice), General practitioners, Medical education

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Poverty medicine

Article Abstract:

The Wedding Goes On Without Us by Downing, Raymon

Books, Book Review, The Wedding Goes On Without Us (Book), Downing, Raymon

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