Robert M. Heyssel

Abstract The incidence of leukemia is higher among those closely exposed than among those more remote from the hypocenter. This increase was first manifest approximately three years following exposure. It apparently reached its peak between the years 1950 and 1952. Thereafter, the incidence has been diminishing, but 13 years after exposure it is still higher than would be expected in the general population. The type of leukemia most increased in incidence is the chronic granulocytic variety. No apparent difference in the natural history of the specific types of leukemia in exposed and nonexposed Japanese has been observed. Preliminary analyses of the data show a linear relation between dose of radiation and incidence of leukemia above 50 to 100 rad. Below this dose, the shape of the curve is not certain.

HARTMANN, ROBERT C.; JENKINS, DAVID E. Jr.; McKEE, L CLIFFORD; HEYSSEL, ROBERT M. Author Information

For more than a decade American hospitals have been asked to contain costs. The most recent program is the Medicare prospective payment system, which reimburses hospitals a fixed price per case based on diagnosis-related groupings (DRGs). If this approach proves successful, it may be adopted by other payers and perhaps extended to the reimbursement of physicians through prospective professional fees.Hospital reaction to the new payment scheme varies. Some look for cost controls and more efficient management techniques to reduce expenses; others carefully analyze their mix of DRGs to measure which are profitable and which involve unusual and expensive services. . . .