1Q[3a]. Should patients be able to sue HMOs for malpractice?
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Biomedical subjects
Publications and source records attributed to W Zelman.
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Hepatic rupture is a rare and serious complication of pregnancy. A case of hepatic rupture is presented along with a review of the recent literature.
A set of 25 key performance indicators were developed to support managers and policy makers in assessing the performance of their program relative to others. The indicators cover four major areas: Revenue mix, client mix, staff mix, and service mix. Comparisons can be made among programs within or across a state or region, or among programs of similar circumstances (e.g., urban or rural).
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Are you ready to take your organization into the 21st century? Do you fully grasp the implications of current and emerging trends in the field? Healthcare Executive talked with six healthcare experts and asked them what they saw as the greatest challenge for both executives and their organizations in the new millennium. Although the experts' opinions vary, their responses emphasize the importance of repairing old relationships and building new partnerships between those working in healthcare organizations, as well as bringing a consumer focus back to healthcare delivery.
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The purpose of the case study was, firstly, to evaluate (starting from the time the patients are admitted to the intensive care unit--ICU) a type of cardiac, pulmonary and peripheral microcirculation in patients with severe traumas by using a multi-component and invasion-free monitoring; the second purpose was to measure quantitatively the changes in the cardiac, pulmonary and peripheral hemodynamics leading to recovery or death; and finally, it was to investigate the effectiveness of applying the discriminative analysis for the sake of assessing the biological value of the controllable changes and of forecast outcome. The invasion-free monitoring system comprising the below tools was in use: an improved bio-impedance method (evaluation of the cardiac output), pulsometry (examination of the pulmonary function), transcutaneous oxygen pressure (tissue perfusion function) and arterial blood pressure (ABP--general circulation status). The results of continuously controllable invasion-free measurements were used for a prospective evaluation at the emergency unit of the county hospital, which was supervised by the university. The accumulated integral values of the deficit or excess of each controllable parameter were calculated by using the differences between the normal values and the values obtained for each patient and for the groups of survivors and dead. A probable outcome and a degree of the deficit of the pulmonary and cardiac functions as well as of the tissue-perfusion function were analyzed by using the discriminant function. The values of pure aggregate deficits (-) or excesses (+) were for the survivors and dead, respectively, as follows: cardiac index--(+)93 +/- 49.8 l/m2 versus -232 +/- 138 l/m2 (p < 0.07); mean ABD(-)-12 +/- 12.4 mm Hg versus -57 +/- 23.5 mm Hg (p < 0.066); arterial saturation(-)-1 +/- 0.09% h versus -9 +/- 2.6% h (p < 0.001): and tissue perfusion--(+)311 +/- 87 tor/h versus 793 +/- 175 tor/h (p < 0.0001). The pure aggregate value of reduced circulation, tissue perfusion and of hypoxemia degree was found to be higher in the dead versus the survivors. The invasion-free monitoring systems secure a constant real-time control over the data, which makes the circulatory malfunction revealed as soon as possible in emergency settings. The mentioned systems can be used to describe, for each patients, a temporal hemodynamic model and to evaluate quantitatively a functional-deficit severity; they also provide for composing a clear-cut and successive treatment scheme from the emergency stage to the intensive care unit.