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PubMed1990

Utilisation of outpatient services at Red Cross War Memorial Children's Hospital, Cape Town.

The demand for outpatient services continues to grow at Red Cross War Memorial Children's Hospital (RCCH). To determine current utilisation patterns, we conducted a 2-week survey in the outpatient department (OPD). In addition, we reviewed the RCCH Annual Reports for the period 1961-1988. Annual outpatient attendances have increased from around 42,000 in 1957 to their highest level ever; nearly 350,000 in 1988. This steady rise in outpatient attendance was stemmed during the 1970s by the expansion of health services in the greater Cape Town area, in particular the introduction of day hospitals. In general, blacks are utilising the OPD as a primary community hospital for the treatment of infectious and environmentally induced diseases. In contrast, the white outpatient profile is more characteristic of a tertiary referral centre, with a higher proportion of specialist clinic attendances. The utilisation patterns for coloured children are intermediate. Analysis of the residential address of patients and their presenting diagnoses indicates an urgent demand for primary health care services in the most recently settled and poorest suburbs of Cape Town, many of which are remote from the hospital.

Black or African American↗
PubMedDate not supplied

Ambulatory patient satisfaction: a systematic approach to collecting and reporting information.

The importance of outpatient services to most hospitals continues to escalate. The number of ambulatory outpatients is much larger than the number of inpatients, and revenues from outpatient services are predicted to equal or exceed inpatient revenues in the near future. The ability to provide outpatient services with exceptional quality is paramount to long-term survival of hospitals. This article describes a methodology for systematically collecting and reporting patient satisfaction information from a wide array of hospital ambulatory care services. By systematically measuring satisfaction, hospitals can determine the outpatient areas and service dimensions in need of performance improvement.

Ambulatory Care↗
PubMedDate not supplied

[Social inequality in health and the utilization of health services among the elderly in Latin America].

OBJECTIVE: To learn if there is social inequality in health and in the utilization of health services among the elderly in six cities of Latin America: Buenos Aires, Argentina; São Paulo, Brazil; Santiago, Chile; Havana, Cuba; Mexico City, Mexico; and Montevideo, Uruguay. METHODS: This study used data from a project called Health, Well-being, and Aging in Latin America and the Caribbean (known as the "SABE project"). To investigate the presence of social inequality in health an ordinal probit model was used, with health status indicated by the following dependent variables: activities of daily living, instrumental activities of daily living, physical mobility, and self-rated health. To measure social inequality in the utilization of health services two characteristics were assessed: one for outpatient medical services (whether or not individuals received outpatient care, and how many times), and one for hospital admissions (whether or not individuals were hospitalized). For outpatient services, we estimated a negative binomial hurdle model, and for hospital admissions, a logit model was constructed. RESULTS: Our main results suggest the presence of social inequality in health in all the cities, with better-off socioeconomic groups having better health. The difference in health was less marked in Havana, Buenos Aires, and Montevideo, and it was more pronounced in São Paulo and Mexico City. With respect to the utilization of health services we found inequalities in the use of outpatient services in Santiago, Mexico City, and São Paulo. In Santiago and Mexico City, more schooling was associated with a higher number of expected outpatient medical visits; however, the opposite was found in São Paulo. For hospital admissions, inequality was found only in São Paulo, with individuals with more years of schooling being much more likely to be hospitalized. CONCLUSION: To a certain extent, our results reflect the socioeconomic and demographic characteristics of the countries in which each of the six cities is located. The cities in the countries with the worst social indicators (high income inequality and low human development index) tended to have the greatest inequalities in health and in the utilization of health services.

Age Factors↗
PubMed1984

Combined services of a community hospital and clinic to provide antineoplastic drugs for outpatients.

An outpatient antineoplastic drug service that uses the services of a community hospital and clinic is described. The hospital pharmacy department assumed responsibility for preparing doses of antineoplastic drugs for use in a local medical clinic; previously, clinic nursing staff prepared the doses on a countertop. To provide this service, the hospital purchased a vertical laminar-flow safety cabinet, developed policies and procedures, and devised standard dilution protocols. The pharmacy maintains patient profiles for all outpatients. Each physician order is telephoned to the pharmacy from the clinic followed by delivery of the written order to the pharmacy via a courier service. After review of the written order by a pharmacist, the courier delivers the medication to the clinic. Since beginning the service December 1982, the pharmacy has prepared an average of three doses of antineoplastic drugs per day; about one hour of pharmacist time per day is devoted exclusively to this service. Revenue from the service has covered start-up costs and has generated profit. By using the combined resources of health professionals in the community, quality care is provided to outpatients receiving cancer chemotherapy.

Antineoplastic Agents↗