PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “HOSPITAL OUTPATIENT SERVICE”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed2004

Multinational economic evaluation of valsartan in patients with chronic heart failure: results from the Valsartan Heart Failure Trial (Val-HeFT).

BACKGROUND: The Valsartan Heart Failure Trial (Val-HeFT) compared valsartan versus placebo in 5010 patients taking prescribed background therapy for New York Heart Association class II to IV heart failure. Valsartan reduced the risk of heart failure hospitalization and improved clinical signs and symptoms of heart failure. We sought to compare resource use, costs, and health outcomes among patients taking prescribed therapy for heart failure and randomly assigned to receive valsartan or placebo. METHODS: Measures of resource use were based on data collected during the trial. Unit cost estimates were collected from individual countries and converted to 1999 US dollars. Total costs were estimated for hospitalizations, inpatient and outpatient physician services, ambulance transportation, deaths outside the hospital, and outpatient cardiovascular medications. RESULTS: Mean follow-up was 23 months. Mean costs for heart failure hospitalizations were 423 dollars lower among patients receiving valsartan (95% CI, -706 to -146). Mean total costs were 9008 dollars for patients receiving valsartan and 8464 dollars for patients receiving placebo, a net incremental cost of 545 dollars (95% CI, -149 to 1148), including the cost of valsartan. There was an overall reduction in total costs of 929 dollars (95% CI, -3243 to 1533) among patients not receiving an ACE inhibitor at baseline but a slight increase in costs of 334 dollars (95% CI, -497 to 1199) among those receiving an ACE inhibitor without a beta-blocker and a 1246 dollars increase (95% CI, 54 to 2230) in patients receiving both an ACE inhibitor and a beta-blocker at baseline. CONCLUSIONS: Valsartan provided clinical benefits at a mean incremental cost of 285 dollars per year during the trial. In patients not taking ACE inhibitors, valsartan was economically attractive, increasing survival while reducing or marginally increasing overall costs.

Adrenergic beta-Antagonists↗
PubMed1995

The effects of hospital-physician integration strategies on hospital financial performance.

STUDY QUESTION: This study investigated the longitudinal relations between hospital financial performance outcomes and three hospital-physician integration strategies: physician involvement in hospital governance, hospital ownership by physicians, and the integration of hospital-physician financial relationships. DATA SOURCES AND STUDY SETTING: Using secondary data from the State of California, integration strategies in approximately 300 California short-term acute care hospitals were tracked over a ten-year period (1981-1990). STUDY DESIGN: The study used an archival design. Hospital performance was measured on three dimensions: operational profitability, occupancy, and costs. Thirteen control variables were used in the analyses: market competition, affluence, and rurality; hospital ownership; teaching costs and intensity; multihospital system membership; hospital size; outpatient service mix; patient volume case mix; Medicare and Medicaid intensity; and managed care intensity. DATA COLLECTION/EXTRACTION: Financial and utilization data were obtained from the State of California, which requires annual hospital reports. A series of longitudinal regressions tested the hypotheses. PRINCIPAL FINDINGS: Considerable variation was found in the popularity of the three strategies and their ability to predict hospital performance outcomes. Physician involvement in hospital governance increased modestly from 1981-1990, while ownership and financial integration declined significantly. Physician governance was associated with greater occupancy and higher operating margins, while financial integration was related to lower hospital operating costs. Direct physician ownership, particularly in small hospitals, was associated with lower operating margins and higher costs. Subsample analyses indicate that implementation of the Medicare prospective payment system in 1983 had a major impact on these relationships, especially on the benefits of financial integration. CONCLUSIONS: The findings support the validity of hospital-physician financial integration efforts, and to a lesser extent the involvement of physicians in hospital governance. The results lend considerably less support for strategies built around direct physician ownership in hospitals, particularly since PPS implementation. RELEVANCE/IMPACT: These findings challenge prior studies that found few financial benefits to hospital-physician integration prior to PPS implementation in 1983. The results imply that financial benefits of integration may take several years after implementation to emerge, are most salient in a managed care or managed competition environment, and vary by hospital size and multihospital system membership.

Analysis of Variance↗
PubMed1997

Inpatient and ambulatory patient satisfaction with nursing care.

This study reports on the development and psychometric testing of inpatient and ambulatory patient satisfaction scales designed to measure patient satisfaction using the standards of nursing practice within a medical center. The surveys were administered to patients 4-6 weeks after discharge from the hospital or following a clinic visit. A total of 619 inpatient and 955 ambulatory patient questionnaires were analyzed. Factor analyses suggest there exist four scales for inpatient satisfaction anf five scales for outpatient satisfaction with high reliability and reasonable validity.

Health Care Surveys↗
PubMed1986

Acceptance and use of patient-carried health records.

The ultimate goals of providing health records to patients are to improve continuity of care, to improve patient understanding of instructions, and to encourage patients to take a more active role in maintaining their health. In the current study, four types of patient-carried health records were evaluated in a hospital-based outpatient service to determine whether records would be accepted and used, to estimate the cost of the process, and to obtain patient and provider reactions. Records were provided at moderate cost and the primary determinants in record acceptance and use were physicians' support of the process, the type of record, and the employment status of the patient. A small record which could be carried in a wallet seemed suited to most patients; other more elaborate participatory records appeared to have benefits for selected patients. More extensive use of participatory records appears to require changes in the way health care would be delivered.

Attitude of Health Personnel↗
PubMed1996

A survey of general practitioners: implications for the hospital/community interface.

This paper presents the results of a survey that was conducted under the auspices of a Commonwealth-funded Ambulatory Care Reform Project. The survey was undertaken in all telephone areas of South Australia (08, 085, 086, 087, 088) to investigate issues of access to, and availability of, clinical allied health outpatient services at the Royal Adelaide Hospital with respect to general practitioners. Six hundred and twenty general practitioners in South Australia received a mailed survey enclosing a reply-paid envelop. Forty-nine per cent of the general practitioners responded. The highest response was from practitioners in the metropolitan area (08 telephone area) and the immediate Adelaide country area (085 telephone area). General practitioners supplied quality and in-depth responses that clearly indicated issues they felt impeded full use of clinical allied health services at the Royal Adelaide Hospital. These issues have implications not only for the clinical allied health outpatient services at the Royal Adelaide Hospital, but for all clinical allied health outpatient services in the public hospital system.

Adult↗
PubMedDate not supplied

Outpatient nurses: from handmaiden to autonomous practitioner.

Little seems to have been written about health promotion in outpatients' departments. This article argues that outpatient nurses have the potential to play a significant part in promoting people's health. Outpatient nurses may be the first hospital nurses that an individual meets. What people observe and how they are treated may make a difference to both their experience of hospital care and their health. Outpatient nurses may have been perceived as the doctors' handmaidens of yesterday, but today they are evolving into an effective force for change. For example, evaluation of nurse-led outpatients' clinics is showing that they have the potential to complement doctor-led clinics and improve the healthcare experience of patients. It is argued that the health-promoting role of the outpatient nurse can be enhanced by a department that is a health-promoting environment.

Ambulatory Care↗
PubMed1990

Outpatient care: a nationwide revolution.

Most CEOs expect outpatient utilization to increase, but are executives planning ahead for what some term a virtual "revolution" in health care delivery? This issue's cover story takes a look at some of the key strategies that outpatient executives are implementing in their markets. Examples range from a large university teaching hospital, to a suburban facility, to a 40-bed rural hospital in Minnesota. Business strategy is only part of the outpatient story, however. One of the key questions that health care executives must answer is where the outpatient management talent will come from. Outpatient executives report that many of the same skills are needed in this setting as are necessary in the traditional inpatient side; however, there are major differences in management expertise that could make or break a hospital's outpatient services. Moreover, some experts say that this emerging definition of what it takes to be a successful outpatient services executive may be shaping the mold for all future health care executives, both inpatient and outpatient.

Education, Medical↗
PubMed1999

Quality of diagnostic services for cancer: a comparison of open access and conventional outpatient clinics.

OBJECTIVE AND STUDY DESIGN: To assess quality of a quick and early diagnosis route (QED) by determining effectiveness and cost-effectiveness of five clinics compared with three conventional outpatient clinics. Prospective economic evaluation. Six-month cohort of all referrals (November 1996-April 1997). SUBJECTS: All referrals for suspected cancers of: upper gastro-intestinal tract; urinary tract, prostate and testis; skin. EFFECTIVENESS: Median days saved between GP referral and date of: diagnostic appointment; consultant decision; intervention. RESULTS: GP referral to diagnostic appointment: QED was effective (median days) for all clinics. Diagnostic appointment to consultant decision: QED was effective for testicular and haematuria clinics. Consultant decision to intervention: QED was effective for haematuria, testicular and melanoma clinics. COST-EFFECTIVENESS: Extra (incremental) NHS cost per patient diagnosed. RESULTS: Less than 5 Pounds per day saved between GP referral and diagnostic appointment for: endoscopy; haematuria; prostate; testicular; melanoma. Less than 3 Pounds per day saved between GP referral and consultant decision for: testicular; haematuria. Less than 3 Pounds per day saved between GP referral and intervention for: endoscopy; haematuria; testicular; melanoma. CONCLUSION: A "quick and early" diagnostic route provides a higher quality service through improved effectiveness and cost-effectiveness compared to conventional outpatients.

Cohort Studies↗