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At least 451 records · Page 25Linked to original sources
PubMedDate not supplied

Hospital's six-point program clears up financial picture.

To deal with the many changes affecting patient accounts today and reduce the backlog in accounts due, Mercy Hospital, Hamilton and Fairfield, OH, adopted a six-point program with the following goals: Creation of an admitting and outpatient registration quality assurance program; Creation of a patient financial representative position; Commitment to electronic claims processing; Redistribution of work load in the billing office; Improved relations with community employers; Internalization of collection efforts. Since the program was implemented, the hospital has reduced accounts receivable from $15,935,000 to $10,809,000 and days outstanding from 115 to 70.7 gross. It has improved community and patient relations and intensified collection efforts, all with a staff reduction from 26 full-time employees to 24.5. The hospital's further plans include acquiring new software to electronically process commercial accounts; improving cash collections for deductibles and copayments at the time of discharge'; reducing collection expense through an automated collection software package, inexpensive collection letter series, and credit cards; and providing on-the-spot bank loans at discharge.

Accounting↗
PubMedDate not supplied

[The bioethics challenge of equity: its significance in public health].

This paper presents the bioethical discourse as a stimulus to dialogue between beliefs, ideologies, rationalities, and persons. Among its dominant themes, it may be distinguished between those related to communities and those related to individuals. Although equity belongs into the former, it finds expression in individual life as solidarity and empathy. It is possible to formulate guidelines for research in social science and epidemiology distinguishing between values, principles and behavior rules, which find expression in the notion that bioethical reflection must anticipate challenges and dangers and not simply respond to technoscientific developments.

Bioethics↗
PubMed1984

Institutional objectives for medical education that relates to the community.

The graduate of most medical schools in North America is described as an "undifferentiated physician", but there is no universally agreed upon definition of the term. With the proliferation of subspecialties during the past 30 years, each division or department has its own concept of the undifferentiated physician. The result is strong pressure on curriculum committees to increase curriculum content. The medical faculty of the University of Ottawa used an approach to developing institutional objectives for medical schools that was based on the premise that graduates should possess the knowledge, skills and attitudes of a primary care practitioner in the community, and they accepted an institutional goal and 10 institutional objectives after five revisions of the original proposal. An essential element in the development of the objectives was the use of a list of common medical problems, ranked in order of frequency, as guidelines. The resulting institutional objectives are relevant to current community needs and may be used to project the future needs of the community.

Academic Medical Centers↗
PubMed1981

Community integration of mentally retarded adults: community placement and program success.

The extent of community and program success of 166 mentally retarded clients placed into a community-based program was evaluated over a 9-year period. Twenty predictor variables measuring institutional factors, client characteristics, training variables, and community characteristics were related to community or program success. Successful community placement was associated with sensorimotor and work skills, appropriate social-emotional behavior, gender, and family acceptance of community placement and involvement with the interdisciplinary team process. Program success was associated with language and psychomotor skills, education received prior to community placement, community and institution size, and family involvement. Sixteen percent of the clients were reinstitutionalized into either the state mental retardation facility or a mental health facility. Factors associated with successful placement and program progression were discussed as was a model for future deinstitutionalization research.

Adult↗
PubMed1990

The Framingham Disability Study: relationship of various coronary heart disease manifestations to disability in older persons living in the community.

The relation between coronary heart disease and disability was examined in 2,576 community-dwelling women and men ages 55-88 years. These Framingham Study participants were originally recruited in 1948-51 for an examination of cardiovascular disease. Twenty-seven years later, remaining members of the cohort were interviewed to ascertain physical abilities, and a score on a disability scale was assigned. Multivariate logistic analyses examined disability in relation to uncomplicated angina pectoris (AP), complicated AP, and coronary heart disease other than AP, controlling for possible confounders. In younger and older women and men, uncomplicated and complicated AP were associated with disability. Coronary heart disease other than AP was associated with disability only in the younger men. Congestive heart failure predicted disability only in the women. These results suggest that onset of AP should be recognized as a critical point in the development of disability and that AP is a better predictor of disability than is myocardial infarction or coronary insufficiency.

Aged↗
PubMed1996

Predictors of fall-related injuries among community-dwelling elderly people with dementia.

To determine the annual incidence of fall-related injuries among community-dwelling elderly people with dementia and to identify the factors predicting those likely to sustain such injuries, we conducted a cohort study with a one-year follow-up. As predicting factors, we paid particular attention to behavioural problems and difficulties in helping with activities of daily living based on the Assessment of Basic Care for the Demented (ABCD) scale. Thirty-five of 86 final study subjects and nine of 98 final control subjects sustained fall-related injuries. Significant factors associated with fall-related injuries to demented elderly subjects were ABCD score (adjusted odds ratio 0.73, 95% confidence interval 0.60-0.89), history of falls in the past year (3.65, 1.34-9.95), and Barthel index score (1.04, 1.00-1.08). This highlights the predictive value of better physical function but more difficult care status in relation to ADL for fall-related injuries.

Accidental Falls↗
PubMed1997

Symptomatology of HIV-related illness and community-acquired illness in an HIV-infected emergency department population.

STUDY HYPOTHESIS: Community-acquired infections and non-AIDS-related illnesses are a significant proportion of the final diagnoses in HIV-infected patients presenting to an emergency department. We hypothesized that emergency physicians over-diagnose opportunistic infections in the HIV-infected patient. We also hypothesized that the absolute CD4 lymphocyte level could be used to stratify patients by likelihood of HIV related disease. METHODS: We retrospectively reviewed ED logbooks and medical records to find all ED patients with self-reported HIV seropositivity during a 19-month period. Age, sex, insurance status, chief complaint(s), ED assessment, and disposition were recorded from the ED logs; absolute CD4 lymphocyte counts, risk factors, and final diagnoses were recorded from the medical records. HIV-related disease was evaluated with the use of established Centers for Disease Control and Prevention criteria. Data were evaluated with the use of the chi 2 test, the chi 2 test for trend, and kappa-proportions. RESULTS: Analysis of 344 ED visits demonstrated that decreasing absolute CD4 lymphocyte counts were associated with increasing incidence of HIV-related disease (P < .001), even when noninfectious causes were excluded. Only 34% of visits were related to HIV-associated illness. Emergency physicians exhibited high sensitivity (72.9%) and specificity (95.5%) in diagnosing HIV-related disease and conducted appropriate visit disposition. CONCLUSION: ED visits by HIV-infected individuals are often not made for reasons of opportunistic infection, and the absolute CD4 lymphocyte count is inversely related to HIV-related disease.

AIDS-Related Opportunistic Infections↗
PubMed1986

Obstetric hospital stays by diagnosis related groups: a community-based analysis.

The study analyzed obstetric inpatient hospital stays by diagnosis related group in Sacramento, California, and Syracuse, New York, two areas with similar admission rates, between 1981 and 1984. The sample included 123,308 hospital discharges. The data indicated that aggregate obstetric stays in Syracuse were 32.9% longer than those in Sacramento, which was typical of differences between these stays in the western and northeastern United States. Obstetric stays in both areas declined between 1981 and 1984; however, the rate of decline in Sacramento (6.1%) was substantially higher than that of Syracuse (3.5%). Variability of obstetric stays was substantially lower in Syracuse for most diagnosis related groups, including those with the largest caseloads. These results suggest that community and regional differences in obstetric hospital stays may be produced by system-wide consumer preferences and physician practice patterns, more than by hospital bed availability, health maintenance organization activity, or other factors.

California↗