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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.

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PubMed1998

State-coordinated services for traumatic brain injury survivors: toward a model delivery system.

Since 1985, the state of Minnesota, through a variety of advocacy, legislative, and interagency efforts, has made incremental gains in public policy and service development for persons with traumatic brain injury (TBI). This article reviews the roles and functions of select state programs and departments in coordinating TBI services. Key initiatives, as well as the current model of public policy and services, are outlined. Current and future service development and initiatives are discussed. Finally, specific implementation recommendations are proposed.

Brain Injuries↗
PubMed2001

Social class inequalities in the use of and access to health services in Catalonia, Spain: what is the influence of supplemental private health insurance?

OBJECTIVE: To analyse social class inequalities in the access to and utilization of health services in Catalonia (Spain), and the influence of having private health insurance supplementing the National Health System (NHS) coverage. DESIGN: 1994 Catalan Health Interview Survey, a cross-sectional survey conducted in 1994. SETTING: Catalonia (Spain). STUDY PARTICIPANTS: The participants were a representative sample of people aged over 14 years from the non-institutionalized population of Catalonia (n = 12,245). MAIN OUTCOME MEASURES: Health services utilization, perceived health, having only NHS or NHS plus a private health insurance, and social class. RESULTS: Although one-quarter of the population of Catalonia had a supplemental private health insurance, percentages were very different according to social class, ranging from almost 50% for classes I and II to 16% for classes IV and V in both sexes. No inequalities by social class were observed for the utilization of non-preventive health care services (consultation with a health professional in the last 2 weeks and hospitalization in the last year) among persons with poor self-perceived health status, i.e. those in most need. However, social inequalities still remain in the use of health services provided only partially by the NHS, and when characteristics of last consultation are taken into account. Subjects who paid for a private service waited an average of 18.8 minutes less than those attending the NHS. Within the NHS, social classes IV and V waited longer (35.5 minutes) than social classes I and II (28.4 minutes). CONCLUSION: The NHS in Catalonia, Spain, has reduced inequalities in the use of health services. Social inequalities remain in the use of those health services provided only partially by the NHS.

Adolescent↗
PubMed2001

[High vaccination rates among children of Amsterdam].

OBJECTIVE: To examine if in Amsterdam there are social or cultural groups of children with a relatively low vaccination coverage for diphtheria, pertussis, tetanus and poliomyelitis (DPTP) and mumps, measles and rubella (MMR). DESIGN: Descriptive cross-sectional study. METHOD: In the Department of Child Health Care of the Municipal Health Service of Amsterdam all 83,217 children aged 2-12 years living in Amsterdam on the 1st of January 2000 were analysed for vaccination and sociodemographic data collected routinely by the Department of Child Health Care. The sociodemographic data concerned sex, year of birth, country of birth of the mother and child, name of the school and postal code of the home address. Schools were grouped by (religious) affiliation on the basis of the Amsterdam school guide 1999/2000. Based on postal codes children were classified by the neighbourhoods in which they were living. Neighbourhoods were grouped by socio-economic status based on data from the Central Bureau for Statistics. RESULTS: The overall vaccination rates of DPTP and MMR were 92.4% and 93.5% respectively. No important variation in vaccination coverage was identified between more and less affluent neighbourhoods. The uptake rate among foreign children was sometimes slightly higher and sometimes slightly lower compared with native children. Especially foreign children born abroad (Surinam, Antilles, Morocco, Turkey) were not fully vaccinated: 70.9% were fully immunized for DPTP, 79.5% for MMR. Children who visited anthroposophical schools were considerably less frequently fully immunized compared with children visiting other schools: for DPTP and MMR 81.0 and 59.9% respectively versus 94.4 en 95.3% for children attending general municipal schools. CONCLUSION: The vaccination coverage was high in children in Amsterdam. Further improvement of the vaccination uptake might be achieved by a more outreaching attitude to children born abroad, and by more intensely informing sceptical parents about the benefits and (supposed) dangers of vaccinations.

Child↗
PubMed1988

Western Cape local authority compliance with tuberculosis policy, 1984.

Local authority compliance with the national tuberculosis regimen in 1984 was examined in 29 of the 32 largest local authorities in the western Cape. The variability in management practices was especially evident with respect to children. The effects of the relative lack of uniformity and deviations from recommended policy need to be determined.

Child↗
PubMed1995

CMA-cosponsored conference raises many questions about future of regionalized health care.

Is regionalization better because it's cheaper? Or because it provides better outcomes? Or simply because it's different from whatever went before? Those were some of the questions asked during a recent conference cosponsored by the CMA and Queen's University. With each successive speaker, says Charlotte Gray, the message became clearer: there are more muddled theories behind the trend and more pitfalls ahead than planners ever expected when they embarked on the exercise to decentralize health care in Canada and elsewhere.

Canada↗
PubMed1994

Organ procurement in Spain: impact of transplant coordination.

Organ transplantation is a well-established treatment for irreversible renal, liver, cardiac, and respiratory failure. However, there is a shortage of organs that remains a serious obstacle to the full development of these therapeutic procedures. Some solutions such as presumed consent laws, the use of organs from living unrelated donors, compensation or payment for organs or xenografting have been proposed. In Spain during the last 3 years a well-designed program of transplant organization including a network of well-trained transplant coordinators has been established. In each potential donor hospital there is a transplant coordination team that is responsible for the whole process of organ procurement, from the detection of the donor to the organ grafting or tissue banking. Annual rate of cadaveric donors rose from 14.3 per million population (pmp) in 1989 to 21.7 donors pmp in 1992. Organ retrieval rate increased by 81% during the same period. Renal, liver and cardiac transplants increased by 44%, 175% and 162% respectively. We conclude that this particular approach to the problem has been successful in Spain, overcoming obstacles such as untrained or undertrained requesting staff, unidentified donors, and reluctance to approach grieving families. This kind of approach should be considered initially before resorting to more controversial approaches to the problem of the organ donor shortage.

Government Agencies↗