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At least 55 records · Page 3Linked to original sources
PubMed1992

Evaluating the treatment of sexually transmitted diseases at an urban public hospital outpatient clinic.

Sexually transmitted diseases occur disproportionately among the poor, are often treated in public hospitals and clinics, and have not been subjected to quality-of-care evaluation. We designed a medical record abstraction system using well-established, specific process-of-care criteria drawn from the medical literature and experts and grouped into three levels of quality: excellent, adequate, and minimal. One hundred seventy-six consecutive patients were identified from the clinic logbook and their medical records abstracted. Deficiencies in history taking, physical examination, laboratory testing, treatment, and public health reporting were identified.

Abstracting and Indexing↗
PubMed2006

[The growing endangerment of specialists in private practice--opening up access to hospital outpatient clinics from the medical specialists' point of view].

The legislator is increasingly disadvantaging medical specialists in private practice by promoting hospital-based ambulatory treatment. It should not be ignored, though, that the office-based specialist covers a range of services which has so far not been provided by hospitals, which means that hospitals will have to cope with an additional demand. In the past, hospitals have not exhausted their options either. For instance, only 5% of all ambulatory surgical interventions are performed in hospitals. Apart from institutionally opening up access of hospitals to ambulatory treatment the legislator has provided the hospitals with further advantages and clearly created distorted competition by introducing the concepts of integrated care and ambulatory healthcare centres. The advantages of the office-based specialists' higher flexibility and management competence will be lost. Ambulatory care will be placed in settings producing the highest costs. A much more reasonable alternative, namely the development of specific models of co-operation will be proposed in the following text.

Germany↗
PubMed1983

The value of the 24-hour urine analysis in the assessment of stone-formers attending a general hospital outpatient clinic.

The daily urinary excretion of calcium, oxalate, uric acid and glycosaminoglycans, and 24-h urinary volume and pH, were measured in 39 normal men and 65 male patients who had formed at least one calcium oxalate stone. No significant difference could be found between the two groups of subjects with respect to any of the urinary parameters. Nonetheless, a higher proportion of stone-formers than normals had daily excretion levels of oxalate in excess of the normal 95th percentile. On the other hand, there was no difference between the proportion of stone-formers and normals who fell into this category with respect to calcium excretion. It was concluded that a single 24-h urine analysis is of limited practical value in explaining the occurrence of stones or in predicting the likelihood of further episodes in unselected stone-formers attending a general hospital outpatient clinic.

Adult↗
PubMed2006

[The growing endangerment of specialists in private practice--opening up access to hospital outpatient clinics from a legal point of view].

There are two new rules of the German Health System Modernisation Act (GMG) affecting the activity of specialists in private practice: the authorization of a hospital according to Sect. 116 a (SGB V; Title Five of the Social Code) subsidiary to the registration of a SHI physicians and the authorization of a hospital-based physician. Negative effects on office-based physician in private practice will only occur if, for example, an ambulatory healthcare centre (MVZ) is being established by the hospital owner. Currently, Sect. 116 b SGB V also does not have any negative impact on office-based specialists. The benefits catalogue according to Sect. 116 b Para 3 SGB V has so far been narrowly defined. And, in the face of the diverging interests within the Joint Federal Committee Health Insurances/NationalAssociation of Statutory Health Insurance Physicians and Health Reform Consensus Act (GKG)--a noticeable broadening of this catalogue is not to be expected. Also, such a broadening of the scope of this catalogue will be counteracted by the fact that no legal right exists to the conclusion of a contract with the health insurance companies and that the health insurers will actually have to additionally reimburse for medical services according to the catalogue of Sect. 116b Para 3 SGB V beyond the total reimbursement budget.

Germany↗
PubMed1994

[A table for converting ICD-9 to ICPC. A common platform for health insurance statistics for primary health care and hospitals, outpatient clinics and specialists' practices].

In 1992 Rikstrygdeverket decided that the analysis of billing systems and certificates of illness issued by the primary and secondary health care services should be based on ICPC. All general practitioners are expected to use ICPC-codes. Doctors working in hospitals and other specialists have already used the ICD-9 classification for many years and did not want to have to use two different encoding systems. To obtain a common platform for statistical analysis, a referral system was necessary to convert ICD-9 codes to corresponding ICPC codes. In this article, the head of project discusses the material and methods used in this project, and summarizes the results and the structure and formats of the referral table. The author also briefly discusses the potentials and limitations when diagnostic codes are converted from ICD-9 to ICPC.

Ambulatory Care Facilities↗
PubMed1995

Physical examinations and laboratory tests in antenatal care visits in Denmark. Do reported practice and current official guidelines concord with results of literature reviews? A nationwide study of the public scheme of shared antenatal care in general practice, centres of midwifery and hospital outpatients' clinics.

OBJECTIVE: To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness. DESIGN: A nationwide cross sectional study based on questionnaires completed by general practitioners (GPs), midwives, and hospital doctors. Physical examinations and laboratory tests in connection with one specific visit were reported. SUBJECTS: The questionnaires were completed by 722 GPs (61% of eligible from a random sample), 584 midwives (86% of eligible), 250 hospital doctors who made health examinations in pregnancy, week 16-18 (63% of eligible), and 181 hospital doctors who saw women with at-risk pregnancies (55% of eligible). RESULTS: General practice: weight, blood pressure (BP) measurement, and test for proteinuria were reported in more than 90% of visits. Urine culture was reported in 46%, and cervical smear in 41% of first visits. Rubella antibody test at the first visit was only reported in 23% of nulliparae. Vaginal examination was reported in 95% of first visits. Fewer were reported in second (27%) and third (48%) routine visits during pregnancy. Midwives: checks of BP, oedema, and proteinuria were reported in more than 95% of visits irrespective of week of gestation. Vaginal examination was reported in about a third of checkups. Hospitals: vaginal examination was reported in 66% of checkups in at-risk pregnancies. CONCLUSIONS: A surplus of resources were spent on (repeat) examinations and tests with little or no documented benefit. Cervical cytology was grossly overused. Urine culture and rubella serology were not sufficiently applied.

Clinical Laboratory Techniques↗
PubMed2007

Swallowing difficulties reported by adults infected with HIV/AIDS attending a hospital outpatient clinic in Gauteng, South Africa.

OBJECTIVE: Swallowing difficulties can exert a profound effect on quality of life, may result in reduced nutritional intake and place individuals at risk of aspiration. However, there is little data available on the swallowing difficulties occurring within the HIV/AIDS population in South Africa. A descriptive study was therefore conducted to document the presence of reported swallowing difficulties in a sample of adults with HIV. PATIENTS AND METHODS: One-to-one semi-structured interview schedules were administered to 120 adults with HIV attending a clinic in Gauteng, and medical records were evaluated to document the presence of reported swallowing difficulties. RESULTS: Participants described a range of swallowing difficulties and the number of swallowing difficulties reported by participants was negatively correlated with CD4 count. Swallowing difficulties were significantly associated with various opportunistic diseases and related medical pathologies. Prescribed medications were associated with reported swallowing difficulties. Treatment of swallowing difficulties was mainly medical in nature. Swallowing difficulties had affected quality of life. CONCLUSIONS: From the results it was concluded that speech therapists have a role to play in the assessment and treatment of swallowing difficulties in individuals with HIV/AIDS.

Acquired Immunodeficiency Syndrome↗