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At least 595 records · Page 33Linked to original sources
PubMed1999

An international perspective on the well being and health care costs for patients with systemic lupus erythematosus. Tri-Nation Study Group.

OBJECTIVE: To compare health care expenditure and health status for patients with systemic lupus erythematosus (SLE) between nations with distinct mechanisms for funding and delivering health care services. METHODS: Seven hundred eight patients with SLE from 2 centers in each of 3 countries (Canada 229, United States 268, United Kingdom 211) underwent physician assessment of disease activity and damage and reported on physical and psychosocial well being, satisfaction, social support, and health resource utilization. To compare overall utilization, constant prices (1997 Canadian dollars) were applied across countries for each service, enabling diverse resources to be collapsed into a single expression. RESULTS: After adjusting for important patient covariates, Canadian, compared to American and British patients, reported significantly superior health status in 3 of 8 Medical Outcome Survey Short Form-36 (SF-36) subscales, the SF-36 physical component summary score, and the visual analog scale of general health status. There was no consistent trend in patient satisfaction. Overall annual resource utilization did not vary significantly, with mean annual per patient expenditures (adjusted for demographics, disease duration, activity, damage, social support, health status, patient satisfaction, and age and sex adjusted country-specific SF-36 general population norms) totalling $4853, $5285, and $4760 for Canada, US, and the UK, respectively. However, within each resource category, differences were observed. Canadians saw more specialists than the British, the British more generalists. Canadians and Americans were more frequent users of the emergency room; Americans of laboratory/imaging procedures. Canadians had higher hospital costs than Americans. CONCLUSION: After adjustment, Canadian patients reported better well being than their counterparts. Despite considerable differences in the mechanisms of health care funding and service mixture, overall resource utilization did not vary significantly between the countries, although there was a trend towards more intense use of inpatient services in Canada and outpatient services in the United States.

Adult↗
PubMedDate not supplied

Pediatricians' opinions about the problems between the departments of pediatrics and child psychiatry and possible solutions.

The necessity of collaboration between the Departments of Pediatrics and Child Psychiatry is an accepted idea. However, relevant literature reveals that collaboration between the two departments is not satisfactory. Rearrangement of relations between the two departments in Hacettepe University Ihsan Doğramaci Children's Hospital has been designated a goal. An education program will be planned accordingly. A questionnaire was designed to determine 65 pediatricians' knowledge, thoughts, expectations and needs about collaboration between the two departments; all were working in Hacettepe University Children's Hospital, in inpatient services, outpatient clinics or emergency services. An education program for consultation-liaison activities has been constituted to achieve the desired results. Efficacy of the program was discussed considering the features and tendencies of the two departments.

Adult↗
PubMed2003

[Comparative study of centralized and decentralized outpatient surgical services].

The results of work of decentralized and centralized out-patient surgical service in two regions of the city of Novokuznetsk are compared. The authors make a conclusion that the centralized out-patient surgical service has a number of advantages as compared with the decentralized service since it allows to concentrate the material resources, to improve the staff of specialists, to widen the volume and spectrum of the medical care and makes prerequisites for profitable work of the institution under conditions of the market relations and competition.

Ambulatory Care↗
PubMed1991

[Outpatient emergency services].

Emergency is felt very differently according to the level of education, and the sensitivity of the patient and his family circle. Pain is often the alarm but a physician only is able to appreciate the seriousness and the development of a seriously threatening emergency, which slowly evolves in their beginning but becomes degraded afterwards. The only victims who are operated on the first hour, the golden hour, take chance to survive. But there are only 2 or 3 golden minutes to rescue a cardiac arrest. Quicker an effective treatment is done, better the results are. If time is lost, a tissular hypoxia settle and lead to multiple organ failure especially in the brain. Then the dead come in more or less longer time whatever it is done: it's the irreversible shock which drive to the brain death. In the beginning the only patient and his family circle are able to do something. From that you can understand the importance of public education and alert organization for getting suited and early aid. The attending physician have to educate his patients as they are able to recognize the signs of a real seriousness. Telephone play an essential role especially because the dial 15 for health free call is now put in service in France. The phone questioning allows medical regulation of "SAMU-15" (EMS-dial 15 Centre) to dismiss most of the ill-founded calls and to carry the patient in an hospital able to immediately treat him efficiently. The emergencies organization is inspired by two principles: 1. without any loss of time all patient shall fully treated, possibly on the spot. 2. effective intensive care shall be done to avoid tissular hypoxia. Hence the rescue medicalization and the emergency medical system. These principles are the basis of organization of french SAMU whom control role is also to inform the receiving hospital for preparing the reception. The 6.1.1986 french law had defined the emergency medical system, legalizing the SAMU, and fixing their role in connection with policy and firemen. The equipment of ambulances is well standardized and they should radio connected with SAMU. Helicopters may give inestimable service to carry patients in well equipped center as U.S. trauma centres. Small hospitals should only treat small emergency according their means in personnel and equipment.

Emergencies↗
PubMed1989

[The evaluation of the operation of and the pathology cared for at a rural outpatient emergency service].

We investigated the emergency service at Reinosa to evaluate the following: equipment, characteristics, performance (policies, criteria of use of transport), and the type of the attending patients, demand for care and severity. Attention was given to 8,039 patients, with a monthly mean of 674,416 +/- 21,750 and male predominance. The severity index was distributed between "consultation" (48.36%) and "emergencies" (51.44%). The conditions with a higher demand for care were: accidents, trauma, poisoning and aggression injuries; and respiratory, infective and parasitic diseases. 3.66% of patients were referred to the hospital, using ambulance (57.3%), private means of transportation (32.2%), and mobile intensive care unit (10.4%). Our study shows that 96.34% of the demand can be correctly cared for with an adequate equipment. This type of services should be encouraged as they are highly cost effective from the social, health care and economic points of view.

Age Factors↗
PubMed1989

Growth in outpatient PT services aids consumers.

More physical therapy is being offered outside the hospital setting, and health care experts expect this trend to continue as providers plan to expand their services to meet the needs of an increasingly fitness-minded, health-conscious society. In addition, don't miss the exclusive consumer data on who's using physical therapy services.

Data Collection↗
PubMed1989

[A microbiology clinic in outpatient gynecologic service].

The authors report on their experiences gained at the sexually transmitted disease clinic they established at the First Department of Obstetrics and Gynecology of Semmelweis Medical University. A total of 456 patients presenting with signs and symptoms of lower genital tract infection have been examined in one year. The investigation of patients included aerobic and anaerobic culture of vaginal bacteria, vaginal smear and the identification of sexually transmitted Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasmatales and Gardnerella vaginalis. The authors conclude that a sexually transmitted disease clinic is appropriate to contribute to the prevention of horizontal and vertical spread of the sexually transmitted bacterial infections.

Ambulatory Care Facilities↗