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At least 649 records · Page 36Linked to original sources
PubMed1983

Assessment of transportability of a perinatal education program.

We evaluated a perinatal outreach education program to determine its "transportability" (usefulness to other regional centers). Three kinds of data were available from seven regional centers: (1) participation in the program by health care providers, (2) changes in cognitive knowledge, and (3) changes in neonatal care practices. Data were obtained from 2,735 program participants and from retrospective chart review of 2,781 at-risk babies born in participating hospitals. Analysis showed that results were comparable when the program was used by six regional centers from two states and when it was used by the regional center that originally developed the program. We therefore concluded that the Perinatal Continuing Education Program is transportable.

Education, Continuing↗
PubMed1999

Service delivery for patients with HIV in a rural state: the Vermont model.

The incidence of human immunodeficiency virus (HIV) infection is increasing rapidly in rural areas of the United States. Barriers to health-care delivery for this patient population include the complexity of this rapidly changing field, inexperienced rural physicians, long travel distances to receive expert care, lack of psychosocial support systems, and concerns about confidentiality. Models of HIV care for rural areas have not been developed that remove these barriers. We present the philosophy, structure, implementation, and services of a model of care in Vermont that is designed to remove many of these barriers and bring HIV expertise into the rural areas of the state. Three HIV specialty clinics have been developed in regional hospitals throughout the state. The clinic team includes an HIV-trained nurse practitioner and social worker from the hospital, a client consultant from the regional AIDS service organization, and an infectious disease specialist who travels to each of the clinics monthly. Patient care will be centralized in these regionally located clinics. The dispersion of HIV care among numerous and inexperienced rural providers will be obviated. Confidentiality will be emphasized within the hospital environment. The model has the potential to provide a complete continuum of medical care and psychosocial case management, integrate patient care and regional provider education, and increase community awareness. Patients will be able to receive their care in their own community, avoiding long travel distances. This may encourage patients to seek care earlier in their illness. The model may be adaptable to other rural areas of the United States.

Case Management↗
PubMed1984

[Obesity as a current social problem].

The increasing prevalence of overweight and obesity, the classification of the population whose age is the most favourable for working activities as patients, considerable prevalence of the disease among children and young people, the disease progress and severe complications make obesity one of the most important problems today. The development of obesity and complications is mainly caused by energy imbalance which gets aggravated in subjects manifesting lipid metabolism pathology. Disorders in the character and rhythm of nutrition are most remarkable in cases of obesity complicated by cardiovascular pathology, diseases of the hepatobiliary system, diabetes mellitus, and so forth. Taking into consideration the significance of the problem of obesity the Institute of Nutrition, Academy of Medical Sciences of the USSR, developed a program of measures whose realization will favour the solution of the Food Program.

Adolescent↗
PubMed1985

Consumer products and hospitalized burn injuries among elderly Massachusetts residents.

This study is based on data for Massachusetts residents who were burned between July 1, 1978 and June 30, 1979 and who were treated as hospital inpatients in any of the 240 hospitals participating in the New England Regional Burn Program. Demographic information and information regarding the nature of the burn injury and consumer products involved were obtained by review of the medical record for each case. One hundred seven (9%) of the 1237 burn victims identified were aged 65 years or older, yielding a burn incidence rate equal to 15.5 burns per 100,000 person-years compared with a rate of 23.8 burns per 100,000 person-years for younger Massachusetts residents. The burn mortality rate for the elderly who survived long enough to be hospitalized was 2.6 deaths per 100,000 person-years compared with a rate of 0.4 deaths per 100,000 person-years for younger individuals. For survivors, the average length of hospital stay for elderly victims was 28.6 days compared with 12.0 days for younger individuals. Clothing ignition, stoves and ovens, smoking materials, and bathroom showers and tubs contributed significantly to the causes of burning among the elderly. In addition, evidence was found suggesting that elderly patients receive medical care relatively later after injury, thus considerably complicating their illness.

Age Factors↗
PubMed1993

Neonatal transport. Outreach educational program.

Neonatal transport is an integral part of a regionalized system of perinatal health care delivery. An effective outreach educational program promotes early identification of high-risk neonates, consultation, communication, and referral. The education offered in several formats also promotes optimal pretransport and intratransport stabilization of referred neonates. This improved stabilization may favorably influence the overall neonatal outcome. The impact of education in the region can be determined by a systematic review of referral patterns, standard of care during stabilization, and neonatal outcome. An organized outreach educational effort is therefore an essential aspect of any neonatal transport program.

Documentation↗
PubMed2004

Regionalized perinatal care in North America.

The aim of this article is to familiarize the reader with the status of regionalized perinatal health care in North America, and specifically in the United States of America, using the Iowa regionalization model. The evolution of the regionalization movement in the late 1960s and early 1970s is reviewed. It is noted that the movement was largely without federal government intervention. The role of the March of Dimes in developing the first set of so-called national guidelines is chronicled. The Iowa model, utilizing some non-tertiary referral centres, is discussed in depth. This model included extensive outreach education for the entire state, and worked well largely because of the lack of competition to the major university teaching hospital located at the University of Iowa in Iowa City. This was not true for many other states and regions because competition did exist between tertiary centres. The impact of managed care systems on the overall role of regionalization is discussed. Suggestions are offered for controlling the impact of third-party payers (managed care) on the quality of perinatal health care. An idealized system of monitoring the impact of regionalization and monitoring the effect of managed care is detailed. Finally, the future of regionalization is discussed in the face of deregionalization in populous areas. The need for the best possible care as close to patients' homes as possible (regionalization) still seems apparent.

Female↗