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At least 919 records · Page 51Linked to original sources
PubMed1998

A new national allocation scheme for adult kidneys in the United Kingdom. United Kingdom Transplant Support Service Authority (UKTSSA) Users' Kidney Advisory Group and its Task Forces.

A new allocation scheme for kidneys from adult cadaver donors was introduced in the UK on July 1st, 1998. The new scheme is based on data from an analysis of factors influencing transplant survival instigated by the Kidney Advisory Group (KAG) of the UKTSSA. A cohort of 6,363 first cadaver allografts performed in the UK between 1986-1993 was used for the analysis with 99.6% one-year follow-up and 97.8% 5-year follow-up. HLA matching was one of a number of factors that were found to influence transplant survival, thus supporting the policy of exchange of kidneys based on matching. The new allocation scheme is based on 3 tiers in which cadaver organs are offered first in Tier 1 to patients with zero HLA antigen mismatches (000 matchgrade), in Tier 2 to favorably matched patients, (matched for HLA-DR and mismatched for a maximum of one HLA-A and one-B locus antigen -100, 010, 110 matchgrades) and remaining kidneys in Tier 3 to non-favorably matched patients. A points score devised by a subgroup of the KAG to reflect natural justice and common sense is used as a discriminator between equally matched patients. The points are based on recipient age, donor-recipient age difference, waiting time, matchability for HLA antigens, sensitization to HLA antigens and the transplant unit balance of organ exchange. The performance of the scheme will be closely monitored, but computer simulations predict that there will be an overall improvement in transplant survival as a result of an increase in well matched transplants.

Adolescent↗
PubMedDate not supplied

[Analysis of the flow of users of health services at a diagnostic center].

A marketing investigation was carried out in 1998 in the Yekaterinburg Multiprofile Diagnostic Center in order to detect the problems in the activity of this institution and adopt the managing decisions. A random sampling of 405 subjects was selected, 58.8% of them were examined at the expense of budget financing and 41.2% for extra payment. The results indicate that 50.5% patients consulting the specialists of the Center were in need of diagnosis, 26.2% needed a more accurate diagnosis of a previously diagnosed condition, 9.4% patients consulted for correcting their treatment protocols, 8.4% were followed up at the Center, and 4.9% were examined within the framework of prophylactic check-ups. Half of patients were completely satisfied, about one-third were satisfied partially, and only 2% were not satisfied at the Center. 86.9% respondents aid that they would apply into the Center again, if necessary. The main sources of information of the city and region population were local physicians (52.7%), friends and relatives previously examined at the Center (19.8%). Marketing investigations in public health become an integral part of effective management under conditions of expanding the scope of marketing services in practical medicine.

Adult↗
PubMed1996

[Socioprofessional integration of users of a service teaching work habits].

Programs for the social and professional rehabilitation of people suffering from mental illness are more or less successful. A substantial proportion of people cannot with this help, find or maintain a job; moreover many prematurely leave their rehabilitation program. This retrospective study attempts to identify variables associated to 1) the fact of completing the program and related to 2) maintaining a working activity in a regular environment, once the program is completed. The research is conducted with 67 people registered in an apprenticeship of working habilities program. The study shows that the fact of being in a first stage of socioprofessional rehabilitation is associated with participants staying in the program. The time spent in the program and the participants' level of education are also related to the success of integration. Variables regarding diagnosis are not associated to the different trajectories of the people. Suggestions to adjust intervention are proposed in this paper.

Humans↗
PubMedDate not supplied

[Prescriptions, access, and expenses on drugs among users of health services in Mexico].

OBJECTIVE: To analyze the medical prescription, drug access and drug expenditure by patients based on the National Health Survey in Mexico, 1994. MATERIAL AND METHODS: A descriptive analysis of drug access and expenditure was undertaken and predictive factors for medical prescription were identified by logistic regression for 3,324 patients. RESULTS: 78% of the patients received drug prescriptions. 92% of the Social Security patients and 35% of the Ministry of Health patients received drugs free of charge (p = 0.000). The region with the highest poverty index received the least amount of drugs free of charge. Regarding drug expenditure of patients who purchased drugs, median expenditure was 40.00 pesos (12.50 USD). Private health service patients spent significantly more than public health service patients. CONCLUSIONS: Drug access and drug expenditure are linked to socioeconomic factors and to the institutions attended by patients. The Mexican health system faces, among others, the challenge of increasing the equity of access to medical drugs.

Drug Prescriptions↗
PubMed2005

The attitudes, knowledge and skills needed in mental health nurses: the perspective of users of mental health services.

Knowledge about the practice and roles of mental health nurses in New Zealand is currently limited. In a sociopolitical climate where the views of users of mental health services are increasingly incorporated into education and the planning and delivery of services, there is a need for research that reflects the perspective of users. In this study a qualitative descriptive methodology with focus group interviews was used to explore with users of mental health services, the attitudes, knowledge and skills that they need in mental health nurses. Users of mental health services valued the therapeutic work of mental health nurses, and identified positive attitudes towards users of mental health services as essential in mental health nurses. However, they did not consistently experience a therapeutic approach in their interactions with mental health nurses.

Adaptation, Psychological↗
PubMed2005

Effect of a social services intervention among 911 repeat users.

OBJECTIVE: To determine whether emergency medical services (EMS) 911 frequent users would benefit from social services intervention. METHODS: The design was a descriptive prospective subject evaluation. All nonhomeless frequent EMS users (>3x in 1 month) were identified monthly from December 2 to May 3 and contacted by 2 social workers. Information extracted from their contact with the subjects included demographics, ability to enter a social services intervention, and reason for transport. RESULTS: Eighty-four patients were eligible for inclusion in the study. Seventy-four patients were unable to enter a social services intervention for the following reasons: not home (2x) (26%), not at address (19%), refused (13%), unable to complete Mini-Mental Status Exam (10%), deceased (6%), hospitalized (5%), safety issues (4%), and others (10%). The reasons for frequent EMS use were cardiac (24%), asthma/chronic obstructive pulmonary disease (25%), seizures (14%), dialysis problems, alcohol problems, and diabetes-related problems (<10% each). CONCLUSION: Among all patients, the primary reasons for transport were cardiac, asthma/chronic obstructive pulmonary disease, and seizures. Only 12% of patients contacted could enter a social services intervention. On the basis of the small cohort of patients that were able to enter a social services interventions, more targeted interventions are warranted.

Adolescent↗
PubMed1982

Effects of cost-sharing on users of a state's health service program.

This study analyzed some of the effects of the introduction of cost-sharing on users of the state's health service program. The study population had previously received services at no charge and consisted of people with provider-determined medical need, and included, but was not limited to people in financial need. The study sample was selected from 3 years of program service records (1977-1980). Sampling was random and stratified by key variables. Time-series analysis as well as pre/post-policy comparisons were employed. Analysis of changes in the distributions of service user characteristics and in services provided indicated that use of services was not affected adversely and that lower-income, medically needy people were not deterred from using services following the introduction of cost-sharing. Limitations to the study are reviewed, and implications of using cost-sharing in programs such as Medicaid are considered.

Adolescent↗
PubMed2005

Quality of care of modern health services as perceived by users and non-users in Burkina Faso.

OBJECTIVE: Only one-fifth of the population in rural Burkina Faso uses modern health services. This article aims to identify barriers to increased use, which may help decision makers to develop policies to remove them. DESIGN: This article compares perceived quality of care of 853 pairs of users and non-users of modern health services. Non-users were matched to users on age, sex, occupation of the head of the household and distance to health post. Questions were structured according to four dimensions of quality of care. SETTING: Nouna health care district, Burkina Faso. RESULTS: Both users and non-users were relatively favourable about health personnel practices and conduct (77% versus 70% of the maximum attainable score), and about health care delivery (77% versus 74%). They were less favourable about adequacy of resources and services (51% versus 46%), and financial and physical accessibility of care (57% versus 51%). Both groups were very negative regarding the availability of drugs (33% versus 27%). Users were more favourable than non-users overall (66% versus 61%), and especially regarding payment arrangements (51% versus 43%) and costs (50% versus 40%). Observed differences were generally significant. CONCLUSION: To remove barriers to increase utilization, policy makers may do good to target their attention to improve financial accessibility of modern health services and improve drugs availability. These factors seem most persistent in decisions of ill people to stay with home-based care and/or traditional medicine, or go to consult modern health services.

Adolescent↗
PubMed1996

The value of an outcomes information resource. An evaluation of the UK Clearing House on Health Outcomes.

Reports on the first phase of an evaluation of the UK Clearing House on Health Outcomes (UKCHHO) undertaken by a sample survey of purchasers and providers on its mailing list and users of its enquiry service. Explores user satisfaction with the services and publications of the project, uses made of the information provided and perceptions of the future role of a UKCHHO. Reports overwhelming satisfaction with the enquiry service and agreement about the usefulness of Outcomes Briefing. States that the main areas of use for the information provided were within clinical audit, guidelines and the exploration of outcomes within routine clinical practice. Also that the findings provide evidence of the need for an expanded brief for a UKCHHO, to include the provision of an enquiry service on study design and demonstrations of the value of the collection of outcomes data. Notes there is an urgent need to show that the systematic collection and use of outcomes data makes a difference to the quality of care provided to patients and to the purchase of services.

Attitude↗
PubMed2006

[Gender violence and other factors associated with emotional distress in female users of public health services in Mexico].

OBJECTIVE: To identify and describe the factors associated with emotional distress in a national sample of women users of public health services in Mexico, such a Secretaria de Salud (SSA), Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE). MATERIAL AND METHODS: This research study was conducted using the database of the National Survey of Violence against Women that consisted of the responses of a total of 26 042 female users of health care services provided by the Mexican government health agencies. The Personal Health Scale (ESP per its initials in Spanish) was used to assess emotional distress. To measure violence a 19-item scale which explores different types of violence as well as severity was used. The relationship between emotional distress and gender violence was determined through a binary logistic regression model, as were economic status and demographic variables. RESULTS: One of the most important findings of this study is the high prevalence of emotional distress (15.3%) among women seeking health care services from the public sector and the relationship of such emotional distress with the experience of marital physical, psychological, and sexual violence. Factors associated with emotional distress among female users of health care services were age (26 and older); activity (laborer); working hours (71 hours a week or more); alcohol intake (greater intake); abuse during childhood (frequency and types of abuse); severity of marital violence (severe violence); socioeconomic status (very low SES); and type of dwelling (urban). CONCLUSIONS: The principal predictor of emotional distress was intimate partner abuse, especially in severe expression. The next predictor was violence in childhood. Taking into consideration these predictors it is recommended to use screening instruments to identify emotional distress and gender violence in health setting. It is important to design and implement attention and reference programs in public health services for women suffering from emotional distress and gender violence.

Adolescent↗