PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Ambulatory Care”

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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1979

A health education model for ambulatory care.

Nurses in this ambulatory care center recognized a need for a systematic, planned approach to health education, and developed a health education model. The nurses on the committee serve as inhouse consultants to help other nurses develop, implement, and evaluate health education programs.

Ambulatory Care↗
PubMed1978

Assessing technical performance at diverse ambulatory care sites.

The purpose of the large study reported here was to develop and test methods for assessing the quality of health care that would be broadly applicable to diverse ambulatory care organizations for periodic comparative review. Methodological features included the use of an age-sex stratified random sampling scheme, dependence on medical records as the source of data, a fixed study period year, use of Kessner's tracer methodology (including not only acute and chronic diseases but also screening and immunization rates as indicators), and a fixed tracer matrix at all test sites. This combination of methods proved more efficacious in estimating certain parameters for the total patient populations at each site (including utilization patterns, screening, and immunization rates) and the process of care for acute conditions than it did in examining the process of care for the selected chronic condition. It was found that the actual process of care at all three sites for the three acute conditions (streptococcal pharyngitis, urinary tract infection, and iron deficiency anemia) often differed from the expected process in terms of both diagnostic procedures and treatment. For hypertension, the chronic disease tracer, medical records were frequently a deficient data source from which to draw conclusions about the adequacy of treatment. Several aspects of the study methodology were found to be detrimental to between-site comparisons of the process of care for chronic disease management. The use of an age-sex stratified random sampling scheme resulted in the identification of too few cases of hypertension at some sites for analytic purposes, thereby necessitating supplementary sampling by diagnosis. The use of a fixed study period year resulted in an arbitrary starting point in the course of the disease. Furthermore, in light of the diverse sociodemographic characteristics of the patient populations, the use of a fixed matrix of tracer conditions for all test sites is questionable. The discussion centers on these and other problems encountered in attempting to compare technical performance within diverse ambulatory care organizations and provides some guidelines as to the utility of alternative methods for assessing the quality of health care.

Adolescent↗
PubMed1978

Marketing ambulatory care.

A number of environmental factors are bringing about the "day of the vertical patient"--making the providing of comprehensive ambulatory care important for a hospital's survival. Careful design and implementation of ambulatory care programs must be accompanied by equally well-considered marketing strategies.

Ambulatory Care↗
PubMed1977

Quality assurance in ambulatory care.

This article is one example of how a more simplified audit system for evaluating patient outcomes can be implemented and can be applied to an ambulatory care setting. Quality assurance activities are here to stay, either as a result of our feeling a professional obligation to monitor our own practice in relationship to the public we serve, or as a result of pressure from consumers and third-party payers. I prefer to believe that as professionals, we do recognize our obligation to be accountable for our actions, and that only we can set the standards of practice to which we will be held accountable. Through the development of criteria for care, we are able to establish these standards of practice. In complex care settings such as our Ambulatory Care Service, the CMA/CHA audit process is a reasonable approach to assuring quality by looking at patient outcomes. This process supports the team approach to patient care, is a less expensive method because less time is required to orient personnel to the audit process, and meets JCAH requirements for accreditation.

Ambulatory Care↗
PubMed1979

Consumer impact of a Cold Self-Care Center in a prepaid ambulatory care setting.

A Cold Self-Care Center was developed to be an alternative to professional care and to encourage more active involvement of consumers in their own care. A sample of the self-selected user population (n = 74) was studied by comparison with a random sample of plan members (n = 104), and the program was evaluated for cost, consumer satisfaction, and impact on behavior, knowledge and attitudes. Users demonstrated higher levels of knowledge about cold care than non-users, indicated more dependency on professional resources, and differed in health-related attitudes and cold-care behavior. The Cold Self-Care Center appears to have had little impact on self-medication behavior. However, it did affect care-seeking behavior. Knowledge of criteria for seeking professional care was greater than in non-users; 20 per cent sought professional care, and 6 per cent anticipated seeking professional care for future colds. General satisfaction with the program was quite high. Speed and ease of use were cited most often as reasons for satisfaction. The Center also was demonstrated to have a favorable impact on clinic costs. A flexible system which is convenient to use and which retains access to professional care when appropriate both can relieve clinic overload and meet the needs of a large percentage of cold patients.

Common Cold↗
PubMed1976

The reform of ambulatory care: a financial paradox.

The purpose of this paper is to examine the financial factors which have effectively constrained the movement toward major reform in the out-of-hospital medical care area within this country. Analysis of the current economic picture in the health field leads inescapably to the conclusion that the major wave of new out-of-hospital programs predicted in the early 1970s is not likely to occur in the immediate future. The financial constraints are so substantial that the expansion of new forms of delivering ambulatory care services (HMOs, restructured OPDs, neighborhood health centers, etc.) into low- and moderate-income communities will proceed more slowly than was originally anticipated. The facts outlined in this paper clearly indicate that many new ambulatory care projects designed to serve low- and moderate-income people will face serious financial difficulties and will place a heavy burden on the resources of sponsoring institutions. In the future, widespread reform in the out-of-hospital area will await major improvements in the way this country finances its ambulatory care services.

Ambulatory Care↗
PubMed1977

The CR Alpha Diagnostic Coding System for ambulatory care.

A three-digit code system for patient encounters in ambulatory care was constructed to meet the criteria of integrity, retrievability, flexibility, and acceptability. The system is distinguished from other comparable codes by the use of an alphabetical letter as a category designator, the provision of "open" areas within each category for the addition of new rubrics in appropriate sequence, and the availability of "open" categories for use in research or expansion. The system has the capacity to expand from 22 primary categories to 97 subheadings and to a maximum of 3,200 rubrics. The system uses both diagnostic and symptom-oriented rubrics. The diagnostic terms are adopted from the International Classification of Diseases, Adapted, Eighth Revision (ICDA-8) and the symptoms from the National Ambulatory Medical Care Survey Symptom Classification.

Ambulatory Care↗
PubMed1978

The Johns Hopkins ambulatory-care coding scheme.

A classification and coding system for ambulatory-care problems has been developed at the Johns Hopkins Medical Institutions and three affiliated institutions. The provider's statement of the patient's problem, as recorded on an encounter from, is kept in a computer file. Codes from the classification scheme, based on those used in four existing schemes, are automatically assigned to diagnoses, symptoms, well-care services, and treatment procedures categorized by physiological system and subsystem. About 85 percent of recorded problems are machine-codable; the remainder are alphabetized for efficient manual coding. The coding system is integrated with an overall information system that allows linkage of coded problem data to diverse data on patient and provider characteristics. Examples are given of the uses and limitations of the linked data for care evaluation, management, and clinical research.

Adolescent↗
PubMed1979

Evaluating ambulatory care: three approaches.

The article describes three approaches to establishing an ambulatory audit program for nursing. These approaches are variations of a single methodology--that of the Joint Commission on Accreditation of Hospitals--used by the University of Minnesota Hospitals and Clinics. The authors discuss three audit topics from ambulatory care; postkidney transplant; desensitization; and well child.

Ambulatory Care↗
PubMed1975

Impact of physician's assistants on patient visits in ambulatory care practices.

The addition of a physician's assistant to an ambulatory care practice increases the practice's productivity. Practices using physician's assistants (medexes) had a 12% increase in the number of patient visits during the first year of training and 1 3/4 years later had an average increase of 37%. The medex by himself provided care to 28% of the patients and, in company with the physician, to another 10%. No consistent changes across practices were noted in patient waiting times or time physicians spend with patients.

Acute Disease↗
PubMed1977

A method for analyzing resource use in ambulatory care settings.

The major objective of this research is to develop a methodological framework to help analyze the use of resources in ambulatory care environments. Emphasis is placed on trying to understand reasons for variation in treatment patterns. Important methodological considerations include: 1) the selection of a set of medical problems appropriate for evaluating the interaction effects of the variables being considered; 2) the development of problem-specific computerized routines for defining episodes of care based on patient visit information; and 3) the selection of appropriate measures of utilization. The Frontier Nursing Service (FNS) was used as a study setting. FNS is a primary health care service and training center located in Leslie County in eastern Kentucky. an area that covers 1,000 square miles with a population of approximately 15,000. The analysis indicates that for common primary care problems, the level of provider training as well as accessibility of services significantly influence patterns of care.

Ambulatory Care↗
PubMedDate not supplied

Allocation of resources for ambulatory care -a staffing model for outpatient clinics.

The enormous commitment of resources to ambulatory health care services requires that flexible and easily implementable management techniques be developed to improve the allocation of health manpower and funds. This article develops a feasible model for staffing outpatient clinics and thereby potentially provides an important analytical tool for allocating and monitoring the utilization of the most critical and expensive of ambulatory care resources-professional and nonprofessional clinic personnel. The model is simplistic, extremely flexible, and can be applied to many modes of delivering ambulatory care-from HMOs to traditional hospital outpatient clinics. To employ the model, certain decision variables must be specified so that the model can produce a least-cost staffing configuration to meet the demand for service in accordance with the desired mode and intensity of care. The key decision varables that require input from administrators and medical personnel include standards for physician-patient contact time, a desired ratio of staff time actually spent treating patients to total paid staff time, and the desired mix of various staff categories to achieve program objectives. Specific benefits of using the model include determining staffing for new, expanded, or existing outpatient clinics, determining budget requirements for such staffing needs, and providing quantitative productivity and utilization objectives and measurements.

Ambulatory Care↗