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At least 19 recordsLinked to original sources
PubMed1988

End of an experiment: report from an inner city community hospital.

Community hospitals are associated with the provision of health care in rural rather than urban areas. However, the urban community hospital can reduce the pressure on acute hospitals and decrease the isolation of community health workers. In 1982 a community hospital was established in an inner London health district. This paper examines the role and function of this hospital over a oneyear period in 1986-87 and makes comparisons with the hospital's first two years of operation. The problems identified in the initial evaluation, such as low bed occupancy and the limited participation by general practitioners in the area, were still present. It was found that there had been a decrease in the number of patients treated for musculoskeletal, nervous system and respiratory problems but an increase in circulatory disorders and injuries or poisoning. There was also a marked decrease in the percentage of acute admissions but an increase in admissions for convalescence, rehabilitation and carer relief. Following a severe financial crisis in the health district the hospital was closed temporarily in November 1987.

Attitude of Health Personnel↗
PubMed1980

Product-market differentiation: a strategic planning model for community hospitals.

Community hospitals would seem to have every reason to identify and capitalize on their product-market strengths. The strategic marketing/planning model provides a framework for rational analysis of the community hospital dilemma and for developing sensible solutions to the complex problems of accelerating hospital price-inflation.

Fees and Charges↗
PubMed1994

Assessing Catholic community hospitals versus nonprofit community hospitals, 1989-1992.

Catholic community hospitals are becoming more like nongovernment, not-for-profit community hospitals of a similar bed size located in the same states. After controlling for state, urban-versus-rural location, and bed-size range, a matched set of 303 Catholic community hospitals are compared with nongovernment, not-for-profit community hospitals. This empirical study documents that the average 1992 Catholic hospital is less profitable, with older equipment, and treats more Medicare patients than the average matched community hospital.

Catholicism↗
PubMed2006

Free tissue transfer: comparison of outcomes between university hospitals and community hospitals.

BACKGROUND: In university hospitals, free tissue transfer has become a standard method of reconstruction for a broad spectrum of defects. Because of its complexity, free tissue transfer has not been routinely performed in a community hospital setting. This study reports the outcomes of two equal groups of free tissue transfer performed by the same surgeons, comparing the university versus the community hospital setting. METHODS: A total of 735 free tissue transfers were performed at one university hospital and six community hospitals in our region over a 10-year study period. Outcome parameters used in this study included wound complications such as infection, dehiscence, delayed healing, hematoma, and fat necrosis. RESULTS: A total of 674 operations were performed using 735 free tissue transfers: 386 free tissue transfers were performed at the university hospital (53 percent) and 349 (47 percent) were performed at the community hospital. Categories of free tissue transfer reconstruction included breast, lower extremity, head and neck, and upper extremity reconstructions. Most of the breast reconstructions were performed in the community hospital, whereas most of the lower extremity and head and neck reconstructions were performed at the university hospital. Fifty-one major postoperative complications occurred in the university hospital (14 percent), while 31 (10 percent) occurred in the community hospital. Complication rates did not differ significantly between settings; however, there was a trend toward more wound infections in the university hospital and more cases of fat necrosis in the community hospital, most likely reflected in the differing case mix between hospital settings. CONCLUSION: Free tissue transfer is an effective and practical method of reconstruction that has been safely performed in both university and community hospital settings.

Academic Medical Centers↗
PubMed1990

Cardiac services find a new home in community hospitals.

Community hospitals increasingly are entering the cardiac-care business, with hopes of enhancing their public image, increasing revenues and winning managed-care contracts. But some question whether advanced services such as cardiac catheterization and open-heart surgery are profitable for smaller hospitals, or even medically appropriate.

Cardiac Catheterization↗
PubMed1978

A medical education program strategy for community hospitals.

Community hospital physicians, nurses, and other health care practitioners should be involved in their institution's educational planning activities. Strategic planning that considers both internal and external pressures is required. All programs should have clear, measurable goals; be flexible; and subjected to continuous reassessment. All efforts must be related to quality of patient care as judged by community standards.

Education, Medical↗
PubMed2005

Utilization of hospital services among older rural persons: a comparison of critical access hospitals and community hospitals.

Critical access hospitals (CAHs) are intended to improve the accessibility of local emergency and short-term inpatient services, but limited research has evaluated their effects on hospital service utilization. This article asks whether the utilization of hospital and emergency room services differs between older persons residing in rural areas with a CAH versus a community hospital. Information about the utilization of hospital and emergency room services as well as demographic, health insurance, and health status factors were abstracted from a large population-based survey of community-dwelling elders (age 65 and older) residing in West Texas. The frequencies of hospital inpatient and emergency department admission do not differ between older persons who reside in counties with a CAH and a community hospital. These findings support the broad goals of the program and illustrate how Medicare can effectively support healthcare systems under fiscal stress.

Aged↗
PubMed1995

Comparison of unscheduled hospital admission following ambulatory operative laparoscopy at a teaching hospital and a community hospital.

The objective was to identify and compare causes of unscheduled admission following ambulatory major operative gynecologic laparoscopy in a university hospital and a community hospital setting. Each patient admitted on an unscheduled basis was compared with 2 patients who did not require admission. Twenty-seven variables were evaluated by univariate analysis. Significant factors (p < 0.5) were analyzed by multivariate stepwise logistic regression. Patients admitted at the university hospital were compared with patients at a community hospital. In a 7-year period, 43 patients at the University of Mississippi Medical Center and, in a 6-year period, 30 patients at Gilmore Memorial Hospital required unscheduled admission following ambulatory major operative gynecologic laparoscopy. Site-specific analysis was performed, and these groups also were combined for analysis. The only factor associated with admission by multivariate analysis was estimated operative blood loss. Postoperative emesis was the most common reason for unscheduled admission at both hospitals and occurred in 27 patients. An additional 17 patients were admitted because of the severity of postoperative pain. Operative blood loss seems to be associated with extensive operations. Furthermore, increased blood loss typically leads to a very conservative approach to the postoperative patient, whereas minimal blood loss allows patients to be managed in a routine fashion. Patients at the university hospital seem to be generally comparable to patients at a community hospital. Postoperative nausea and pain resulted in over one half of admissions. Successful therapy for nausea and pain may reduce unscheduled admissions.

Ambulatory Surgical Procedures↗
PubMed1981

Outpatient pharmaceutical services in academically affiliated hospitals and selected community hospitals.

The outpatient pharmaceutical services provided by university or medical school-affiliated hospitals and those offered by community hospitals were compared. A questionnaire was sent to a sampling of hospitals that had full-time pharmaceutical services. The hospital pharmacists were asked how frequently they performed 13 patient-oriented services. Four hundred community hospitals from 13 western states and 95 university hospitals nationwide were surveyed. The four null hypotheses tested were: (I) There is no difference between university and community hospitals in mean frequency of patient-oriented pharmaceutical services; (II) the mean frequencies of patient-oriented services are independent of hospital bed capacity; (III) the mean frequencies of patient-oriented services are independent of whether or not clinic outpatients are served by the outpatient pharmacy; and (IV) the mean frequencies of patient-oriented services are independent of the number of full-time equivalent pharmacists employed by the pharmacy. Performance of the 13 patient-oriented services was almost parallel for both the university and community hospitals. The only service that demonstrated a significant difference (p less than 0.05) between the two groups was "prescribing and renewing medication at the request of the physician." The most frequently performed services were to give patients oral medication instructions and drug information for the medical staff. Null hypothesis I was not rejected. A four-way analysis of variance was performed on null hypotheses II, III, and IV; II and III were rejected (alpha less than or equal to 0.05). Nevertheless, a one-way analysis of variance, post-hoc test, and t test revealed that the performance of patient-oriented services was more frequent in hospitals with less than 100 beds and in hospitals that provided outpatient services to clinic patients. Null hypothesis IV was not rejected.

Hospitals, Community↗
PubMed1983

Cooperative groups and community hospitals. Measurement of impact in the community hospitals.

The Eastern Cooperative Oncology Group, composed of major cancer treatment centers, has an outreach program which involves community hospitals in ongoing cancer clinical trials. A prevalence survey was carried out in February 1981 among 104 community hospitals and 21 member institutions to determine the characteristics of patients being treated, their staffing, and reasons why patients were not on protocol studies. The survey sampled 25 (50) consecutive patients from community hospitals (member institutions). The purpose of the study was to assess the impact of a community cancer control program. The results of the study demonstrated that 16% of patients surveyed in the affiliated community hospitals were being treated on a research protocol. In addition, a further 35% had their treatment plan influenced by a protocol. Consequently protocols have impacted directly or indirectly on 51% of the patients. The corresponding figures in member institutions were 23% and 38% for a total of 61%. In studying protocol availability, it was found that 66% of all patients were ineligible for any protocol. Of patients eligible for a protocol but not registered on one, 52% were not registered because of physician preference for a specific treatment. The affiliates surveyed were shown to be on average half as large as member institutions in terms of number of beds and staff size. Also, staff/patient ratios are generally smaller in the community hospitals. The median age of patients was considerably lower than SEER incidence data. Also, elderly patients were slightly more prevalent in community hospitals than in member institutions. A clear relationship between disease stage and age in breast cancer patients was noted with the representation of early-stage disease much higher in young women.

Adult↗
PubMed1988

Diagnostic yield of the autopsy in a university hospital and a community hospital.

To determine the extent to which autopsies yield unexpected findings that are relevant to the patient's death and whether cases with a high yield of such findings can be identified selectively, we studied a total of 233 autopsies at a university hospital and at a community hospital. The rates at which autopsies detected major unexpected findings whose premortem diagnosis would probably have improved survival were 11 percent at the university hospital and 12 percent at the community hospital. Major unexpected findings whose premortem diagnosis would not have prolonged survival were found in another 12 and 21 percent of cases, respectively. Pulmonary embolism and fungal infections in immuno-compromised hosts were the most common major unexpected findings. Neither we nor the patients' physicians were able to identify from the clinical data the autopsies likely to have high yields. Furthermore, the physicians' estimates of an autopsy's expected yield were similar for patients evaluated by autopsy and for matched patients who were not. We conclude that the autopsy continues to yield clinically relevant findings at a high level and that it is not currently possible to predict which cases will have high yields. Autopsies are vital to ensure the quality of medical care, and autopsy rates must be increased substantially if this role is to be fully realized.

Adolescent↗
PubMed1980

Evaluation of television consultations between a large neonatal care hospital and a community hospital.

Two-way television consultations between community hospital nurses and neonatologists at a nearby teaching hospital were conducted over a two- and one-half year period of time and were evaluated with respect to a baseline time period in which the television was not available. Screening for illness and prematurity in neonates occurred in a high risk population residing in a black, economically deprived, innercity area. Outcomes including transfer of sick babies from the community hospital to the large teaching hospital are analyzed in relation to prenatal maternal risk characteristics. Apgar scores, birth weight and gestational age. Evidence available suggests that television consultations facilitated formation of appropriate criteria for interhospital transfer and that routine clinical screening tests were performed more consistently following initiation of interhospital consultations.

Age Factors↗