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At least 19 recordsLinked to original sources
PubMed1977

The continuing emergency care clinic: improving patient compliance with follow-up care.

Traditionally, emergency patients have been noted for high rates of noncompliance with appointments in outpatient clinics for follow-up care. S study of cases referred for follow-up care at the outpatient clinic of The Medical College of Pennsylvania showed that less than 20% of the patients kept their appointments. To cope with this problem, a Continuing Emergency Care (CEC) clinic was established on the assumption that a change in structural environment could change noncompliance behavior patterns. The clinic is a small unit near the emergency department, separate from the larger hospital outpatient clinic area. Patient compliance data were collected on each case referred to the CEC clinic during a three-month period. Findings showed a threefold increase in appointment compliance over the previous study in which referrals were made to the hospital clinics.

Appointments and Schedules↗
PubMed1979

Survey of outpatient pharmaceutical services in university hospitals.

The results of a 1978 survey of outpatient pharmacies in university-affiliated hospitals are reported. A questionnaire with 55 items was sent to 75 university-affiliated hospitals with outpatient clinics. Sixty hospitals responded. Of the 47 usable responses, 44 were from hospitals with outpatient pharmacies. The outpatient pharmacies served a mean of 163 patients/day, dispensing a mean of 295 prescriptions/day. Prescriptions from outpatient clinics accounted for a mean of 57% of the outpatient pharmacies' prescriptions. Only four outpatient pharmacies provided 24-hour, seven-day/week services; the remainder provided a mean 11.1 hours of service per day on weekdays. The mean number of full-time equivalent pharmacists employed in the outpatient pharmacies (2.9) correlated positively with the number of prescriptions dispensed daily. The straight-fee pricing system was used by 62% of outpatient pharmacies but pricing systems varied with the type of product dispensed. Computer services were used in 28% of the outpatient pharmacies but were restricted mainly to accounting and inventory functions. Only 15% of the outpatient pharmacies maintained patient profiles for all patients served, and only 21% conducted special patient education programs in drug therapy.

Drug Prescriptions↗
PubMed1978

[Diagnosis and psychiatric care.--First working report of the psychiatric outpatient hospital in the Steglitz Clinic (author's transl)].

The article begins with a review of the geographically unfavourable distribution of psychiatric ward beds in Berlin. This unfavourable distribution hampers therapeutic efforts. The authors describe and examine the work done in the Psychiatric Outpatient hospital which forms part of a university clinic in the Steglitz district of Berlin. 1517 case records are subjected to statistical evaluation. The article concludes with the demand for a new plan for distributing the psychiatric ward beds according to a more reasonable key based on subsectors in line with the requirements of the different districts of the city of Berlin.

Adolescent↗
PubMed1978

[Hospital and outpatient clinic for dentistry-past and future].

A short historical survey deals with the development of the Clinic and Policlinic of Stomatology of the Magdeburg Medical Academy. Apart from especially marked stages prior to the erection of the new building in 1958 and the appreciation of the merits of F. Meyer, founder of the Clinic, the present paper treats the interdisciplinary connexion of the Clinic with other institutions of the Magdeburg Medical Academy and indicates its tasks in the fields of medical care, of medical education, training and continuing education, and of research. From a discussion on its significance and importance in the framework of the health policy of the Socialist Health Service of the GDR, certain speculations on its prospects are deduced (with reference to certain facts), and the consequences necessary for the continuation of its present development are pointed to.

Dental Clinics↗
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↗
PubMed1977

Acute schizophrenia: an efficacious outpatient treatment approach as an alternative to full-time hospitalization.

A research study was designed to test the hypothesis that acutely schizophrenic patients treated for a few minutes a day in a specially designed, city-county hospital outpatient clinic could remit as frequently, rapidly, and economically as a similar group managed on the ward of the same hospital. The results of the study permitted acceptance of the hypothesis. To wit, 90% of the clinic patients remitted in a median time of 12.5 days, as opposed to 70% of the ward patients remitting in a median time of 19.5 days and for approximately six times the cost.

Acute Disease↗
PubMed1976

Studies with prazosin--a new effective hypotensive agent. I. Open clinical study of prazosin in combination with other antihypertensive agents.

The use of prazosin, a new antihypertensive agent, in combination with other conventional antihypertensive agents, in a hospital outpatient clinic setting, was studied in a mixed group of 104 hypertensive patients. Prazosin effectively lowered the lying and standing blood pressure in the majority of patients whose blood pressure was uncontrolled or poorly controlled before the introduction of prazosin. Blood pressure control was adequately maintained in patients who were given prazosin because of the occurrence of side effects of other antihypertensive medication. No significant change in renal function attributable to prazosin was found in patients with normal or impaired renal function.

Adult↗
PubMed1977

[Outpatient management of diabetic children and adolescents: control of fractional 24-h glucosuria (author's transl)].

The optimal ambulatory treatment of diabetic children requires the cooperation of the patient and his family. Following a careful and extensive information about the course of diabetic mellitus, its management, and its possible complications, the patients and their parents have to take charge of an important part of the metabolic control. Fractionating 24-h-urines in three portions and estimation of the glucose excretion using the Clinitest-method proved to be a valuable tool to judge the metabolic control and to adjust the insulin doses. The comparison of the glucose excretion in 595 fractionated urines of 30 juvenile diabetics estimated with both the Clinitest-method and polarimetry in the clinical laboratory showed good agreement for low glucose conentrations. The discrepancies between the two methods increased with rising glucose concentrations and increasing urine volumes. 139 insulin-dependent diabetic children and adolescents were presented to the Children's Hospital outpatient clinic every 6-7 weeks for a physical examination and measurements of the 24-h-glucose excretions as well as the postprandial blood glucose concentrations. The average glucose excretion in two groups of patients with one or two daily injections of insulin was 24 and 30 g/day, respectively, which is higher than the recommended limit of 20 g/day. The glucose excretion was not significantly influenced by the frequency of insulin administration (one or two injections per day), by the age of the patient or by the duration of the diabetes mellitus. The good agreement of the evaluations of the 24-h-glucosuria using Clinitest on one side and polarimetry on the other proves regular controls at home by the patients and their parents to be useful and to facilitated the outpatients management of juvenile diabetics. Measuring the 24-h-glucose excretion at least 2-3 times a week seems desirable.

Adolescent↗
PubMed1979

III. Profile, expectation and satisfaction of outpatients (1970-1972).

The present study deals with patients' assessment of the OPD and the experimental changes in terms of "patient satisfaction". The hypothesis tested, stated that the level of satisfaction of clients of the OPD at Machakos hospital would increase after the introduction of changes in the operational and technical procedures. Data on clients' profiles and satisfaction were collected by means of structured interview schedule; 24 background variables and 17 satisfaction indicators were selected for final analysis to compare profiles and satisfaction of 324 baseline and 367 evaluation respondents. Profiles and satisfaction differed significantly at the 5% level. The significant difference in satisfaction could not be explained by the difference in profiles; the hypothesis was confirmed. A detailed analysis showed that total clinic time (the total time patients spent in the clinic) was significantly correlated with some of the 24 background variables and with some of the 17 satisfaction indicators; its duration was one of the key determinants for patient satisfaction, with a highly discriminative value. Another key variable was the answer to the question: "Did you get the treatment you wanted?". OPD patients discriminated various aspects and facets of OPD process and procedures for their assessment.

Consumer Behavior↗
PubMed1979

Reducing ward-clinic conflicts by rotational scheduling of house staff.

Many internal medicine residency training programs are being modified to permit each resident to gain more outpatient experience, including providing continuous care to a defined panel of patients for three years. Increasing emphasis on these outpatient responsibilities and education, however, places demands on the resident that conflict with his responsibilities on the inpatient wards. In this paper the authors describe the development and implementation of a rotational scheduling system aimed at substantially alleviating the conflict between inpatient and outpatient responsibilities. During the first year of operation 84 percent of house staff members indicated their preference for continuing the system in future years.

Hospital Bed Capacity, 500 and over↗
PubMed2026

Providing Feedback on Previous Pain Scores Did Not Affect Weekly Pain Variability: A Cohort-Nested Randomised Study.

BACKGROUND: Spinal pain is one of the leading causes of disability worldwide and repeated symptom monitoring is increasingly used to capture its fluctuating nature. However, repeated pain assessments may be influenced by prior responses, potentially affecting longitudinal patterns of pain reporting. This study examined whether providing feedback on prior pain scores influenced within-person variability in weekly pain intensity ratings and retention over 60 weeks. METHODS: This randomised study evaluating a methodological feature of repeated pain assessment was embedded within a cohort of adults with spinal pain referred to an outpatient hospital clinic. Participants (n = 2448) were randomised 1:1 to weekly pain intensity ratings (0-10 numerical rating scale) either with feedback ('You answered [X] last week') or without feedback. Analyses included participants with ≥ 40% valid responses (n = 1883), of whom 948 received feedback and 935 did not. The primary outcome was within-person variability in pain intensity, quantified using the root mean square of successive differences. Secondary outcomes included additional fluctuation metrics and the number of weeks with missing responses. RESULTS: No meaningful between-group differences were observed for the primary outcome (mean difference -0.04 points [95% confidence interval -0.08 to 0.01]) or secondary outcomes, including retention rates. Sensitivity analyses yielded consistent findings. CONCLUSIONS: Providing participants with feedback on their previous pain score did not meaningfully influence within-person pain variability or retention during 60 weeks of weekly monitoring. These findings aid the interpretation of repeated longitudinal pain assessments by showing that the observed variability was robust to this specific study design. SIGNIFICANCE: This randomised study showed that providing participants with feedback on prior pain scores did not meaningfully alter weekly pain variability or retention during 60 weeks of longitudinal monitoring. These findings contribute to the interpretation of repeated longitudinal pain assessments in spinal pain research and suggest that weekly pain reporting patterns are robust to prior-pain feedback during long-term symptom monitoring.

Humans↗