Medical care in the U.S.S.R. Report of the US. delegation on health care services and planning. U.S. Department of Health Education and Welfare. National Institute of Health. 1972. 50 cents

1973 ◽  
Vol 60 (6) ◽  
pp. 504-504
PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 851-857
Author(s):  
David R. Smith

During the past 30 years, social and economic barriers to health care services have increased for many Americans, especially for the nation's most vulnerable populations. Health status actually has declined for certain populations during this time. Meanwhile, national attention has been focused primarily on containing health care costs and on devising strategies for reforming the financing of health care rather than strategies for achieving improvements in the health status of the population. Existing methods of financing health care services, health research priorities, the increasing centralization and compartmentalization of health care services, and the recent failure of national health reform all serve to hinder this nation's progress towards developing a comprehensive and accountable health care system focused on promoting and achieving improved health as well as treating sickness. Recent changes in the health care marketplace, however, including a growing movement toward measuring the outcomes of medical treatments and an emphasis on improving the quality of services, have increased interest among payers and providers of health care services in investing in preventive services. Health maintenance organizations and other integrated health care delivery systems are beginning to devise incentives for increasing preventive care as well as for containing costs. The transformation of the nation's current medical care system into a true health care system will require innovative strategies designed to merge the existing fragmented array of services into coordinated and comprehensive systems for delivering primary and preventive health care services in community settings. The community-Oriented Primary Care concept successfully blends these functions and has achieved measurable results in reducing health care costs and improving access to preventive services for identified populations. There is flexibility in existing funding sources to promote preventive services in various public and private health care settings and to assist in the transformation from a disease-oriented medical care system to one focused on health.


JAMA ◽  
2021 ◽  
Vol 325 (22) ◽  
pp. 2315
Author(s):  
Larry Levitt

2020 ◽  
Vol 35 (6) ◽  
pp. 669-675
Author(s):  
Mehmet Ali Ceyhan ◽  
Gültekin Günhan Demir

AbstractBackground:Shopping centers (SCs) are social areas with a group of commercial establishments which attract customers of numerous people every day. However, analysis of urgent health conditions and provided health care in SCs has not been performed so far.Objective:The aim of the study was to perform a comparative analysis of clients visiting SCs and demographics, complaints, and health care of patients admitted to Emergency Medical Intervention Units (EMIU) located in grand SCs in Ankara, Turkey.Methods:Customer and health care records of nine grand SCs in Ankara from January 1, 2018 through December 31, 2018 were evaluated retrospectively. Health care services in EMIUs of SCs were provided by employed medical staff. Data including demographic characteristics, complaints, treatment protocols, discharge, and referral to hospital of the patients were retrospectively analyzed from medical registration forms.Results:Medical records of nine grand SCs were analyzed. Number of customers could not be obtained in three SCs due to privacy issues and were not included in patient presentation rate (PPR) and transport-to-hospital rate (TTHR) calculation. Total number of customers in the remaining six SCs were 53,277,239. The total number of patients seeking medical care was 6,749. The number of patients seeking health care in six SCs with known number of customers was 4,498 and PPR ranged from 0.018 to 0.381 patients per 1,000 attendants. The median age of the recorded 4,065 patients (60.2%) was 28 (interquartile range [IQR]: 38-21), and 3,611 (53.5%) of the patients admitted to EMIUs were female. The number of patients treated in the SC was 4,634 (68.6%) and 189 patients (2.8%) were transferred-to-hospital by ambulance for further evaluation and treatment. Transportation to hospital was required in 125 patients who sought medical care in six SCs which provided total number of customers, and TTHR ranged from 0.000 to 0.005 patients per 1,000 attendants. No sudden cardiac death was seen. Medical conditions were the primary reasons for seeking health care. The most frequent causes of presentation were laceration and abrasions (639 patients, 9.4%).Conclusion:The PPR and TTHR in SCs are low. The most common causes of presentation are minor conditions and injuries. Majority of urgent medical conditions in SCs can be managed by health care providers in EMIUs.


2016 ◽  
Vol 31 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Anthony E. Kemp

AbstractIntroductionThe introduction of advanced practitioner roles has challenged the traditional boundaries of health care. While studies have been undertaken to understand the role of physicians in respect of mass-gathering medicine, the role of advanced nurse practitioners (ANPs) has not been investigated.ProblemDoes the presence of an ANP reduce the referral rates of patients presenting for medical care at mass-gathering events to external health care resources?MethodsA prospective observational study was undertaken to determine whether the presence of an ANP would reduce the patient referral rate to external health care services by first aiders and paramedics working within an event medical team. Patients identified as requiring referral were reviewed by an ANP as part of the on-site medical provision for four mass-gathering events in the south of England. Additionally, information was gathered identifying which patients would have been transported to hospital by ambulance compared to those actually transported following ANP review. Statistical analysis was undertaken for three key measures (referrals to all local health resources, referrals to hospital-based acute services, and transfers to hospital by ambulance).ResultsA rounded total of 842,000 people attended four mass-gathering events held over 14 days. Of these, 652 presented for medical care, many self-referring.Using a one-tailed Fisher’s Exact Test and Phi analysis, this study demonstrated statistically significant reductions in the overall referral of patients to all external health care resources (P<.001; φ=0.44), to the emergency department (ED; P<.001; φ=0.43), and a reduction in ambulance transport (P<.001; φ=0.42). Effect size analysis demonstrated a medium-sized effect evident for all of the above, which was also demonstrated in economic terms.The event medical team would have referred 105 (16.3%) of the 652 patient presentations to external health care services; 47 (7.2%) would have been transported by ambulance. In comparison, the ANP referred 23 patients (3.5%) with 11 (1.7%) being transported by ambulance. It also was noted that the first aiders and paramedics could be more selective in their referral habits that were focused primarily on the ED.ConclusionsAppropriately trained and experienced ANPs working within event medical teams have a positive impact on referral rates from mass-gathering events.KempAE. Mass-gathering events: the role of advanced nurse practitioners in reducing referrals to local health care agencies. Prehosp Disaster Med. 2016;31(1):58–63.


Medical Care ◽  
1974 ◽  
Vol 12 (Supplement) ◽  
pp. 83
Author(s):  
Charles K. Stewart ◽  
Darwin S. Liggett

2020 ◽  
Vol 2 (2) ◽  
pp. 71-89
Author(s):  
Yaaqoob Alhammadi, M.D. ◽  
Merlita V. Caelian

Emirati women in the Western Region have limited access to specific health care. Thus, this study assessed the awareness and utilization of health care services of Emirati women of the seven municipalities in the Region identified through stratified random sampling. This quantitative descriptive-comparative and correlational research used a researcher-made questionnaire based on the guidelines of the Department of Health. Statistical computation using the mean revealed the women’s lack of knowledge and information about government health care services and their rare availing of these services. The use of ANOVA showed significant differences in their awareness and utilization according to demographics. Pearson Product Moment Correlation showed a significant relationship between awareness and utilization of health care services. Significant challenges encountered are the distance to the health center, the long waiting time for the doctor, and religion. The study recommends to strengthen advocacy programs and provide appropriate health facilities to women.


2019 ◽  
Vol 131 (4) ◽  
pp. 1037-1045 ◽  
Author(s):  
Michael A. Williams ◽  
Tessa van der Willigen ◽  
Patience H. White ◽  
Cathy C. Cartwright ◽  
David L. Wood ◽  
...  

The health care needs of children with hydrocephalus continue beyond childhood and adolescence; however, pediatric hospitals and pediatric neurosurgeons are often unable to provide them care after they become adults. Each year in the US, an estimated 5000–6000 adolescents and young adults (collectively, youth) with hydrocephalus must move to the adult health care system, a process known as health care transition (HCT), for which many are not prepared. Many discover that they cannot find neurosurgeons to care for them. A significant gap in health care services exists for young adults with hydrocephalus. To address these issues, the Hydrocephalus Association convened a Transition Summit in Seattle, Washington, February 17–18, 2017.The Hydrocephalus Association surveyed youth and families in focus groups to identify common concerns with HCT that were used to identify topics for the summit. Seven plenary sessions consisted of formal presentations. Four breakout groups identified key priorities and recommended actions regarding HCT models and practices, to prepare and engage patients, educate health care professionals, and address payment issues. The breakout group results were discussed by all participants to generate consensus recommendations.Barriers to effective HCT included difficulty finding adult neurosurgeons to accept young adults with hydrocephalus into their practices; unfamiliarity of neurologists, primary care providers, and other health care professionals with the principles of care for patients with hydrocephalus; insufficient infrastructure and processes to provide effective HCT for youth, and longitudinal care for adults with hydrocephalus; and inadequate compensation for health care services.Best practices were identified, including the National Center for Health Care Transition Improvement’s “Six Core Elements of Health Care Transition 2.0”; development of hydrocephalus-specific transition programs or incorporation of hydrocephalus into existing general HCT programs; and development of specialty centers for longitudinal care of adults with hydrocephalus.The lack of formal HCT and longitudinal care for young adults with hydrocephalus is a significant health care services problem in the US and Canada that professional societies in neurosurgery and neurology must address. Consensus recommendations of the Hydrocephalus Association Transition Summit address 1) actions by hospitals, health systems, and practices to meet local community needs to improve processes and infrastructure for HCT services and longitudinal care; and 2) actions by professional societies in adult and pediatric neurosurgery and neurology to meet national needs to improve processes and infrastructure for HCT services; to improve training in medical and surgical management of hydrocephalus and in HCT and longitudinal care; and to demonstrate the outcomes and effectiveness of HCT and longitudinal care by promoting research funding.


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