Improving Care for Minority Children With Asthma: Professional Education in Public Health Clinics

PEDIATRICS ◽  
1997 ◽  
Vol 99 (2) ◽  
pp. 157-164 ◽  
Author(s):  
D. Evans ◽  
R. Mellins ◽  
K. Lobach ◽  
C. Ramos-Bonoan ◽  
M. Pinkett-Heller ◽  
...  
2017 ◽  
Vol 30 (8) ◽  
pp. 680-692 ◽  
Author(s):  
Domingos Fernandes Campos ◽  
Rinaldo Bezerra Negromonte Filho ◽  
Felipe Nalon Castro

Purpose The purpose of this paper is to investigate the expectations and quality gaps in services provided at city public health clinics in the city of Natal, Brazil, from the perspective of patients and healthcare service providers. Design/methodology/approach The research sample consisted of 1,200 patients who used public health services and 265 providers – doctors, nutritionists, physiotherapists, psychologists, pharmacists and managers at three health clinics in the city of Natal, Brazil. A scale with 25 health service attributes was used in data collection. Summary statistics and t-test were used to analyze the data. Findings The results show that the providers think that users have lower levels of expectations than those indicated by the users in all attributes. Providers and users have the most approximate insights into what attributes are considered most important: explanations, level of knowledge and attention dispensed by health professionals. Users and providers perceived similar quality gaps for most of the attributes. The gaps were statistically the same, when comparing the mean quality shortcomings by means of a Student’s test, considering a significance level of 5 percent, obtained independently by the manifestation of users and providers. Research limitations/implications The results reveal only a photograph of the moment. The study did not consider the differences that may exist between groups with different income levels, genders or age groups. A qualitative study could improve the understanding of the differences and coincidences of the diverse points of views. A more advanced research could even study possibilities so that health managers could promote changes in the service, some of them low cost, as the health professionals training for contact with patients. Practical implications The evaluation of the service quality complemented by the matrix of opportunities, importance × quality gaps generates information to help make decisions in the rational allocation of available resources and improvement of the quality of the service delivered to patients. Besides, it offers a focus to prioritize specific actions. Originality/value It is important to compare the perceptions of service quality between patients and the healthcare service providers who work in direct contact with them. The managers can smooth out these differences and ensure, over time, customer satisfaction. In this study, providers were asked to express what they think about the expectations of patients and about their own service performance delivered. Thus, not only the traditional gap 5 was measured, but it was also possible to evaluate the distance between what providers think that patients need and their actual needs.


Author(s):  
Donald W. Winnicott

In this essay, Winnicott expresses his opinion that it would be a tragedy if private practice in child psychiatry were to disappear in the face of public health clinics. Winnicott describes his own contribution to the field of child psychology through his work at Paddington Green Children’s Hospital and states his belief that private practice provides an economical psychiatric method when compared with ordinary clinic results.


PEDIATRICS ◽  
2003 ◽  
Vol 112 (5) ◽  
pp. 1076-1082 ◽  
Author(s):  
C. D. Tierney ◽  
H. Yusuf ◽  
S. R. McMahon ◽  
D. Rusinak ◽  
M. A. O' Brien ◽  
...  

1991 ◽  
Vol 165 (4) ◽  
pp. 924-927 ◽  
Author(s):  
Sherry K. George ◽  
Jan Price ◽  
John C. Hauth ◽  
Doris M. Barnette ◽  
Pete Preston

2008 ◽  
Vol 14 (8) ◽  
pp. 435-438 ◽  
Author(s):  
Cassius Torres-Pereira ◽  
Renata Seleme Possebon ◽  
André Simões ◽  
Marcelo Carlos Bortoluzzi ◽  
Jair Carneiro Leão ◽  
...  

We examined the feasibility of distance diagnosis of oral diseases, using transmission of digital images by email. Twenty-five cases of oral lesions were documented during a 12-month study in a primary care public health clinic in Paraná in Southern Brazil. Clinical electronic charts and images were produced and sent by email to two oral medicine specialists with a median of 10 years experience in the field. The consultants provided a maximum of two clinical hypotheses for each case. In 15 of the 25 cases (60%) both consultants made a correct diagnosis; in seven cases (28%) only one consultant made a correct diagnosis; and in three cases (12%) neither consultant made a correct diagnosis. Thus in 88% of cases, at least one consultant was able to provide the correct diagnosis. The results suggest that distant diagnosis can be an effective alternative in the diagnosis of oral lesions and that the using two distant consultants improves diagnostic accuracy. Primary care public health clinics may benefit from the use of email and digital cameras for telehealth in remote areas where oral medicine specialists are not available.


2008 ◽  
Vol 19 (2) ◽  
pp. 562-573 ◽  
Author(s):  
Jessica M. Robbins ◽  
Vivian G. Valdmanis ◽  
David A. Webb

2009 ◽  
Vol 73 (3) ◽  
pp. 358-374 ◽  
Author(s):  
Roberta E. Aston-Brown ◽  
Bonnie Branson ◽  
Cynthia C. Gadbury-Amyot ◽  
Kimberly Krust Bray

PEDIATRICS ◽  
1994 ◽  
Vol 93 (5) ◽  
pp. 777-777
Author(s):  
J. F. L.

Cynics argue that the reason Bill and Hillary Clinton pistol-whipped the drug industry over vaccine prices just days before the State of the Union was to intimidate the rest of U.S. industry into silence oven the tax-laden economic proposal. And the reason cynicism like this is coming back into vogue is that the Clintons, as elsewhere, had so transparently demagogued the vaccine issue, leaving huge and obvious parts of the immunization problem unmentioned ... A more honest explanation of the problem at least would have mentioned both the famous liability suits that pushed up the cost of vaccines and the government bureaucracy's own failed efforts to immunize the poor. That brings us to the second widely known reason that so many children don't receive the proper immunizations: The bureaucracy can't figure out how to get the job done. Any child in any state can receive free vaccines at a public-health clinic paid for by state and federal money. So why don't more parents respond? One large reason is that the public system is very inconvenient. Before they will administer a vaccination, many public-health clinics require a physician's referral or a complete physical. They don't phone with a reminder that it's time again for the shots. And, like the department of motor vehicles, their hours often aren't convenient for working parents .... So yes, there's a problem, but clearly it's about something more complicated than just price. The President's answer is to spend $300 million to "improve outreach efforts" and hire more staff for the public clinics.


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