Psychiatric Services in a Rural General Hospital

1978 ◽  
Vol 8 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Arnold Werner ◽  
Frederick A. Knarr ◽  
Jack M. Stack
Keyword(s):  
General Hospital ◽  
Rural Areas ◽  
Psychiatric Patients ◽  
Rural Setting ◽  
Medical Community ◽  
Care Providers ◽  
Illness Episode ◽  
Inpatient Psychiatric Care ◽  
Center Staff ◽  
Number Of Patients

Rural areas face severe problems related to the inadequate distribution of psychiatrists. This paper describes a model of inpatient psychiatric care in a rural general hospital which has successfully overcome many of the constraints of the rural setting using a four member psychiatric consultation team. Using the medical community and its resources as the basis for care, a strong emphasis is also placed on continuing education for care providers. Important factors in the system include allowing all physicians to admit and care for psychiatric patients and the use of the emergency room physicians as interim admitting doctors when patients have no family physician. Other factors in the program are discussed. Problem areas have included continuity of care and treatment of certain types of patients. The results of the project have been an increase in the number of psychiatric patients admitted (140 to 268 per year) and a decrease in the number of patients sent to the state institution. Consultations requested on non-psychiatric patients, including children, have increased from thirty-five to sixty-seven per year. Most patients now remain in the care of their own physicians throughout a mental illness episode. Cooperation between community practitioners and the center staff has improved. With increased skill, center staff and community physicians have shown greater self sufficiency in working with hospitalized patients and their families.

scholarly journals Economic Advantages of Telehealth and Virtual Health Practitioners: Return on Investment Analysis

10.2196/15688 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e15688
Author(s):  
Centaine L Snoswell ◽  
John B North ◽  
Liam J Caffery
Keyword(s):  
Rural Health ◽  
Health Care Providers ◽  
Rural Areas ◽  
Return On Investment ◽  
Models Of Care ◽  
Rural Site ◽  
Health Practitioner ◽  
Care Providers ◽  
Model Of Care ◽  
Number Of Patients

Background Telehealth is a disruptive modality that challenges the traditional model of having a clinician or patient physically present for an appointment. The benefit is that it offers the opportunity to redesign the way services are offered. For instance, a virtual health practitioner can provide videoconference consultations while being located anywhere in the world that has internet. A virtual health practitioner also obviates the issues of attracting a specialist medical workforce to rural areas, and allows the rural health service to control the specialist services that they offer. Objective The aim of this research was to evaluate the economic effects of 3 different models of care on rural and metropolitan hospital sites. The models of care examined were patient travel, telehealth using videoconferencing, and employment of a virtual health practitioner by a rural site. Methods Using retrospective activity data for 3 years, a return on investment (ROI) analysis was undertaken from the perspective of a rural site and metropolitan partner site using a telehealth orthopedic fracture clinic as an example. Further analysis was conducted to calculate the number of patients that would be required to attend the clinic in each model of care for the sites to break even. Results The only service model that resulted in a positive ROI for the rural site over the 3-year period was the virtual health practitioner model. The breakeven analysis demonstrated that the rural site required the lowest number of patients to recoup costs in the virtual health practitioner model of care. The rural site was unable to recoup its costs within the travel model due to the lack of opportunity for reimbursement for services and the requirement to cover the cost of travel for patients. Conclusions Our model demonstrated that rural health care providers can increase their ROI by employing a virtual health practitioner.

scholarly journals Economic Advantages of Telehealth and Virtual Health Practitioners: Return on Investment Analysis (Preprint)

2019 ◽  
Author(s):  
Centaine L Snoswell ◽  
John B North ◽  
Liam J Caffery
Keyword(s):  
Rural Health ◽  
Health Care Providers ◽  
Rural Areas ◽  
Return On Investment ◽  
Models Of Care ◽  
Rural Site ◽  
Health Practitioner ◽  
Care Providers ◽  
Model Of Care ◽  
Number Of Patients

BACKGROUND Telehealth is a disruptive modality that challenges the traditional model of having a clinician or patient physically present for an appointment. The benefit is that it offers the opportunity to redesign the way services are offered. For instance, a virtual health practitioner can provide videoconference consultations while being located anywhere in the world that has internet. A virtual health practitioner also obviates the issues of attracting a specialist medical workforce to rural areas, and allows the rural health service to control the specialist services that they offer. OBJECTIVE The aim of this research was to evaluate the economic effects of 3 different models of care on rural and metropolitan hospital sites. The models of care examined were patient travel, telehealth using videoconferencing, and employment of a virtual health practitioner by a rural site. METHODS Using retrospective activity data for 3 years, a return on investment (ROI) analysis was undertaken from the perspective of a rural site and metropolitan partner site using a telehealth orthopedic fracture clinic as an example. Further analysis was conducted to calculate the number of patients that would be required to attend the clinic in each model of care for the sites to break even. RESULTS The only service model that resulted in a positive ROI for the rural site over the 3-year period was the virtual health practitioner model. The breakeven analysis demonstrated that the rural site required the lowest number of patients to recoup costs in the virtual health practitioner model of care. The rural site was unable to recoup its costs within the travel model due to the lack of opportunity for reimbursement for services and the requirement to cover the cost of travel for patients. CONCLUSIONS Our model demonstrated that rural health care providers can increase their ROI by employing a virtual health practitioner.

Toxicology and Management of Novel Psychoactive Drugs

2014 ◽  
Vol 28 (1) ◽  
pp. 50-65 ◽  
Author(s):  
Brian P. Kersten ◽  
Megan E. McLaughlin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Drugs Of Abuse ◽  
Medical Community ◽  
Published Data ◽  
Psychoactive Drugs ◽  
Care Providers ◽  
Perceived Safety ◽  
Emergency Medical ◽  
Number Of Patients

Health care providers are seeing an increased number of patients under the influence of several new psychoactive drug classes. Synthetic cannabinoids, cathinones, and piperazines are sought by users for their psychoactive effects, perceived safety profile, minimal legal regulations, and lack of detection on routine urine drug screening. However, these drugs are beginning to be recognized by the medical community for their toxic effects. The neuropsychiatric and cardiovascular toxicities are among the most common reasons for emergency medical treatment, which in some cases, can be severe and even life-threatening. Management strategies are often limited to supportive and symptomatic care due to the limited published data on alternative treatment approaches. The purpose of this article is to offer health care providers, emergency medical personnel in particular, an awareness and understanding of the dangers related to some of the new psychoactive drugs of abuse. The background, pharmacology, toxicity, management, detection, and legal status of each class will be discussed.

Hämophilie-Zentrum Bonn 1980 – 2009

2011 ◽  
Vol 31 (S 01) ◽  
pp. S4-S10 ◽  
Author(s):  
I. Besmens ◽  
H.-H. Brackmann ◽  
J. Oldenburg
Keyword(s):  
Young Patients ◽  
Severe Form ◽  
Coagulation Disorder ◽  
Care Providers ◽  
Long Distance ◽  
Patient Age ◽  
Patient Âgé ◽  
Number Of Patients ◽  
Clotting Disorder ◽  
Regional Character

SummaryThe Bonn Haemophilia Care Center provides patient care on a superregional level. The centre’s large service area is, in part, due to the introduction of haemophilia home treatment and related to this the individualized prophylaxis in children and adults by Egli and Brack-mann in Bonn in the early 1970s, that represented a milestone in German haemophilia therapy. Epidemiologic patient data from the two selected time points, 1980 and 2009, are evaluated to illustrate the change in the composition of the patient clientele. In 1980 a total of 639 patients were treated at the Bonn Haemophilia Center. 529 patients exhibited a severe form and 110 a non-severe form of the respective clotting disorder. In 2009 the Bonn Haemophilia Center took care for a total of 837 patients. There were 445 patients who suffered from a severe form of the considered clotting disorder while 392 showed a non-severe course. The number of less severely affected patients has increased significantly in 2009. Patients in 1980 were predominantly suffering from a severe form and most had to travel more than 150 km from their homes to the treatment center. In 2009 the number of patients living a medium-long distance from the care provider has significantly increased while the number of patients living more than 150km from the center has decreased. Comparing 2009 to 1980 a growth of the center’s regional character becomes apparent, especially when patient age and severity of the coagulation disorder are taken into consideration. The regional character was more strongly pronounced with milder disease severity and lower patient age. Due to the existence of well established primary haemophilia care in CCCs in Germany, the trend for the recent years is that the proportion of young patients that choose haemophilia care providers closer to their homes is increasing.

Updates in the Prevalence of Rotavirus Gastroenteritis in Babylon City

2018 ◽  
pp. 1-12
Keyword(s):  
Health Care Providers ◽  
Rural Areas ◽  
Causative Organism ◽  
Care Providers ◽  
Sample Collection ◽  
Rotavirus Infection ◽  
Rotavirus Gastroenteritis ◽  
Age Range ◽  
Latex Test ◽  
Children Under 5

Background: Diarrhea is a main cause of morbidity and mortality in children under 5 years old. Globally it is responsible for approximately four billion cases and three million deaths annually. In developing countries, it causes two million deaths each year. The major causative organism is rotavirus which is responsible for one-third of hospitalizations with approximately 40% mortality. Objectives: To determine the prevalence and demographic characteristics of rotavirus infection in Babylon city, Iraq. Materials and Methods: Fecal samples were taken from children with age range of 6 months to 5 years complained of diarrhea during the period beginning in October 2016 till August 2017. The age, gender, residence, the type of feeding, place of the sample collection and duration of diarrhea were recorded. Specimens were analyzed by Latex test for detection of rotavirus. Results: A total of 349 children presented with diarrhea, the rotavirus antigen was detected in 169 fecal specimens from children with diarrhea (48%). More percentages of positive rotavirus specimens were seen in the 5year of age. No gender differences were observed, meanwhile samples obtained from rural areas and breastfed children showed less rotavirus positive infection. Conclusion: The present study confirms that rotavirus infection is still currently a prevalent gastroenteritis causative agent and required careful clinical attention. Pediatricians and health care providers are needed to be encouraged to take into account the children who at risk for developing rotavirus infection including age, residence and type of feeding.

Updates in the Prevalence of Rotavirus Gastroenteritis in Babylon City

2018 ◽  
pp. 1-12
Keyword(s):  
Health Care Providers ◽  
Rural Areas ◽  
Causative Organism ◽  
Care Providers ◽  
Sample Collection ◽  
Rotavirus Infection ◽  
Rotavirus Gastroenteritis ◽  
Age Range ◽  
Latex Test ◽  
Children Under 5

Background: Diarrhea is a main cause of morbidity and mortality in children under 5 years old. Globally it is responsible for approximately four billion cases and three million deaths annually. In developing countries, it causes two million deaths each year. The major causative organism is rotavirus which is responsible for one-third of hospitalizations with approximately 40% mortality. Objectives: To determine the prevalence and demographic characteristics of rotavirus infection in Babylon city, Iraq. Materials and Methods: Fecal samples were taken from children with age range of 6 months to 5 years complained of diarrhea during the period beginning in October 2016 till August 2017. The age, gender, residence, the type of feeding, place of the sample collection and duration of diarrhea were recorded. Specimens were analyzed by Latex test for detection of rotavirus. Results: A total of 349 children presented with diarrhea, the rotavirus antigen was detected in 169 fecal specimens from children with diarrhea (48%). More percentages of positive rotavirus specimens were seen in the 5year of age. No gender differences were observed, meanwhile samples obtained from rural areas and breastfed children showed less rotavirus positive infection. Conclusion: The present study confirms that rotavirus infection is still currently a prevalent gastroenteritis causative agent and required careful clinical attention. Pediatricians and health care providers are needed to be encouraged to take into account the children who at risk for developing rotavirus infection including age, residence and type of feeding.

Epidemiological Features of Dog Bites among Children Attending Emergency Room in Al-showmely General Hospital

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Hasan Alwan Baiee ◽  
Weli Hatif
Keyword(s):  
Emergency Room ◽  
General Hospital ◽  
Health Problem ◽  
Lower Limbs ◽  
Care Providers ◽  
Dog Bite ◽  
Female Ratio ◽  
Post Exposure ◽  
Dog Bites ◽  
Bite Injuries

Dog bites are common and can affect victims of different ages.Dog bite injuries in children are a preventable health problem.Dog bites are a serious health problem that cause both physical and emotional damage to victims and considerable cost to communities. Studies on dog bites among Iraqi children were very scarce.This study focuses on theincidence,mechanisms,and epidemiologicalcircumstances ofdog biteinjuriesin a series of pediatric patients who sustained dog bites in emergency Room. MethodologyA cross sectional study was designed to studyall cases of dog bites attending the emergency room in AL-Showmely General Hospital located in the southern district – Babylon province-Iraq, during the period ; from the January, first,2017 through theend of March, 2018.Special constructed were prepared to collect data through interview of victims or their companions who attended the emergency section during this period,ethical clearances were obtained.*A total of 320 children presented to the hospital with dog bite injuries.The incidence rate of dog bites was 275 per 100000 population, the male to female ratio was 3:1.the most common dog bite injuries took place in September44 (13.75%). Injury rates were highest in those aged 0-4,declining thereafter with age. In the 6-10, year age group141 (44.1%), most of cases living in rural district (villages). The most affected location were lower limbs, only 3.4% of the injured children had completed the post exposure anti rabies vaccine. Dog bites are common health problem among children,Children who are younger than 10 years represent the high-risk group for dog attacks. very few of them had complete the prophylactic post exposure vaccine Therefore, prevention strategies should focus on public education,training health care providers and controlling stray dogs.

Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 131
Keyword(s):  
Health Care ◽  
General Hospital ◽  
Health Care Providers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Medical Services ◽  
Tertiary Level ◽  
Care Providers ◽  
Level Hospital ◽  
Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

Barriers and Facilitators of Using Telehealth to Identify and Manage Behavioral Health and Substance Use Disorder Conditions in Rural Areas: An Environmental Scan (Preprint)

2020 ◽  
Author(s):  
Naim Naim ◽  
Laura Dunlap
Keyword(s):  
Substance Use ◽  
Behavioral Health ◽  
Substance Use Disorder ◽  
Rural Areas ◽  
Primary Care Providers ◽  
Care Patient ◽  
Direct Patient Care ◽  
Care Providers ◽  
Provider Education ◽  
Opioid Use

BACKGROUND Access to behavioral health services, particularly substance use disorder (SUD) treatment services, is challenging in rural and other underserved areas. Some of the reasons for these challenges include local primary care providers without experience in behavioral health treatment, few specialty providers, and concerns over stigma and lack of privacy for individuals from smaller communities. Telehealth can ease these challenges and support behavioral health, specifically SUD treatment, in a variety of ways, including direct patient care, patient engagement, and provider education. Telehealth is particularly relevant for the growing opioid epidemic, which has profoundly affected rural areas. OBJECTIVE We sought to understand how telehealth is used to support behavioral health and SUDs, with a particular focus on implications for medication-assisted treatment for opioid use disorders. The intent was to understand telehealth implementation and use, financing and sustainability, and impact in the field. The results of this work can be used to inform future policy and practice. METHODS We reviewed literature and interviewed telehealth stakeholders and end users in the field. The team identified a diverse set of participants, including clinical staff, administrators, telehealth coordinators, and information technology staff. We analyzed research notes to extract themes from participant experiences to answer the study questions. RESULTS Organizations varied in how they implemented telehealth services and the services they offered. Common themes arose in implementation, such as planning for technical and organizational impacts of telehealth, the importance of leadership support, and tailoring programs to community needs. CONCLUSIONS Telehealth is used in a variety of ways to expand access to services and extend service delivery. As the policy and reimbursement landscape continues to evolve, there may be corresponding changes in telehealth uptake and services provided. CLINICALTRIAL NA

Sign in / Sign up

Export Citation Format

Share Document