The Planning Department of the health authority for the Canton of Basel-Stadt has decided to develop a process of planning and decision-making to install performance contracts between them and the acute hospitals situated in the canton. In part I, a short description of the Swiss health system is given, followed by an analysis of the situation in the Canton of Basel-Stadt. The second and main part describes the process of planning and decision-making to achieve performance contracts for public and private hospitals.

Ambulatory Care↗

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A low cost computerized system for data management in a surgical department.

A computerized system is necessary for a surgical ward in order to document systematically the performed activity and set up a follow-up for patients. The aim of this paper is to report a program to store, recall and processing clinical data concerning fundamental information about the hospitalized patients. The main characteristic of this system is its low cost, due to the low initial hardware investment and the easy introduction of data. The use of the program does not require trained personnel. The surgeon itself, setting out simple tests, is able to obtain clinical and statistical informations of epidemiologic interest, concerning surgical cases, incidence of complications and other parameters. The system has proven itself as the basis for future highly specialized data bases for scientific and clinical research.

Computers↗

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Relationship of alexithymia and poor social support to ulcerative changes on gastrofiberscopy.

The effects of psychosocial factors on peptic ulceration and/or erosions were examined in a sample of 189 volunteers. Analysis of variance found that the severity of gastrofiberscopic findings was related to two psychosocial factors-poor social support and degree of alexithymia- and that both psychosocial factors were significantly correlated with one another. Analysis of covariance indicated that gastrofiberscopic findings remained significantly related to poor social support when alexithymia was controlled for. These findings suggest that in both healthy persons, and in persons with alexithymia, peptic ulceration or erosions tend to manifest when social support is low. Poor social support and alexithymia may be an especially high-risk combination for the development of peptic ulceration and/or erosions.

Adult↗

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A fish induced pneumothorax: dilemmas in the remote management of a sucking chest wound.

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Animals↗

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Acupuncture in bronchial asthma: bodyplethysmographic measurements of acute bronchospasmolytic effects.

In 12 patients with bronchial asthma the effects of acupuncture (45 tests altogether) on airway resistance have been investigated. In 9 patients there was a significant decrease of airway resistance 10 minutes, 1 hour and 2 hours after the end of acupuncture. The lowest level for airway resistance (70.1% of control value) was reached during the first hour after acupuncture. The possibility of a merely suggestive effect could be excluded, because "placebo-acupunctures" did not change airway resistance significantly. The comparison with a parasympatholytic acting drug as a metered aerosol (Atrovent) demonstrated that acupuncture had a somewhat weaker bronchospasmolytic effect. Three patients did not show any reaction after repeated acupunctures.

Acupuncture Therapy↗