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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 451 records · Page 25Linked to original sources
PubMed1996

Nursing's agenda for health care reform: policy, politics, and power through professional leadership.

This article is an eye witness account of nursing's participation in the health care reform debate from 1991 to 1994. In that debate, the nursing profession achieved high visibility and recognition for the cogency of its policy positions as developed in Nursing's Agenda for Health Care Reform and for its united voice through the leadership of the American Nurses Association, the Tricouncil for Nursing, and the Nursing Organization Liaison Forum. While comprehensive health care reform failed to pass the 103rd Congress, nursing and nurses gained much in the process of their participation.

Health Care Reform↗
PubMed1995

Primary care of children with HIV infection.

As the number of children affected by the HIV epidemic increases, the primary care physician can have an important role in ensuring that these children receive comprehensive health care. Clinical aspects of pediatric HIV disease are reviewed, including the recently revised Centers for Disease Control and Prevention classification system. Important advances include the development and application of techniques for establishing in early infancy whether or not a child is infected. The implications for the use of these techniques are discussed, and recommendations are made for a system of coordinated care between the primary care physician and specialty clinic. Specific treatment approaches, such as the early introduction of Pneumocystis carinii pneumonia prophylaxis, antiretroviral medications, and the use of intravenous immunoglobulin, are discussed.

AIDS Vaccines↗
PubMed2002

Holistic health care for native women: an integrated model.

Providing health care services to Native women has become a challenge owing to the severity of illness--in particular, diabetes, alcoholism, and arthritis--in this group today. If comprehensive health care is to be offered, coordination of services between health and mental health practitioners is needed. Gathering together to support each other has been a traditional custom for Native women. An integrated health care model is discussed that offers Native women an opportunity to deal with the challenge of mental health and health issues through traditional activities, enhancing their physical and spiritual health and receiving education while creating an atmosphere of empowerment and mutual support.

Attitude to Health↗
PubMed1985

Medical school forensic psychiatry units in health care delivery facilities rather than criminal justice institutions: an alternative model.

We have presented a model for developing forensic psychiatric treatment and teaching services of a medical school Department of Psychiatry, but where these services are the basic comprehensive health care delivery system for the entire community. These offer consultative and treatment services for adult and family court clinic, psychiatric forensic services, of forensic psychiatry open bed and medium security-type bed, as well as day hospital and outpatient services. All of these are sited in the normal health care delivery system of the university teaching hospitals and its patient treatment, teaching, and research facilities. Consultative services are offered on request to the criminal justice system, but the basic health care delivery system is controlled administratively by the ordinary university teaching hospital authorities and exists as a one of a kind unit at the Royal Ottawa Hospital. The Royal Ottawa Hospital is a private nonprofit hospital, with its own Board of Trustees, and is affiliated with the medical school, as part of a major university network. We believe it important to present this model for an overall forensic psychiatric service, in contradistinction to the more commonly established forensic psychiatric facilities in state mental hospitals, in a special facility for the criminally insane, or in a criminal justice system institution such as a penitentiary. We believe that our model for forensic psychiatric facilities has great advantages for the patient. Here the patient is treated in a specialized facility (as all psychiatric patients with specialized problems should be); but one which is a specialized forensic facility, within the range of specialized psychiatric facilities that are needed by an urban community.(ABSTRACT TRUNCATED AT 250 WORDS)

Criminal Law↗
PubMed1997

The cost of health care for HIV-positive patients.

Utilizing a prospective study of health service activity for HIV/AIDS, 2 estimates of hospital costs of care analysed with reference to gender, risk activity, immunological and clinical staging (1987 definition of AIDS) were undertaken. Utilizing combined costs per life year (based on hospital and hospice activity but not primary and community care) the ratio of costs for CD4 < 200 and CD4 > 200 was for most risk groups between 2-5:1 whilst for AIDS: pre-AIDS it was between 3.6-8.3:1 except for homosexuals where it was 12.6:1. A comparison of the standard hospital costs for infectious diseases with the published accounts for clinical AIDS care in Lothian suggests a 3-4-fold underestimate in the costs of providing a comprehensive health care service.

Acquired Immunodeficiency Syndrome↗
PubMed1976

Curriculum for the new college of health sciences: A departure from the traditional medical education.

As an outgrowth of the Report of the Imperial Commission on the Study of Health and Medical Problems, The College of Health Sciences was established as the basic educational unit to provide comprehensive health care education within the framework of a team approach to Iranian national health care. The programs are to nonrestrictive, thereby demonstrating the principles of the concept and practice. Because of this, the College is a multidiscipline institution, and will expand to include programs of study in all health care specialties. The program of study for the equivalent of the baccalaureate degree in the College is based on functional analysis of the tasks to be performed by the primary care workers called behdars. The curriculum is task oriented and is made up to two sections, each of 33 months instruction. The first year concentrates on basic functional science and medicine in an academic setting, and the following two years are spent in clinical training in geographically diverse dispensaries and health care facilities. The second stage of the academic program will be available to graduate behdars who have successfully completed two or more years of work in the health care network and who display academic and professional excellence. Through a unit system approach these candidates for doctor of medicine will complete eleven months or more of comprehensive instruction in functional basic sciences, and this will be followed by two years in comprehensive hospital internship.

Allied Health Personnel↗
PubMed1979

Health care delivery in Belgium.

Formerly Belgium's Catholic hospitals prospered within a system based on collectivized financing and individualistic service delivery patterns. Now faced with decreasing vocations, the religious congregations and the national Catholic hospital association are working toward a comprehensive health care delivery system in which laypersons' role is expanded and regional activities are coordinated.

Belgium↗
PubMed2006

A comprehensive women's health care center: are gynecologists offering primary care?

OBJECTIVE: The purpose of this study was to compare patient characteristics and diagnoses in a comprehensive Women's Health Care Clinic between gynecologists and internal medicine physicians. STUDY DESIGN: This retrospective cohort study evaluated International Classification of Diseases, 9th Revision, codes that were recorded between January 1, 2001, and January 4, 2004, at the Women's Health Care Clinic. We compared demographics and prevalence of diagnosis codes for patients who were seen by obstetricians/gynecologists and internal medicine physicians and compared these data with national survey statistics. A sampling of charts was reviewed for coding verification. RESULTS: We analyzed 13,462 visits at the Women's Health Care Clinic. Patients who were seen by internists were older, had greater racial diversity, and had more gender-nonspecific medical disorders (hypertension, depression). Gynecologists saw more specific women's health problems (P < .05). The diagnoses of menstrual disorders, menopause, pelvic pain, and abnormal cytologic findings within the Women's Health Care Clinic follow closely with the national ambulatory survey data. CONCLUSION: Within this multispecialty Women's Health Care Clinic, internal medicine physicians are practicing primary care and obstetricians/gynecologists are providing specialty care.

Adolescent↗
PubMed1982

The optometrist's role in public health.

The scope of the optometric profession, and its relationship to the total health care system, is in a state of constant change; many of the changes are influenced by or impact upon that area of health care that is referred to as public health. Very basically, public health is "people's health" --a concern for the health and well-being of groups of people. It emphasizes the role of health care practitioners in the delivery of health care to the aggregate, as opposed to the individualized or private system of health care delivery. Fundamental to the overall philosophy of public health is the necessity to make comprehensive health care readily available and accessible to all segments of the population. Optometry must expand its efforts to recognize, evaluate and assume its role in the maintenance of the health and well-being of the public, both domestically and internationally.

Adult↗
PubMedDate not supplied

Level of education and patient opinion: significant differences in perceptions of health care.

BACKGROUND: As part of the general competencies set forth by the Accreditation Council for Graduate Medical Education (ACGME), residents must have an understanding of systems-based practice, which is demonstrated by an awareness of-and responsiveness to-the comprehensive health care system. Residents must be able to effectively access and use system resources to provide care that is of optimal value. Essential to understanding and implementing systems-based practice is an awareness of how different patient populations perceive health care; one key factor that influences patients' perceptions of health care is their level of education. METHODS: We surveyed 2900 adult patients in the Cincinnati, Ohio area and stratified them into 2 groups based on their level of education. Group 1 included patients with some high school education or a high school degree. Group 2 included patients with some college education, an undergraduate degree, or graduate/professional-level coursework. We then compared the groups' perceptions of common health care issues, including physician compensation, patient obligation for medical bills, and increased cost for the freedom to choose a physician. RESULTS: Of 395 respondents, a higher percentage of Group 2 patients, compared with those in Group 1, understood that physicians do not collect 100% of what they bill (p < 0.001) and that businesses do influence the amount a physician is paid by insurance companies (p = 0.009). Conversely, a higher percentage of Group 1 patients thought that physicians are overpaid (p = 0.030) and that they keep a large portion of what they charge (p < 0.001). Further, fewer Group 1 respondents felt obligated to pay medical bills not covered by insurance (p = 0.002); they also were less willing to pay more for better medical care (p = 0.002) or for the freedom to choose a physician (p = 0.015). CONCLUSIONS: This study indicates that patients with a lower level of education believe that physicians are overpaid and that they keep a large portion of insurance reimbursement. These findings may explain why fewer patients in this group feel that they are obligated to pay medical bills not covered by insurance and why they are less likely to pay more for better medical care or for the freedom to choose a physician.

Adult↗
PubMed1995

A comprehensive system for quality improvement in ambulatory care: assessing the quality of diabetes care.

A comprehensive state-of-the-art system for quality improvement in ambulatory care has been designed to test (1) whether patients at 8 intervention sites demonstrate improved health status and satisfaction with their care as compared to patients at 8 control sites and (2) the extent to which timely patient self-reported data influences provider practice patterns. During the study pilot period, several investigators developed, tested and analyzed disease-specific questionnaires for 7 common chronic conditions. An advanced automated information system was designed to link hospital computer information and patient questionnaire data in order to provide timely communication between patients and providers about important health problems. This report briefly describes the 3-year quality of ambulatory care clinical trial and details the development and pilot testing of the disease specific questionnaire for diabetes. Reliability testing showed correlations were higher for fixed events such as foot ulcers than for subjective judgments such as satisfaction with providers. Responsiveness testing indicated that this questionnaire could measure behavior and care modifications in patients 6 months following an outpatient education course, compared to the baseline pre-education values. Diabetes severity information has been collected from self-administered questionnaires and laboratory data to assist providers in assessing the patients' likelihood of 4-year mortality. It is anticipated that the rapid identification of important patient issues will assist patients and clinicians in mutually addressing and resolving health care problems, thereby improving the quality of outpatient care.

Ambulatory Care↗