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At least 469 records · Page 26Linked to original sources
PubMed1979

The contribution of medical missionaries to tropical medicine. Service-training-research.

Medical missionaries, historically the pioneers in introducing Western medicine into many tropical countries, are today responsible for a significant proportion of health care in several of those countries. Illustrating his theme with references to personal experiences in the former Belgian Congo, the author enlarges on the organization of a church-related comprehensive health care programme based on a chain of rural health centres and satellite dispensaries that brought curative and preventive medicine to the whole population within the area covered. Trypanosomiasis was eradicated, yaws and tuberculosis controlled, cerebral malaria eliminated, worm-loads reduced and nutrition improved. Leprosy was treated within the integrated service as soon as the sulphones became available. Medical auxiliaries and nurse-midwives were trained practically to tackle the local problems. Students from many missions over a wide area went into government, mission and company employ after training. Research concentrated mainly on the solution of pressing local problems, such as onchocerciasis and leprosy, but incidentally investigated interesting clinical phenomena.

Community Health Services↗
PubMed2006

[The Unified National Health System and public policies: psychological care for menopausal women in the Federal District, Brazil].

This study focused on psychological care for middle-aged women in public health services in the Federal District (Brasilia), Brazil. The article discusses women's health and more specifically menopause and its place in Brazilian public health policies. The survey confirmed the lack of psychological support for menopausal women. In most cases only outpatient medical care was offered. No psychologist had been designated in any of the units surveyed to assist these women. The study concludes that this period of women's life has failed to receive psychological care in Brazil, thus neglecting the principles of the Unified National Health System. Menopausal women deserve comprehensive health care, including attention to conflicts related to biological, psychological, and socio-cultural dimensions of aging, thus contributing to the process of working through maturity.

Adult↗
PubMed1982

The foster care system and health status of foster children.

The foster home care system is the most commonly used alternative for the care of dependent children in the United States. However, it often fails to achieve its objective of returning the child to his home or providing a permanent substitute family. Children entering foster care have frequently suffered social, emotional, and medical neglect, and physical abuse. They have a high rate of chronic medical problems, educational handicaps, and severe emotional impairment. In many cases the health care that foster children receive fails to recognize and/or adequately address their disabilities. In order for the pediatric practitioner to work successfully with a foster child, he must not only provide comprehensive health care, but also must be familiar with the social welfare system within which the child lives.

Adolescent↗
PubMedDate not supplied

African American men: the ideal AIDS program.

Because designing programs based on an understanding of the target population's perceptions, expectations, and experiences is not only beneficial but feasible, a convenience sample of 17 African American men who have sex with men attended one of four focus groups to identify the needs of AIDS clients and what constitutes an ideal AIDS program. These men articulated what they needed and expected from the health care system. These needs and expectations should be incorporated into program planning to promote a more productive relationship between provider and providee and, thus, more efficacious programs. Their needs are competent comprehensive health care, adequate funds, and emotional support to enhance inner strength to cope with dying and death, dependency, and uncertainty. The ideal AIDS program would be holistic, providing health care needs as well as financial, social, emotional, and familial needs by means of both traditional and alternative treatments.

Acquired Immunodeficiency Syndrome↗
PubMed2003

[Implementation of psychosocial care in pediatric cardiology. Results of a national survey].

In the German health care system patient self-help groups assume growing importance. The aim of the umbrella organisation for self help groups in paediatric cardiology (Bundesverband Herzkranker Kinder e.V., BVHK) is to continuously improve comprehensive health care to children with heart diseases and their parents. One of the most important aims of the BVHK is to implement psychosocial services for inpatients. In some recent projects the BVHK has analysed the current structures of psychosocial care in German departments of paediatric cardiology. Existing structures are compared with the optimal standards of psychosocial care. Selected results of these projects are described in this article.

Child↗
PubMed1977

Role of the clinical psychiatrist and psychologist in primary care medicine.

Both the clinical psychiatrist and clinical psychologist can be important adjuncts to the family practitioner in delivery of comprehensive health care services. Some general guidelines are offered for distinguishing between the two disciplines and knowing how and when to utilize their respective services.

Family Practice↗
PubMed1994

Health maintenance organizations and persons with severe mental illness.

Many if not most scenarios for reform of the U.S. health care system imply that health maintenance organizations (HMOs) will continue their rapid growth. Some advocates argue that a comprehensive health care system should offer services to the severely mentally ill on the same basis as the physically ill. Others note that severe mental illness has traditionally been addressed by a separate, social service system which, for all its deficiencies, has at least provided some level of care. Still others contend that allowing severely mentally ill persons "barrier free" access to health care would be prohibitively expensive. Inspired by this debate the author reviews our knowledge about HMOs and persons with severe mental illness. It is argued that workers in community mental health programs need to understand HMOs and their potential contribution to providing services for persons with severe mental illness.

Delivery of Health Care↗
PubMed1999

The shifting sands of health care delivery: curriculum revision and integration of community health nursing.

The health care delivery system in the United States is moving from an institutionally driven and controlled medical care model toward the Primary Health Care model described by the Alma-Alta Conference (World Health Organization [WHO], 1978) as community-driven comprehensive health care. However, nursing education still remains institutionally based, anchored in a medical model. Dynamic curricula must be developed that prepare nurses to practice in an ever-changing health care delivery system that is becoming more community based. The purpose of this article is twofold: to provide an overview of the revised curriculum of Brigham Young University's College of Nursing (BYU-CON) as one example of a faculty's attempt to develop a program that prepares graduates skilled in providing health care in the 21st century; and to examine closely the integration of community health nursing into the curriculum.

Community Health Nursing↗
PubMed2003

Mental health service delivery following health system reform in Colombia.

BACKGROUND: In 1993, Colombia underwent an ambitious and comprehensive process of health system reform based on managed competition and structured pluralism, but did not include coverage for mental health services. AIMS OF THE STUDY: In this study, we sought to evaluate the impact of the reform on access to mental health services and whether there were changes in the pattern of mental health service delivery during the period after the reform. METHODS: Changes in national economic indicators and in measures of mental health and non-mental health service delivery for the years 1987 and 1997 were compared. Data were obtained from the National Administrative Department of Statistics of Colombia (DANE), the Department of National Planning and Ministry of the Treasury of Colombia, and from national official reports of mental health and non-mental health service delivery from the Ministry of Health of Colombia for the same years. RESULTS: While population-adjusted access to mental health outpatient services declined by -2.7% (-11.2% among women and +5.8% among men), access to general medical outpatient services increased dramatically by 46%. In-patient admissions showed smaller differences, with a 7% increase in mental health admissions, as compared to 22.5% increase in general medical admissions. DISCUSSION: The health reform in Colombia imposed competition across all health institutions with the intention of encouraging efficiency and financial autonomy. However, the challenge of institutional survival appears to have fallen heavily on mental health care institutions that were also expected to participate in managed competition, but that were at a serious disadvantage because their services were excluded from the compulsory standardized package of health benefits. While the Colombian health care reform intended to close the gap between those who had and those who did not have access to health services, it appears to have failed to address access to specialized mental health services, although it does seem to have promoted a change in the pattern of mental health service delivery from a reliance on costly inpatient care to more efficient outpatient services. CONCLUSIONS: Health reform in Colombia improved access to health services for the general medical services, but not for specialized mental health services. Although the primary goal of the health reform was to provide universal medical coverage, by not including mental health services in the standardized benefits package, inequities in the delivery of mental health services appear to have been perpetuated or even exacerbated. IMPLICATIONS FOR HEALTH CARE AND POLICY FORMULATION: If health reform in Colombia and elsewhere is to provide universal coverage and adequate access to comprehensive health care, mental health services must be added to the standardized package of health benefits and efforts to develop accessible and effective mental health treatment at the primary care level should continue. IMPLICATIONS FOR FUTURE RESEARCH: Mental health services research in Colombia should focus future studies on the differential impact of health reform on access to mental health services across regions, and between urban and rural areas.

Colombia↗
PubMedDate not supplied

Best medical practice: the case of Japan.

'Best medical practice' can be given three different definitions. Definition A, by the medical profession, emphasizes the maintenance of technical standards in diagnosis and treatment. Definition B, by the essentially healthy general population, emphasizes preventive measures and the reassurance of the healthy status. Definition C, by the chronically sick and disabled, emphasizes rehabilitation and nursing care. Although each has its inherent weakness, each could be said to be describing an essential but distinct aspect of comprehensive health care which can be utilized to legitimize each party's claim for priority in the allocation of resources. Thus, the relative weight that is given to the three definitions of 'best medical practice' in society as a whole appears to be ultimately dependent on the social and cultural conditions unique to each country. In the case of Japan, Definition B has become the most dominant: it has resulted in the health care demands of the essentially healthy general population being well taken care of without excessive allocation to high technology medicine. However, a combination of demographic, technological and social changes will necessitate a different emphasis in the future.

Clinical Medicine↗
PubMedDate not supplied

Cost-effectiveness of providing mental health services: the offset effect.

An offset effect occurs when the provision of one type of service leads to a reduction in the use of other related services. This article examines the offset which occurs in medical utilization when mental health services are appropriately provided, especially within prepaid group health care settings. While no study in this area is free of methodologic flaws, the weight of the evidence strongly suggests that, within such settings, the provision of psychiatric input not only provides a service which is indispensible to the concept of comprehensive health care, but also is affordable, in part because of the realization of offset effects.

Cost-Benefit Analysis↗
PubMed1992

[Health protection in the workplace in Germany (former Federal Republic of Germany) in 1973-1990].

1. In Germany health protection against injuries at work is distinctly separated from the general health care of the population. 2. Health protection at work includes: recognition, prevention, treatment and rehabilitation connected with occupational diseases as well as prevention of accidents at work. The total cost of this system including accident indemnities is covered by the employer. 3. The system of health care and safety at work within the enterprise comprises a coordinated activity of the physician inspector and a representative of the enterprise and the owner. 4. In big enterprises there is another system operating parallel to the one mentioned above: this system provide comprehensive health care. The costs are covered by contributions both on the paid of the employers and the employees.

Germany, West↗
PubMed1994

Medical education: leadership and adaptation in a changing world.

Health care reform has remarkably accelerated in recent years and is now being driven by economic considerations more than by any others. There have been great changes in medical effectiveness, practice and, in consequence, medical education. These trends will continue and accelerate even more if comprehensive health care reform is achieved. Health care is highly valued by our society and medical education is an integral and essential part of health care. The challenge for health professions educators is to lead constructive change and to adapt to changes imposed by systemic reform to assure that the quality of our graduates enables them to best serve society.

Cost Control↗