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PubMed1965

AN EMPHYSEMA CLINIC.

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Ambulatory Care Facilities↗
PubMed1991

Measuring hospital productivity and output: the omission of outpatient services.

A common measure of hospital productivity is the "cost per patient day". This measure, however, has a variety of drawbacks, one of which is its omission of outpatient care in the measure of hospital output, since a patient day is merely a measure of the volume of patient services, while the cost of outpatient services is included in the input. This study uses information from the Statistics Canada Annual Return of Hospitals to examine the volume of inpatient, outpatient and total patient services, to separate inpatient and outpatient costs and to study hospital productivity from 1976 to 1987-88 using both inpatient cost per patient day and outpatient cost per outpatient visit. Operating costs for Canadian public hospitals, in constant dollars, increased by 38.5% from 1976 to 1987-88. A large increase in hospital costs is not cause for concern unless costs are rising faster than hospital output. There does seem to be some indication that this is the case. The productivity of public hospitals in Canada, measured by "cost per patient day," has fallen by 19.8% from 1976 to 987-88. However, a major drawback to this measure of hospital productivity is that outpatient services were not included in the measure of output and therefore the productivity of hospitals is underestimated. When inpatient costs and services are separated from outpatient costs and services, inpatient services productivity as measured by inpatient cost per patient day still declines but only by 16.3%. On the other hand, outpatient cost per outpatient visit decreased by 2.3%, indicating an increase in productivity.

Canada↗
PubMed1983

[Various aspects of the clinical psychologist in the outpatient department of a psychiatric hospital].

Experience gained in the course of an experimental-psychological study of the mentally ill under conditions of the out-patient department of a psychiatric clinic is reviewed. The specific features of the design and conduction of such studies due to their closeness to a natural experiment, a peculiar attitude of patients toward this kind of frustrating situation and the peculiar methods of psychological studies under conditions of the out-patient department are outlined. The specific tasks of such investigations differing from those set up in the framework of in-hospital psychoneurological treatment are outlined. These include consultations, activities on military draft boards, sanitary educational and psychohygienic activities in the social groups such patients belong to.

Hospitals, Psychiatric↗
PubMed2004

Diabetes-related utilization and costs for inpatient and outpatient services in the Veterans Administration.

OBJECTIVE: -The purpose of this study was to calculate the total number of inpatient hospitalizations, outpatient clinic visits, and total direct health care costs associated with veterans with diabetes receiving care in Veterans Administration (VA) facilities. RESEARCH DESIGN AND METHODS-The number of inpatient hospitalizations is tracked for years 1994-1998, and outpatient clinic visits are tracked for years 1997 and 1998. Trends in utilization across different age and racial groups, as well as total direct inpatient and outpatient costs for 1998, are presented. RESULTS: -Between 1994 and 1998, hospitalization rates decreased from 1.68 to 1.61. The average number of outpatient visits was 4.5 in 1997 and 4.6 in 1998. VA incurred $214.8 million in outpatient expenditures and $1.45 billion in inpatient expenditures for veterans with diabetes receiving VA care. CONCLUSIONS: -Health care delivery systems and payors track the cost and utilization of services by specific patient groups to support disease management, quality improvement, external reporting, and cost containment. Tracking the utilization and cost of diabetes care is necessary to understand the financial impact of diabetes on health care systems and the overall burden of diabetes on individuals.

Aged↗
PubMed1994

The school behaviors of children in three psychiatric treatment settings: an outpatient clinic, a day hospital, and an inpatient hospital.

Compares teachers' ratings of the school behaviors of children entering an outpatient clinic, a day psychiatric program, and an inpatient psychiatric hospital. Many of the ratings did not discriminate among the three groups. Children starting outpatient versus day treatment were rated as higher in aggression, anxiety, and hostile withdrawal, and children beginning outpatient and day treatment versus inpatient treatment, were reported as more skilled socially.

Achievement↗