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PubMed1997

[Characteristics of private health care services in Salvador, Bahia, Brazil]

To study the organization of private health services in the city of Salvador, Bahia, Brazil, a survey was carried out in 1994 involving 174 facilities registered at the Brazilian Institute of Statistics and Geography - IBGE. Health services characteristics studied were the following: number of physicians, hospital beds, production and cost of outpatient services, and legislative aspects. Health services were classified according to the amount of resources each type of granting agency contributed to support outpatient care. We found that the majority (51.1%) of private health care services in Salvador do not depend on public funds. The main sources of revenue for health services are private health insurance (41.9%) and other kinds of private health plans (54%). These changes in the organization of health services challenge health planners to review strategies for municipalization of health care and the relations between public and private health services in Brazil.

Journal Article↗
PubMed2006

[Factors associated with condom use and knowledge about STD/AIDS among teenagers in public and private schools in São Paulo, Brazil].

This study aimed to compare knowledge about STD/AIDS and identify the factors associated with adequate knowledge and consistent use of male condoms in teenagers from public and private schools in the city of São Paulo, Brazil. We selected 1,594 adolescents ranging 12 to 19 years of age in 13 public schools and 5 private schools to complete a questionnaire on knowledge of STD/AIDS and use of male condoms. Prevalence ratios were computed with a 95% confidence interval. The score on STD knowledge used a cutoff point corresponding to 50% of correct answers. Statistical tests were chi-square and Poisson multiple regression. Consistent use of male condoms was 60% in private and 57.1% in public schools (p > 0.05) and was associated with male gender and lower socioeconomic status. Female gender, higher schooling, enrollment in private school, Caucasian race, and being single were associated with higher knowledge of STDs. Teenagers from public and private schools have adequate knowledge of STD prevention, however this does not include the adoption of effective prevention. Educational programs and STD/AIDS awareness-raising should be expanded in order to minimize vulnerability.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Health care of very low birth weight infants in Montevideo, Uruguay: a comparison between public and private sectors]

OBJECTIVE: To compare morbidity and mortality in very low birthweight infants admitted to public and private intensive care units in Montevideo, Uruguay. METHODS: Longitudinal design. All very low birth weight infants born in public hospitals of Montevideo between May 1st and October 31st, 1999, were included in the study and followed up until they were discharged from hospital, or died. The quality of care, and morbidity and mortality rates obtained in private intensive care units were compared with those observed in public intensive care units (infants who were never transferred). RESULTS: Of 141 infants, 19 were excluded from the study (13 died at the delivery room and six were transferred to intensive care units of other public hospitals). Of the remaining 122 infants, 61 were kept at the intensive care units of public hospitals, and 61 were transferred to a private unit. The infants who were transferred presented lower gestational age and increased neonatal depression. However, mortality among infants treated at intensive care units of public hospitals was twice as high (Hazard Ratio 1.8; 95%CI 1.1-3.4; P=0.04), especially in infants who weighed less than 1,000g (Hazard Ratio 2.4; 95%CI 1.1-5.5; P=0.04). CONCLUSIONS: The health status of very low birth weight infants treated at intensive care units of public and private hospitals in Montevideo, Uruguay, was assessed. Mortality was lower, and health care was better in neonatal units of private hospitals.

Journal Article↗
PubMedDate not supplied

[Public and private day-care centers in Pelotas, RS: compliance with the regulations]

OBJECTIVES: Seventy-seven day-care centers were evaluated in Pelotas, RS, Brazil, in 1996, in order to assess compliance with current service regulations. METHODS: Information about physical structure, facilities, equipment, hygiene practices, and day-care staff was collected through a structured questionnaire. RESULTS: The median number of children in public day-care centers was 89 children per center, while in the private centers the median was 29 children per center (p<0.001). A nursery was available in 88% of public day-care centers, and in 36% of the private centers (p<0.001). Concerning the physical structure, the majority of the public centers had exclusive toilet facilities for the children (91%), while this was the case in only 66% of the private centers (p<0.001). Fire extinguishers were found in public centers in a proportion three times higher than in the private centers. Proper bottle washing and refrigeration was done in 95% of the day-care centers studied, while sterilization of the bottles was reported in only 47% of the centers. Despite the fact of 85% of the centers kept records with health information on the children, 93% of the centers did not have the required health license provided by the municipal authority. CONCLUSIONS: There is a good deal of work to do in both private and public day-care centers in order for them to comply with the current service regulations.

Journal Article↗
PubMed1991

The private GP and leprosy: a study.

In urban and rural areas alike, people in India tend to prefer private medical care to the existing government health services. Nevertheless, the large private health care sector has hitherto been virtually alienated from activities of public health importance including priority disease control programmes. This study of 106 private general practitioners (GPs), practising in low socioeconomic areas of Bombay, shows a gross lack of knowledge and awareness among private doctors about leprosy and also about the National Leprosy Control Programme. The possible reasons are discussed. Effective involvement of GPs in the National Leprosy Control Programme should facilitate both integration and better implementation of leprosy control activities. The study also highlights some areas for future interventions at both primary and secondary health care levels and the need for a strategy, based on larger studies, to train and make private doctors participate in controlling diseases of major public health concern like leprosy.

Attitude of Health Personnel↗
PubMed1996

Differences in public and private health services in a rural district of Malaysia.

A cross-sectional study, comparing the nature of services in 15 private clinics and 6 public health facilities, was undertaken in a rural district of Malaysia. Semi-structured interviews and observations using check-lists were employed. Public health facilities were run by younger doctors (mean age = 31.1 years), supported mostly by trained staff. The private clinics were run by older doctors (mean age = 41.2 years) who had served the district for much longer (8.9 years vs 1.5 years) but were supported by less well trained staff. The curative services were the main strength of the private clinics but their provision of preventive care was less comprehensive and of inferior quality. Private clinics were inclined to provide more expensive diagnostic services than the public facilities. 'Short hours' private clinics had very restricted opening hours and offered limited range of services.

Health Services↗
PubMedDate not supplied

Private pay clients in adult day services.

Data collected for all 3,992 participants in Maryland's adult day care programs as of December 31, 1993 showed that the majority of clients were supported by publicly supported "welfare" funding sources. The authors examined the differences in characteristics and service needs between the public payer population and private pay patients, including those who were charged on a sliding scale. They found that private pay clients were not dependent on others to "initiate service arrangements when they want and can find them." Private pay clients were twice as likely to be self or family referrals and more likely to be older, white, and living with a spouse or adult child. Private pay patients were also much more likely to have a history of the recent onset of cognitive impairment and associated memory loss but less likely to fall into the more ADL dependent categories. The nuclear families of private pay clients who are primary caregivers are described as the "critical marketing targets" and that services specifically for the cognitively impaired should be developed.

Activities of Daily Living↗
PubMed1997

Previous private psychiatric treatment among public mental patients: a preliminary local survey.

There has been considerable concern over disturbances to the public-private equilibrium in local health care provision. We investigated the situation among mental patients. Only 11.5% of new patients presenting to a public general hospital psychiatric unit had consulted a private sector psychiatrist previously. Of these, 60% had moved to the public sector for financial reasons and the same proportion had had their last contact with private care within the previous three months. There were no dominant reasons for choosing the private sector initially. No particular privately practising psychiatrist's patients were more likely to seek public treatment subsequently. The results are analysed and the implications discussed.

Journal Article↗
PubMed2002

Acute gastroenteritis associated with seafood privately imported from the Pacific Islands.

AIMS: To investigate a potential link between consumption of food privately imported from the Pacific Islands and presentation with acute gastroenteritis to Middlemore Hospital Emergency Department. METHODS: This was a three month prospective observational case study that included patients aged greater than fifteen years presenting with acute gastroenteritis and a history of food privately imported from the Pacific Islands. Data included case demographics, symptoms, island of food origin and food type. Stool and blood samples were collected and analysed. RESULTS: Of 358 patients who presented to Middlemore Emergency Department during the study period with gastroenteritis, 34 (9.4%) had a history of consumption of food privately imported from the Pacific Islands. The seafood came from Tonga (23 cases), Samoa (10 cases) or Niue (1 case). The implicated seafood was shellfish (28 cases), jellyfish (2 cases), fish intestine (2 cases), seaweed or seaslug (1 case each). Fourteen patients (41%) provided stool samples; all were culture positive for Vibrio parahaemolyticus (VPH). CONCLUSIONS: This case series confirms a link between acute VPH gastroenteritis and consumption of seafood privately imported from the Pacific Islands. A number of public health initiatives to reduce the burden of VPH gastroenteritis among Auckland's Pacific Islanders have commenced. The Ministries of Health, Agriculture and Forestry are considering tighter controls or banning food privately imported from the Pacific Islands.

Adolescent↗
PubMed2002

The use of nursing home and assisted living facilities among private long-term care insurance claimants: the experience of disabled elders.

Little is known about individuals in nursing homes (NHs) and assisted living facilities (ALFs) who receive private long-term care (LTC) insurance benefits. No one knows whether claimants and/or their families feel they are getting good value for their premiums, or whether the presence of private insurance influences the type of care people get. This brief provides descriptive information on disabled private LTC insurance policyholders receiving LTC benefits in these settings, comparing them to institutionalized elders who lack such insurance. The information shows that private LTC insurance benefits are targeted to individuals with significant functional and/or cognitive impairments; that claimants are satisfied with their policies although many report unmet needs; and that private LTC insurance gives claimants access to alternatives to nursing home care.

Aged↗
PubMedDate not supplied

[Diagnostic results of the carotid artery duplex ultrasonography performed in the private offices in Zagreb].

The purpose of the investigation was to evaluate the diagnostic value of duplex ultrasonography (DU) of the cerebral arteries in the patients with cerebrovascular insufficiency performed in private offices in Zagreb town. The investigation was performed for all patients referred to digital subtraction angiography (DSA) after DU examination performed in one of private offices (in total, 12 offices) during the period of three years. During mentioned period 127 patients were examined (100 male, 67 female, age 28-79 y, mean 62 y) according to DU exams performed in private offices. Other patients, who had DU examinations in offices other than private, were not examined in present investigation. The method of investigation was prospective comparison between DSA and DU findings, where DSA was used as the gold standard. The investigation was performed by three radiologists prospectively. They did not know DU findings before performing DSA. The pathological findings of the supraaortal arteries and especially significant stenoses (70%-99%) of the extracranial part of the carotid arteries, obliteration and ulcerated plaques were examined. For the significant stenoses of the carotid arteries, which are indication for operative treatment, DU showed sensitivity of only 63%, specificity 79%, positive predictive value 60% and negative predictive value 81%. The diagnostic difference between occlusion and subtotal stenosis of the carotid artery was also very important. DSA showed 18 occluded arteries, while DU presented 20, nine of them false positive and seven false negative (sensitivity 36%). DU diagnosed ulcerated plaque in only three out of 37 patients, including two false positive and 36 false negative results. According to results presented here, DU of the carotid arteries performed in analysed practices are not reliable and the price of DU presents expense without benefit. The insufficient education of the doctors and defective regulations of the private practices are the possible reasons for such results.

Adult↗
PubMed1991

[Meaning of the "scientific validity clause" of private hospital insurance (section 5/1 f MB/KK 76). With reference to recent verdicts].

As per Section 5/1 f of the classic conditions 1976 of the "Association of private health insurance carriers" (Verband der privaten Krankenversicherung), benefits won't be paid for methods of examination or treatment and remedies which are from the scientific point of view generally not recognized. Basic reflections have led to the fact that today the term "scientifically recognized methods" and the term "traditional medicine" will be treated as equivalent. Contrary verdicts, according to which treatments on the basis of anthroposophic medicine or by means of electro-acupuncture by Voll would be considered as generally recognized medicine from the scientific point of view and would have to be paid by the private health insurance carriers, are consequently not comprehensible. Supposing that the trend continues that private health insurers have to pay more and more expenses incurred for all kind of outsider-methods, this would lead not only to a great drain on the purse of the private health insurance carriers, but have also unpleasant consequences for the whole medicine, because the uniformity of the medicine is endangered. To take steps against has not only to be the task of the private health insurance carriers, but it is also in the interest of the physicians and, at last, of the patients, too.

Complementary Therapies↗
PubMed1991

[Private accident insurance in Switzerland with reference to liability insurance as a part of social security].

On the Swiss market there exist various different accident insurance schemes and systems. Private accident insurance which is offered by the private insurers, date back to the middle of the 19th century. Since 1912 accident insurance is compulsory for all employees working in particularly dangerous industries, since 1984 it covers all employees in the country. In Switzerland there exists no general compulsory accident insurance. To perform as insurance carriers are qualified: private insurance companies, the Swiss Accident Insurance Company, and a number of the social health (sickness) insurers. Depending on the insurance system there are different approaches to renumerate the health costs. In the various social insurance systems the patient is rather free to chose his doctor and hospital (among those who have a contract with the insurer); in private insurance he is completely free. Yet the billing systems and the applicable rates and tarifs differ considerably. There are trends to simplify these systems and bring them more into mutual accordance. Due to the important rise of the health costs in Switzerland, there exists the danger that possible simplifications will bring about more public influence yet less private initiative and less incentives to really control costs without lessening the patients' possibilities.

Humans↗
PubMed1989

Heterosexuals at risk for HIV: differences between private and commercial partners in sexual behaviour and condom use.

To study the prevalence of HIV and other sexually transmitted diseases (STDs), sexual behaviour and condom use among heterosexuals, 193 women and 157 men entered a longitudinal study. Participants were recruited through an STD clinic, and had had five or more heterosexual partners in the preceding 6 months but had no other AIDS risk factors. Participants were divided in groups with respect to private and/or commercial sexual partners. One hundred and thirty-six (71%) women worked as prostitutes and had, on average, 115 customers a month, and 99 (63%) men had visited, on the average, eight prostitutes in the past 4 months. One hundred and seventy-one (89%) women (114 prostitutes) had had, on average, four partners, and 112 (78%) men (of whom 64 had visited prostitutes) had had, on average, seven private partners in the past 4 months. Vaginal intercourse was often or always reported by all participants whilst anal contact was seldom reported. Non-high-risk sexual techniques (for example, oro-oral, masturbation) were practised more frequently with private than with commercial partners (P less than 0.001). Although no differences were found in the frequency of practising high-risk sexual techniques (for example, vaginal, ano-genital), differences were found for frequency of condom use. Condom use during vaginal intercourse was reported more frequently with commercial than with private partners (P less than 0.01). However, if the number of partners is taken into account, prostitutes had unprotected vaginal intercourse with an estimated average number of 160 partners in 4 months, which is far more than customers (seven) and men and women with private partners only (four).(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1988

Private social welfare expenditures, 1972-85.

This article updates the private social welfare expenditures series with complete data for 1985 and information for most categories through 1986. In the United States, private sector expenditures play a substantial role in the provision of social welfare services. This article presents private social welfare expenditures in terms of the four major categories--health, education, welfare and related services, and income maintenance that includes private pensions, sickness and disability benefits, and group insurance. The private expenditures, which totaled $429.3 billion in 1985, are distributed by major category beginning in 1972 and are also related to public social welfare expenditures and gross national product.

Education↗
PubMed1988

Satisfactions and dissatisfactions with public and private hospitals.

A fully national sample of 1255 people were questioned about their degree of satisfaction with hospital care in New Zealand. Questions covered both public and private hospitals and concerned actual experience of care as well as general attitudes to that care. Almost half the sample (49%) rated public hospital care as "excellent" or "very good", and a similar proportion (48%) assigned those grades to private hospitals. Only 7% of the sample rated public hospital care as "poor" or "very poor" and only 1% rated private hospitals in this way. Major reasons for satisfaction with public hospital care were the high standard of nursing care (41% of sample), the high qualifications of staff (34%) and the availability of appropriate equipment for emergencies (17%). The most common complaints were that hospitals are short-staffed/overworked (15%) and there are long waiting lists (14%). Reasons for satisfaction with private hospital care were no waiting (26%), good standard of care (20%) and good hotel facilities (14%). In general, both public and private hospitals were highly regarded. Dissatisfaction with public hospitals was most evident amongst younger, working people and amongst those in the north and central regions. Dunedin respondents were more satisfied with their hospital care than those in other parts of the country.

Adult↗
PubMed1987

[Studies on the relation between the classifications (including our private plan) and subsequent success in pregnancy in endometriosis].

The relationship between classifications (Beecham, Acosta, Sugimoto, AFS and private plan) and chances of subsequent gestation was studied on 26 patients with laparoscopically diagnosed endometriosis. The success in conception was judged one year after diagnosis or completion of subsequent Danazol administration. In our private plan, [A] blueberry spots, blood blebs, [B] chocolate cyst, [C] periadnexal adhesions ([C']: only less involved side was evaluated) and [D] Closing change in cul-de-sac, were designated targets of evaluation and each was divided into 4 grades. As a result, a significant difference between success and failure groups was noted in initial classification with Beecham, AFS [posterior cul-de-sac obliteration] and private plan [C'], and was also noted in post-treatment classification with AFS [posterior cul-de-sac obliteration] and private plan [D]. (2) Only in the success group, Danazol was recognized as effective in every classification, and the improvement in AFD[posterior cul-de-sac obliteration] and private plan [D] was considered to be contributory. The effects, however, on adnexal adhesive changes were not significant. (3) Whenever conception is attempted by medication, the adnexal condition of the less involved side may significantly influence the chances of subsequent pregnancy.

Adult↗
PubMedDate not supplied

Private sector support of nursing research.

Members of the American Nurses' Association Council of Nurse Researchers were surveyed for information about their nursing research funding activity within the private sector: their submission of proposals to private organizations, the outcomes, and effective funding strategies. Results indicated that 51% of applications submitted to private organizations and 78% of intramural applications were funded. However, 65% of proposals funded by private organizations and 59% of intramurally supported projects were for $3,000 or less. A variety of strategies led to private sector support of successful nursing research proposals. These included making direct, personal contact with funding agencies, matching proposals with the needs and interests of the funding agency, networking with other professionals to obtain funding information, and submitting well-written proposals consistent with agency guidelines.

Financing, Organized↗