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At least 613 records · Page 34Linked to original sources
PubMed1997

Assessment of rational drug use and prescribing in primary health care facilities in north west Ethiopia.

A study on rational drug use was undertaken in nine health centres (HCs) and nine health stations (HSs) in Ethiopia. Prescribing, patient care and facility specific factors were measured using drug use indicators. Prescribing patterns of drugs were also assessed. With only few exceptions, the drug use indicators in HCs and HSs and between retrospective and prospective studies were similar despite differences in manpower and facilities. The average consultation time (in minutes) in HSs and HCs was 5.1 +/- 0.8 and 5.8 +/- 1.06, respectively. The dispensing time (in minutes) was 1.5 +/- 0.7 in HSs and 1.9 +/- 0.6 in HCs. Both patient care indicators seem to be adequate to influence patient satisfaction to the overall health service and patient knowledge of important dosage instructions. Most drugs (more than 89% in HCs and 71% in HSs) were actually dispensed from the health facilities and labelling was satisfactory. Prescribing by generic names (average: 75% in HCs and 83% in HSs) was encouraging. While the availability of key drugs was ensured, essential documents were missing in most facilities or they were unpopular for use, and those available required revision and updating. Polypharmacy in which the number of drugs/encounter was < 2.5 was minimal, but that a large proportion of the prescriptions contained two or more drugs could result in adverse drug-drug interactions. The most frequently prescribed drugs were anti-infectives and analgesics accounting for over 76% in HCs and 82% in HSs and in most cases they are probably prescribed with little justification. The exposure of patients to antibiotics (average: 60% in HCs and 65% in HSs) was unacceptably high to justify epidemiological trends. The high exposure of patients to injections, especially in the HSs (over 37%), should be seen from the health and economic points of view. The results revealed priority areas for intervention. They also provide standard references to compare drug use situations and their change over time in different settings, area and time in Ethiopia.

Drug Prescriptions↗
PubMed1997

[Fetal growth retardation: epidemiology and intrauterine growth rate].

OBJECTIVE: This study aimed at two purposes: 1) To become aware, in our environment, of some epidemiological factors of fetal growth retardation in its harmonious, non-harmonious and semiharmonious variants. 2) To obtain fetal growth curves, from the 31st to the 43rd weeks of pregnancy, of the three types of deficiencies and compare them with the intrauterine growth of normal newborns. PATIENTS AND METHODS: We have studied the last 249 growth retarded fetuses admitted to the Neonatology Service. The statistical study was carried out in comparison to 7,720 cases of fetuses with normal growth. RESULTS: The main results were the following: 1) An unquestionable influence of a deficient educational, laboral and economical level of the mother in the genesis of fetal growth retardation. 2) Fetuses with harmonious retardation reached the highest gestational ages. 3) The obstetric procedure is conditioned by the fetal growth retardation. 4) There was higher morbility in the studied group. 5) The increased weekly anthropometry tendency was similar in the three groups of growth retarded fetuses.

Adult↗
PubMed1979

Statistical models of the demand for emergency medical services in an urban area.

First- and second-order statistical regression models are presented for the Emergency Medical Services (EMS) demand in an urban area as it relates to various socioeconomic, demographic, and other characteristics of the area. Individual models are formulated for different types of medical emergencies with the city of Atlanta, GA, serving as the data base. These models are generally shown to provide excellent fits to the empirical data.

Emergency Medical Services↗
PubMed2006

[Financing the public health services. 1967].

Federal statistic figures show that the Brazilian States altogether have, in their respective territories, a collection of taxes which is higher than the Union one. The highest collection of the Central Government which is shown at the official statistics is due to the excess of collection of the federal taxes over the ones of the States; this usually happens in five or six states, of which, in 1964 Guanabara and São Paulo were responsible for 91% of this difference. One can not change the present system of competence in Public Health Services in the three levels--central, regional and local--without modifying at the same time the present Brazilian tributary system, where the municipal governments received back in 1962 only 5.6 of the general collection of taxes. Figures from 1955 show that the per capita cost of Public Health Services in Brazil, comprising the three levels, was Cr 123 Cr dollars dollars ( 1.82 US dollars), and in 1962, Cr 827 (US 2.30 US dollars). These three levels of government reserved in 1955, 5.6% of the money spent in its total expenditure for Public Health activities; this percentage declined to 4.5% in 1962. In relation to the sum invested on Public Health government activities, the Union spent in 1962, 36.4% of the total expenses, the States 59.3% and the counties only 5.5%. There is a great disproportion in the distribution of Public Health expenditure among the various Brazilian States, ranging from a minimal percentage over the total public expenses such as the case of Goiás (1.6% in 1964) up to a maximum of 17.2% in Pará in the same year. There is also a considerable variation from one state to another and in 1964 it ranged from the lowest limit of 70 Cr dollars in Maranhão up to 5.217 in Guanabara. If we analyze the per capita expenses of each state with Public Health activities, using 1964 and 1954 figures represented in 1964 monetary values, we can verify that the expenditure of 20 states dropped of 17.2%. One can not know, without an adequate planning, whether theses per capita expenses with Public Health government-owned services should be increased or not. It is not advisable to perform an international comparison; the figures on hand are not reliable due to the lack of a rational public accountancy system.

Brazil↗
PubMed1986

Sickness absence and duration of service in the Post Office 1982-3.

For some years a high severity of sickness absence has been noted in young postmen. This cross sectional study is of 4419 male postmen and 787 male postal officers and postal assistants, of whom 3753 and 709 respectively were employed for the whole year of the study from 1 April 1982 to 31 March 1983. A stratification technique was used to assess the influence of duration of service on sickness absence within certain age ranges. Differences in the proportion of men taking more than a stated number of spells or days, in groups of short and long service, are tested statistically using Chi square tests with a continuity correction. Statistically significant reductions, with increasing duration of service, are found for self certificated spells and days in all postmen and for certificated spells but not days in younger postmen. Older postal officers and postal assistants have a statistically significant reduction in self certificated spells. Young postal officers and postal assistants show no significant change in spells and days of sickness absence with duration of service. It is concluded that the excess severity of sickness absence in younger postmen is due to self certificated absence rather than certificated absence. The difference in severity of sickness absence in various diagnostic groups with increasing duration of service is discussed. The limitations of a cross sectional study mean that further work is required to investigate this problem using longitudinal techniques.

Absenteeism↗
PubMed1981

Evaluation of rural primary health care services in Iran: report on vital statistics in West Azarbaijan.

Iranian indigenous front-line health workers (FLHW) were locally trained to deliver environmental and primary health care services to mothers and children. After two years, there was a significant decline in crude birth and death rates and in infant and 1-5 year mortality rates in the test area as compared to a control area. One out of four encounters was referred to a health center physician, the remainder being handled by the FLHWs themselves. (Am J Public Health 1981;71:739-742.)

Evaluation Studies as Topic↗
PubMed2005

Information and sorting in the market for obstetrical services.

Using a statistical model and a partial equilibrium economic search model, we develop a methodology for appraising the value of consumer information about the quality of health care providers and apply it to information about physicians' predispositions to perform cesarean section deliveries. There are three primary results. First, information's value is roughly proportional to a simple statistical metric of its accuracy; the constant of proportionality can be imputed from knowledge of consumer search methods and consumer preferences. Second, the function governing the production of information from data 'inputs' can have surprising economic properties, such as economies of scale, that usefully inform the efficient production of consumer information. These properties are robust even when the value of information cannot be precisely determined. Third, information's value is enhanced by the way physicians are sorted into hospitals but greatly attenuated by the presence of other dimensions of physician heterogeneity. Under plausible assumptions, the value of information in our empirical application is small enough that it is not surprising that consumers do not utilize it when selecting a physician.

Cesarean Section↗
PubMed1978

An epidemiological review of Japanese encephalitis.

Twenty-five years ago, Japanese encephalitis (JE) was known as an endemic, mosquito-borne disease in East Asia. Today, the causative virus is known to be distributed from maritime Siberia to the north, eastern India to the west, the Archipelago of Japan presumably the Philippines to the east, and from Indonesia to the south. Since the late-1960s, the geopathological status of JE epidemics has undergone considerable changes. The sizes of JE epidemics in Japan and China (Province of Taiwan) have steadily declined. In fact the JE virus itself appears to be disappearing from Japan. Long-term prediction of JE epidemics is more difficult for Korean Peninsula, nevertheless, reported JE morbidity rate in the Republic of Korea has remained at a relatively low level since 1969. In contrast to the trend in East Asia, new epidemic foci of JE have been emerging in the northern part of Tropical Eastern South Asia starting in 1969. Of particular importance are the continued high incidence (annual morbidity rate: 8.67-22.04/100 000) of reported JE in the northern part of Viet Nam between 1969 and 1974, and the high incidence (14.7/100 000) recorded in Chiang Mai Valley, Thailand, between 1969 and 1970. Apparently, the epidemic in Chiang Mai Valley spread to the neighbouring Shan State of Burma in 1974. Another JE epidemic broke out in West Bengal State, India in 1973. The occurrence of JE in the endemic zone south of these areas has remained sporadic. An increasing number of pathogens have been shown to cause signs and symptoms clinically indistinguishable from JE. In this review, the quality and international comparability of available JE statistics are also examined. Only a few countries and areas with reasonably developed statistical and laboratory services are able to provide national JE statistics in a form ready for epidemiological analysis. A practical surveillance system for JE needs to be organized in those countries where JE is a newly emerging health problem.

Asia↗
PubMed1983

Factors influencing physician assignment decisions under Medicare.

The factors that influence physician assignment decisions under Medicare are of major importance to Medicare patients, physicians, and the federal government. This study used a unique data base gathered in Colorado during 1979 to examine these factors. The data base coupled information from Medicare claims with detailed survey information on beneficiaries who received the services. Multiple regression analysis was applied to a sample of approximately 6,500 services. It showed that a variety of physician, beneficiary, and service characteristics are statistically significant determinants of whether a Medicare service is provided on assignment.

Colorado↗
PubMed1978

[The study of psychotherapy. Analysis of the psychotherapies given in an ambulatory psychiatric service].

Using critisized statistical technics, the authors have studied the psychotherapies done at a given time in a university psychiatric outpatient clinic. Thereupon they display some correlations, more specifically, the importance of sex gender, of patients' socio-cultural level, of unconscious socio-cultural stereotypes present in the therapists, of diagnosis and of the motivation to seek treatment by psychotherapy. Statistical analysis allows a more coherent approach of these problems.

Adolescent↗