Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Privatization”

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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources
PubMed1998

[Tonsillectomy and adenoidectomy in a private clinic].

In order to examine whether the risk is higher when these types of surgery are conducted in private clinics compared to outpatient surgery in hospitals, we conducted a review of 404 patients referred from a public hospital for surgery in a private practice. There were no complications among the 101 adenoidectomy cases reviewed. Out of a total of 303 patients with tonsillectomy, eight had postoperative bleedings. Four patients (1.3%) were reoperated with ligature in the clinic within a few hours, and four were admitted to hospital for observation. Only two patients disliked being referred to a private clinic for surgery. The findings are comparable to other series and indicate that performing tonsillectomies and adenoidectomies in private practice does not imply higher risk than outpatient procedures in hospitals if selection criteria are carefully used.

Adenoidectomy↗
PubMed2004

Trends in private and public health insurance for adolescents.

CONTEXT: Previous studies (1984-1995) of adolescent health insurance have shown little change in the proportion with coverage. Federally mandated expansions in Medicaid were offset by declines in private coverage. Further expansions of Medicaid and implementation of the State Children's Health Insurance Program (SCHIP) have opened new avenues for increasing coverage rates. OBJECTIVES: To assess the current health insurance status of adolescents, the demographic and socioeconomic correlates of insurance coverage, and document recent changes in public and private coverage rates. DESIGN, SETTING, AND PARTICIPANTS: We analyzed data on 12 995 adolescents aged 10 to 18 years, who had been included in the 2002 National Health Interview Survey. We conducted multivariate analyses to assess the independent association of age, sex, race, poverty status, family structure, family size, and region on the likelihood of having insurance coverage. Results are compared with previously published findings on adolescent health insurance coverage spanning 1984 to 1995. MAIN OUTCOME MEASURE: Insurance coverage for adolescents. RESULTS: An estimated 12.2% of adolescents were uninsured in 2002, which is a decrease from 14.1% in 1995 (P<.003). The decrease occurred entirely because of an expansion of public coverage and is concentrated among children in poor (<100% of the federal poverty level) and near-poor (100%-199% of the federal poverty level) families. A substantial decrease in the differences between poor and higher-income groups occurred between 1995 and 2002 due to gains in coverage for adolescents in poor and near-poor families and losses in coverage among those in middle- and upper-income families (> or =200% of the federal poverty level). Specifically, the proportion of adolescents in poor families without coverage declined from 27.4% in 1995 to 19.7% in 2002 (P<.001). The proportion of adolescents in near-poor families without coverage declined from 24.8% in 1995 to 19.2% in 2002 (P<.002). In contrast, the proportion of adolescents in middle- and higher-income families without insurance increased from 4.1% in 1995 to 6.3% in 2002 because availability of insurance through the private market declined (P<.001). CONCLUSIONS: A modest but significant reduction in the percentage of adolescents without insurance has occurred since 1995, largely as a result of expansions in public coverage. An even larger reduction in the proportion of adolescents without coverage would have occurred, if not for a reduction in private coverage for adolescents in middle- and higher-income families.

Adolescent↗
PubMed1998

The effect of employment status on private health insurance coverage: 1977 and 1987.

Analyzing cross-sectional data from the National Medical Expenditure Survey (NMES), we find that the predicted probability of private insurance coverage for low-income individuals as a group fell dramatically from 1977 to 1987. The results of a decompositional technique show that the relationship between full-time employment and private insurance has weakened over the period for low-income females, but has strengthened for males in this group. While it appears that low-income females benefit from part-time employment relative to their unemployed cohorts, no discernible difference is found in the likelihood of being covered by private insurance for part-time and unemployed males. Finally, evidence suggesting a weakening over time in the relationship between part-time employment and private insurance coverage is found among middle-income females and high-income males. From a policy perspective, passage of the Health Insurance Portability and Accountability Act of 1996 has taken an important first step in attempting to lower the number of uninsured, especially among full-time workers. Our findings, however, suggest that this legislation may be too limited in scope to effectively reach part-time workers presently uninsured.

Adolescent↗
PubMedDate not supplied

Private versus social opportunity cost of time: valuing time in the demand for health care.

In this paper we examine whether the current method of valuing time within economic appraisals is appropriate. The cost to society of time taken to use health care may differ from the private opportunity cost of such time. However, demand for health care may be affected by the private opportunity time cost and not by the value of time to society. In this paper we show that the private opportunity cost of time is a better predictor of demand for a screening service than the societal approach. It is important, therefore, to use the private opportunity cost of time when assessing the demand for, and impact of, a health care intervention.

Bone Density↗
PubMed1986

The effects of cognitive-behavior modification on private speech and task performance during problem solving among learning-disabled and normally achieving children.

Recent research has supported the hypothesis that poor performance among learning-disabled (LD) children is frequently the result of deficits in self-regulation of strategic behaviors, rather than structural or ability deficits. As a result, cognitive-behavior modification (CBM) techniques that emphasize development of self-regulation through self-verbalizations (private speech) have been strongly recommended. The present study examined the natural occurrence of regulatory private speech among LD and normally achieving children during problem solving, as well as the effects of CBM training on private speech and task performance. Results indicated significant deficiencies in private speech and task performance among LD children; CBM training resulted in significant improvements. These results provide further verification of deficits in self-regulation of cognitive activity among LD children and import implications for intervention.

Behavior Therapy↗
PubMed2000

Problems with quality monitoring for Medicaid managed care: perceptions of institutional and private providers in New York City.

The study objective was to examine quality oversight efforts by Medicaid managed care organizations (MCOs) for children in a sample of ambulatory care institutions and private practices in New York City. This was a cross-sectional study of quality assurance priorities and strategies of MCOs and their impact date in institutions in New York City. Data were from structured interviews administered in 1997 to medical directors in the eight largest MCOs; and medical directors, heads of ambulatory pediatrics, and institutional pediatricians in a random sample of 15 institutions and 20 private office-based providers. Medical directors in MCOs reported that their main priority areas were the preventive care measures (e.g., immunization and lead screening) that they must report to the state. Knowledge of these MCO priority areas and monitoring activities was high for medical directors in the random sample, but decreased from these medical directors to heads of ambulatory pediatrics to institutional pediatricians, with the differences between the medical directors and institutional pediatricians significant (P < .05). However, 96% of the institutional pediatricians reported knowing their own institution's priorities and monitoring activities. In contrast, most private pediatricians reported they knew MCO priorities and monitoring activities (80%). Less than 33% of any group reported activities as "very effective" or felt any incentive to improve performance. There was a high level of overlap in provider networks, with institutions and private providers having children in many MCOs, and MCOs having children in many sites. Conclusions. The current model of quality oversight is producing reports for the state, but is not translating into effective strategies at the provider level. The need to work through the leadership in institutions to influence quality is highlighted. The level of overlap in provider networks suggests the need for collaboration among MCOs in quality monitoring.

Attitude of Health Personnel↗
PubMed2007

Frequency, nature and determinants of pharmaceutical consultations provided in private by Dutch community pharmacists.

OBJECTIVE: According to a report published by the federation of Dutch patients' associations, patients would like to see a pharmacist, who acts more as a personal adviser. This raised the question, how often Dutch community pharmacists have personal consultations with their patients in daily practice, on which factors this depends, and what kind of topics are discussed during these meetings. SETTING: Community pharmacies in the Netherlands. METHOD: A questionnaire was distributed among 800 randomly selected pharmacies. Questions were restricted to consultations characterized by one-to-one contact, drug therapy related content, and adequate privacy. These consultations were labelled as pharmaceutical consultations in private to distinguish them from other contacts between pharmacists and patients. MAIN OUTCOME MEASURE: Number, content, and character of consultations. RESULTS: 198 (24.8%) community pharmacies responded. The pharmacists provide an average of roughly 1.2 consultations in private per working day. The vast majority of respondents provided face-to-face and telephone consultations (94.4 and 91.9%, respectively), only a minority gave consultations by e-mail (30.8%). These consultations primarily dealt with topics related to medication safety. The mean overall time spent was 290 min per month. A relatively high frequency of personal consultations was significantly associated with the absolute number of full-time equivalent pharmacists in the pharmacy. CONCLUSION: The frequency of pharmaceutical consultations in private is low, but may be improved by reorganisation of the pharmacist's activities. The possibility of personal consultations by e-mail is not yet well-developed. Further research is needed to assess the patient's view of pharmaceutical consultations in private.

Adult↗
PubMed1987

Causes of low birth weight births in public and private patients.

This examination of the cause of low birth weight births in two model populations, one of public and one of private patients, finds significant differences in the reasons for low birth weight births in the two groups. Idiopathic premature labor was related to 47.1% of private low birth weight births, but only 24.8% of public births; low birth weight term (26.7%) and premature rupture of fetal membranes (33.7%) were more common in public low birth weight births than in private births (13.8% and 23.0%, respectively). Medical problems were related to 16.1% of private and 14.9% of public low birth weight births. Since current prematurity prevention methods are most likely to prevent low birth weight births related to idiopathic premature labor, the relative success of such programs in reducing the rate of low birth weight births is likely to depend on the characteristics of the patient population to which the programs are directed.

Ethnicity↗
PubMed1993

Reducing cesarean births at a primarily private university hospital.

OBJECTIVE: The rise in cesarean birth at Northwestern Memorial Hospital in 1986 to 27.3% prompted implementation of three initiatives to reverse the escalating cesarean section rate. STUDY DESIGN: First, vaginal birth after cesarean section was more strongly encouraged. Second, after the 1988 calendar year the cesarean section rate of every obstetrician was circulated annually to each attending physician. Third, on completion of a prospective, randomized trial of the active management of labor in early 1991, this protocol was recommended as the preferred method of labor management for term nulliparous patients. RESULTS: The total, primary, and repeat cesarean section rates declined from 27.3%, 18.2%, and 9.1% in 1986 to 16.9%, 10.6%, and 6.4%, respectively, in 1991. At the same time the perinatal mortality dropped from 19.5 to 10.3. Significant reductions in abdominal deliveries occurred for both private patients (30.3% to 19.1%, p < 0.0001) and clinic patients (20.8% to 11.5%, p < 0.0001). A decline in operative deliveries for dystocia and an increase in vaginal birth after prior cesarean section were the principal factors contributing to the lower cesarean section rates. However, in 1991 individual private physicians still had wide variations in primary cesarean section rates (4.6% to 21.1%) and use of vaginal birth after prior cesarean section (5.3% to 90%). CONCLUSION: The cesarean section rate has been significantly reduced for both private and clinic patients. Differences in population demographics and individual physician practice patterns contributed to a higher incidence of cesarean birth on the private service.

Birth Weight↗
PubMed1990

Children's understanding of private keys in referential communication.

A private key is a referential utterance used to inform selectively. The ambiguity of the utterance conceals meaning from nonselected audience members. The purpose of this study was to examine three aspects of children's understanding of the use of private keys. Experiment 1 concerned children's sensitivity to information in the context of utterance (i.e., the common ground). Experiment 2 examined appreciation of audience design and the speaker's intent. Experiments 3, 4, and 5 explored some reasons for children's problems in understanding private keys. The results show that even first graders are sensitive to common ground information and the speaker's intent. However, audience design is troublesome even for second graders in some situations, probably because they fail to assess the knowledge of the audience members. Private keys are important theoretically because they represent an aspect of referential communication involving the uses of ambiguous utterances that have been ignored by developmental researchers.

Attention↗
PubMed1981

Privational and malabsorption metabolic bone disease: plasma vitamin D metabolite concentrations and their relationship to quantitative bone histology.

Plasma 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] and 25-hydroxyvitamin D (25OHD) concentrations were measured in twenty patients with metabolic bone disease due either to privational causes (10 patients) or malabsorption (10 patients). Abnormally low plasma 1,25(OH)2D3 levels were found in eleven patients, six with privational and five with malabsorption bone disease. Normal plasma 1,25(OH)2D3 concentrations were found in the remaining nine patients; of these, five were either receiving anticonvulsant therapy or had been hospitalised prior to investigation. In the absence of either of these factors, normal plasma 1,25(OH)2D3 levels were only found in patients with malabsorption-associated bone disease. Plasma 25OHD levels were below normal in eleven patients; six had malabsorption and five had privational bone disease. In the fifteen patients not receiving anticonvulsants there were significant inverse correlations between plasma 1,25(OH)2D3 levels and the osteoid volume, surface and seam thickness index. This study indicates that plasma 1,25(OH)2D3 concentrations are low in privational osteomalacia in the absence of anticonvulsant therapy or hospitalisation, although normal levels may occur in malabsorption metabolic bone disease uncomplicated by these factors. The plasma 1,25(OH)2D3 concentration appears to be inversely related to the histological severity of bone disease in patients not receiving anticonvulsant therapy.

Adult↗
PubMed1989

Availability of pharmaceuticals in sub-Saharan Africa: roles of the public, private and church mission sectors.

Although the availability of pharmaceuticals is critical for both curative and preventive health care, drugs are, at best, sporadically available in governmental facilities in sub-Saharan Africa. The religious missions and private sectors are more successful than the public sector in obtaining and distributing drugs. The public sector operates under a myriad of constraints inherent in a bureaucracy; the religious missions have the advantages of better management and access to foreign currency; the private sector is innately efficient. Donor assistance to increase the availability of drugs in the public sector has included support for revolving drug funds, national drug services, the improvement of management techniques, and the local production of pharmaceuticals. None of these interventions has been notably successful. In 1987, UNICEF presented The Bamako Initiative--a proposal to launch an internationally-financed fund for essential drugs for sub-Saharan Africa. However, the proposal is unrealistic in anticipating that the requisite resources and/or hard currency can be raised to support the proposal. As the private sector is a more efficient distributor, it is recommended that the private sector be given responsibility for the distribution of drugs. Nonetheless, some governmental controls will be necessary to ensure that essential drugs are available at the least cost to the consumer.

Africa↗
PubMed2006

Public and private domains of religiosity and adolescent smoking transitions.

We used data from a nationally representative sample of US adolescents in school grades 7 through 12 to explore the effects of public and private religiosity on initiation, escalation, and cessation of smoking. We found that adolescents' decisions to experiment with smoking are influenced by both their individual practice of their faith and by participation in a larger faith community. However, the effects of private and public religiosity are specific to different decision points on the smoking uptake process. Private religiosity was protective against initiation of regular smoking among nonsmokers. It also was protective against initiation of experimental smoking but only when the young person frequently attended religious services or a religious youth group. Although private religiosity appeared to discourage the uptake of smoking, it was unrelated to reduction or cessation once a young person has become addicted to cigarettes. In contrast, public religiosity did predict reduction and cessation of cigarette use among regular smokers. Taken together, these findings demonstrate that the domains in which religiosity are important extend beyond the individual and include religious institutions.

Adolescent↗
PubMed1982

Private adoption.

During an 18-month period 219 couples and 3 single women were counseled concerning private, non-agency adoption. Ninety-seven clients adopted privately a total of 105 babies. Thirty-one other couples are still actively pursuing adoption, 39 are no longer pursuing adoption, 13 became pregnant, 9 adopted through an agency, and 33 were lost to follow-up. One hundred of the 105 adopted babies were placed with the family directly from the hospital at 2 to 3 days of age. The majority of the adopting parents had a baby in their home within 4 months of the time they actively began trying to adopt. Four babies were reclaimed by the biologic mother before the adoption was finalized in court, but three of the couples that lost their babies adopted again. The average cost of a private adoption in this series was $3300. Private adoption is an important alternative to agency adoption.

Adoption↗
PubMed1999

Purchasing a quick fix from private pharmacies in the Gaza Strip.

Increasingly, it is recognised by health planners and social scientists that self medication with drugs bought over the counter in private pharmacies is extremely widespread. Some anthropologists see this trend as an aspect of the 'commodification of health'. In this study, group interviews with health service users and providers in Gaza revealed many health service users reporting an inadequate supply of drugs resulting in the purchasing of drugs in private pharmacies. As a result, a survey of the pattern of utilization of three private pharmacies in three contrasting urban areas within the Gaza Strip was undertaken. Using a questionnaire, data were collected from all customers buying drugs. The results show that variations in the patterns of health seeking behaviour were associated with socioeconomic status. Adult males were the most frequent customers of all three pharmacies. They were buying medicines for members of their nuclear family more often than for themselves. Overall, pain and influenza were the most commonly reported conditions. The drugs purchased most frequently for women were for reproductive health problems, particularly infertility. Customers of the pharmacy in the relatively prosperous area more commonly purchased drugs which were prescribed by a private doctor.

Adult↗
PubMed2003

Drug and alcohol treatment among privately insured patients: rate of specialty substance abuse treatment and association with cost-sharing.

OBJECTIVE: To examine the rate of formal substance abuse (SA) treatment in a privately insured population, and the association between cost-sharing, residential treatment, and outpatient SA treatment, we analyzed claims data for 332442 adults in 41 health plans with comprehensive SA treatment benefits. DESIGN: SA treatment utilization during 1999 and the relationship between patient cost-sharing, gender, and SA diagnosis on SA treatment utilization were examined using a cross-sectional retrospective analysis. RESULTS: Only 0.37% (n=1230) of adults had a SA related claim during 1999. Individuals in plans with higher levels of cost-sharing had lower rates of residential SA treatment and specialty SA outpatient treatment compared to individuals in plans with lower cost-sharing, adjusting for age, sex, and SA diagnosis. CONCLUSIONS: Few individuals had SA related claims, raising questions about rates of undocumented treatment, out-of-network treatment, and unmet need for treatment in the privately insured, and its implications for assessing the quality of SA treatment available in private health plans. At a time when levels of cost-sharing are increasing among privately insured individuals, consideration should be given the potential impact of such changes on the treatment of individuals requiring specialty SA treatment.

Adult↗
PubMed2002

A sequential analysis of private and social speech in children's dyadic communication.

The purpose of this study was to perform a sequential analysis of private and social speech in children's dyadic communication. To investigate the communication patterns, a category system was applied to the communication of 64 paired third (M = 8 years and 8 months) and fifth (M = 10 years and 8 months) graders, while playing with a Lego-set (construction material). The results revealed that: (a) at both grades, when one child addresses the other child about the task, it is highly probable that the latter will address the first child immediately afterwards and will adapt to task-related semantic content; (b) at both grades, children's private speech about the task stops them from communicating a task-related production to their partner immediately afterwards; (c) at third grade, task-relevant private speech favors the prolongation of the break in interpersonal communication and the use of inner speech by both children; and (d) at fifth grade, children are more able to distinguish private speech from social speech than at third grade.

Age Factors↗
PubMed2001

Public eyewitness confidence ratings can differ from those held privately.

Despite much research on eyewitness confidence, we know very little about whether confidence ratings given in public might differ from those held privately. This study tested a prediction derived from self-presentation theory that eyewitnesses will give lower confidence ratings in public when there is a possibility of their account being contradicted by other witnesses as compared to when they report their confidence in private. In groups of 3 or 4 people, 96 participants watched a videotape of a simulated robbery and then answered 16 forced-choice questions about details from the videotape. In half of the experimental sessions, the participants shared their answers and confidence ratings aloud with the other participants (public condition), and in the other half, the answers and ratings were not shared (private). As predicted, confidence ratings were significantly lower in the public condition than in the private condition, but the privacy manipulation had no effect on response accuracy. These results are consistent with a self-presentation explanation, and they highlight the need to examine public confidence ratings more thoroughly.

Adolescent↗