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PubMed1989

Health services utilization and physician income trends.

Statistics from several Organization for Economic Cooperation and Development countries on consumption and cost of health care services, physician workload, and physician earnings are presented. Data are analyzed according to type of physician payment used: fee for service, per case, capitation, or salary. Incentives theoretically embodied in each payment method are often offset by other factors--scale of charges, patient out-of-pocket payment, and patient access or physician activity restrictions. Moreover, the impact of payment method on use appears to be weaker than the impact of such factors as population morbidity, national health insurance, professional ethics, and medical technology.

Canada↗
PubMed1980

Child health care in Finland.

The following article presents an overall picture of child health care delivery in Finland. The history and priorities of the Finnish Child Care Services are discussed with statistical data regarding birth rate, mortality and immunization.

Birth Rate↗
PubMed1998

The development of a comprehensive interdisciplinary HIV/AIDS center: a community needs assessment.

Meeting the needs of HIV-infected patients in a focused, cost-efficient, coordinated manner is one of the most challenging problems in health care today. Before developing an intervention program, accurate surveys of need must be done. This article presents one such needs assessment conducted in a rural section of the Midwest. The assessment consisted of (1) surveys of HIV+ individuals/people with AIDS, area physicians, and local key informants and service providers, and (2) statistical data from health departments. Results of analyses suggest that access to primary care, self-care education, mental health and family support services, case management, financial assistance, community education, and home health services are this community's highest priority needs.

Adolescent↗
PubMed2006

Prevalence of adverse behaviors among young military conscripts in Taiwan.

OBJECTIVES: To evaluate cigarette smoking prevalence and to examine the clustering of adverse behaviors among young military conscripts in Taiwan. METHODS: Cross-sectional screening was conducted among conscripts in southern and eastern sections of Taiwan from August 1 to December 31, 2001. A total of 7,931 conscripts who had > 1 month of service were included in this multistage sampling study. RESULTS: Adjusted prevalence rates of cigarette smoking before and during military service were 49.2% and 51.9%, respectively. The prevalence of smoking slightly increased during military service, and this was statistically significant. Adjusted prevalence was highest in the Navy (53.8%) and lowest in the Air Force (48.4%). Less education and longer duration of service were associated with increased prevalence of smoking. Conscripts with high school educations or below and those in service > 18 months had higher adjusted prevalence rates (65.6% and 55.2%, respectively). During military service, the adjusted prevalence rates of smoking among conscripts were similar in different geographic areas. There was significant aggregation of adverse behaviors, such as cigarette smoking, alcohol consumption, and betel nut chewing, among these young military conscripts in Taiwan. CONCLUSIONS: The prevalence of cigarette smoking was slightly increased during military service. Furthermore, the prevalence of cigarette smoking was still higher among military conscripts, compared with the general population in Taiwan, which suggests that military service is a potential factor associated with cigarette smoking for adolescents and young adults. This finding and the aggregation of adverse behaviors among conscripts indicate that more surveillance and intervention studies are needed to evaluate the best way to control and to stop smoking among military conscripts in Taiwan.

Adult↗
PubMed1989

Statistical analysis of data on airborne asbestos levels collected in an EPA survey of public buildings.

Data from a recent EPA study of airborne asbestos levels in 49 buildings occupied by the General Services Administration (GSA) are statistically analyzed. The study focuses on differences between indoor and outdoor levels, and on differences among buildings with no asbestos-containing material (ACM) (6 buildings), buildings with ACM generally in good condition (6 buildings), and buildings containing damaged ACM (37 buildings). Seven indoor samples and a single outdoor sample were collected from most buildings and analyzed by TEM (transmission electron microscopy) using a direct preparation method. No statistically significant differences were detected in asbestos levels between indoors and outdoors or among the three categories of buildings. The average indoor concentration of asbestos was 0.00073 fibers/cc (f/cc) for all fibers and 0.00007 f/cc for fibers 5 microns or longer. The current OSHA occupational standard is 0.2 f/cc for fibers 5 microns or longer as measured by phase-contrast microscopy.

Air Pollutants, Occupational↗
PubMed1992

[Practical use of mortality statistics and mass examination results by health workers in the local authority of the community].

In Kochi prefecture, the prefectural health service bureau tabulates both mortality statistics and mass examination results for each community and the tabulated report is sent annually to public health services staff in each local authority. While recognizing its limitations, methods of how to use the annual report are demonstrated. For example comparison of the mortality statistics and the mass examination results of the male population of A town, which is administered by Susaki Health Center, to that of the combined male population of all the towns administered by the health center shows that although the mortality rate for cerebrovascular disease for the A town-male population had been much higher than that of the combined male population in the early 1980's, the difference disappeared in the late 1980's. On the other hand, prevalence of systolic hypertension in the A town-male population continued to be higher than that for the combined male population in the late 1980's. Therefore hypertension prevention programs appears to still have significance in the A town-male population. Certain weaknesses exist in this annual report. In the comparison of mass examination results among different populations, the presence of selection bias of those receiving examinations should be considered. Standardization of mass examination procedures and quality controls of the examinations should also be considered. To get health workers to utilize the annual report further, the reported items should be improved. Particularly useful would be tabulation by residential subdivision and occupation.

Community Health Services↗
PubMed2006

The characteristics of self-referrals to ER for non-urgent conditions and comparison of urgency evaluation between patients and nurses.

The aim of the study was to identify the characteristics of self-referrals for non-urgent conditions to the ER, and compare urgency evaluation between patients and nurses. The participants were 73 Israeli clients who arrived at ER without referral from a physician, during the morning shift, and were discharged home after treatment. Their average age was 39.4 years. Most of the visits resulted from orthopedic problems. Over 60% indicated that they had chosen the ER because the treatment there was better, and a third reported that they usually turn to ER when they feel sick. In most cases, the visits were within 3 h of the symptoms emerging, and about a third of the participants indicated that lately they had been under situations of stress and anxiety. Significant differences (p=0.000) were found between nurses and patients, in the urgency evaluation of the visit. While most of the clients (77%), evaluated their condition as urgent to most urgent, most of the nurses (78%) evaluated it as non-urgent. Identifying the characteristics of the non-urgent use of the ER and the differences between caregivers and patients regarding the urgency evaluation of the visit, will provide insights into the population perceived as a burden on the work of the ER as well as benefiting and improving services.

Adolescent↗
PubMed2004

Use of a routine outcome measure in a consultation-liaison mental health service.

OBJECTIVE: The problem severity of patients seen by a psychiatric consultation- liaison service was studied through the use of a routine outcome measure. METHODS: Ratings on the Health of the Nation Outcome Scales (HoNOS) over nearly 3 years in the emergency department, general hospital, and on admission to the acute psychiatric unit were compared. RESULTS: Mean HoNOS total scores in the emergency department were not significantly different from those at admission to the acute psychiatric unit, but were significantly higher than those in the general hospital. Mean scores in all three settings were higher than those obtained at case review of psychiatric patients in the community. Despite differences in age, sex, and psychiatric diagnosis between the three hospital settings, differences in mean HoNOS total scores remained substantially unchanged after adjustment for these factors. Most HoNOS assessments were performed by medical staff. CONCLUSIONS: The suspected high levels of problem severity and comorbidity of patients seen by a psychiatric consultation-liaison service were confirmed through the use of a routine outcome measure.

Adult↗
PubMed1979

The relationship between infant mortality rates and medical care and socio-economic variables, Chile 1960-1970.

Infant mortality rates (IMR) have traditionally been considered useful as health status indicators, and changes in these rates are thought to reflect changes in both medical care services and socio-economic circumstances. In order to explore this relationship of IMR with medical core and socio-economic factors in a developing country, Chilean health zone data for the decade 1960--1970 were used to construct 25 variables which were then classified into groups representing antenatal-obstetric services, acute and preventive medical services and socio-economic variables. In an analysis which involved developing a series of linear multiple regression equations for each year of the decade 1960--1970 with IMR as the dependent variable, the percentage of births with professional attention proved to be the stronger variable.

Child Health Services↗
PubMedDate not supplied

Patient satisfaction of emergency nursing care in the United States, Slovenia, and Australia.

Patient satisfaction with nursing care in the emergency department (ED) was measured in 616 patients in California and Kentucky in the United States, Slovenia, and rural and urban Victoria in Australia. Patients were almost equally divided between men and women, primarily white, with a mean age of 44. They responded to the caring and teaching subscales of the Consumer Emergency Care Satisfaction Scale (CECSS). While scores indicated no differences in caring, the US and Slovenian groups reported greater satisfaction with teaching than did the Australian group. The subscale alpha coefficients were .87 for the caring subscale and .92 for the teaching subscale.

Adult↗
PubMed1996

Continuous quality improvement in health maintenance organizations: an application of the HEDIS model.

One aspect of the Clinton Healthcare Reform programme is to assist health maintenance organizations (HMOs) in collecting and analysing data for the purpose of continuous quality improvement. The HEDIS 2.0 quality performance measurement model is currently in use and endorsed by the National Committee for Quality Assurance (NCQA). Outlines a process using HEDIS 2.0 by which an HMO can identify crucial problem areas and track the success of the solution process. Discusses the use of other relevant statistical tools.

Data Interpretation, Statistical↗