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At least 955 records · Page 53Linked to original sources
PubMed2006

Is there a duty for private employers to provide emergency mental health care services?

This article presents a discussion of whether employers in private companies have a duty to provide an emergency action plan with a mental health component for its employees. It discusses basic negligence concepts and focuses mainly on the "duty of care" component of negligence. It then applies the negligence concepts to private employers and discusses how private companies arguably might have a duty under the laws of negligence to provide employees with an emergency action plan, specifically a plan including mental health provisions.

Disaster Planning↗
PubMed2006

Quality of tuberculosis care provided in different models of public-private partnerships in South Africa.

SETTING: Free State, North West and Western Cape provinces, South Africa. OBJECTIVE: To evaluate quality of care for the treatment of tuberculosis (TB) provided in different public-private partnerships. DESIGN: Quality of care analysis comparing three different models of directly observed treatment (DOT) provision: purely public, public-private workplace partnership (PWP), and public non-governmental organisation (NGO) partnership (PNP). For each type of provision model, two sites were selected. Three dimensions of quality of TB care--structure, process and outcome--were assessed. RESULTS: The PWP sites had the highest score in all three aspects of quality of care. In terms of process quality, the sites achieved similar scores, reflecting a very good knowledge of the treatment guidelines for both private and public providers. Patients supervised in the public clinics generally had lower treatment completion rates than those supervised in the occupational health clinics in the workplace and in the community. CONCLUSION: Partnerships with community-based NGOs and employer-based medical services should be established when the government does not have the capacity to provide services. The capacity of the public sector to monitor the quality of care provided in the partnerships is therefore crucial.

Cooperative Behavior↗
PubMed2006

The right to health and the privatization of national health systems: a case study of the Netherlands.

Many countries have national health systems that cover all or part of the population. An aging population and advances in medical technology are making health insurance increasingly expensive, and governments are left seeking cost-effective options. The Dutch government is reorganizing its health care system and seeking to combine economic competition with a right to health in order to improve the health of its population. This article addresses privatization in terms of a right to health and asks whether governments can privatize their health care systems while also guaranteeing the availability, accessibility, acceptability, and quality of health care services. It is suggested that a "right to health impact assessment" can be a useful tool applicable also to the privatization processes in other countries.

Health Services Accessibility↗
PubMed2006

[Duration of treatment in private psychiatric practices].

INTRODUCTION: The purpose of the study was to investigate duration of treatment and dropout from treatment in private psychiatric practices. MATERIALS AND METHODS: Data from the data base: Quality Assurance in Danish Psychiatric Private Practice (QAD3P) is applied for the investigation. The database was established in 1996 and includes information about approximately 40,000 treatment episodes. The present investigation uses information about 6,067 treatment episodes from 10 private practising psychiatrists, all of whom participated continuously in the Quality Assurance data base in the period 1998-2002 inclusive. RESULTS: Depression, anxiety and personal disorders constitute 82% of the treated episodes. Schizophrenia spectrum disorders show the longest duration of treatment (33.4% are treated for longer than 12 months), and persons with personality disorders have the shortest treatment duration (66.9% terminate the treatment within 6 months). Dropout from treatment is predicted (logistic regression) by gender (male), OR 1.31, 95% CI, 1.15-1.48 and age (< or = 44 years) (OR 2.49, 95% CI 2.21-2.81). CONCLUSION: Approximately 25% of the patients drop out of treatment. The causes for this are not known, but are correlated to patients' young age (< or = 44 years) and gender (male).

Adult↗
PubMed2006

A rural public-private partnership model in tuberculosis control in south India.

SETTING: A rural tuberculosis (TB) unit in South India, 2001-2003. OBJECTIVE: To evaluate a rural public-private partnership model (PPPM) within the TB control programme (RNTCP). DESIGN: All of the private practitioners trained in modern medicine (PPs, n = 52) and the private laboratories (PLs, n = 13) in the area were listed. The PPs underwent training about the RNTCP, and PL staff were trained in sputum microscopy. PPPM included referral of TB suspects to the smear microscopy centres (government or PLs) for diagnosis and treatment of patients as per RNTCP guidelines. Patients were back-referred to the PPs. The directly observed treatment providers and centres were chosen by the PPs in consultation with their patients. The case detection rate, cure rate and profile of patients referred by the PPs were compared with those of self-reported patients. RESULTS: Of 489 TB suspects referred by the PPs, 24% were smear-positive compared to 10% of 15 278 self-reported patients (P < 0.001). Of 319 referred to PLs, 7% were smear-positive. The annual average case detection rate increased from 66 to 75 per 100 000 population. The cure rates of patients referred by the PPs were comparable to those of self-reported patients. CONCLUSIONS: This rural PPPM is effective and does not require additional staff or any direct financial incentives.

Adult↗
PubMed1991

[Standards of nursing services for private hospitals].

The formalization of nursing quality assurance in private hospitals is of critical importance. The purpose of this study was to formulate national nursing service standards for private hospitals. A structured two phase research technique was utilised to validate the standards by a representative national group of experts. Statistical validity of the standards was calculated by means of a content validity index for each standard. Fourteen (5%) of these standards (N = 275) were rejected and 25 (9%) require reformulation. It is recommended that these standards should serve as optimum standards for nurse administrators in private hospitals, and that these standards be published formally.

Disaster Planning↗
PubMed1991

[Frequency and antibiotic susceptibility of bacteria responsible for urinary infections in private practice from 1986 to 1990. Results of 5398 samples].

For each year from 1986 to 1990, fourteen private laboratories from all over France collected epidemiological data on germs discovered in urinary infections in France. This retrospective and comparative study covers 5,398 dossiers. The sensitivity of germs in private practice in urinary infections (ampicillin, AM-AC, cephalosporin, ceftriaxone, gentamicin, pipemidic acid, pefloxacin, cotrimoxazol) were analysed. Germ resistance tests carried out by the CMI study in the centre of reference (Pr Thabaut, HIA Bégin) showed variable divergences according to the different antibiogram techniques employed by the private laboratories.

Adolescent↗
PubMed1991

Health promotion behaviors of private practice dental hygienists.

Today, there is increased emphasis in oral healthcare on health promotion and disease prevention. This is consistent with the focus of the dental hygiene profession. The purpose of this study was to investigate the health promotion behaviors of private practice dental hygienists within the ADHA District X region (Colorado, Montana, Utah, Wyoming). Statistical analysis procedures (frequencies, tests of statistical significance, and factor analysis) were performed on the questionnaire responses of 817 respondents who were employed in private practice settings. The results indicated that most respondents spent approximately five to 10 minutes on oral hygiene instruction (OHI) during a prophylaxis appointment, and focused on a variety of "traditional instructional" activities (e.g., discussing brushing and flossing, plaque control, caries, and periodontal disease). The majority of the respondents were satisfied with the amount of time they spent on OHI. When asked what factors limited the amount of time spent on OHI, the respondents most often cited "lack of interest on the part of the patient." Most respondents indicated there was no separate fee charged for OHI, even if separate OHI appointments were scheduled. The factor analysis indicated that some low-frequency behaviors (e.g., use of disclosants) were related more strongly to the concept of health promotion than were some high-frequency behaviors (e.g., use of a periodontal probe). The results of this study indicate that although health promotion services are provided frequently by dental hygienists, these services may not be provided consistently in the most effective way. Future research efforts could investigate the health promotion behaviors of private practice hygienists across the nation with a revised questionnaire to determine more adequately the status of these behaviors.

Analysis of Variance↗
PubMed1990

A comparison of low back pain profiles of chiropractic teaching clinic patients with patients attending private clinicians.

A study was undertaken at six chiropractic college outpatient (teaching) clinics and 60 private chiropractic clinics, to evaluate the comparability of patients' pain quality and pain intensity in each of three low back pain diagnostic groups. The McGill Pain Questionnaire (MPQ) was employed for this purpose. There was a tremendous range of measurable pain characteristics (Pain Rating Index scores) within the three diagnostic groups in both patient samples. Overall, patients of field doctors had higher mean scores on all dimensions of pain quality measured by the MPQ, and they described a higher pain intensity than patients attending the teaching clinics. In all three diagnostic groups, patients attending teaching clinics were more likely than private patients to present with a chronic low back condition. Although patients in the field more frequently used words implying greater pain intensity, the characteristics of pain quality (descriptor profiles) showed similar trends among the two patient samples. The consistent findings of less pain intensity among teaching clinic patients support previous reports that these patients have milder complaints than patients seen by field doctors. While these findings do not rule out the use of teaching clinic patients as subjects in clinical trials, it is suggested that generalizations from teaching clinic patients to private patients should be made with caution.

Adult↗
PubMed1990

The privatization of treatment services for alcohol abusers: effect on the black community.

This article discusses the "new wave" of privatization of treatment services for alcohol abusers. Despite the prevalence of alcohol abuse among ethnic minorities, the problem is still only marginally accepted as a focus for public health services. Instead of a consolidated effort or an integrated network, there are territorial fights among providers, a mistargeting of audiences, and a lack of any effort directed toward preventive health care. Recent research indicates that 68.5% of private sector employees are now covered by alcohol abuse treatment benefits as compared with only 36.2% in 1982. The growing number of employee assistance programs also has addressed the financial problems associated with long-term treatment in the work environment. Unfortunately these efforts are only directed at those in the society who are employed. As minority employment is much lower than that of the majority, minorities have not received the benefits of employer-financed treatment. This article assesses the growing privatization of treatment services and the failure of public alcohol prevention and rehabilitation programs to provide needed treatment for American minorities.

Black or African American↗
PubMed1990

The private health sector in South Africa--current trends and future developments.

The private health sector is experiencing a crisis of spiralling costs, with average annual cost increases of between 13% and 32% over the decade 1978-1988. This trend is partly explained by the high utilisation rates that result from the combination of the 'fee-for-service' system and the 'third-party' payment structure of the sector. Medical schemes have responded by promoting the idea of 'flexible packages', and have won the right to 'risk-rate' prospective members. It is argued that these measures will undermine the principle of equity in health care, and will not solve the problems of the private sector. Instead, a more significant restructuring of the sector is likely to emerge. This may take the form of 'managed care' structures, along the lines of the health maintenance organisation model from the USA. The principles, advantages and problems of 'managed care' structures are described. These are shown to be potentially more rational and efficient than the current structure of the private sector. Although some resistance to 'managed care' structures can be expected, the convergence of interests of large employers and trade unions in containing health care costs suggests that their emergence is a likely development.

Costs and Cost Analysis↗
PubMed1988

Private practice of periodontics. Past patterns, future prospects.

The private practice of periodontics has grown in a comparatively short time from a handful of clinicians to a significant factor in the overall practice of dentists. Periodontics has matured into a specialty that interfaces with every aspect of dentistry. Patient awareness demands it service. With the changes taking place in the health delivery system, there has emerged insurance and capitation programs that have influenced the private practice of periodontics. Along with these changes have come economic factors that have encouraged many periodontists to seek new avenues of revenue such as implantology. The dental awareness of the public and the continuance of the high standards of periodontics will prevail. If this is the case, then the future prospects of the private practice of periodontics is ensured.

Delivery of Health Care↗
PubMed1986

Urinary response to oral potassium citrate therapy for urolithiasis in a private practice setting.

Oral potassium citrate therapy was recently approved for treatment of urolithiasis based on results of experiments in a university research setting. However, no supporting studies from private practice have been published. The present study was undertaken to assess the response to one week of oral potassium citrate therapy (60 mEq/day), with respect to urinary risk factors for kidney stones, in a private practice setting. A significant rise in urinary pH, citrate, and potassium excretion, accompanying a significant fall in calcium excretion, were observed. Urinary saturation of calcium oxalate was significantly reduced, as some risk factors in urolithiasis were corrected with oral potassium citrate therapy. The response to therapy in private practice was comparable to that observed in a university research setting.

Adolescent↗
PubMed1986

Beyond equity: Swedish health policy and the private sector.

The rapid development of private medicine in Sweden poses a challenge to that nation's traditional commitment to equity and a public system of health care. Economic constraints in public-sector spending, physician intent in private practice, popular interest in individual choice, and criticism of the public system have been the stimulus. The dominant Social Democrats will likely accept those elements of the private sector that are ideologically compatible, but resist others.

Health Facility Administration↗
PubMed1978

Private psychiatric practice: image and reality.

This study reports data collected from an individual private psychiatric practice. Despite the paucity of information concerning private practice, a popular image has evolved. An analysis of a sample of 400 patients' records confirmed certain aspects of this image, but suggested that other aspects of the image are misleading. A short-term model of private practice may be more effective than other competing models.

Adolescent↗
PubMed1995

Physical therapists in private practice: information sources and information needs.

Increasing numbers of physical therapists are providing evaluation and therapy in their own private-practice clinics. Their move out of the hospital setting has reduced their access to the sources of information designed to support clinical and practice-management decision making. The author designed a survey to determine how often physical therapists in private practice in Vermont use seven sources of information for clinical and practice-management decision making. Survey respondents also were asked to rate the anticipated usefulness of a variety of health sciences library information and research services not currently available to them and to rank access paths to information according to their preferences. The therapists' responses show frequent reliance on personal and office collections of professional literature for clinical decision making but virtually no use of bibliographic databases. Respondents ranked document-delivery services and mediated searches as having the greatest anticipated usefulness for clinical decision making. The limitations of their current information-seeking behavior and their high level of interest in increased access to a wide range of information and research services make physical therapists in private practice of special interest to health sciences librarians who are planning outreach programs.

Information Services↗
PubMed1995

[An orientation program for nurses in a private hospital. Phase III].

An exploratory, descriptive and contextual research study was executed in the description of an orientation programme for registered nurses in a private hospital. The data for the orientation programme were inferenced from phase 1 (experience of the registered nurse in a private hospital), and the conceptual framework and phase 2 (the expectations of doctors regarding the nursing duties of a registered nurse in a private hospital). These data therefore represent the population. Data-analysis was done through utilization of the three sets of premises as supportive data for the orientation programme. The result is the description of the orientation programme, as well as the description of guidelines in the operationalization of the programme.

Hospitals, Private↗
PubMed1993

Community care, competition and coercion: a legal perspective on privatized mental health care.

Even as the Clinton administration considers an increased federal commitment to mental health care, delivery of such care remains fixed at the state level. In Massachusetts, state officials are privatizing mental health care on an unprecedented scale, an experiment that promises to provide better care at lower cost. This Note explores whether privatization can achieve that lofty goal, given a legal system that has made individual patient autonomy its preeminent value. The author concludes that wide-scale privatization and modern notions of self-determination can only coexist with a significant investment in the support services that are critical to the community tenure of former state hospital patients.

Commitment of Persons with Psychiatric Disorders↗