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At least 991 records · Page 55Linked to original sources
PubMed1984

[What role are private organizations going to play tomorrow in the field of health?].

Health care-almost exclusively a private affair in earlier times-is now more and more influenced by public administration. The role of the private organizations and with it the role of the health leagues has changed, but their importance remains. Motivation is stronger among volunteers, and services are more easily adapted to specific needs. Personal-also financial-engagement is a needed basis for many preventive actions, and public interventions should ideally be kept to a necessary minimum. Finally, private organizations are more ready and able to try new approaches and respond to changing needs. Their potential for innovation and flexibility will guarantee the persistence of their action within the Swiss health system, also in a future characterized by increasingly rapid change.

Forecasting↗
PubMedDate not supplied

Predominantly female caseloads: identifying organizational correlates in private substance abuse treatment centers.

This study used a national sample of private substance abuse treatment centers to identify the organizational attributes characterizing facilities with a predominantly female caseload. Data were drawn from the National Treatment Center Study, a nationally representative study of private-sector alcohol and drug abuse treatment centers (N = 365). Bivariate and multivariate analyses were conducted to explore which organizational characteristics are associated with higher percentages of women in treatment. Private substance abuse treatment facilities were more likely to have a predominantly female caseload if they (1) offered childcare programs, (2) had a higher percentage of families participating in treatment, (3) treated psychiatric disorders, (4) employed a greater percentage of counselors with at least a master's degree, (5) received a higher proportion of referrals from mental health sources and a lower proportion of referrals from workplace-based referral sources, and (6) accepted higher proportions of Medicare and/or Medicaid clients.

Family↗
PubMed1998

[First annual report of practitioners of interventional cardiology in private practice in Germany. Results of procedures of left heart catheterization and coronary interventions in the year 1996].

The German Society for Cardiac Angiography and Interventions in Private Practice has started a registry of cardiac procedures since 1996 in order to establish a standard for performance. Although quality management for the cath lab makes sense and is also legally required, there is no generally recommended infrastructure for quality assurance existing in Germany at this time. Therefore, the German Society of Cardiologists in Private Practice (BNK) initiated a project in 1994 to develop a computer program for paperless documentation of diagnostic cardiac catheterizations and coronary interventions (PTCA) using a minimal data set. In 1996, 8 private associated groups participated in this project. The (anonymous) analysis of 10,316 diagnostic cardiac catheterizations and 2597 PTCA yielded the following results: In 95% of the patients, diagnostic cardiac catheterization was performed using the femoral and in 5% the brachial/radial approach. The mean volume of administered contrast medium was 164 +/- 138 ml/patient. The mean LV-EF was greater than 50% in 58.4% of the patients and between 30% and 50% in 10.1%. Coronary artery disease was diagnosed in 69.6% of the patients and valvular/congenital heart disease in 8.5%. In 18.4% of the patients undergoing diagnostic cardiac catheterizations no significant heart disease was identified. Mortality in the cath lab as well as the rate of cerebral insults was 0.05%. In 22.9% and 19% of the patients PTCA and cardiac surgery respectively was recommended. In patients undergoing PTCA, stable angina was present in 74.4% and unstable angina in 13.1%. Of the total number of PTCA procedures, 5.8% were performed in the setting of acute myocardial infarction. The PTCA lesion success rate was 96%, the mean diameter stenosis was 81% pre and 6% post-intervention. The mortality rate at 1 month post-PTCA was 0.4%, and myocardial infarction 1.0%. An acute occlusion occurred in 1.3% of the PTCA patients; 0.6% had to be transferred for emergency bypass surgery. None of the cath labs had on-site surgery. In comparison to other registries, our data show some similarities but also some different trends. Thus, our newly developed software proved to be reliable, fast and easy to use. Participating centers receive immediate feedback regarding their position within the whole group.

Angiocardiography↗
PubMed1997

State Forest Practice Regulatory Programs: An Approach to ImplementingEcosystem Management on Private Forest Lands in the United States

/ Implemented in the context of a long history ofintense public debate, forestry practices applied on private forest land areregulated in some form by 38 states. State regulatory activities can involvemany agencies implementing numerous regulatory laws, a single forestry agencyadministering a comprehensive regulatory program, or a combination of thetwo. Regulatory programs are designed to protect resources such as soils,water, wildlife, and scenic beauty. Program administration often involvesrule promulgation, harvest plan reviews, coordination of interagency reviews,and pre- and postharvest on-site inspections. Forest practice rules usuallyfocus on reforestation, forest roads, harvest procedures, and wildlifehabitat protection. Emerging regulatory trends include growth of multiagencyregulatory authority and associated jurisdictional conflicts, increasedtendencies to narrowly specify standards in statutes and rules, emergence ofcontingent regulations, growing sensitivity to processes enabling theadoption of new forest practice technologies and an ability to addresscumulative effects, interest in collaborative rule-making stemming fromheightened concern over legalization of administration processes, and growingconcern over the constitutional foundations for regulatory programs and thegovernment and private sector cost of implementing such programs.KEY WORDS: Ecosystem management; Forestry practices; Private landowners;Regulatory programs; State government

Journal Article↗
PubMed1986

Private exposure and covert sensitization in the treatment of exhibitionism.

The present report describes the treatment of a long standing exhibitionism case by covert sensitization and private exposure in front of his wife within an A-BC-B-BC-C single case experimental design. The therapeutic phase of the treatment lasted 10 weeks. Results show that the combination of covert sensitization and private exposure seems to be an interesting technique for married exhibitionists and their wives. Covert sensitization was used to eliminate deviant fantasies and private exposure seemed to have rendered exhibitionism socially acceptable. The various measures of subjective responses indicated that there were no exhibitionist activities during baseline and treatment nor during the year's follow-up, and the patient has been asymptomatic for more than 2 years, as confirmed by a recent follow-up visit. Controlled studies with larger groups of patients are now needed to prove the efficacy of this active, nonaversive and economical treatment for exhibitionists and their wives.

Adult↗
PubMed1986

Suppression of in vitro human antithyroglobulin antibody secretion by private and cross-reactive anti-idiotypic antibodies.

This is a report on suppression of in vitro human antithyroglobulin antibody secretion in Epstein-Barr (EB) virus-transformed B lymphocytes by private and cross-reactive anti-idiotypic antibodies. Two polyclonal anti-idiotypic antibodies, private anti-Yo-Id and cross-reactive anti-Uc-Id antibodies, were raised in rabbits. Human IgG, lambda antithyroglobulin antibody-producing cell line (Yo3) and human IgG-producing cell line (Yo5), which did not contain the antithyroglobulin activity were established by EB virus transformation of peripheral lymphocytes of patient Yo with chronic thyroiditis. Binding of anti-Yo-Id and anti-Uc-Id antibodies to IgG F(ab')2 antithyroglobulin derived from patient Yo was significantly inhibited by human thyroglobulin and affinity-purified IgG antithyroglobulin of Yo3 cell line. Both private anti-Yo-Id and cross-reactive anti-Uc-Id antibodies suppressed the antithyroglobulin antibody secretion in Yo3 cell line. But these anti-idiotypic antibodies did not suppress the IgG secretion in Yo5 cell line. These results suggested that interactions between idiotype and anti-idiotype may play a role in the immune system of human chronic thyroiditis.

Antibodies, Anti-Idiotypic↗
PubMed1988

Private idiotypes on human polyclonal IgG anti-DNA antibodies are not expressed on coexisting IgM anti-DNA antibodies in systemic lupus erythematosus.

Sharing of private idiotypes (Id) on human polyclonal IgG anti-double-stranded DNA (dsDNA) with coexisting IgM anti-dsDNA was investigated using rabbit (R) anti-Id raised against IgG anti-dsDNA. The R-anti-Id showed specificity to private Id in or near the antigen-binding sites. The R-anti-Id poorly bound to the immobilized enriched IgM anti-dsDNA preparation but significantly bound to IgG anti-dsDNA preparation by a direct-binding ELISA (0.020 OD vs 0.295 OD, respectively). The R-anti-Id poorly inhibited the binding of IgM anti-dsDNA to immobilized dsDNA but significantly inhibited the binding of IgG anti-dsDNA to dsDNA (6% vs 55% inhibition, respectively). This was confirmed by poor inhibition of binding of the R-anti-Id to immobilized IgG anti-dsDNA by the enriched IgM anti-dsDNA preparation (maximum of 26% inhibition at 50 micrograms/ml). Nonsharing of private Id between IgG and coexisting IgM anti-dsDNA may represent the idiotypic diversity of human anti-DNA antibodies secondary to the frequent occurrence of somatic mutation on anti-DNA antibody during class switching.

Animals↗
PubMed1990

Development of a medical-psychiatric program within the private sector. Potential problems and strategies for their resolution.

Recent reports regarding the development of combined medical-psychiatric units have primarily involved units operated under the auspices of academic medical centers. Almost no published information is available regarding the fiscal, administrative, or clinical feasibility of operating such programs within the context of the private community hospital setting. This article outlines the organization and development of such a private unit and discusses the various medical, administrative, political, and financial considerations that must be evaluated in planning for the successful operation of medical-psychiatric units within the private sector.

Cost Control↗
PubMed1991

The reaction of private physicians to price deregulation in France.

French private physicians are paid on a fee-for-service basis and nearly all of them are under contract to the Social Security, which refunds part of the medical fee to the whole population. Previously the prices of medical services were fixed, but since 1980, a new option has been possible: a doctor can choose to fix the price of his services freely, provided he pays a higher social insurance contribution. But the amount refunded by Social Security does not vary, so that the consumer has to bear the extra charge. Our purpose here is to identify the factors that influence the physician's option. In Section 2, we define a model of the private physician's economic behaviour, of the classic income-leisure type. In Section 3, empirical tests are performed on a sample of observations in 95 'départements', gathering information about private GPs on the one hand, and the whole population on the other. According to our results, GPs' decisions depend on characteristics of both supply of and demand for GPs' services. One of our conclusions is that GPs seem to make up for low activity levels with higher prices, on condition the income of their practice allows it.

Choice Behavior↗
PubMed2004

Hospital costs associated with surgical complications: a report from the private-sector National Surgical Quality Improvement Program.

BACKGROUND: The National Surgical Quality Improvement Project (NSQIP) has reduced morbidity rates in Veterans Affairs Hospitals. As the NSQIP methods move to private-sector hospitals, funding responsibilities will shift to the medical center. The objective of the current study was to calculate hospital costs associated with postoperative complications, because reducing morbidity may offset the costs of using the NSQIP. STUDY DESIGN: Patient data were obtained from a single private-sector center involved in the NSQIP from 2001 to 2002 (n=1,008). Cost data were derived from the hospital's internal cost-accounting database (TSI; Transitions Systems Inc). Total hospital costs associated with both minor complications and major complications were calculated. Multiple linear regression was used to determine the cost of each type of complication after adjusting for patient characteristics. RESULTS: Rates of minor complications (6.3%, 64 events) and major complications (6.6%, 67 events) were similar. Median hospital costs were lowest for patients without complications (4,487 dollars) compared with those with minor (14,094 dollars) and major complications (28,356 dollars) (p<0.001). After adjusting for differences in patient characteristics, major complications were associated with an increase of 11,626 dollars (95% CI, 9,419 dollars to 13,832 dollars; p<0.001). Minor complications were not associated with increased costs in the adjusted analysis. CONCLUSIONS: Given the substantial costs associated with major postoperative complications, reducing morbidity may provide sufficient cost savings to offset the resources needed to participate in the private-sector expansion of the NSQIP.

Adult↗
PubMed2003

The link between public and private insurance and HIV-related mortality.

As policymakers consider expanding insurance coverage for the human immunodeficiency virus (HIV+) population, it is useful to ask whether insurance has any effect on health outcomes, and, if so, whether public insurance is as efficacious as private insurance in preventing premature death. Using data from a nationally representative cohort of HIV-infected persons receiving regular medical care, we estimate the impact of different types of insurance on mortality in this population. Our main findings are that (1) ignoring observed and unobserved health status misleads one to conclude that insurance may not be protective for HIV patients, (2) after accounting for observed and unobserved heterogeneity, insurance does protect against premature death, and (3) private insurance is more effective than public insurance. The better performance of private insurance can be explained in part by more restrictive Medicaid prescription drug policies that limit access to highly efficacious treatment.

Adolescent↗
PubMed1984

Contribution of the private sector to elective surgery in England and Wales.

From a sample of 12 959 records of patients treated in 148 of the 153 independent acute hospitals in England and Wales in 1981, it was estimated that 344 008 patients were admitted during that year. Residents of England and Wales admitted for inpatient elective surgery other than termination of pregnancy represented 162 000 of these cases. From 1980 Hospital Inpatient Enquiry data it was estimated that a further 57 000 similar elective treatments were undertaken in National Health Service pay-beds. The 219 000 patients treated in the combined private sector represented 13.2% of the total case-load in domestic inpatient elective surgery. For certain operations this proportion rose to 26%, and for some regions the private sector cases represented more than 20% of the total work-load; therefore when assessing the need for, and provision of, acute health care in England and Wales, the contribution of the private sector cannot be ignored.

Adolescent↗
PubMed2001

Private science and the Imperial imagination: John Herschel's Cape voyage.

In 1833 Sir John Herschel sailed to the British Cape Colony in southern Africa. It was a private voyage, the purpose of which was to undertake an astronomical survey of the southern heavens. But his private voyage was interpreted by both the British Government and the British public as a voyage of Imperial scientific exploration. Despite Herschel's explicitly private scientific intentions, he nonetheless became popularly incorporated into the ranks of imperial scientific explorers.

Astronomy↗
PubMed2002

Public and private science at home and abroad: networks among chemists, physicians and industrialists in the 1780s.

The tensions between public and private science, so familiar to us today, were alive in the science of the industrial revolution. These tensions confronted the members of a society of chemists and natural philosophers, physicians, industrialists and instrument makers who met in London from 1780 to 1787. Their meetings, held in private rooms in coffee houses, provided an ideal forum for their blend of public and private science, reinforced by a vital international network of scientific intelligence. The records of those meetings tell us a good deal about communication among natural philosophers in the 1780s, and show that some, at least in Britain, were well-informed about the latest foreign developments.

Communication↗
PubMed1999

Optimal social health insurance with supplementary private insurance.

This paper investigates the structure of a National Health Service in which there is compulsory social insurance covering a package of essentials, a given part of individuals' health expenditure, and supplementary private policy topping up the remaining services. The latter insurance contract provides for a co-payment by patients, limiting the so-called "third-party payer" effect. Thus, an individual's health expenditure is divided into three parts: the first covered by social insurance, the second by a private policy and the third out-of-pocket. Such mixed system design has received increasing attention in recent years and has been adopted by several industrialized countries. The conditions for optimal rates of social insurance coverage and of private coinsurance are analysed and discussed. The optimality requirements refer to efficiency as well as equity concerns.

Health Expenditures↗
PubMed2001

The impact of changes in private health expenditure on New Zealand households.

The proportion of New Zealand's total health expenditure financed by the public sector has fallen from 87% in 1983/84 to 77% in 1997/98 in real per capita terms. In the paper, we firstly describe changes in private health expenditure in New Zealand and compare these changes with trends in private and public health expenditure in a number of OECD countries. Secondly, we find that in New Zealand, there have been increases in both out-of-pocket payments and membership of private health insurance funds over the period from 1983/84 to 1997/98. We analyze the relationship between out-of-pocket expenditure, insurance expenditure, and household income across income deciles and across time. We find that out-of-pocket payments are regressive but the regressivity did decline in 1993/94 in response to a government initiative to improve the targeting of government subsidies towards lower income households.

Australia↗
PubMed1982

Comparisons between inner-city and private school adolescents' perceptions of health problems.

A youth health survey was administered to 247 students in an inner-city ghetto high school and 404 students in a private boarding school. Significant differences between the two socioeconomic groups were found for responses about health information, health concerns and problems, and health status and service utilization. Sex-related issues were of greater concern to the private school youth and they desired more help with depression-sadness and birth control. Inner-city youth had more health worries and indicated a desire for more help with physical problems such as toothaches, headaches, and stomach aches, and social problems such as racial discrimination and parent relations. From a list of 22 health problems, the inner-city youth ranked dental problems, acne, and health worries highest while the private school youth ranked depression-sadness, tiredness, and acne highest. Regardless of social class, most adolescents perceived large gaps in their health education. One implication of our data is that the specific self-reported needs and concerns of adolescents should be considered in planning health services and education programs.

Adolescent↗
PubMed2002

Private demand for a HIV/AIDS vaccine: evidence from Guadalajara, Mexico.

The private demand for a hypothetical vaccine that would provide lifetime protection against HIV/AIDS to an uninfected adult was measured in Guadalajara, Mexico, using the concept of willingness to pay (WTP). A 91-question survey instrument was administered by trained enumerators employing contingent valuation techniques to 234 adults, aged 18-60. Our estimates of private demand indicate that individuals anticipate sizable personal benefits from such a vaccine, and that they would be willing to allocate a substantial portion of their income to be protected in this way from HIV infection. A conservative estimate of the mean WTP of adults in the Guadalajara sample is 6358 pesos (669 US dollars) and the median is 3000 pesos (316 US dollars). A multivariate statistical analysis of the determinants of individuals' WTP shows that individuals with higher incomes, with spouses or partners, and with higher perceived risks of becoming infected with HIV are willing to pay more for the vaccine. Older respondents are willing to pay less. These results suggest that there is likely to be a potentially large private market for a HIV/AIDS vaccine in the middle-income developing countries such as Mexico. These findings have important implications both for the level of R&D effort that is devoted to a vaccine and, assuming these efforts are successful, for future policies to make the vaccine available to the public.

AIDS Vaccines↗