Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Purchasing, Hospital”

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 1,027 records · Page 57Linked to original sources
PubMed1999

Analysis of six months' referrals to a "one-stop" neurovascular clinic in a district general hospital: implications for purchasers of a stroke service.

OBJECTIVE: To determine the effectiveness of a "one-stop" neurovascular clinic (NVC) in guiding the diagnosis and investigation of patients suffering a mild stroke or transient ischaemic attack (TIA). DESIGN: Six months' survey of the activity of a new neurovascular clinic (NVC). SETTING: Borders region of Scotland. SUBJECTS: Patients referred with a suspected diagnosis of stroke or TIA. RESULTS: The clinic served 23 general practices and a population of 106,000. Over a 6 month period 128 patients were referred; 93% of patients were referred by general practitioners, 5% by consultant physicians and 2% from wards in the Borders General Hospital. Most patients were independent prior to the presenting event and had minimal disability on presentation to the clinic. Patients were seen within 48 hours of referral in the majority of cases and all within five working days. However, only 52% were seen within two weeks of the onset of their symptoms. Only 50% of patients were shown to have sustained a stroke or TIA. A variety of other diagnoses mimicked vascular events including epilepsy, migraine, cranial nerve palsies and cerebral tumour. The stroke-related group differed significantly in age (P = 0.003) and in the number of patients already on aspirin (P = 0.010) but not in any other risk factor. CT scan and carotid doppler examination were considered necessary in only 47% and 24% respectively of referred patients. Only five stroke-related patients and one non-stroke-related patient needed further input from physiotherapy, occupational therapy or speech therapy. Over 90% of patients were discharged home. Patient and general practitioner satisfaction with the service received were rated at 9 (0 = very poor; 10 = excellent). CONCLUSION: Applying evidence-based medicine to patients attending a "one-stop" neurovascular clinic with minor stroke and/or transient ischaemic attack resulted in an efficient delivery of appropriate investigations and therapy to this group of patients. The NVC prevented unnecessary requests for both CT scanning and carotid doppler examination, which are valuable resources, and may have prevented admissions to hospital. Patients were anxious about their symptoms and appreciated being seen quickly and a diagnosis made. We would recommend that these clinics be set up as part of the stroke service in all district general hospitals.

Aged↗
PubMedDate not supplied

Orchestrating a unified approach to information management.

Articles in both business and healthcare literature make frequent reference to the need for integration in healthcare organizations. In healthcare, the term horizontal integration can refer to the purchase of one hospital by another in the same geographical area, particularly where the hospitals' services overlap. Services might be consolidated in this example or one hospital may totally shut down the acquired one. Vertical integration refers to a hospital exercising control of its inputs or outputs. In one sense, patients referred to a hospital can be considered inputs. A hospital that purchases physician practices or integrated delivery systems is an example. Purchasing a nursing facility by an integrated delivery system (IDS) is another. This article focuses on organizational or holographic integration, where an organization is understood and embedded--like a hologram--in each of its smaller components, and each operating unit has knowledge about the whole system in which it is embedded. Conceptually, a hospital can achieve organizational integration relatively easily. One way is to assign administrative responsibility for two departments, radiology and pathology, for example, to one person who will handle billing, budgeting and human resources issues. Organizational integration breaks down turf barriers between distinct functional areas (often known as stovepipes or the silo mentality) because the result is less energy expended to solve problems. Organizational integration must include the merging of information technology (IT) into a single computer system that can report results across several departments, for example, in order entry, result reporting, resource scheduling or billing. At the University of Michigan Health System, technical and organizational integration are taking place across the information systems of the radiology and pathology departments. Deployment of an intranet-based architecture for ancillary information systems will provide the means to achieve high level integration across previously heterogeneous and non-integrated department-based clinical information systems.

Cooperative Behavior↗
PubMed1999

Assessing the outcomes of total knee replacement.

The past few years have seen a growth of interest in outcome measurement in a variety of settings including audit, health care management and commissioning - besides the traditional applications in research work. This paper reports on a study of the outcomes of total knee replacement in an acute hospital where the outcomes were studied as part of an audit process. The outcome measures used included clinical and symptomatic measures as well as generic health status scales. The initial study in one hospital was expanded to include a number of others in the same region and a comparative database of outcomes developed. Examples of the results are shown. The technical measures using knee scores and general health status measure show significant improvement from pre-operatively to 3 months later. This improvement was maintained up to the 1-year follow-up on both measures. Although the information systems for collecting and measuring outcomes has been successful, the ability of such measures to lead to behavioural change has been limited. The problems in using outcome measures are discussed in particular in the context of an audit within hospitals, and for purchasing agencies.

Arthroplasty, Replacement, Knee↗
PubMed2002

Health care funding in the Australian Capital Territory: from hospital to community.

This paper presents an outline of the socio-demographic features of the Australian Capital Territory (the ACT) and of its health care system. I describe how health care resources are allocated in the government sector, present a more detailed description of the way that hospital services are purchased, and summarise the government's policy directions for health. I argue that the main directions are sensible, and particularly those that support more integrated care that is largely based in the community. There appear to be no major weaknesses in the budget-share output-based funding model used in the purchase of hospital services, although the rationale for some of the components might be clarified. In total, the ACT government appears to be on the right track. However, I argue that more rapid progress might be possible if there were greater collaboration between the Territory health authority and the relatively powerful private medical profession.

Adolescent↗
PubMed1953

PURCHASING.

Explore the source record for details and available documents.

Hospital Administration↗