Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Service Statistics”

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 1,063 records · Page 59Linked to original sources
PubMed1992

Occupational injuries among minors doing farm work in Washington State: 1986 to 1989.

BACKGROUND: There is growing evidence that many children are injured while engaged in agricultural work. However, little specific information on farm work-related injuries among minors is available, probably because employment or workers' compensation data for children are hard to obtain. METHODS: Workers' compensation data were used to evaluate occupational injuries among children in Washington State from 1986 through 1989. The frequency and severity of injuries among minors doing farm work were compared with the distributions of injuries among minors working in food service and all other occupations by year of injury, age of injury, and month and hour of injury. RESULTS: A total of 16,481 claims filed by children under age 18 were evaluated. Although farm workers accounted for only 7% of all claims, they made up 36% of claims filed by children under age 14, and 17% of claims filed by children aged 14 or 15. Injuries classified as serious accounted for 26% of farm worker claims compared with only 16% of all claims filed by children. CONCLUSIONS: Although injury rates could not be developed owing to the lack of denominator data, this study demonstrates that farm work is dangerous for young children.

Accidents, Occupational↗
PubMed1975

Epidemiology of lumbar disc lesions in the military in World War II.

A study was carried out in 1095 first Army hospital admissions for lumbar herniation of the nucleus pulposus (HNP) who were individually matched on age and period of service during World War II to holders of Army National Service Life Insurance policies. For both the cases and the comparison group, data were obtained from military records, particularly records of induction into service. Factors showing a statistically significant positive association (p less than 0.05) with admission for HNP in the entire sample and also among enlisted cases matched to enlisted members of the comparison group were: occupation of craftsman or foreman, married status, rural residence, excess height, excess weight, heavy frame, good posture, defects relating to back or legs, military occupation specialty of ground combat, and rank of sergeant or staff sergeant. Factors showing a negative association with admission for HNP in these same groups were: clerical occupation, two or more battle stars earned and officer rank. Essentially the same relationships were found among cases with surgically confirmed diagnoses of HNP, less than 30 years old at hospital admission, and with recent onset of symptoms, when the cases in these groups were compared with their matches in the comparison group. Mechanical factors related to body build as evaluated by height and weight measurements appear to be of significance in the etiology of HNP. Occupational factors also appear to be of importance. Some cases and some controls were hospitalized prior to the first hospital admission of the case for a disease possibly related to HNP. For that time period there were no remarkable differences between cases and controls in service hospital diagnoses, including those of trauma.

Age Factors↗
PubMed1988

Job-related stress experienced by hospital pharmacists and nurses.

Pharmacists' and nurses' perceptions of job-related stress and its relationship to career satisfaction were surveyed. A questionnaire was developed and mailed in 1987 to pharmacists and nurses whose names were randomly selected from national mailing lists. Subjects were asked to rate, on a five-point scale (4 = very often), how often they found 39 situations to be stressful. The first 30 situations composed the Health Professions Stress Inventory (HPSI), which was created for this study; the remaining nine questions were included for validation of the HPSI. Respondents were also asked whether they would choose the same profession again. Usable questionnaires were returned by 107 pharmacists and 263 nurses practicing in hospitals. Of the potentially highest stress score of 120, overall mean scores were significantly higher for nurses (63) than for pharmacists (57). Statistical analysis indicated that the sample size was adequate and the HPSI was valid and reliable. Both pharmacists and nurses found situations that dealt with interruptions, poor opportunities for advancement, inadequate staffing levels, excessive workload, and inadequate pay to be the most stressful. Pharmacists viewed not feeling challenged as a significantly more stressful situation than did nurses. Career satisfaction was significantly related to job stress for both pharmacists and nurses; 45% of the pharmacists and 37% of the nurses said they would not choose the same profession again, and those with the highest scores on the stress scale were least likely to choose the same profession again. These hospital nurses and pharmacists reported moderate job-related stress.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1984

Methods of reporting hospital financial information.

Various methods for reporting financial information in a hospital are discussed. Both statistical and financial reporting are used in management decision making. Financial statements, such as the hospital balance sheet and the statement of revenues and expenses, constitute the majority of management information prepared within the hospital's finance department. Financial indicators derived from these statements are explained. Accounts receivable, budget, and cash reports are also discussed. Several types of reports that analyze financial information by diagnosis-related groups are described, and the level of detail needed in these reports is discussed. Management of hospital financial operations under new hospital reimbursement systems will require more specialized types of management information and reporting. Through the marriage of medical and financial data, hospitals will have the information needed to manage their product--health care--in the most cost-effective and efficient manner.

Budgets↗
PubMed1990

Health services research in a quick and dirty world: the New York City hospital occupancy crisis.

In 1987/1988, New York City experienced an unexpected health care crisis: a severe and prolonged communitywide shortage of inpatient hospital beds. A rapid rise in hospital occupancy rates dramatically ended a long-term decline in hospital utilization and left health care providers and policymakers baffled about both cause and remedy. This article describes the course of a short-term, intensive, midcrisis study that unraveled the reasons for the high occupancy rates. As a case study for a research effort that successfully yielded valid and timely results, this article illuminates the research design and methodological decisions that lay behind the findings and discusses the implications of those decisions. Key to the success of the study were a mandate to diagnose the crisis, a statewide patient discharge data base, our previous hands-on experience with that data base, active support for the study from the community of health care providers, and strong results.

Bed Occupancy↗
PubMed1998

Furniture tipping accidents: redesign for prevention.

A large public service organization was concerned with protection of its customers against hazards associated with furniture tipping in public use concourses. Because no injury experience was available for analysis, hazard patterns for tipping accidents were developed from an observational study of public interaction with the furniture. For each hazard pattern, anthropometric models were used to find the probability of the furniture being safe from tipping, for different age and gender combinations. A safety criterion was developed from this modeling, and used to change the weights of some furniture items to resist tipping. These modifications have now been implemented and are in widespread use. Implications for broader application of these models to the development of valid tipping standards for furniture are discussed.

Accidental Falls↗
PubMed1997

[A modeling analysis of possible generic substitutions in an inpatient facility].

The paper presents an example of a sectional analysis of drug consumption in a large in-patient health-service facility which is to be used as a foundation for making decisions about the measures to decrease the costs of drugs. Consumption of industrially produced pharmaceutical preparations at a selected facility for a period of four months was analyzed. The authors evaluated possible substitution of administered important preparations by cheaper equivalents and by means of model analysis they calculated expected savings when using the cheapest available mass-produced pharmaceutical preparations. In the preparations under study, possible savings of costs in the extent of 2.2% of the spent sum were found. On the basis of the results of the analysis, the hospital formulary authors consider the positive list with a quality system of objective monitoring of drug consumption to be the most suitable way of introduction of more rational prescription of industrially produced drugs in an in-patient facility.

Cost Savings↗
PubMed2005

Prevalence of probable mental disorders among pediatric asthma patients in an inner-city clinic.

OBJECTIVE: To determine the screen-positive prevalence of anxiety disorders and depression among pediatric asthma patients in an inner-city asthma clinic and to investigate the association between probable diagnoses of anxiety disorders and depression and medical service use among inner-city pediatric asthma patients. METHOD: In this pilot study, a consecutive sample of pediatric asthma patients aged 5-11 in the waiting room of an inner-city asthma clinic was screened for mental disorders using the DISC Predictive Scales (DPS), which produces probable DSM-IV diagnoses. In addition, data on health service use for asthma were collected. Statistical analyses were performed to examine the relationship between probable anxiety disorders and depression and health service use for asthma among pediatric asthma patients. RESULTS: Approximately one in four (25.7%) pediatric asthma patients in an inner-city asthma clinic met criteria for a probable diagnosis of current anxiety disorders or depression (past 4-week prevalence). Specifically, childhood separation anxiety disorder was common among 8.1%, panic among 14.9%, generalized anxiety disorder among 4.1%, agoraphobia among 5.4%, and 2.7% had depression. Having more than one anxiety disorder or depression diagnosis was associated with higher levels of inpatient and outpatient medical services, compared with patients who were negative on screening for anxiety or depressive disorders, although differences failed to reach statistical significance. CONCLUSIONS: These findings are the first to provide preliminary evidence suggesting that mental health problems are common among pediatric asthma patients in an inner-city clinic. The results also suggest that mental health problems in pediatric asthma patients may be associated with elevated levels of medical service use for asthma. Replication of this pilot study is needed with a larger sample, more precise diagnostic methodology, and a comparison group with chronic medical illness.

Ambulatory Care Facilities↗
PubMed1997

Methodological issues in the evaluation of the quality of public health nursing: a case study of the maternal and child health centres in Hong Kong.

The demand for the evaluation of the quality of patient and client care has increased in public health nursing as in all disciplines of nursing. In Hong Kong this demand led to the development of a collaborative study with the Department of Health to evaluate the quality of public health nursing in the maternal and child health centres. A multiple case study design was developed to undertake the research using both qualitative and quantitative methods of data collection. The findings from the study demonstrated not only implications for clinical practice which have been reported elsewhere, but also methodological issues for the evaluation of care. These findings indicate three major issues for consideration. The first issue is that of the cultural context of care which includes perceptions of care such as demands on the service and expectations of care. The second issue is the use of health data, including both the methods of recordings as well as the sources of data. The final issue is that of the method of data collection, in particular the implications of the use of language in data collection tools. The findings suggest that both the use of professional language and the need for translation have implications for data collection methods. Indeed in the author's view the development of methodologies for the evaluation of care must address culturally specific issues, particularly where English is not the first language of subjects in the study. In addition the use the use of language in the method of data collection highlights more general issues raised by the use of translation in the collection and analysis of qualitative data.

Attitude of Health Personnel↗
PubMed1999

Do measures of self-reported morbidity bias the estimation of the determinants of health care utilisation?

Most national surveys of health care utilisation capture only self-reported measures of morbidity. If self-reported morbidity is measured with error, then the results of applied work may be misleading. In this paper we propose a model of the relationship between morbidity and health service utilisation which allows for reporting errors and simultaneity. Errors in self-reported morbidity are expressed as a function of person-specific reporting thresholds and recent contact with health services, arising because of better self-evaluation of current health status or a desire to justify consumption of a publicly-provided good. We demonstrate the bias in ignoring the potential problems of reporting errors and simultaneity for a variety of special cases, but in the general case the biases are of ambiguous sign. The empirical nature of these biases is investigated using limiting long-standing illness (LLI) and recent contact with a General Practitioner (GP) in two waves of The UK Health and Lifestyle Survey. Biomedical measures of functioning are used as objective indicators of health status. We find evidence of substantial and significant differences between individuals in reporting thresholds and some evidence that the reporting of LLI may depend on recent visits to a GP. Adjustments for these biases significantly increase the estimated effect of morbidity on utilisation.

Adult↗
PubMed2001

Do battery depletion indicators reliably predict the need for pulse generator replacement?

The aim of this study was to test the validity of battery depletion indicators to forecast end of service (EOS) in dual chamber pulse generators (PG). Two additional approaches for prediction of EOS were evaluated as well: the real-time telemetry of cell impedance and a battery stress test (BST) that used a transitory increase in pacing rate. The study population consisted of 119 patients with Intermedics dual chamber PG models Cosmos II and Relay, in which cell impedance had exceeded 2.5 k omega. The patients were followed in 6-month intervals. If the interrogation of the PG or the BST prompted the appearance of the intensified follow-up indicator (IFI), the next follow-up was scheduled within 2 months. PG replacement was performed on physician's discretion or immediately on appearance of the elective replacement indicator (ERI), regardless of the method of ERI provocation. During a period of 2 years/and 9 months, 33 patients underwent PG replacement. Out of 21 patients with positive ERI indicators, only 5 had positive warning indicators of approaching battery depletion in the preceding follow-up (IFI during BST, n = 4; ERI during BST n = 1). The majority of patients (n = 16, 76%) revealed ERI without prior activation of IFI, neither spontaneous nor during the BST. Four of these 16 ERI-positive patients had cell impedance values far below the ERI limits of the manufacturer. Based on battery depletion indicators, an exact prediction of EOS of dual chamber pacemakers is not possible. Measuring battery impedance allows for a statistical estimation of remaining service life but it may be misleading in the individual case. A BST that is based on a temporary increase of pacing rate is invalid in forecasting battery depletion. As activation of the ERI can trigger an abrupt change to the VVI backup mode, pacemaker dependent patients with low programmed basic pacing rates may be hemodynamically compromised by an unexpected activation of ERI. Close monitoring intervals and PG replacement before appearance of the ERI is recommended in those patients.

Electric Impedance↗
PubMed1990

Adjusting for clustering in survey research.

The current widespread application of cluster sampling in survey design presents concerns to the researcher regarding the chosen unit of study. The statistical power of a study could be spuriously increased or decreased, sample size could be altered dramatically, and the uniqueness of the individual unit under study (e.g., a patient) could be lost and substituted by average values of characteristics depending on which unit of study is selected. The 1985 National Ambulatory Medical Care Survey of the U.S. National Center for Health Statistics was used to illustrate research methodologies that would deflate spuriously high results due to clustered sampling. Using the individual patient as the study unit, correction factors ranging from 1.99 to 35.40 were calculated in order to deflate exaggerated t-tests, chi-square, and F values of predictor variables. The effect of clustering was more marked on (1) continuous rather than binary outcome variables, as the former provide a richer environment to form clusters; and (2) on outcome variables relating to the practice-related or personal style of physicians. Using the physician (who represented a cluster of patients) as the unit of study, it was realized that correction factors were relevant to physician-specific predictors but not patient-specific predictors. Using design effect correction factors developed from a simple univariate analysis of variance, pharmacoepidemiologists can analyze accurately the currently available large survey databases of clustered samples.

Cluster Analysis↗
PubMed1996

Diffusion of six surgical endoscopic procedures in the Netherlands. Stimulating and restraining factors.

The diffusion of six surgical endoscopic procedures in the Netherlands was investigated. Questionnaires were sent to 138 laparoscopic surgeons. They were asked which of the following laparoscopic procedures they had adopted in their hospital: cholecystectomy, appendicectomy, Nissen fundoplication, inguinal hernia repair, large bowel resection and thoracoscopic procedures. Furthermore, they were asked to indicate the influence of 13 pre-defined factors: "budget', "competition', "conference', "extra benefit', "media', "nature of the technology', "patient demand', "planning/logistics', "reimbursement', "service industry', "support industry', "surgical technique' and "training/course' on the adoption of those procedures. The adoption rates for the procedures were: 100%, 69%, 19%, 43%, 19% and 52%, respectively. In general, factors were assessed more positively by adopters than by non-adopters. Significant differences were mainly found for "extra benefit', "nature of the technology', "surgical technique' and "conference'. The surgeon's perception of the additional benefits of an endoscopic technique and, to a lesser degree, of its technical aspects were the most important factors in deciding whether or not to adopt a procedure. In an ideal diffusion model, a description is given of when and how the 13 factors can influence the diffusion of an endoscopic procedure in the desired direction. In this model, the extra benefit of a new procedure must be proven before other factors are allowed to influence the diffusion.

Budgets↗
PubMedDate not supplied

The supportive care needs of men with prostate cancer (2000).

The diagnosis and subsequent treatment of prostate cancer is followed by a range of significant disease specific and iatrogenic sequelae. However, the supportive care needs of men with prostate cancer are not well described in the literature. The present study assesses the supportive care needs of men with prostate cancer who are members of prostate cancer self-help groups in Queensland, Australia. In all, 206 men aged between 48 and 85 years (mean=68) completed the Supportive Care Needs Survey (SCNS) (62% response). The SCNS is a validated measure assessing perceived need in the domains of psychological needs, health system and information needs, physical and daily living needs, patient care and support, and sexuality. Items assessing need for access to services and resources were also included. One third of the sample reported a moderate to high need for help for multiple items in the sexuality, psychological and health system and information domains. Younger men reported greater need in the sexuality domain; living in major urban centres was predictive of greater psychological need; being closer to the time of diagnosis was related to greater need for help in the physical and daily living domain; having prostate cancer that is not in remission, having received radiation therapy, and lower levels of education were predictive of greater need for help in patient care and support. Of the total sample, 55% of men had used alternative cancer treatments in the past 12 months, with younger and more educated men more likely to use alternative therapies. Interventions in sexuality, psychological concerns and informational support are priorities for men with prostate cancer.

Aged↗
PubMedDate not supplied

Evaluation of accuracy of health studies reported in mass media.

OBJECTIVE: To evaluate communication of clinical research in the written media for completeness and accuracy. DESIGN: Observational assessment. SETTING: United States. PARTICIPANTS: Not applicable. INTERVENTIONS: Content of media articles discussing randomized controlled trials was assessed by three reviewers on the basis of the Consolidated Standards of Reporting Trials (CONSORT) criteria modified for the mass media. Reports from October 1 through December 31, 2002, published in the top two U.S. daily newspapers (USA Today and Wall Street Journal), weekly news magazines (Time and Newsweek), and daily news Web sources (CNN.com and MSNBC.com) and the corresponding published RCTs were analyzed. MAIN OUTCOME MEASURES: Total score and score in 10 specific content areas, leading to classification of coverage as poor, fair, or excellent. RESULTS: A total of 60 media reports discussing results of 25 RCTs appeared in these media during the study period. All reports were categorized as fair, and no content area was rated excellent. Several content areas received poor rankings in all and/or most media, including reporting of adverse effects, outcomes data, and statistical tests used. Media reports written by newswire services were rated more highly than were those prepared by nonnewswire services, but only 1 of 10 criteria had statistically significant differences. CONCLUSION: Mass media reports of RCTs are often incomplete. This type of reporting may misinform the lay public and may lead to questions about the applicability of the results to individual patients.

Health Services Research↗
PubMed2002

Power for T-test comparisons of unbalanced cluster exposure studies.

Studies of individuals sampled in unbalanced clusters have become common in health services and epidemiological research, but available tools for power/sample size estimation and optimal design are currently limited. This paper presents and illustrates power estimation formulas for t-test comparisons of effect of an exposure at the cluster level on continuous outcomes in unbalanced studies with unequal numbers of clusters and/or unequal numbers of subjects per cluster in each exposure arm. Iterative application of these power formulas obtains minimal sample size needed and/or minimal detectable difference. SAS subroutines to implement these algorithms are given in the Appendices. When feasible, power is optimized by having the same number of clusters in each arm k(A) = k(B) and (irrespective of numbers of clusters in each arm) the same total number of subjects in each arm n(A)k(A) = n(B)k(B). Cost beneficial upper limits for numbers of subjects per cluster may be approximately (5/rho) - 5 or less where rho is the intraclass correlation. The methods presented here for simple cluster designs may be extended to some settings involving complex hierarchical weighted cluster samples.

Cluster Analysis↗
PubMed1983

Patient satisfaction with mental health services: a meta-analysis to establish norms.

Patients typically express high rates of satisfaction with their mental health care. This finding and the lack of well controlled studies on patient satisfaction in the literature underscore the need for meaningful guidelines for clinicians and program evaluators in interpreting patient satisfaction data. To address this problem a meta-analysis was undertaken to establish norms on patient satisfaction for various types of mental health programs. Programs were categorized according to three dimensions: inpatient vs. outpatient vs. residential care; chronic vs. non-chronic; and conventional vs. innovative. Meta-analysis procedures were modified to accommodate the single-group study designs that dominate the literature. The analysis revealed that chronic patients express less satisfaction with their treatment compared to non-chronic patients. Innovative programs are viewed more positively than conventional ones. No differences were found in rates of patient satisfaction between inpatient and outpatient programs. Acceptably reliable norms and confidence intervals of patient satisfaction were established for conventional inpatient programs serving either chronic or non-chronic patients; conventional outpatient programs for non-chronic patients; and for all programs combined according to chronic vs. non-chronic, inpatient vs. outpatient, and conventional vs. innovative. However, data were insufficient to compute norms for other program types. The norms thus established can be used for comparative purposes by program evaluators. A cumulative, national data base on patient satisfaction is recommended to further refine these norms.

Consumer Behavior↗
PubMed2006

Factors predicting unmet health services needs among incarcerated substance users.

Negative health consequences of illicit drug use, such as cardiovascular complications and infectious diseases, increase the likelihood of the need for health care. However, evidence suggests that, with the exception of emergency services, drug users generally are medically underserved. Furthermore, the effect of illicit drug use on health care utilization is becoming an especially important issue for the criminal justice system, because an increasing proportion of inmates in correctional institutions have a history of drug use. This 1998-1999 study of 661 incarcerated men in the Kentucky prison system focused on predictors of unmet physical, behavioral, and overall health care needs among chronic substance users. Analyses revealed that White incarcerated drug users were more likely to report unmet physical and overall health care needs than non-Whites and those with high school education or above were more likely to report unmet physical, behavioral, and overall health care needs. In addition, more episodes of serious illness, more mental health problems, and poorer self-rated health were predictive of all three types of unmet health care needs. A longer career of drug use emerged as a significant predictor of unmet behavioral health care needs, whereas more frequent drug use in the year before incarceration predicted unmet physical health care needs. Further research directions and implications for in-prison health care planning are discussed.

Adult↗