Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Hospital Distribution Systems”

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 1,099 records · Page 61Linked to original sources
PubMed1980

A computer system for transcribing radiology reports.

A minicomputer system has been developed to assist in the transcription, distribution, and long-term storage of radiology reports. Reports are dictated in the traditional manner by a radiologist and then entered into specially programmed computer terminals by a transcriptionist. Completed reports are electronically distributed throughout the department and the hospital. Inactive reports are stored by the computer on microfiche. At one institution, the system is used to produce all of the reports in the radiology department, a total of approximately 200,000 reports per year.

Computers↗
PubMed1990

Health in Israel: patterns of equality and inequality.

While Israel does not have a nationalized health care system, 94.5% of its population is covered by comprehensive health insurance which includes curative and preventive ambulatory care as well as hospitalization. There is formal equality in access, distribution, and quality of the health services; nevertheless, there are pockets of deprivation that affect certain segments of the population. The paper focuses on three topics: (a) structure of the health care delivery system in terms of coverage, geographical and social distribution, and the public/private balance of the services; (b) processes of health care delivery in terms of utilization and quality; (c) health outcomes in terms of mortality, morbidity, health behavior, and disease vulnerability. Inequality in Israel appears to be structured in terms of six dimensions: coverage of health insurance, distribution of health services, the balance of public and private sectors of health services, utilization of existing services, quality of health services, and health outcomes as expressed by mortality, morbidity, health behavior and risk factors. Only two types of health care are not covered by the general health insurance: (a) dental care, and (b) long-term nursing care. Given the small area of Israel there are striking differences in the geographic distribution of health personnel of various types. There is evidence for gaps between needs and institutional services for many elderly who are on waiting lists for institutionalization. The ratio of primary care physicians to population is 1:2326 in development towns and 1:1852 in the older more established veteran communities. Kibbutzim, which are also located in large part in geographically remote areas, enjoy high quality health services and are not characterized by low ratios of health care personnel. In 1968-69, 6% of those insured by the sick funds purchased services at least once from a private physician, while in 1975-76 this figure rose to 32%. As in other countries, utilization of preventive services is generally correlated with socio-economic status and with education. While the network of primary care facilities in Israel is widespread and generally accessible, it is poorly integrated with the hospital system. Longevity has increased over the past years and is relatively high; 76.6 for women and 73.1 for men in 1984. Nevertheless, differences between Jews and non-Jews may still be seen among both men and women. The same may be said concerning mortality and especially with regard to infant mortality. Differences with regard to certain risk factors among Jewish infants and adults are correlated with socio-economic class and country of origin.

Cross-Cultural Comparison↗
PubMed2004

Seasonal distribution of acute myocardial infarction and its relation to acute infections in a mild climate.

BACKGROUND: There is evidence that acute myocardial infraction (aMI) occurs more frequently in certain seasons and months of the year. Recently various infectious agents have been implicated in atherogenesis. In the present study we recorded the seasonal distribution of aMI and evaluated its relation to acute systemic infections (AIs). METHODS: The study included 1196 patients with aMI hospitalized during the years 1988-1998 in the General Hospital of the island of Rhodes and 2976 patients with AI during the years 1993-1998. Foreigners or visitors in the island were excluded to avoid their influence in the annual distribution. We corrected the absolute number of the aMI and AI cases by month and season in such a way that all months and seasons would have standard 30 and 90 days, respectively. RESULTS: During the entire period of the study, more patients with aMI were hospitalized in winter [30.7%, 95% confidence limits (CL) 28.1 to 33.3%]. In spring the percentage of aMI cases hospitalized was 24.5% (CL 22.1-27%), in summer 23.2% (CL 20.1-25.6%) and in autumn 21.6% (CL 19.2 -24%). There were 42.35% more cases hospitalized in winter than in autumn. The monthly distribution showed that March was the month with the most aMI cases (10.83%, CL 9.06-12.6% ) and October with the fewest (6%, CL 4.65-7.35%). The percentage of patients with AI hospitalized in winter was 30.5% (CL 28.8-32.2%), in spring 25.2% (23.6-26.7), in summer 23.5% (CL 22-25%) and in autumn 20.8% (CL 19.4-22.3%). The correlation coefficient (r) between the distribution of aMI and AI was 0.73 (P<0.01). CONCLUSIONS: Our results indicate that (1) there is a seasonal distribution in aMI with the winter being the season of the highest incidence of aMI and autumn of the lowest and (2) there is a significant correlation of the distribution of aMI to AI cases, which is of interest in the understanding of the pathogenesis of acute coronary syndromes.

Acute Disease↗
PubMed2003

User acceptance of an anaesthesia information management system.

BACKGROUND AND OBJECTIVE: This paper describes the user acceptance of an anaesthesia information management system at the University Hospital in Giessen, Germany, after 5 yr of routine use. METHODS: A questionnaire with 75 items was distributed to all anaesthesiologists and anaesthetic nurses of the Department of Anaesthesiology. The questions were answered anonymously on a five-point Likert scale. RESULTS: The return rate was 60% (44 physicians and 24 nurses). The results indicated that the system generally met user expectations. The respondents thought that electronic record keeping improved the quality of their work, and they did not want to switch back to paper records. Problems arose with hardware placement and software features, e.g. coding tools for diagnoses and type of surgery. The perceived quality of training strongly influenced user acceptance. CONCLUSIONS: Despite the deficits revealed by the survey, the respondents did not want to switch back to manual record keeping. A structured user survey is a useful tool for the development, adaptation and implementation of an anaesthesia information management system. A training strategy that takes the needs of the users into account is recommended.

Adult↗
PubMed1999

Evaluating dispensing error detection rates in a hospital pharmacy.

OBJECTIVES: The filling of unit dose orders and checking for filling errors are two essential distributive responsibilities of a hospital pharmacy. Previous studies have shown that nonpharmacists, usually technicians, are capable of assuming these distributive tasks traditionally performed by hospital pharmacists. The study tested whether nonpharmacists, in this case licensed practical nurses/medication nurses, were as competent as pharmacists in checking for errors in unit dose cassettes prepared for hospital patients. METHODS: A university teaching hospital was used for the study. Artificial errors (n = 812) were introduced into the drug distribution system during a 4-month period in 1995. Included in the study were seven staff pharmacists and nine medication nurses (licensed practical nurses) involved in the decentralized drug distribution system. The primary measure was the ratio of errors detected to the number of artificial errors introduced into the system. This primary measure is different from those used in prior studies that do not separate dispensing errors and checking errors. RESULTS: Overall, pharmacists were significantly more accurate in detecting errors (87.7% vs. 82.1%). In one category of serious errors, that of wrong strength, the difference between pharmacists and licensed practical nurses was even greater (93.3% vs. 83.3%). CONCLUSIONS: This study's results do not support conclusions of prior studies that nonpharmacists can match the error detection accuracy of pharmacists. It demonstrates the importance of considering the types of errors under examination and of using appropriate measures of error checkers when drawing conclusions on relative competence.

Clinical Competence↗
PubMed1998

An analysis of the geographical distribution of severe malaria in children in Kilifi District, Kenya.

BACKGROUND: Although malaria is known to be a major cause of child mortality and morbidity throughout sub-Saharan Africa there are few detailed studies of malaria mortality rates and incidence of severe malarial disease in defined communities. We have studied the geographical pattern of admissions to hospital with severe malaria and the stability of this pattern over time in Kilifi District on the Kenyan Coast. METHODS: Over a 2-year period all children under 5 years of age with severe malaria admitted to the district hospital and living in a rural study population of about 50,000 people were identified. Annual censuses were carried out in the study area, and all households were mapped using a hand-held satellite navigation system. The resulting databases were linked using a geographical information system (GIS). RESULTS: Using methods originally developed for the study of the geographical distribution of childhood leukaemia we assessed the spatial pattern of hospital admission rates for severe malaria. As expected, admission rates were significantly higher in children with easier access to the hospital. For example, those living more than 25 km from the hospital had admission rates which were about one-fifth of those for children living within 5 km of the hospital. Those living more than 2.5 km from the nearest road had admission rates that were about half of those for children living within 0.5 km of a road. We also investigated short-term local fluctuations in severe malaria and found evidence of space-time clustering of severe malaria. CONCLUSIONS: Hospital admission rates for severe malaria are higher in households with better access to hospital than in those further away. The finding of space-time clusters of severe malaria suggests that it would be of value to conduct case-control studies of environmental, genetic and human behavioural factors involved in the aetiology of the disease.

Animals↗
PubMed2005

[National health resources for highly specialised medicine].

BACKGROUND: In order to monitor quality and efficiency in the use of health resources for highly specialised medicine, a National Professional Council has since 1990 advised the Norwegian health authorities on the establishing and localisation of such services. MATERIALS AND METHOD: A comprehensive review of both the quality, economy and the geographical distribution of patients in each specialised service has been carried out. RESULTS: 33 defined national programmes were centralised to one hospital only and distributed among seven university hospitals. Eight multiregional programmes were centralised to two hospitals only and included four university hospitals. In 2001, a total of 2711 new patients were treated in these programmes. The system seems to have secured a sufficient patient flow to each programme so as to maintain quality. However, a geographically skewed distribution of patients was noted, particularly in some of the national programmes. INTERPRETATION: In a small country like Norway, with 4.5 million inhabitants, a centralised monitoring of highly specialised medicine seems both rational and successful. By the same logic, however, international cooperation should probably be sought for the smallest patient groups.

Centralized Hospital Services↗
PubMed2002

Teledermatology's impact on time to intervention among referrals to a dermatology consult service.

The aim of this study was to determine if a teledermatology consult system, using store-and-forward digital imaging technology, results in patients achieving a shorter time from referral date to date of initial definitive intervention when compared to a traditional referral process. Patients being referred to the dermatology consult service from the primary care clinics at the Durham VA Medical Center were randomized to either a teledermatology consultation or usual care. A usual care consultation consisted of a text-based electronic consult request. A teledermatology consultation included digital images and a standardized history, in addition to the text-based electronic consult. Time to initial definitive intervention was defined as the time between referral date and the date the patient was scheduled for a clinic visit for those patients that the consultant requested a clinic-based evaluation, or the time between referral date and the date the consult was answered by the consultant if a clinic visit was not required. Patients in the teledermatology arm of the study reached a time to initial definitive intervention significantly sooner than did those patients randomized to usual care (median 41 days versus 127 days, p = 0.0001, log-rank test). Additionally, 18.5% of patients in the teledermatology arm avoided the need for a dermatology clinic-based visit compared to zero patients avoiding a dermatology clinic visit in the usual care arm of the study (p < 0.001, z-test). Teledermatology consult systems can result in significantly shorter times to initial definitive intervention for patients compared to traditional consult modalities, and, in some cases, the need for a clinic-based visit can be avoided.

Aged↗
PubMed1995

Dissemination of patient data in the Erlangen Hospital communication and information system.

It is necessary to exchange information between the various institutions of the medical faculty of the University of Erlangen-Nurnberg. For example, basic patient data, which is collected in a central computer, must be distributed to various stations and laboratories. Also medical findings, which are already captured in computers in central laboratories, must be transmitted to various parts of the university hospitals. After the data network, consisting of a glass fiber backbone linking the buildings and cabling in the individual departments, had been implemented, it became possible to provide an electronic exchange of medical information.

Computer Communication Networks↗
PubMed1996

Automated decentralized pharmacy dispensing systems.

Automated decentralized pharmacy dispensing systems (ADPDSs) are medication management systems that allow hospitals to store and dispense drugs near the point of use. These systems, which can be compared with the automated teller machines used by banks, provide nurses with ready access to medications while maintaining tight control of drug distribution. In this study, we evaluated three ADPDSs from two suppliers, focusing on whether these systems can store and dispense drugs in a safe, secure, and effective manner. When rating the systems, we considered their applicability to two different implementation schemes: The use of a system with a pharmacy profile interface. This feature broadens the capabilities of the system by allowing more information to be provided at the dispensing cabinet and by providing better integration of the information from this cabinet with the pharmacy's information system. Two of the evaluated systems have this feature and were rated Acceptable. The use of a system without a pharmacy profile interface. We rated all three of the evaluated systems Acceptable for such implementations. To decide which scheme is most appropriate for a particular hospital, the facility will need to determine both how it intends to use the ADPDS and what it hopes to achieve by implementing the system. By performing this type of analysis, the facility can then determine which ADPDS features and capabilities are needed to accomplish its goals. To help facilities make these decisions, we have provided an Equipment Management Guide, "Improving the Drug Distribution Process-Do You Need an Automated Decentralized Pharmacy Dispensing System?," which precedes this Evaluation. In addition, readers unfamiliar with the roles of both the pharmacy and the pharmacist within the hospital can refer to the Primer, "Functions of a Hospital Pharmacy," also published in this issue.

Automation↗
PubMed2001

Changing time in an operating suite.

This study focussed on time as a key resource within a hospital setting. The introduction of casemix-based funding, which changed the ways funds were obtained and distributed within the hospital, was accompanied by large cuts in the funds available to the hospital system. From the introduction of casemix-based funding to the conclusion of this study there was an increase of 20% in the number of cases through the operating suite. The increase was achieved, with a reduced budget, by intensifying work and increasing flexibility in the use of time. This approach to changing the use of time imposed considerable real 'costs' on staff, especially nurses, and created concerns about safety.

Attitude of Health Personnel↗
PubMed2006

The effect of steroids on the clinical course and outcome of neonates with meconium aspiration syndrome.

Meconium Aspiration Syndrome (MAS) is an important cause of neonatal morbidity and mortality. The present study was undertaken to evaluate the role of steroids in the management of MAS. This was a double blinded randomized controlled trial and a prospective Interventional Study over one-year period in the neonatal unit of the Lady Hardinge Medical College and associated Kalawati Saran Children's hospital. Fifty-one babies of MAS which were randomly distributed into three groups, Control, systemic and nebulized steroids. Methyl prednisolone was given i.v. in dose of 0.5 mg/kg/day in two divided doses. Budecort was given by nebulization in dose of 50 microgram 12 hourly. Infants were assessed in terms of duration of stay, oxygen dependence, X-ray clearances and also assessed for short term adverse effects. There was a statistically significant difference in the duration of stay, duration of oxygen dependence and radiological clearance. The use of steroids was not associated with an increased incidence of sepsis. The conclusion is that steroids alter the course of Meconium Aspiration Syndrome and favorably affect the outcome.

Analysis of Variance↗
PubMed1992

Prevention of blood-borne HIV transmission using a decentralized approach in Shaba, Zaire.

OBJECTIVE: To prevent blood transfusion-acquired HIV infection with a decentralized approach to HIV screening of blood donors, using an instrument-free rapid test. SETTING: Shaba province, Zaire (496,877 km2). METHODS: The programme consisted of training health-care workers, distribution of a rapid HIV-antibody test (DuPont's HIVCHEK) for screening of all blood donations, and quality control of testing by a regional reference centre. RESULTS: Over a 2-year period, 11,940 rapid tests were distributed to 37 hospitals, covering 75% of all hospital beds outside the copper mine's health system in Shaba. Eighty-five per cent of the tests were used to screen blood donors (5.4% positive test rate) and 13% to test patients (39.7% positive test rate). At least 265 cases of HIV-positive blood donation were prevented, at an estimated cost of 137-279 ECU per case. Only 26% of initially positive specimens reached the central laboratory for supplemental testing, and sterile transfusion equipment and blood-grouping reagents were frequently unavailable. The lack of transport and communications and a deteriorating health system were major constraints. CONCLUSIONS: District hospitals in Africa are often long distances from major cities, difficult to reach for most of the year, and perform a small number of transfusions. In this context a classical centralized regional blood bank may not be a feasible option to ensure safe blood transfusions. However, safe blood transfusion can be achieved with a decentralized approach using a rapid test, provided that minimum standards of health-care services are available.

Blood Banks↗
PubMed1994

An inexpensive hospital-based program for outcome evaluation.

A relatively low-cost outcome evaluation program was developed for a 147-bed psychiatric hospital with a variety of inpatient programs and extensive outpatient and partial hospital facilities. The evaluation staff consists of the research director, a senior research assistant, and a secretary. Much of the program's data comes from documents completed by clinical staff, which are then scanned by an optical mark-reading scanner. The data are automatically entered into a data base and analyzed using PC-based software, SPSS for Windows. Data are used to produce in-house reports that are distributed to clinical programs and the hospital's quality assurance committee. This in-house system can be tailored to an individual hospital's needs and is a less expensive alternative to evaluation by an external contractor.

Adolescent↗
PubMed2006

Knowledge, attitudes and practice of healthcare ethics and law among doctors and nurses in Barbados.

BACKGROUND: The aim of the study is to assess the knowledge, attitudes and practices among healthcare professionals in Barbados in relation to healthcare ethics and law in an attempt to assist in guiding their professional conduct and aid in curriculum development. METHODS: A self-administered structured questionnaire about knowledge of healthcare ethics, law and the role of an Ethics Committee in the healthcare system was devised, tested and distributed to all levels of staff at the Queen Elizabeth Hospital in Barbados (a tertiary care teaching hospital) during April and May 2003. RESULTS: The paper analyses 159 responses from doctors and nurses comprising junior doctors, consultants, staff nurses and sisters-in-charge. The frequency with which the respondents encountered ethical or legal problems varied widely from 'daily' to 'yearly'. 52% of senior medical staff and 20% of senior nursing staff knew little of the law pertinent to their work. 11% of the doctors did not know the contents of the Hippocratic Oath whilst a quarter of nurses did not know the Nurses Code. Nuremberg Code and Helsinki Code were known only to a few individuals. 29% of doctors and 37% of nurses had no knowledge of an existing hospital ethics committee. Physicians had a stronger opinion than nurses regarding practice of ethics such as adherence to patients' wishes, confidentiality, paternalism, consent for procedures and treating violent/non-compliant patients (p = 0.01) CONCLUSION: The study highlights the need to identify professionals in the workforce who appear to be indifferent to ethical and legal issues, to devise means to sensitize them to these issues and appropriately training them.

Barbados↗
PubMed2006

Application of Poisson kriging to the mapping of cholera and dysentery incidence in an endemic area of Bangladesh.

BACKGROUND: Disease maps can serve to display incidence rates geographically, to inform on public health provision about the success or failure of interventions, and to make hypothesis or to provide evidences concerning disease etiology. Poisson kriging was recently introduced to filter the noise attached to rates recorded over sparsely populated administrative units. Its benefit over simple population-weighted averages and empirical Bayesian smoothers was demonstrated by simulation studies using county-level cancer mortality rates. This paper presents the first application of Poisson kriging to the spatial interpolation of local disease rates, resulting in continuous maps of disease rate estimates and the associated prediction variance. The methodology is illustrated using cholera and dysentery data collected in a cholera endemic area (Matlab) of Bangladesh. RESULTS: The spatial analysis was confined to patrilineally-related clusters of households, known as baris, located within 9 kilometers from the Matlab hospital to avoid underestimating the risk of disease incidence, since patients far away from the medical facilities are less likely to travel. Semivariogram models reveal a range of autocorrelation of 1.1 km for dysentery and 0.37 km for cholera. This result translates into a cholera risk map that is patchier than the dysentery map that shows a large zone of high incidence in the south-central part of the study area, which is quasi-urban. On both maps, lower risk values are found in the Northern part of the study area, which is also the most distant from the Matlab hospital. The weaker spatial continuity of cholera versus dysentery incidence rates resulted in larger kriging variance across the study area. CONCLUSION: The approach presented in this paper enables researchers to incorporate the pattern of spatial dependence of incidence rates into the mapping of risk values and the quantification of the associated uncertainty. Differences in spatial patterns, in particular the range of spatial autocorrelation, reflect differences in the mode of transmission of cholera and dysentery. Our risk maps for cholera and dysentery incidences should help identifying putative factors of increased disease incidence, leading to more effective prevention and remedial actions in endemic areas.

Bangladesh↗
PubMed2004

Epidemiology of decompensated heart failure in the city of Niterói: EPICA - Niterói Project.

OBJECTIVE: To compare the epidemiological and socioeconomic profiles, clinical features, etiology, length of hospitalization, and mortality of patients with decompensated heart failure admitted to public and private hospitals in the city of Niterói. METHODS: We carried out a prospective, multicenter study (from July to September 2001) comprising all patients older than 18 years with the primary diagnosis of heart failure and admitted to hospitals in the city of Niterói, whose scores according to the Boston criteria were 8 or above. Proportions were compared using the chi-square and Fisher exact tests. RESULTS: The sample comprised 203 patients as follows: 1) 98 patients from public hospitals: 50% were men, their mean age was 61.1+/-11.3 years, 65% were black, 57% had an income of 1 minimum wage or less, 56% were illiterate, 66% had ischemic heart disease, their mean length of hospitalization was 12.6 days, and the mortality rate adjusted for age was 5.23; 2) 105 patients from private hospitals: 49% were men, their mean age was 72+/-12.7 years, 20% were black, 58% had an income greater than 6 minimum wages, 11% were illiterate, 62% had ischemic heart disease, their mean length of hospitalization was 8 days, and the mortality rate adjusted for age was 2.94. The distribution of comorbidities and risk factors was similar among the patients of the 2 hospital systems, except for the smoking habit, which was more frequent among patients from public hospitals. CONCLUSION: In addition to the socioeconomic asymmetries, the hospitalization length and the mortality rate adjusted for age were greater in patients in the public health system.

Aged↗
PubMed1998

[Risk factors for low birth weight].

Low birthweight (LBW) is the main known determinant of infant mortality. In spite of the sharp decrease in infant mortality rates and of the rise in survival rates for children with LBW, no important decrease in LBW rates has been observed in Neuquen, Argentina. The purpose of this study was to try to understand the risk factors for LBW, the frequency of LBW in the population, and the role of prenatal care in its prevention, as well as to develop a risk factor scale that could be used to identify women at higher risk of giving birth to a child with LBW. With this in mind we performed a cross-sectional study based on 50% of the data entered into the Perinatal Information System for 1988-1995 by the 29 hospitals in Neuquen province (46,171 births). The distribution of birthweight and the frequency of potential risk factors for LBW were examined. The relationship between such factors and LBW was studied using a logistic regression model. On the basis of the results obtained, an additive scale was drawn up and validated with the remaining 50% of the data for registered births. The highest odds ratio (OR) was seen in women who had no prenatal care (OR = 8.78; 95%CI: 6.7 to 11.4). ORs for inadequate prenatal care, lateness in attending the first prenatal visit, preeclampsia or eclampsia, hemorrhage and anomalies of the placenta or placental membranes, and a history of a previous child with LBW were greater than 2.0. The risk of having children with LBW was also higher in women over the age of 40, women under 20, single women, smoking mothers, women with an intergenesic interval of less than 18 months, and women with a body mass index of less than 20. Finally, there was a direct linear relationship between points on the risk scale and the risk of having a LBW infant.

Adolescent↗