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[Breast self-examination: knowledge of women attending the outpatient service of a university hospital].

This is a descriptive study developed in the outpatient unit of a university maternity hospital in the city of Natal/RN. It aimed at identifying the knowledge about and alterations found during breast self-examination as well as at describing how women examine themselves. The population was formed by patients sent by other health services and the sample consisted of 109 women with age varying from 15 to 83 years. In order to collect data, the authors used a form containing identification information as well as about breast self-examination. Based on the collected data, they identified that among the 109 participants, the age of 36 (33%) of them varied from 15 to 39 years; of 58 (53%) of them from 40 to 58 years and of 15 (14%) of them from 60 to 83 years. 75% reported that they examined themselves and that they attended a health care service for correct treatment in case any alterations were detected during self-examination.

Adolescent↗
PubMed2001

[An analysis of medical expenses of outpatient service for the elderly at one health insurance society in Fukuoka prefecture--focused on medical service and concentration of medical expenses].

To determine the best way to reduce medical expenses of the elderly, we analyzed the aged outpatients' receipts covered by the Health and Medical Service Law for the Aged at one health insurance society in Fukuoka prefecture. We used 312 medical receipts during July, 1997. The proportion of frequency of each medical service was 89.7% for medications, 45.8% for laboratory tests and 26.3% for procedures. The proportion of expenses of each medical service was 38.3% for medications, 20.0% for examinations and 12.1% for laboratory tests. Medication is considered as one of the main causes of increasing medical expenses. As a result of multiple regression analysis, the number of consulting days, urinary and genital disorder, the number of diseases, home care, laboratory tests and prescriptions for outside pharmacies were detected as statistically significant factors associated with medical expenses. There was a concentration of medical expenses, i.e. about 10% of higher rank receipts consumed around 40% of total outpatients' expenses and included 6 of 10 home medical care receipts. One of the causes of expensive outpatients' medical expenses was medication. The separation of dispensary and prescription of drugs does not contribute to the reduction of medical expenses. In the higher rank of the expenses group, compared with the lower rank of the expenses group, the consultation days were longer, the number of diseases was greater and the proportions of expenses for procedures and home care were larger. Medical expenditures for patients receiving home medical care were higher than those of others, but home care should be compared with admissions. Because the insurance societies are now facing financial difficulties in Japan, analyzing the data of medical receipts is very important. During our analysis, we had to make an enormous effort to combine two data sources, because the receipts were made separately by clinics and pharmacies. It is strongly suggested that a computerized information system with a standardized format for clinics and pharmacies be developed.

Aged↗
PubMed1990

[Prevalence of psychiatric disorders in an outpatient service of general medicine].

A psychiatric evaluation was performed in 100 patients attending the outpatient clinic of a large general university hospital. Psychiatric diagnosis followed the DSM-III-R criteria. 66 were female and the mean age was 50 years. The clinical diagnosis for the consulting problem related mainly to cardiovascular, metabolic, gastrointestinal and respiratory problems. Some psychiatric disorder was present in 55% of patients, mainly in the area of mood and adaptation problems. A psychiatric diagnosis was made by the general physician in only 14 patients and was labelled as neurosis of anxiety state. Our results show a high prevalence of psychiatric disorders in patients who consult in general clinics. A better psychiatric training of clinicians in charge of primary medical care is needed.

Adult↗
PubMed2004

Diabetes-related utilization and costs for inpatient and outpatient services in the Veterans Administration.

OBJECTIVE: -The purpose of this study was to calculate the total number of inpatient hospitalizations, outpatient clinic visits, and total direct health care costs associated with veterans with diabetes receiving care in Veterans Administration (VA) facilities. RESEARCH DESIGN AND METHODS-The number of inpatient hospitalizations is tracked for years 1994-1998, and outpatient clinic visits are tracked for years 1997 and 1998. Trends in utilization across different age and racial groups, as well as total direct inpatient and outpatient costs for 1998, are presented. RESULTS: -Between 1994 and 1998, hospitalization rates decreased from 1.68 to 1.61. The average number of outpatient visits was 4.5 in 1997 and 4.6 in 1998. VA incurred $214.8 million in outpatient expenditures and $1.45 billion in inpatient expenditures for veterans with diabetes receiving VA care. CONCLUSIONS: -Health care delivery systems and payors track the cost and utilization of services by specific patient groups to support disease management, quality improvement, external reporting, and cost containment. Tracking the utilization and cost of diabetes care is necessary to understand the financial impact of diabetes on health care systems and the overall burden of diabetes on individuals.

Aged↗