Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Privatization”

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 1,297 records · Page 72Linked to original sources
PubMed2006

[Public school programme for fissure sealants and its effect on the private demand for restorative dentistry for temporary teeth].

OBJECTIVE: To analyse the effect of a public school odontological programme of fissure sealants on the private demand for restorative dentistry for temporary teeth. DESIGN: A longitudinal, comparative study was conducted. It had 2 groups, control and sealant, with 3 years monitoring. SETTING: Santa Fe Health Area, concretely in the local districts (LD) of Santa Fe and Pinos Puente, Granada, Spain, starting in the school year 1996/1997. PARTICIPANTS: The sealant group was selected from the Santa Fe LD (which had a public programme of fissure sealants) (n=129); and the control group (n=120), from Pinos Puente LD. INTERVENTIONS: All the school students were examined (+ report issued) in the schools every 6 months for 3 years. The sealant group children received at the health centre fissure sealants in their first permanent molars. MAIN MEASUREMENTS: The restorations performed in temporary teeth for both groups were analysed (x+/-EE) during the study at 12, 24, and 36 month follow-up. RESULTS. The sealant group had a significantly greater increase in restorative treatment for temporary teeth (P< .05) than the Control group at all monitoring points. CONCLUSIONS: A public programme of fissure sealants raised private restorative treatment for temporary teeth.

Child↗
PubMed1976

Mental health services in the public and private sectors.

Analysis of data on mental health service providers indicates that in 1971 the private sector accounted for 34% of inpatient days, 86% of outpatient visits, 44% of expenditures by source of funds, and 51% of expenditures by receipt of funds. The author believes that mental health professionals must familiarize themselves with the economic interests influencing national health insurance proposals and with public policy making processes if they are to help preserve appropriate roles for the public and private sectors in mental health service delivery.

Costs and Cost Analysis↗
PubMed1988

How to survive in the private practice of psychiatry.

The private practice of psychiatry is being transformed by the new economics of medical care. Patients are paying more out-of-pocket for necessary care (demand-side cost sharing), and health care providers are being asked to assume part of the risk of treatment through prospective payment (supply-side cost sharing). Specific survival strategies for psychiatrists in private practice include development of a balanced practice, expansion of referral networks, participation in alternative delivery systems such as health maintenance organizations and preferred provider organizations, active involvement in utilization and claims review, participation in outcome studies, and expansion of patient care advocacy and community involvement.

Health Maintenance Organizations↗
PubMed1994

Selection of patients for management of attention deficit hyperactivity disorder in a private practice setting.

Attention deficit hyperactivity disorder (ADHD) is a syndrome characterized by age-inappropriate levels of motor activity, impulsivity, and inattention. A system of triage was developed to select an ADHD patient population which was manageable in a private practice setting. Seventy-four subjects with symptoms suggestive of ADHD were evaluated and diagnosed with ADHD and followed for 2 years. All subjects included in the study were shown a teaching videotape, received a full physical examination, and were counseled for approximately 1 hour. The diagnosis of ADHD was made based on the presence of eight of 14 criteria described in DSM-III, elevated Connors Rating Scale (CRS) scores, physical examination, observation, and historical information. A treatment plan involving behavioral therapy and medication was implemented with frequent follow-up. Ninety-six percent of the patients showed improvement in behavior (parental report and decreased CRS scores) and/or grades (one letter grade in two classes for 12 weeks). Fifteen percent of the treated subjects were suspected of having coexistent disorders and 4% did not respond to treatment. By implementing a simple triage system and protocol for diagnosis, treatment, and follow-up, a manageable patient population with ADHD and similar disorders was selected and successfully treated in a private practice setting.

Attention Deficit Disorder with Hyperactivity↗
PubMed1996

The association between parental health beliefs and immunization status among children followed by private pediatricians.

To determine the association between parental health beliefs and the immunization status of their children, parents of children seen in two private pediatric practices completed a questionnaire on attitudes about immunizations. Five components of health beliefs were surveyed: perceived benefits of immunizations, susceptibility to diseases prevented by immunizations, severity of those diseases, parental feelings of self-efficacy in promoting their child's health, and barriers to immunization. Responses to the health-beliefs statements were transformed to an ordinal scale between 1 and 6, with "6" corresponding to strongly positive feelings about immunizations. Immunization data were abstracted from practice medical records. Overall, 162/194 (83.3%) study children were fully immunized. There were no significant differences between parents of fully immunized children and those of under-immunized children in total health-beliefs score or for the benefits, susceptibility, severity, or barriers components. Self-efficacy scores were significantly higher among parents of fully immunized children (P = 0.019); however, this was largely due to differences in the subgroup of children of mothers with lower education levels. The results of this study suggest that among parents of children followed by private pediatricians, health beliefs do not significantly influence immunization status.

Attitude to Health↗
PubMed2003

Evaluating the efficiency of private sector organizations in helping welfare beneficiaries find employment.

This research examines the relative success of private, public, and nonprofit organizations in finding employment for Temporary Assistance for Needy Families beneficiaries in Florida. A variety of data are used to measure success in this endeavor. Type of organization used to assist in finding employment was entered into a regression model that controlled for demographic characteristics of the welfare population. Ordinary least squares regression, analysis of variance, difference of means, and descriptive statistics were employed to test the hypothesis that private service providers were more efficient and effective than were public or nonprofit organizations in finding employment for welfare beneficiaries. The analysis did not support the hypothesis.

Analysis of Variance↗
PubMed1995

Nurses in private nursing homes: a study of their knowledge and attitudes to pain management in palliative care.

Nurses working in private nursing homes may not have the same degree of access to support and education in palliative care as nurses in NHS 'care of the elderly' wards. A study was conducted comparing two groups of nurses working in these two environments in one health district. Twenty-four nurses underwent semistructured interviews focusing on pain management. Both groups showed equal enthusiasm for their work with elderly patients. However, those from the care of the elderly wards were able to offer many more treatment strategies to relieve pain than their colleagues from the private nursing homes. The study uncovered a sense of isolation and a lack of postbasic education opportunities for nurses outside the NHS. If this small local study reflects a national trend, then there are major implications for the educational activities of palliative care teams.

Adult↗
PubMed1985

Private practice: the first five years.

This is a longitudinal study of all patients seen in the first five years of a private psychiatric practice. At the present time, it is believed to be the only known complete study of patients in a typical private practice. The data from 486 patients has been collected and analyzed and some of the results have been compared to those obtained in other studies. Some significant findings emerged. Depression is the single commonest condition and its frequency was similar to that found in other studies. Psychoses were rare. A large category of patients was described as having a Personality Disorder. The implications of these and other findings are discussed. The data are relevant to aspects of clinical psychiatry, to the teaching of psychiatry, and to the financial insurance coverage of medical services.

Adult↗
PubMed2000

Privatizing indigent health services in Los Angeles County: understanding the effects on community-based providers.

Faced with imminent financial collapse of its public healthcare system, the Los Angeles County Department of Health Services solicited community-based providers to supply primary care health services to the medically indigent. This study highlights the effects that participation in the programme has had on these community providers. While strongly committed to the programme's objectives, community providers tended to overextend themselves financially, putting their organizations at substantial risk of failure should contractual expectations or patient demand forecasts not be met. Because of this risk, policymakers involved in public-private partnerships with community-based providers must exercise extreme caution owing to the unique status many of these providers hold as centrally positioned actors in their communities. On the positive side, we found evidence of increased levels of co-operation and innovation between community providers outside their formal roles in the county-sponsored public-private partnership programme.

Community Health Centers↗
PubMed2002

The introduction of Norplant in Cambodia through the private sector.

The objectives of this study are to determine whether Norplant would be an acceptable contraceptive method for Cambodian women, given its technology and the socio-cultural context, and whether it can be delivered by a private sector clinic with good quality care. This is a prospective cohort study of the first 966 acceptors. It was found the one-year continuation rate was 90.5%, there were no pregnancies and client satisfaction was high. In general, Norplant was delivered with high quality of care. Findings indicate that Norplant suits the contraceptive needs of many Cambodian women and is appropriate for their socio-cultural context. Norplant can be introduced, with high quality care, in a private clinic in a developing country.

Cambodia↗
PubMed1990

The differential effects of a change in reimbursement on public and private university hospitals.

The primary purpose of the government's prospective payment system was to decrease the rate of federal spending for Medicare patients by paying fixed prices for services and by transferring the financial risk for the care provided to the hospital. While PPS certainly has affected all hospitals, this article has attempted to identify some of the expected and unexpected consequences of the change in reimbursement on publicly and privately owned university hospitals. Of importance is the discussion that has analyzed the specific effects of PPS on the components of the UHs' missions. The implementation of PPS may exaggerate the effects of the payment change on both types of UHs. The provision of broadly based primary and specialty care services may be in question as institutions find themselves potentially unable to deliver these services on a price-competitive yet profitable basis. The costs associated with educational, research, and community service programs can no longer be subsidized by excess patient care revenues as payers streamline payments to reflect only the costs of clinical care. Thus, university hospitals may be forced to reexamine their missions and change their operating plans to reflect the current fiscal environment. If taken to an extreme, it is likely that the local society may be negatively affected by these actions. Clinical and community services that increase access, assure continuity of care, or provide needed but costly (public) health services may be eliminated or reduced in scope in an effort to contain costs. Even those services that are cost beneficial from a societal perspective may be eliminated without some form of subsidy or direct payment as institutions are forced to reallocate their limited funds from these types of public health services to support nonprofitable, but critical clinical or academic programs. The potential impact on access, continuity of care, and morbidity and mortality will not be known for many years. Although it is not known how these changes will eventually affect university hospitals, two outcomes seem clear. University hospitals with different governance and management structures may not change their missions and means for achieving institutional goals as much as might have been expected. The interdependence of the university hospitals' goals and the role they play in their local communities may force them to begin to explore new ways to achieve their missions. Public-private sector cooperation is suggested as one approach to use in response to the demands of payers and patients while the institution remains true to its historical mission.(ABSTRACT TRUNCATED AT 400 WORDS)

Community-Institutional Relations↗
PubMed2005

Differing mental health practice among general practitioners, private psychiatrists and public psychiatrists.

BACKGROUND: Providing care for mental health problems concerns General Practitioners (GPs), Private Psychiatrists (PrPs) and Public Psychiatrists (PuPs). As patient distribution and patterns of practice among these professionals are not well known, a survey was planned prior to a re-organisation of mental health services in an area close to Paris METHODS: All GPs (n = 492), PrPs (n = 82) and PuPs (n = 78) in the South-Yvelines area in France were informed of the implementation of a local mental health program. Practitioners interested in taking part were invited to include prospectively all patients with mental health problem they saw over an 8-day period and to complete a 6-month retrospective questionnaire on their mental health practice. 180 GPs (36.6%), 45 PrPs (54.9%) and 63 PuPs (84.0%) responded. RESULTS: GPs and PrPs were very similar but very different from PuPs for the proportion of patients with anxious or depressive disorders (70% v. 65% v. 38%, p < .001), psychotic disorders (5% v. 7% v. 30%, p < .001), previous psychiatric hospitalization (22% v. 26 v. 61%, p < .001) and receiving disability allowance (16% v. 18% v. 52%, p < .001). GPs had fewer patients with long-standing psychiatric disorders than PrPs and PuPs (52%, 64% v. 63%, p < .001). Time-lapse between consultations was longest for GPs, intermediate for PuPs and shortest for PrPs (36 days v. 26 v. 18, p < .001). Access to care had been delayed longer for Psychiatrists (PrPs, PuPs) than for GPs (61% v. 53% v. 25%, p < .001). GPs and PuPs frequently felt a need for collaboration for their patients, PrPs rarely (42% v. 61%. v. 10%, p < .001). Satisfaction with mental health practice was low for all categories of physicians (42.6% encountered difficulties hospitalizing patients and 61.4% had patients they would prefer not to cater for). GPs more often reported unsatisfactory relationships with mental health professionals than did PrPs and PuPs (54% v. 15% v. 8%, p < .001). CONCLUSION: GP patients with mental health problems are very similar to patients of private psychiatrists; there is a lack of the collaboration felt to be necessary, because of psychiatrists' workload, and because GPs have specific needs in this respect. The "Yvelines-Sud Mental Health Network" has been created to enhance collaboration.

Adult↗
PubMed2005

Symptom correlates of MMPI-2 scales and code types in a private-practice setting.

The purpose of this study was to determine empirical symptom correlates of MMPI-2 (Butcher et al., 2001) scales for private-practice clients, a very understudied yet important population. We examined the scores of 240 male and 407 female clients on the Clinical scales, Content scales, Supplementary scales, and frequently occurring code types. We used a factor analyzed version of the Adult Clinical scales of the Multiaxial Diagnostic Inventory (Doverspike, 1990) as a criterion measure. The results generally indicated that the symptom correlates for the MMPI-2 scales and code types were quite similar to those that have been previously reported in other outpatient and inpatient settings. We concluded that descriptors of MMPI-2 scales and code types generated in other settings may be used when interpreting MMPI-2 profiles of private-practice clients.

Female↗
PubMed2006

Incremental validity of the MMPI-2 Restructured Clinical (RC) scales in a private practice sample.

Building on results reported in Sellbom, Graham, and Schenk (2005), in this study, we examined the incremental validity of the newly introduced MMPI-2 (Butcher et al., 2001) Restructured Clinical (RC) scales (Tellegen et al., 2003) over both the Clinical and Content scales. Participants were 647 clients in private practice who were administered the MMPI-2 and the Multiaxial Diagnostic Inventory (Doverspike, 1990) early in therapy. The results indicate that the RC scales had acceptable internal consistency, reduced intercorrelations (compared to the Clinical scales), and promising convergent and discriminant validity. Hierarchical regression analyses revealed that the RC scales added incrementally to both the Clinical and Content scales in predicting self reported clinical symptoms. These findings suggest that the RC scales are relatively homogenous measures of core clinical constructs that can add unique information to the understanding of private practice clients above and beyond the Clinical and Content scales.

Adult↗
PubMedDate not supplied

Reform and remembrance: the place of the private sector in the future of health care policy.

Although the nation failed during the past decade to enact large-scale, structural change in government health policy, it has seen health care in the private sector remodeled dramatically during the same period. In this article I argue that a new round of equally significant changes is quite possible, this time at the hands of the national government. More specifically, I argue that for a variety of reasons, both enduring and more recently born, support for the private sector and the market in health care is relatively weak: that given likely trends in costs, demographics, and inequalities, it is likely to get even weaker; and that in the potential coming crisis of the health care system. there will be a real opportunity for seizing the agenda and winning policy battles on the part of would-be reformers pushing large-scale, public sector-oriented changes that go well beyond the recent reform efforts directed at managed care and HMOs.

Attitude to Health↗
PubMed2002

Public versus private hospital maternity length of stay: a gamma mixture modelling approach.

Application of a gamma mixture model to obstetrical diagnosis-related groups (DRGs) revealed heterogeneity of maternity length of stay (LOS). The proportion of long-stay subgroups identified, which can account for 30% of admissions, varied between DRGs. The burden of long-stay patients borne was estimated to be much higher in private hospitals than public hospitals for normal delivery, but vice versa for Caesarean section. Such differences highlights the impact of DRG-based casemix funding on inpatient LOS and have significant implications for health insurance companies to integrate casemix funding across the public and private sectors. The analysis also benefits hospital administrators and managers to budget expenditures accordingly.

Diagnosis-Related Groups↗
PubMed2004

Does the private sector have a role in Canadian healthcare?

The current system of public pay with primarily public management for essential healthcare services has largely been successful. The Romanow and Kirby reports have made compelling arguments for expanding the definition of essential healthcare services to include, among other things, medications. The problem facing Canadians is that expanding services is not feasible under the current structure, as it is not affordable. The rigid adherence to a 45-year-old definition of system structure is hampering our ability to innovate. In an increasingly unresponsive system, the introduction of private management, through the judicious use of private contracts, can improve efficiency and increase accountability, while maintaining the important principle of public funding.

Canada↗