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At least 1,441 records · Page 80Linked to original sources
PubMed2006

Knowledge and practice of private practitioners in TB control in Addis Ababa.

SETTING: Private clinics and hospitals in Addis Ababa, Ethiopia. OBJECTIVES: To assess the knowledge of private practitioners (PPs) with regard to tuberculosis (TB) control and their practice of TB diagnosis, treatment and monitoring. DESIGN: A descriptive survey was conducted among PPs. A total of 120 responded to a self-administered questionnaire. RESULTS: According to 81.5% of the PPs, at least two to five TB cases were diagnosed in their clinic per week. The correct anti-tuberculosis treatment regimens recommended by the National Tuberculosis Programme (NTP) were mentioned by only 9.7% of the doctors, while 63% listed 68 regimens. The majority (41.0%) monitored treatment using chest X-ray (CXR) alone, while 21.0% use CXR in combination with another diagnostic tool. Eighty per cent of the PPs did not keep a TB register, and case holding was non-existent. CONCLUSIONS: PPs in Addis Ababa diagnose a high number of TB cases. However, there is a huge lack of information on anti-tuberculosis treatment. This shows the likely irrational use of the few available anti-tuberculosis drugs, which may favour the emergence and spread of drug resistance.

Adult↗
PubMed2007

Hospital DOTS linkage in Indonesia: a model for DOTS expansion into government and private hospitals.

BACKGROUND: To accelerate DOTS expansion, the hospital sector and specialized chest clinics must be engaged. OBJECTIVE: To develop a model for public-private partnership through DOTS expansion into public and private hospitals in Indonesia. DESIGN: Model development included gaining commitment from stakeholders, stepwise training of hospital staff, and developing unified networks for case management, patient referral, laboratory quality assurance, supervision and evaluation. RESULTS: The number of notified tuberculosis (TB) cases (all forms and new smear-positive) increased dramatically from baseline. Together, hospitals and chest clinics accounted for a significant proportion of the total cases notified by the province (51% of total TB cases and 56% of new smear-positive cases in 2004). Compared to health centers and chest clinics, hospitals reported lower cure and success rates. Despite the option for referral to health centers, the majority of patients diagnosed in hospitals and chest clinics in 2002-2004 opted to be fully managed by the diagnosing facility. CONCLUSION: The roles and strengths of hospitals differ with regard to health centers, providing a rational basis for linkage of these health service components. In Yogyakarta, linkage became effective only after establishing a stakeholder-based provincial coordinating (DOTS) committee as the recognized interface between the National Tuberculosis Programme and various providers.

Antitubercular Agents↗
PubMed1991

[Private practice in Switzerland].

Switzerland has 6.7 million inhabitants and 700 practising surgeons, half of whom work in private hospitals. A description is given of the situation in private practices and hospitals including structural and financing problems. The author outlines his range of professional activities and give two examples of frequently performed operations. The relationship of personal trust between patient and doctor is an integral part of this system and is fundamental to the fulfillment of our Hippocratic oath. Belegarzt is defined as specialist/practitioner with hospital affiliation.

Humans↗
PubMed1991

[Attitude of a group of South Africans toward advertising by dentists in private practice].

The advertising of dental services in South Africa is controlled by rules and regulations of the South African Medical and Dental Council. According to these, advertising is not permissible with the exception of specified professional information which may be made known only by means of a nameplate and an entry in a telephone directory. Questionnaires were sent to a randomised sample of 2,100 persons in order to determine the attitude of South Africans towards advertising by private practitioners. According to information obtained from this study there is a strong indication that consumers of dental services prefer a freer form of advertising by dentists in the private practice.

Adult↗
PubMed1991

[Profile of nurse administrators in private hospitals].

The purpose of this study was to identify and describe selected demographical, biographical, educational and professional background characteristics of the nurse administrator in private hospitals and to construct a profile of these characteristics. The results show that the nurse administrator in South African private hospitals is not adequately prepared for her/his managerial responsibilities. She is, however, according to the registered clinical qualifications, adequately qualified to exercise quality control and assurance in the various nursing disciplines.

Adult↗
PubMed1978

Clinic versus private treatment of psychosis.

Thirty patients with a hospital diagnosis of schizophrenia were randomly assigned upon discharge to either 1) a specialized aftercare clinic of 2) to private psychiatrists. At the end of six months, the clinic patients had spent significantly less time as hospital readmissions and were significantly more occupied (i.e. employed or in school) than the private patients. It seems possible that attendance at clinic provides group pressure to maintain drug compliance and may thus work to reduce rehospitalization. It is also likely that the network of clinic paramedical and volunteer staff, by its flexibility and availability, aids the patient's transition into employment.

Adult↗
PubMedDate not supplied

[Primary care in Québec: a comparison between private practitioners and physicians working in public community health centers].

Since the early 1970s, there have been two primary care networks in Quebec: the traditional one characterized by fee-for-service; and the public one regrouping 10% of physicians and characterized by a salaried practice within publicly funded local institutions known as CLSCs. Using 1984 data collected on 616 Quebec generalists, 333 in private practice and 283 in CLSCs, we compared the physicians' profile in both networks. In contrast to their colleagues in private practice, CLSC physicians were younger, more often female and more involved in rural practice as well as in community health. They also differed in their attitudes and to some extent in their clinical practices. Overall, the study suggests that the introduction of a public primary care network has served to facilitate the emergence of a more comprehensive type of medical practice in the Quebec health care system.

Adult↗
PubMed1990

Quality of intraoral radiographs sent by private dental practitioners for therapy evaluation by the Social Insurance Office.

Nearly all Swedish private dentists are affiliated with the Dental Care Insurance. Proposed treatment plans, including radiographs, are submitted to the Social Insurance Office for prior approval. In this study the quality of a sample of intraoral radiographs submitted by 404 private dental practitioners was analysed. Forty-four per cent of 3,708 periapical radiographs, simultaneously evaluated by two examiners, were satisfactory. The most frequent errors were excessive vertical angulation (18 per cent), missing apex (12 per cent), film positioning error (11 per cent) and underexposure (10 per cent). Fifty-five per cent of 294 bitewing radiographs were satisfactory; the major error was missing bone margin (33 per cent). The radiographs of 15 per cent of the 2,844 teeth proposed for therapy had insufficient radiographic documentation, six per cent because of missing radiograph and nine per cent because of missing apex on the radiograph. These errors applied to every second dentist. Compared to a similar study ten years ago, the present results do not indicate that the quality of intraoral radiographs has improved.

Chi-Square Distribution↗
PubMed1987

[Social psychiatry in private practice].

Though in general the practice of Community Mental Health (or "Social Psychiatry") is a task of the State, the County or the City governments, the panel discussed two instances of sizeable contributions by private practices to the tasks of community mental health, such as crisis intervention or the care of the chronically psychiatrically handicapped, which are not commonly treated in psychiatrists' offices. The "Psychosoziale Arbeitsgemeinschaft" of Basle began in a psychiatric group practice through common sessions with public health nurses, social workers and other community helpers and served a workers' section of the city. In the course of five years several other services could be built up, such as a day-care center for psychically handicapped, a patient visiting program through voluntary helpers and a rehabilitation workshop. Ultimately subsidy from State and Federal funds could be obtained. Another program, in Zurich, started in a nonpsychiatric general practice, also in a workers' section. The physicians of that group hired, at their own expense, a social worker-educator and psychotherapist with a five year experience in community mental health work to care for the social and psychological problems commonly found in every general practice. The costs of her work cannot be generally billed to the health insurance carriers, but it is possible for the therapist to negotiate case by case with the insurance, this with success in a good many cases. The discussion with the audience shows that, in spite of considerable difficulty, it appears that private practice and especially a group practice, can make a valuable contribution to the mental health care of a disadvantaged segment of the population.

Chronic Disease↗
PubMed1979

Two management systems in a nursing private practice group.

Entry into private practice can be rewarding for nurses who are willing to risk personal, financial, and professional security. Among the problems faced by the nurse in this new role is the administration of the practice, since few, if any, adequate models exist. This article describes the struggle of nurses in one private nursing practice, Creative Health Services, to meet their needs for individual freedom within an organization that is regulated sufficiently to maintain its viability.

Colorado↗
PubMedDate not supplied

Referral continuity between private and public health care for the patient under 18 in the Montreal metropolitan region.

One of the objectives of the health and social services reform launched in Quebec in the early 70s was to achieve continuity between the public and the private sector. This study focuses on specific aspects of continuity, namely referral continuity as measured by the degree to which physicians refer to public health resources in the care they provide to patients under 18, as well as their perception of these resources. A telephone survey conducted in February, 1984 gathered information on the way Montreal general practitioners and pediatricians use other medical, paramedical and public health resources. The findings indicate that the objective of continuity has not been fully achieved. Among the factors which explain such results are the lack of communication between the two sectors and the perception by physicians that these other resources, especially CLSCs, offer competitive rather than complementary services. Such a view constitutes a major constraint to the effective and efficient coexistence of the private and public sectors in a medical care system.

Adolescent↗
PubMed1989

Quality evaluation of anterior restorations in private practice.

As part of a series of postgraduate courses in Cariology for dentists, a section designed to stimulate the interest in quality evaluation of fillings was included. Thus, 75 private practitioners were asked to evaluate a number of anterior restorations on their own patients. The method used was a modification of the California Dental Association (CDA) quality evaluation system. By use of a four-graded scale the following five properties were evaluated: (1) color of the filling, (2) color of the margin, (3) surface structure and anatomic form, (4) marginal integrity, and (5) caries. The criteria were related to practical-clinical measurements. Altogether 1147 fillings were assessed, most of them 2-4 years old (n = 949). The results showed that 25 different brands had been used, of which 4 composites constituted 68% of all fillings. With the exception for one composite material, no obvious difference in the quality evaluation between the materials was observed. Of the 2-4 year old fillings, approximately every fourth was rated as "not acceptable", i.e. with need for clinical treatment "soon" or "within reasonable time". Our impression was that the system used in this study is suitable for an assessment of the quality of anterior fillings in a private practice and that it should stimulate dentists to a quality thinking in dentistry in general.

Color↗
PubMed1989

Clinical use of multiple nonsteroidal antiinflammatory drug preparations within individual rheumatology private practices.

The clinical use of nonsteroidal antiinflammatory drugs (NSAID) was studied in 15 rheumatology private practices in the USA (in California, the District of Columbia, Florida, Idaho, Minnesota, Pennsylvania and Tennessee). Among 1,423 patients with rheumatoid arthritis (RA) under care in these 15 practices, the most extensively used NSAID preparation within any of the 15 individual practices was taken by a median of 19.5% of patients (mean 20.7%, range 8-36%), and the 3 most extensively used preparations by a median of 45.9% (mean 47.7%, range 34.7-63.5%). The median number of NSAID preparations used (singly) in each of the individual practices was 15 (range 8-20), including a median of 7 (range 4-10) used by more than 5% of the patients with each practice. The NSAID usage of these patients with RA seen in private practice settings was met by 8 preparations for 70%, by 10 preparations for 80%, and by 14 preparations for 90% of the 1,423 patients.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1989

A comparison of two antismoking interventions among pregnant women in eleven private primary care practices.

Despite the dangers of smoking during pregnancy having been widely publicized, few studies have actually examined the effectiveness of antismoking interventions among pregnant women in the private primary care obstetric setting. A randomized experimental study involving 24 private physicians and 109 pregnant smokers was conducted comparing the American Lung Association's Because You Love Your Baby smoking intervention (ALA) to a standard-of-care protocol (non-ALA). The non-ALA protocol was based upon the smoking interventions that study physicians said they commonly used among pregnant women. Self-reported smoking rates were obtained by questionnaire at the first prenatal visit, at 32 to 36 weeks' gestation, and at the six-week postpartum visit. By the time of the first prenatal visit, both groups reduced by half the number of cigarettes smoked. By 32 to 36 weeks, the groups decreased the daily average by an additional 2.3 (ALA) and 1.8 (non-ALA) cigarettes, a nonsignificant difference between the groups. Fifteen (28 percent) of the ALA group compared with 9 (16 percent) of the non-ALA group reported quitting at the 32- to 36-week visit (P = .10). Only 9 percent of the ALA group and 10 percent of the non-ALA were nonsmokers at the postpartum visit. Pregnancy alone is a powerful motivator for women to decrease their smoking. Although the difference between the ALA and non-ALA protocols did not attain statistical significance, the percentage of those who quit was comparable to the results obtained in other controlled trials. The ALA Because You Love Your Baby protocol should be used until more effective methods are available.

Adult↗
PubMed1986

Lasers in private dermatologic practice.

The author has collected and evaluated data from 464 cutaneous laser procedures performed on 315 patients over two and one-half years. All procedures were performed under local anesthesia in a private dermatology office. The quality of results obtained, the advantages and disadvantages of laser treatment for the treatment of cutaneous problems, comparison with more conventional therapies, and the future of the laser in dermatologic private practice are discussed.

Argon↗
PubMed1985

[Sciatica and other low-back disorders in private practice: extent of the problem and therapeutic approaches].

Using data collected by INSERM in a 1975 survey among French general practitioners and specialists in private practice, the reporting of sciatica and low back pain (LBP) was studied, as well as doctors' diagnoses and therapeutic approaches. Only 0.7% of patients were reported as having sciatica, while 2.8% were reported with LBP. These percentages suggest, respectively, 1.5 and 6.5 million consultations with private practitioners. The prevalence of sciatica was estimated at 8%. There was no urban-rural difference in the consultation rate; three-quarters of the patients were seen by GPs. The frequency of LBP was higher among the employed, particularly among manual workers. Referrals for additional examinations were nearly twice as high for sciatica as for LBP. GPs prescribed more medicines, and more sick leave, than specialists, but made fewer referrals for additional examination, probably because the patients seen were different, or were at a different stage of disease. It is concluded that the formulation of standards of care specific to each level of care might be useful.

Adolescent↗
PubMed1987

Assessment of private dental practice: implications for dental education.

The development and testing methods for assessing the quality of private general dental practice are described. The assessment instrument, evolved through the contributions of a panel of private practitioners, provides for the evaluation of the structure, process, and outcome of practice. General practitioners, trained as evaluators, tested the instrument in 300 urban group, urban nongroup, and rural practices in 14 states. The distribution of assessment scores for the entire project sample is compared with those of the sample dentists who graduated before and after 1974. The implications of the project and its results to dental education are discussed.

Dental Care↗
PubMed1986

[Evaluation of prenatal care in Belgium and comparison between public and private medical sectors].

The Belgian health system imposes no regulations regarding antenatal care. A special study was carried out by questionnaire in a sample of 32 maternity units representative of the French-speaking region to determine the coverage rate achieved by the health system. The study also compared the private and public sectors for rate of use, socioeconomic profile of users and regularity of antenatal care. Overall results show that despite the generosity of the system, a utilization rate of 98.8%, and a coverage rate of 84%, are reached. Public and private sector attendance is comparable but their respective populations are different. Regularity of antenatal care varies considerably between the two sectors. The public sector performs better in this regard, especially when it is endowed with medico-public health teams. The results suggest that the regularity of antenatal care is a better indicator of the quality of services than of their accessibility.

Belgium↗