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 1,621 records · Page 90Linked to original sources
PubMed2000

The private hepatocyte nuclear factor-1alpha G319S variant is associated with plasma lipoprotein variation in Canadian Oji-Cree.

We previously showed an extremely strong association between type 2 diabetes and a private polymorphism, namely G319S, in the hepatocyte nuclear transcription factor (HNF)-1alpha. Because HNF-1alpha is involved in the transcription of several apolipoprotein genes, we tested for an association between the private HNF1A G319S variant and plasma lipoproteins in a sample of 55 unrelated Oji-Cree subjects with type 2 diabetes and 175 unrelated Oji-Cree subjects without type 2 diabetes. In Oji-Cree subjects with type 2 diabetes, we found that the HNF1A G319S genotype was significantly associated with lower plasma concentrations of total cholesterol, low density lipoprotein cholesterol, and apolipoprotein (apo) B. In Oji-Cree subjects without type 2 diabetes, we found that the HNF1A G319S genotype was significantly associated with higher plasma concentrations of high density lipoprotein cholesterol and apo AI. There were no associations with plasma triglycerides or lipoprotein(a). Regression analysis indicated that the HNF1A genotype accounted for approximately 10% of the variation in the apo B-related traits in the diabetic subjects and for approximately 5% of the variation in the apo AI-related traits in the nondiabetic subjects. Furthermore, the regression model indicated that the HNF1A S319 allele affected these traits in a dominant manner in subjects with and without type 2 diabetes. These findings provide the first evidence that a rare variant in a nuclear transcription factor is associated with variation in plasma lipoprotein traits.

Adolescent↗
PubMed1981

Effect of the Rennie decision on private hospitalization in New Jersey: two case reports.

The Rennie decision in New Jersey on the right to refuse treatment has been extended from public mental health programs to private psychiatric hospitals where conditions are very different from those which engendered the decision. This ripple effect may result in therapeutic delay, increased cost, possible general medical neglect, family turmoil, and misuse or loss of insurance benefits. The two cases described by the author resulted in expenditures of more than $30,000 by the patients and their insurers. The author criticizes the policy of using independent psychiatrists to review treatment in private hospitals. He believes that if the right to refuse treatment is maintained, prompt judicial review without prior restraining orders should be public policy.

Bipolar Disorder↗
PubMed1985

The private versus the public psychiatric interview.

As videotaping, one-way screens, and other audiovisual aids are used more frequently for teaching and research purposes in psychiatry, it becomes increasingly important to define how the fact of observation changes the traditionally private psychiatric interview. The author defines the difference between the public and private interview, reviews the pertinent literature, and describes personal experiences with a variety of observational situations. He focuses on how observation affects the concentration of the therapist, how it changes the social uniqueness of the therapy situation, and how, with the addition of a potential audience, the one-to-one situation may become more like a group situation, in which different psychological mechanisms may be employed.

Attitude of Health Personnel↗
PubMed1987

Elements of the private therapeutic interview.

A previous paper explored the differences between a psychiatric interview that is entirely private and one observed by way of a mechanical device. The attempt to explore such differences raises questions about what are the special elements in the private interview that rely heavily on privacy. This paper focuses on 1) the specific rhythms that are worked out within each patient-therapist dyad; 2) the quality of the concentration of one individual on another; 3) the capacity for undoing, or taking back, previously stated positions; and 4) the difference between the intimacy developed through privacy in everyday social situations and that achieved in the therapeutic relationship.

Humans↗
PubMed2003

Psychiatric inpatient, outpatient, and medication utilization and costs among privately insured youths, 1997-2000.

OBJECTIVE: The study examined trends in use of inpatient and outpatient mental health services, including pharmacotherapy, among privately insured children and adolescents from 1997 to 2000. METHOD: Data from a national database of more than 1.7 million privately insured individuals were used in an analysis of inpatient, outpatient, and pharmacy claims of users of mental health care age 17 years and younger (approximately 20,000 patients per year). Annual utilization rates and adjusted costs for services and dispensed psychotropic medications were calculated. Results from 1997 and 2000 were compared across diagnostic and age categories. RESULTS: The proportion of youths with an inpatient psychiatric admission decreased by 23.7% from 1997 to 2000, and annual inpatient and outpatient costs decreased by 1,216 US dollars (18.4%) and 157 US dollars (14.4%), respectively. Decreases were driven by a reduction in inpatient days (20.0%) and by a combination of a reduction in outpatient visits (11.3%) and declining payments per outpatient visit (6.1%). Payment trends across diagnoses varied considerably, with the largest reductions seen in treatment of depression, hyperactivity, adjustment disorders, and anxiety disorders. Over the same period, the proportion of youths receiving medication increased by 4.9%, and mean annual medication-related costs per outpatient increased by 41 US dollars (12.1%). CONCLUSIONS: Reductions in inpatient and outpatient mental health service intensity and reimbursements documented in previous research continued through the late 1990s. Declines were accompanied by concurrent increases in the use of and costs associated with psychotropic medications, particularly for youths with mood and anxiety disorders. These results document a shift toward medication-based outpatient treatment modalities.

Adolescent↗
PubMed1976

Psychiatric liaison with private facilities caring for discharged patients.

Motivated by concern about the fate of psychiatric hospital patients after discharge to the community, a community mental health center decided to send a psychiatrist into the community to establish liaison with private-care facilities and to determine the needs of such discharged patients. As a result of the psychiatrist's efforts, owners of the area's private-care facilities acquired a better understanding of the needs of their residents and learned where they could turn for help in caring for discharge psychiatric patients. A study of one board-and-care facility revealed a marked decrease in the use of the center's emergency service and in the number of hospital admissions after one year of this extended service.

Aftercare↗
PubMed1981

The private general hospital's psychiatric emergency service in a decade of transition.

The psychiatric emergency ward of the private general hospital is faced with increasing demands for services and a changing role as a result of the progression of deinstitutionalization and shifts in the relationships between public and private facilities. Ten years ago the psychiatric emergency ward operated primarily as an evaluation and referral unit, triaging patients to primary sources of care; today the public facilities that serve as the primary caregivers frequently turn referrals away. Thus the referral model of service delivery is no longer viable for a psychiatric emergency ward, but it is yet to be replaced by other programs within the ward that will enable the chaos of the current system to be bypassed and prevent further deterioration of patient care. The authors discuss the dilemmas facing the emergency ward staff in the management and treatment of involuntary, psychotic, and chronic crisis patients.

Boston↗
PubMed1983

Deinstitutionalization and the private general hospital inpatient unit: implications for clinical care.

Deinstitutionalization has led to a rapid shift from reliance on state hospitals to use of community-based inpatient psychiatric services. While these inpatient units were initially envisioned as an integral part of the community mental health system, a number of sociopolitical and clinical pressures have caused general hospitals to respond to their new responsibilities in different ways. The authors review trends in deinstitutionalization, the diverging interests of public and private general hospitals, and problems in patient care that result. Based on a discussion of how Beth Israel Hospital, a nonprofit private general hospital in Boston, has dealt with such issues, they describe adaptive responses in four areas: admission criteria, patient management approaches, aftercare planning, and staff training.

Aftercare↗
PubMed1985

The future of public-private sector partnerships for the provision of human services: problem and possibilities.

This article examines the responses of states, localities, and the private sector to recent attempts by the federal government to realign domestic responsibilities for the provision of human services. In exploring this issue, the author conducted a study of agencies assisting the developmentally disabled in Greater Richmond, Virginia. The author finds that the nation is experiencing a fundamental paradigm shift--a reconceptualization of structure, goals, and responsibilities--with respect to social welfare, with new public-private sector partnerships emerging to meet human needs.

Financing, Government↗
PubMed2003

Anti-tuberculous drug prescribing: doctors' compliance at a private teaching hospital in Pakistan.

An adequate and appropriate anti-TB drug prescription is of crucial importance in order to "cure" a TB patient of his or her disease. This study looked at the prescribing habits of doctors working in a private teaching hospital of Pakistan. The results showed that the majority of doctors (79%) were choosing the correct four-drug regiment of RHZE in the intensive phase, as recommended in the National Guidelines. However, the dosage of some drugs were below the recommended ranges (43% of prescriptions for Pyraizinamide and 48% for Ethambutol). Regular audit of doctors' prescriptions is necessary in order to ensure that the National TB Guidelines are fully implemented by physicians working in the private sector of Pakistan.

Adult↗
PubMed2004

Private prescription costs for sildenafil within the NHS: a telephone survey.

Because of the restrictions on prescribing for impotence within the NHS, doctors routinely write private prescriptions for sildenafil. The aim of this study was to determine the variation in cost of a private prescription of four 100 mg tablets of sildenafil. A selection of different pharmacy types within five areas in England was surveyed. We telephoned a total of 86 pharmacies and we were quoted prices ranging from pounds 28.20 to pounds 42.33. There was a significant difference in price between area and between pharmacy type. Best prices are not necessarily found at the major pharmacy chains or hospital pharmacies, as might be expected. NHS doctors and patients need to be aware of this significant difference in cost.

Humans↗
PubMed2005

Beyond the mask: women's experiences of public and private ageing during midlife and their use of age-resisting activities.

Accounts of ageing often employ the metaphor of a mask and suggest that individuals are motivated to present a youthful image. Drawing on interview data, we reveal that women aged 51-57 years distinguish between what we call 'public' and 'private' body ageing, both of which have an impact on age-resistance. Public ageing is visible, arising from physical changes in body appearance. These changes have the potential for concealment through age-resisting activities. Private ageing is less visible and arises largely from physiological changes within the body, which were perceived by women as irreversible indicators of ageing. This obduracy of the body led women to perceive themselves as ageing and also deterred them from participating in age-resistance. In contrast to masking theories, our study shows that most women in their 50s wanted to project a socially acceptable image that reflected their subjective sense of growing old.

Aging↗
PubMed2005

Economic burden and co-morbidities of atrial fibrillation in a privately insured population.

OBJECTIVE: This study assesses the direct (medical and drugs) and indirect (work loss) annual costs associated with Atrial Fibrillation (AFIB) in a privately insured population. BACKGROUND: AFIB is the most common sustained rhythm disturbance, affecting 2.3 million people in the United States. METHODS: Cost and co-morbidity measures for AFIB patients were compared to matched controls using a privately insured administrative database (including medical, drug, and disability claims) for 2 million enrollees, 1999-2002 from 16 employers across the United States. Patients with an AFIB diagnosis on at least two occasions were included in the co-morbidity analysis (n = 3944). A non-AFIB control sample was randomly selected with a 1:1 ratio, with characteristics (i.e., age, gender, health plan) matched to AFIB patients. Excess medical costs (i.e., employer payments) were estimated for AFIB patients, defined as the difference in average annual costs between AFIB and control patients (n = 3944); excess work-loss costs were defined similarly for employees with available work-loss data (n = 603). Statistical significance in the descriptive analysis was measured by paired t-tests for cost, or Chi-square tests for co-morbidity comparisons. A two-part multivariate model of excess cost was further estimated to control for co-existing conditions and other patient characteristics. The excess costs of AFIB patients were estimated as the difference between the observed costs of AFIB patients and their estimated costs, assuming they did not have AFIB. RESULTS: The multivariate analysis found that the excess annual direct cost of AFIB was $12,349 (p < 0.01), with AFIB patients approximately 5 times as costly as non-AFIB individuals ($15,553 versus $3204, respectively). The excess annual total cost was $14,875 (p < 0.01), with AFIB patients again approximately 5 times as costly as non-AFIB individuals ($18,454 versus $3,579, respectively). AFIB was associated with increased incidence of atrial flutter (p < 0.01), heart failure (Relative Risk (RR) = 29, p < 0.01), other arrhythmias/conduction disorders (RR = 16, p < 0.01), heart attack (RR = 8, p < 0.01), and stroke (RR = 6, p < 0.01). CONCLUSIONS: AFIB is a costly disease and one for which more definitive therapies might offer some potential for reducing, not only the clinical impact, but also the economic burden of the disease.

Atrial Fibrillation↗
PubMed2005

Medicines and vaccines for the world's poorest: is there any prospect for public-private cooperation?

This paper reviews the current status of the global pharmaceutical industry and its research and development focus in the context of the health care needs of the developing world. It will consider the attempts to improve access to critical drugs and vaccines, and increase the research effort directed at key public health priorities in the developing world. In particular, it will consider prospects for public-private collaboration. The challenges and opportunities in such public-private partnerships will be discussed briefly along with a look at factors that may be key to success. Much of the focus is on HIV/AIDS where the debate on the optimal balance between intellectual property rights (IPR) and human rights to life and health has been very public and emotive.

Journal Article↗
PubMed1989

Resettlement of old long-stay psychiatric patients: the use of the private sector.

A follow-up study of 17 old long-stay psychiatric patients resettled in private facilities for the elderly is reported. Resident satisfaction with the placement and functioning (using the CAPE Behaviour Rating Scale) was assessed, together with the quality of the physical and social environment, and the regime characteristics in the establishments. All residents were satisfied with life and their functioning had improved significantly. The private facilities were more resident-orientated, and had a generally superior social environment to their local authority 'old people's home' counterparts. The physical amenities, safety features, and architectural choice available were of a similar standard to those in local authority old people's homes, but there were fewer prosthetic and orientational aids and on-site recreational amenities.

Activities of Daily Living↗
PubMed2001

Public and private self-consciousness and smoking behavior in head and neck cancer patients.

Patients who continue to use tobacco following treatment for head and neck cancers are at a greater risk for cancer recurrence and earlier mortality. This study examined the unique effects of public and private self-consciousness and negative affect on smoking behavior in a sample of 40 patients with cancers of the head and neck. Measures of public and private self-consciousness and negative affect were administered and assessments of past and current smoking behavior were obtained. Only public self-consciousness was a significant predictor of continued smoking following oncologic treatment. Specifically, individuals with low levels of public self-consciousness were nearly 13 times more likely to continue smoking compared to those with relatively higher levels of public self-consciousness. This pattern is interpreted in the context of previous theorizing that suggests individuals high in public self-consciousness are more likely to discontinue habitual behavior that is perceived as socially undesirable or incorrect.

Affect↗
PubMed1981

Assessment of private and public self-consciousness: a Dutch replication.

In the present article a replication of a study by Fenigstein, Scheier and Buss (1975), who constructed a Self-Consciousness Scale (SCS), is reported. The SCS was translated into Dutch, and its properties and its relation to Locus of Control was investigated. The norms and reliability coefficients presented are consistent with prior research. Also the results of a factor analysis that yielded the three factors: Private, Public Self-consciousness, and Social Anxiety are consistent with these findings. However, Private Self-consciousness did not correlate significantly with Locus of Control.

Journal Article↗
PubMed1982

Private and public initiatives in health maintenance organizations.

Public policy controversies about the cost-containing potential of HMOs and the failures of many plans should not overshadow the fact that HMOs will be forces in the health care sector in the 1980s, largely as the result of increasing private investment. There is a large, stable segment of the prepaid industry that developed as a result of private sector and community concern long before the federal HMO Act of 1973, and it is their initiatives along with increasing investment activity by insurance companies and management companies in particular, that will serve as a base for consolidation and growth of HMO plans. HMOs have not proved to be the miraculous cost-containing mechanism of the future, but their impact will be felt even more for the changes they stimulate in the customary organizational forms, in financing, and in the role of business in health care.

Capital Financing↗