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[Hospital Federations in Europe].

The Hospital Federations are voluntary associations with non-lucrative ends which join Hospitals together and whose aim is to defend the interests of the Hospitals and their role in society. We study the situation about Hospital Federations in Spain, in the rest of the member States of the European Community and in Switzerland. There are Hospital Federation in West Germany, Luxembourg, The Netherlands, Switzerland, France and Belgium. The Federation has a unitarian character in Germany, Luxembourg, The Netherlands and Switzerland whereas there are several Federations in France and Belgium. There are not Hospital Federations, or they have a very minimum role, in the U.K., Denmark, Portugal, Italy, Ireland and Greece. In this article we analyse the conditions under which a Hospital Federation could be formed in our country which would join a large percentage of hospital beds together in Spain.

Europe↗

Efficiency of federal hospitals in the United States.

This study evaluates the technical efficiency of federal hospitals in the United States using a variable returns to scale, input-oriented, data envelopment analysis (DEA) methodology. Hospital executives, health care policy-makers, taxpayers, and other stakeholders, benefit from studies that improve the efficiency of federal hospitals. Data for 280 federal hospitals in 1998 and 245 in 2001 were analyzed using DEA to measure hospital efficiency. Results indicate overall efficiency in federal hospitals improved from 68% in 1998 to 79% in 2001. However, based upon 2001 spending of $42.5 billion for federal hospitals potential savings of $2.0 billion annually are possible through more efficient management of resources. From a policy perspective, this study highlights the importance of establishing more specific policies to address inefficiency in the federal health care industry.

Efficiency, Organizational↗

Characteristics of women forensic patients in a federal hospital.

Increased criminal activity among women has prompted greater interest in the mentally ill female offender. An analysis of 72 women forensic inpatients at St. Elizabeths Hospital in Washington, D.C., indicated the typical patient was black, unmarried, in her mid-30s, poorly educated, and diagnosed as schizophrenic. The authors examine some relationships between race, type of crime, drug use, institutional history, and age and the utility of such variables as predictors of adjustment. A comparison of the primary sample with a cohort of 72 patients admitted ten years earlier showed that admissions related to public-order and technical offenses such as prostitution, parole violations, and drug violations decreased from 50 to 12 per cent, while admissions related to crimes of violence rose by 17 per cent.

Adult↗

ASHP national survey of pharmaceutical services in federal hospitals--1993.

The results of a national mail survey of pharmaceutical services in federal hospitals conducted by ASHP from May to July 1993 are reported. Mailing lists were compiled of all Air Force, Army, Navy, Public Health Service, and Department of Veterans Affairs (VA) hospitals, as well as some federal prison hospitals. Questionnaires were mailed to each chief of pharmacy. The adjusted gross population size was 326. The net response rate was 76%. Complete unit dose drug distribution was offered by 85% of respondents, and 83% offered complete, comprehensive i.v. admixture programs. About half of the pharmacies provided decentralized services. Over 99% provided services to ambulatory care patients. A computerized pharmacy system was present in 99% of the departments. More than 95% of hospitals participated in adverse drug reaction, medication error management, and drug-use-evaluation programs. A total of 93% provided drug therapy monitoring, and 89% provided patient education. About 70% provided written documentation of pharmacist interventions in the medical records, and 57% participated in drug research. A total of 42% provided pharmacist-managed drug clinics, 41% participated in drug management of medical emergencies, 30% provided written medication histories, and 30% provided drug therapy management planning. Pharmacokinetic consultations were provided by 64% of departments. About 90% had a well-controlled formulary system and prescribing restrictions. Therapeutic interchange was practiced by 64%. Diversified pharmaceutical services included telephone or mail-in refill services (80%), mail-out pharmaceutical services (58%), and services to long-term-care facilities (49%). A total of 70% of the hospitals were affiliated with a pharmacy school. The first ASHP national survey of pharmaceutical services in federal hospitals showed that comprehensive distributive and clinical services were offered by most of the facilities.

Drug Information Services↗