Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Public Sector”

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 19 recordsLinked to original sources
PubMed1990

Utilisation of 350 billion SEK in the Swedish public sector.

Sweden has the largest public sector in the western world. It has been estimated that in 1990 public expenditure will amount to 62% of the GNP compared with 43% in the OECD countries. Sweden has chosen to allow the public sector, on national, regional and local levels, to administer, produce and distribute welfare services such as education, child care, the care of the elderly, medical services and social insurances. Today it is generally agreed that the public sector cannot continue to grow. It has been estimated that total expenditure in the public sector in 1990 will amount to 800 billion SEK. Of this amount, transfers, mainly social insurances, account for 400 billion SEK, investments for 40 billion SEK and consumption for 350 billion SEK.

Financing, Government↗
PubMed1991

Recruitment, motivation, and reinforcement of preprofessionals for public sector mental health careers.

The labor intensive public mental health system needs to encourage trainees in mental health professions to consider careers in the public sector. Recent evidence is that younger professionals are choosing other career paths following their training. This paper suggests that the availability of relevant training opportunities, positive role models, financial support while in training, and a supportive group of peers are important components of training for public sector careers.

Career Choice↗
PubMed1982

Collective bargaining in the public sector of higher education: unit determination criteria.

Public sector, higher education unit determination decisions are often made shortly after enabling legislation becomes law. Once created, units seldom undergo major revisions. Units have a lasting impact on the bargaining relationship, the nature and content of agreements, and the contract administration process. This article reviews the unit determination process being used by administrative agencies in the various states with public sector bargaining statutes. Administrative agencies usually follow precedents set by the NLRB unless specific statutory provisions otherwise control. Some agencies are charged with finding an appropriate unit. Others are required to find the appropriate unit, a more demanding task. Still others merely have to create units that have been defined by the legislature. Criteria used in the unit determination process is also reviewed.

California↗
PubMed1993

State policies and programs that address the needs of mentally ill mothers in the public sector.

OBJECTIVE: The authors sought to determine whether state departments of mental health have specific policies and programs addressing the needs of mentally ill women served in the public sector who have preschool-age children. METHODS: A questionnaire was sent to the commissioner of mental health for each state and the District of Columbia. Questions addressed whether information was routinely collected on the parenting status of women who receive public-sector psychiatric services, whether services targeting mentally ill women with young children were available, and whether the state had policies concerning hospitalized women who are pregnant or who have young children. RESULTS: Sixteen states routinely collect data on whether women who receive public-sector services have young children. Four states have residential programs for mentally ill women and their children. About half of the states have programs for assessing parenting skills and outpatient services focused on improving those skills. No state has a policy about visitation between a hospitalized mentally ill mother and her children. Twenty states have policies for the care of hospitalized pregnant patients, primarily for their medical management. CONCLUSIONS: Further efforts are needed to identify mentally ill women in the public sector who have young children, to enhance the parenting skills of mentally ill patients, and to promote positive outcomes for their children.

Child↗
PubMed1990

ECT use in the public sector: California.

Availability of ECT in the United States often has been greater in the private sector than in the public sector. This is especially true in California, where ECT is heavily regulated. In 1986, ECT was available at 29.6% of the public hospitals and 42.9% of the private hospitals with psychiatric units in California. Public hospital patients accounted for 8.5% of all ECT in the state, while private hospital patients accounted for 91.5%. Of the 88 patients unable to give informed consent, 34.1% came from public hospitals vs. 65.9% from private hospitals. Two university-affiliated county hospitals accounted for 43 of 52 patients (82.7%) treated in the 6 county hospitals with psychiatric units. White patients accounted for 92.4% of ECT, leaving minorities undertreated. Private patients have a greater degree of choice regarding changing physician or hospital if ECT is needed but unavailable. The choices for public patients are limited. Possible causes and potential solutions to this problem are discussed.

California↗
PubMed1979

Why psychiatrists leave the public sector.

The flight of psychiatrists from public mental health facilities must be halted if the sickest psychiatric patients--the severely and chronically mentally ill--are to receive the best care and treatment possible. The author emphasizes the need for commitment by organized psychiatry, universities, and communities to support the public sector and those working in it. He examines the factors that influence psychiatrists to enter public service and those that eventually cause them to leave. He notes that the departure of public hospital psychiatrists for quasi-public settings has parallelled the transfer of patients to community settings, and that these psychiatrists may now be treating in such settings patients they once saw in the hospital.

Attitude of Health Personnel↗
PubMed1983

Attitudes in the development of public sector clinicians.

Attitudes have been a neglected variable in the development of public sector clinicians. Clinicians of differing disciplines may commonly possess attitudes which would affect their role in the public sector. The Houston Consortium assessed some of these attitudes in their students and faculty. The results may have heuristic implications for improving mental health care.

Attitude of Health Personnel↗
PubMed1994

Defining managed care in public-sector psychiatry.

Although managed care is an established force in the private sector, there is growing interest and experimentation with this concept in the public sector. This interest has been generated by the increased demand for services, the shrinking resource base due to cutbacks in state budgets, and the fragmentation of care that has accompanied the shift from a centralized, hospital-based model to a decentralized, community-based model for treating individuals with serious mental illness. But despite this interest, no consensus exists about the form or functions of managed care in the public arena. Simply importing private-sector versions of managed care is inadequate given the substantial differences in the patient population and service delivery mechanisms. The authors present a functional analysis of managed care in the public sector. Drawing on their conceptualization of managed care, they outline a functional approach to evaluating the strengths and weaknesses of treatment systems, innovations such as privatization and capitation, and recent health care reform proposals.

Community Mental Health Services↗
PubMed1990

Access to care: clozapine in the public sector.

Clozapine holds great clinical promise for some chronic schizophrenic patients. However, limitations on access to the drug by the largest subgroup who need it, the indigent, are causing frustration for patients, their families, physicians, and public-sector mental health systems. The drug is available only through the manufacturer's proprietary monitoring system; many public-sector professionals and agencies feel that the system is overpriced, is unfairly exclusive, and has thus far kept the drug out of reach of most patients who need it. Arguments that patient improvement will lead to dollar savings in the long run seem overly optimistic. The ethical issue of access to treatment remains. The author discusses these and related issues and reports early experience from several public mental health systems.

Agranulocytosis↗
PubMed1991

Establishing therapeutic programs in the public sector psychiatric hospital: rethinking the possibilities and priorities.

In public sector hospitals, many patient therapeutic needs are easily identified, but multiple variables present in the system obscure the planning and implementation to meet these needs. Contextual variables that hinder program development include the physical environment; patient population; lack of guiding treatment philosophy; inconsistent approach; staff limitations; resistance to change; morale issues; and bureaucratic impasses. Assessment of the system culture is essential; determining the possibilities and priorities of the system will aid in designing and implementing projects or programs.

Clinical Protocols↗
PubMed1990

The impact of the fee-for-service reimbursement system on the utilisation of health services. Part III. A comparison of caesarean section rates in white nulliparous women in the private and public sectors.

The caesarean section (CS) rate among white women aged 20-35 years and having their first baby was examined, comparing the private fee-for-service medical aid sector with Johannesburg Hospital. The chance of having a CS in the private sector was 50% greater than in the public sector (28.7% v. 19.5%). Twice as many CSs were done on weekdays as over weekends, and it is argued that only a quarter of these are accounted for by elective procedures (planned before labour begins). We also found that in the private sector the daily frequency of non-caesarean deliveries was 56% higher during the week than on Saturdays or Sundays. Considering non-caesarean deliveries separately, it is inferred that the rate of induction of such deliveries was 28.7% in the private sector compared with 2.8% in Johannesburg Hospital. The evidence strongly confirms the international experience that the CS rate in a given population is not objectively determined by medical factors and is strongly influenced by individual doctors' decisions. Moreover, fee-for-service reimbursement of doctors leads to increased intervention in delivery, in the form of more frequent induction of labour and more CSs.

Adult↗
PubMed1995

Compliance with public sector HIV medical care.

Despite the availability of free or low-cost public sector human immunodeficiency virus (HIV) health-care services, important inequities in utilization exist. This study examined two measures of compliance with HIV medical care: attendance of scheduled outpatient visits and use of the emergency room. Clients of two public HIV outpatient clinics were followed from time of health-care initiation to either death or the end of the study. The association of race, sex, age, and injection drug use (IDU) with these measures were examined in multivariate logistic regression. Models were adjusted for disease staging at time of entry and for length of follow-up time in clinic. Of 1824 clients followed, 15% failed to attend scheduled visits and 18.1% had at least one emergency room visit. Clients who missed visits were more likely to be African American, to have a history of IDU, and to have a CD4 cell count < 500/mm3 or an acquired immunodeficiency syndrome (AIDS)-defining opportunistic infection at entry. They were also more likely to have > or = 12 months of follow-up time in the HIV clinic, but were less likely to have entered into health care from an early intervention clinic. Clients who had at least one emergency room visit were more likely to be African American, female, IDU, and under 22 years of age; these clients were also more likely to have entered with CD4 < 200/mm3 or with an opportunistic infection, and to have > or = 12 months of follow-up in the clinic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

A public-sector HMO in a competitive market: ensuring equity for the poor.

While managed care is still a new concept in much of the country, it has been a reality in the Minneapolis-St. Paul area for more than three decades. Metropolitan Health Plan (MHP), a public-sector, county-owned health maintenance organization (HMO), was developed 10 years ago as a mechanism to ensure retention of the county hospital's historical patient base if the state of Minnesota were to mandate managed care for public-assistance patients (which occurred in 1985). Because MHP's chief provider organization was Hennepin County Medical Center, which has a long history of serving the poor, it had an advantage over its more established competitors. MHP's greater knowledge of the population and sensitivity to ethnic and cultural diversity has enabled it to develop programs and systems to streamline access to services, many of which are unique to MHP.

Economic Competition↗
PubMed1993

Managed mental health care in the public sector.

Due to strong market forces and payor concerns, first in the private and now in the public sector, the mental health field is changing. The survivors and leaders will be the innovators and risk takers. They must have the ability to look critically at themselves and make needed changes. This new environment creates great opportunity to provide better mental health care. Capitated mental health programs for Medicaid beneficiaries are developing in various forms across the country, and mental health providers, both private and public, need to be aware of those developments. Such programs have great promise for community mental health centers. Medicaid is generally a major funding source for the community mental health system, and public funds should be used to the best extent possible. Managed care has great promise for cost containment and can provide financial stability for community mental health centers. The most important promise of managed care, however, is improving access to and quality of mental health services for the Medicaid population.

Community Mental Health Services↗
PubMed1990

Containing costs in public sector hospitals--a strategy for the future. Lessons from a large teaching hospital.

Escalating costs of providing health care are cause for worldwide concern. In South Africa there is increasing concern about expenditure in the public and the private health care sectors. Although public sector expenditure has increased in per capita terms over the past 2 decades, at the micro-level comparison of expenditure over a 14-year period in one major teaching hospital region indicates that, despite increasing complexity and sophistication, real costs have not escalated at a greater rate than the consumer price index, if extraordinary factors are discounted. The development and utilisation of productivity and performance indicators are reviewed and some mechanisms for containing costs in public hospitals are discussed. These include formalized strategic planning and allocation of resources, rationalisation and reorganisation of services, improved productivity and utilisation of scarce health manpower, improved accounting and management information systems, and the development and use of measures of outcome. Concern is expressed regarding excessive quantification of costs and efficiency to the detriment of health care in general.

Cost Control↗