Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Health Services: Services for the diagnosis and treatment of disease and the maintenance of health.Hospitals, Teaching: Hospitals engaged in educational and research programs, as well as providing medical care to the patients.Hospitals, General: Large hospitals with a resident medical staff which provides continuous care to maternity, surgical and medical patients.Hospitals, University: Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.Health Services Needs and Demand: Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.Hospital Costs: The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).Mental Health Services: Organized services to provide mental health care.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Family Planning Services: Health care programs or services designed to assist individuals in the planning of family size. Various methods of CONTRACEPTION can be used to control the number and timing of childbirths.Home Care Services: Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Hospitals, Urban: Hospitals located in metropolitan areas.Nursing Staff, Hospital: Personnel who provide nursing service to patients in a hospital.Hospitals, Pediatric: Special hospitals which provide care for ill children.Hospitals, District: Government-controlled hospitals which represent the major health facility for a designated geographic area.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Hospital Bed Capacity: The number of beds which a hospital has been designed and constructed to contain. It may also refer to the number of beds set up and staffed for use.Hospitals, Special: Hospitals which provide care for a single category of illness with facilities and staff directed toward a specific service.Economics, Hospital: Economic aspects related to the management and operation of a hospital.United StatesRural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Hospitals, Private: A class of hospitals that includes profit or not-for-profit hospitals that are controlled by a legal entity other than a government agency. (Hospital Administration Terminology, AHA, 2d ed)Emergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Health Services for the Aged: Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.Financial Management, Hospital: The obtaining and management of funds for hospital needs and responsibility for fiscal affairs.Hospitals, Psychiatric: Special hospitals which provide care to the mentally ill patient.Hospitalization: The confinement of a patient in a hospital.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Hospital Departments: Major administrative divisions of the hospital.Child Health Services: Organized services to provide health care for children.Hospital Planning: Areawide planning for hospitals or planning of a particular hospital unit on the basis of projected consumer need. This does not include hospital design and construction or architectural plans.Maternal Health Services: Organized services to provide health care to expectant and nursing mothers.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Reproductive Health Services: Health care services related to human REPRODUCTION and diseases of the reproductive system. Services are provided to both sexes and usually by physicians in the medical or the surgical specialties such as REPRODUCTIVE MEDICINE; ANDROLOGY; GYNECOLOGY; OBSTETRICS; and PERINATOLOGY.Community Mental Health Services: Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.Hospital Charges: The prices a hospital sets for its services. HOSPITAL COSTS (the direct and indirect expenses incurred by the hospital in providing the services) are one factor in the determination of hospital charges. Other factors may include, for example, profits, competition, and the necessity of recouping the costs of uncompensated care.Hospital Units: Those areas of the hospital organization not considered departments which provide specialized patient care. They include various hospital special care wards.Length of Stay: The period of confinement of a patient to a hospital or other health facility.EnglandQuality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Contract Services: Outside services provided to an institution under a formal financial agreement.Outpatient Clinics, Hospital: Organized services in a hospital which provide medical care on an outpatient basis.Libraries, Hospital: Information centers primarily serving the needs of hospital medical staff and sometimes also providing patient education and other services.Library Services: Services offered to the library user. They include reference and circulation.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Referral and Consultation: The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.Hospital Records: Compilations of data on hospital activities and programs; excludes patient medical records.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.State Medicine: A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.Diagnostic Services: Organized services for the purpose of providing diagnosis to promote and maintain health.Equipment and Supplies, Hospital: Any materials used in providing care specifically in the hospital.Great BritainPatient Admission: The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.Patient Discharge: The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.Adolescent Health Services: Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.Surgery Department, Hospital: Hospital department which administers all departmental functions and the provision of surgical diagnostic and therapeutic services.Nursing Services: A general concept referring to the organization and administration of nursing activities.Food Service, Hospital: Hospital department that manages and supervises the dietary program in accordance with the patients' requirements.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Centers for Medicare and Medicaid Services (U.S.): A component of the Department of Health and Human Services to oversee and direct the Medicare and Medicaid programs and related Federal medical care quality control staffs. Name was changed effective June 14, 2001.Health Services Administration: The organization and administration of health services dedicated to the delivery of health care.Nursing Service, Hospital: The hospital department which is responsible for the organization and administration of nursing activities.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Infant, Newborn: An infant during the first month after birth.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Hospital Bed Capacity, 500 and overHospitals, County: Hospitals controlled by the county government.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Women's Health Services: Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.Obstetrics and Gynecology Department, Hospital: Hospital department responsible for the administration and management of services provided for obstetric and gynecologic patients.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.Cardiology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cardiac patient.American Hospital Association: A professional society in the United States whose membership is composed of hospitals.United States Dept. of Health and Human Services: A cabinet department in the Executive Branch of the United States Government concerned with administering those agencies and offices having programs pertaining to health and human services.Genetic Services: Organized services to provide diagnosis, treatment, and prevention of genetic disorders.Utilization Review: An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.Hospital Shared Services: Cooperation among hospitals for the purpose of sharing various departmental services, e.g., pharmacy, laundry, data processing, etc.Diagnosis-Related Groups: A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system.Hospital Information Systems: Integrated, computer-assisted systems designed to store, manipulate, and retrieve information concerned with the administrative and clinical aspects of providing medical services within the hospital.Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Hospitals, Municipal: Hospitals controlled by the city government.Catchment Area (Health): A geographic area defined and served by a health program or institution.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Medicare: Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)LondonLaboratories, Hospital: Hospital facilities equipped to carry out investigative procedures.Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.Dental Health Services: Services designed to promote, maintain, or restore dental health.Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Cross Infection: Any infection which a patient contracts in a health-care institution.Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.Hospitals, Religious: Private hospitals that are owned or sponsored by religious organizations.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.Oncology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cancer patient.Hospitals, Maternity: Special hospitals which provide care to women during pregnancy and parturition.Patient Readmission: Subsequent admissions of a patient to a hospital or other health care institution for treatment.Health Services, Indigenous: Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Occupational Health Services: Health services for employees, usually provided by the employer at the place of work.Health Services Misuse: Excessive, under or unnecessary utilization of health services by patients or physicians.Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies.Delivery of Health Care, Integrated: A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)Personal Health Services: Health care provided to individuals.Ancillary Services, Hospital: Those support services other than room, board, and medical and nursing services that are provided to hospital patients in the course of care. They include such services as laboratory, radiology, pharmacy, and physical therapy services.Psychiatric Department, Hospital: Hospital department responsible for the organization and administration of psychiatric services.Hospitals, Veterans: Hospitals providing medical care to veterans of wars.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.Hospitals, Military: Hospitals which provide care for the military personnel and usually for their dependents.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Ambulances: A vehicle equipped for transporting patients in need of emergency care.Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.Hospital Bed Capacity, under 100Home Care Services, Hospital-Based: Hospital-sponsored provision of health services, such as nursing, therapy, and health-related homemaker or social services, in the patient's home. (Hospital Administration Terminology, 2d ed)Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Bed Occupancy: A measure of inpatient health facility use based upon the average number or proportion of beds occupied for a given period of time.Fees and Charges: Amounts charged to the patient as payer for health care services.Ownership: The legal relation between an entity (individual, group, corporation, or-profit, secular, government) and an object. The object may be corporeal, such as equipment, or completely a creature of law, such as a patent; it may be movable, such as an animal, or immovable, such as a building.Health Care Reform: Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.ScotlandEmergency Services, Psychiatric: Organized services to provide immediate psychiatric care to patients with acute psychological disturbances.CaliforniaDental Service, Hospital: Hospital department providing dental care.Insurance, Health, Reimbursement: Payment by a third-party payer in a sum equal to the amount expended by a health care provider or facility for health services rendered to an insured or program beneficiary. (From Facts on File Dictionary of Health Care Management, 1988)Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Financing, Government: Federal, state, or local government organized methods of financial assistance.Medicaid: Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.Pharmaceutical Services: Total pharmaceutical services provided by qualified PHARMACISTS. In addition to the preparation and distribution of medical products, they may include consultative services provided to agencies and institutions which do not have a qualified pharmacist.Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Continuity of Patient Care: Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.Health Facility Size: The physical space or dimensions of a facility. Size may be indicated by bed capacity.Hospital Bed Capacity, 100 to 299Patient Transfer: Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.Transportation of Patients: Conveying ill or injured individuals from one place to another.BrazilEconomic Competition: The effort of two or more parties to secure the business of a third party by offering, usually under fair or equitable rules of business practice, the most favorable terms.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Ambulatory Care Facilities: Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.Insurance, Physician Services: Insurance providing benefits for the costs of care by a physician which can be comprehensive or limited to surgical expenses or for care provided only in the hospital. It is frequently called "regular medical expense" or "surgical expense".Regional Medical Programs: Coordination of activities and programs among health care institutions within defined geographic areas for the purpose of improving delivery and quality of medical care to the patients. These programs are mandated under U.S. Public Law 89-239.Emergencies: Situations or conditions requiring immediate intervention to avoid serious adverse results.Day Care: Institutional health care of patients during the day. The patients return home at night.Personnel Staffing and Scheduling: The selection, appointing, and scheduling of personnel.Internet: A loose confederation of computer communication networks around the world. The networks that make up the Internet are connected through several backbone networks. The Internet grew out of the US Government ARPAnet project and was designed to facilitate information exchange.Reimbursement Mechanisms: Processes or methods of reimbursement for services rendered or equipment.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)Medical Records: Recording of pertinent information concerning patient's illness or illnesses.Rural Population: The inhabitants of rural areas or of small towns classified as rural.Developing Countries: Countries in the process of change with economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures.Wounds and Injuries: Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.Databases, Factual: Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.Cost Control: The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)Healthcare Disparities: Differences in access to or availability of medical facilities and services.Tertiary Care Centers: A medical facility which provides a high degree of subspecialty expertise for patients from centers where they received SECONDARY CARE.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Physicians: Individuals licensed to practice medicine.IndiaMultivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.Models, Organizational: Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care.Specialization: An occupation limited in scope to a subsection of a broader field.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients.Organizational Case Studies: Descriptions and evaluations of specific health care organizations.Surgical Procedures, Operative: Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.)Health Facility Closure: The closing of any health facility, e.g., health centers, residential facilities, and hospitals.Workload: The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.Anti-Bacterial Agents: Substances that reduce the growth or reproduction of BACTERIA.Purchasing, Hospital: Hospital department responsible for the purchasing of supplies and equipment.Nurseries, Hospital: Hospital facilities which provide care for newborn infants.Public Sector: The area of a nation's economy that is tax-supported and under government control.Regional Health Planning: Planning for health resources at a regional or multi-state level.Hospital-Physician Relations: Includes relationships between hospitals, their governing boards, and administrators in regard to physicians, whether or not the physicians are members of the medical staff or have medical staff privileges.Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).Cost Allocation: The assignment, to each of several particular cost-centers, of an equitable proportion of the costs of activities that serve all of them. Cost-center usually refers to institutional departments or services.Nigeria: A republic in western Africa, south of NIGER between BENIN and CAMEROON. Its capital is Abuja.Outsourced Services: Organizational activities previously performed internally that are provided by external agents.