Agreements between two or more parties, especially those that are written and enforceable by law (American Heritage Dictionary of the English Language, 4th ed). It is sometimes used to characterize the nature of the professional-patient relationship.

The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).

Artificially induced UTERINE CONTRACTION. Generally, LABOR, OBSTETRIC is induced with the intent to cause delivery of the fetus and termination of pregnancy.

Outside services provided to an institution under a formal financial agreement.

The beginning of true OBSTETRIC LABOR which is characterized by the cyclic uterine contractions of increasing frequency, duration, and strength causing CERVICAL DILATATION to begin (LABOR STAGE, FIRST ).

Pain associated with OBSTETRIC LABOR in CHILDBIRTH. It is caused primarily by UTERINE CONTRACTION as well as pressure on the CERVIX; BLADDER; and the GASTROINTESTINAL TRACT. Labor pain mostly occurs in the ABDOMEN; the GROIN; and the BACK.

Onset of OBSTETRIC LABOR before term (TERM BIRTH) but usually after the FETUS has become viable. In humans, it occurs sometime during the 29th through 38th week of PREGNANCY. TOCOLYSIS inhibits premature labor and can prevent the BIRTH of premature infants (INFANT, PREMATURE).

Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.

Allowing a woman to be in LABOR, OBSTETRIC long enough to determine if vaginal birth may be anticipated.

The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.

The position or orientation of the FETUS at near term or during OBSTETRIC LABOR, determined by its relation to the SPINE of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the NECK.

The final period of OBSTETRIC LABOR that is from the expulsion of the FETUS to the expulsion of the PLACENTA.

Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.

Extraction of the FETUS by means of abdominal HYSTEROTOMY.

Drugs that stimulate contraction of the myometrium. They are used to induce LABOR, OBSTETRIC at term, to prevent or control postpartum or postabortion hemorrhage, and to assess fetal status in high risk pregnancies. They may also be used alone or with other drugs to induce abortions (ABORTIFACIENTS). Oxytocics used clinically include the neurohypophyseal hormone OXYTOCIN and certain prostaglandins and ergot alkaloids. (From AMA Drug Evaluations, 1994, p1157)

The smooth muscle coat of the uterus, which forms the main mass of the organ.

The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.

Contraction of the UTERINE MUSCLE.

CHILDBIRTH at the end of a normal duration of PREGNANCY, between 37 to 40 weeks of gestation or about 280 days from the first day of the mother's last menstrual period.

Drugs that prevent preterm labor and immature birth by suppressing uterine contractions (TOCOLYSIS). Agents used to delay premature uterine activity include magnesium sulfate, beta-mimetics, oxytocin antagonists, calcium channel inhibitors, and adrenergic beta-receptor agonists. The use of intravenous alcohol as a tocolytic is now obsolete.

A change in the CERVIX UTERI with respect to its readiness to relax. The cervix normally becomes softer, more flexible, more distensible, and shorter in the final weeks of PREGNANCY. These cervical changes can also be chemically induced (LABOR, INDUCED).

The innermost membranous sac that surrounds and protects the developing embryo which is bathed in the AMNIOTIC FLUID. Amnion cells are secretory EPITHELIAL CELLS and contribute to the amniotic fluid.

The state of being engaged in an activity or service for wages or salary.

The process of giving birth to one or more offspring.

The obtaining and management of funds for institutional needs and responsibility for fiscal affairs.

Physiologic or biochemical monitoring of the fetus. It is usually done during LABOR, OBSTETRIC and may be performed in conjunction with the monitoring of uterine activity. It may also be performed prenatally as when the mother is undergoing surgery.

The thin layers of tissue that surround the developing embryo. There are four extra-embryonic membranes commonly found in VERTEBRATES, such as REPTILES; BIRDS; and MAMMALS. They are the YOLK SAC, the ALLANTOIS, the AMNION, and the CHORION. These membranes provide protection and means to transport nutrients and wastes.

Any system which allows payors to share some of the financial risk associated with a particular patient population with providers. Providers agree to adhere to fixed fee schedules in exchange for an increase in their payor base and a chance to benefit from cost containment measures. Common risk-sharing methods are prospective payment schedules (PROSPECTIVE PAYMENT SYSTEM), capitation (CAPITATION FEES), diagnosis-related fees (DIAGNOSIS-RELATED GROUPS), and pre-negotiated fees.

A term used to describe pregnancies that exceed the upper limit of a normal gestational period. In humans, a prolonged pregnancy is defined as one that extends beyond 42 weeks (294 days) after the first day of the last menstrual period (MENSTRUATION), or birth with gestational age of 41 weeks or more.

A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments.

INFLAMMATION of the placental membranes (CHORION; AMNION) and connected tissues such as fetal BLOOD VESSELS and UMBILICAL CORD. It is often associated with intrauterine ascending infections during PREGNANCY.

The remuneration paid or benefits granted to an employee.

Spontaneous tearing of the membranes surrounding the FETUS any time before the onset of OBSTETRIC LABOR. Preterm PROM is membrane rupture before 37 weeks of GESTATION.

A clear, yellowish liquid that envelopes the FETUS inside the sac of AMNION. In the first trimester, it is likely a transudate of maternal or fetal plasma. In the second trimester, amniotic fluid derives primarily from fetal lung and kidney. Cells or substances in this fluid can be removed for prenatal diagnostic tests (AMNIOCENTESIS).

A method of payment for health services in which an individual or institutional provider is paid a fixed, per capita amount without regard to the actual number or nature of services provided to each patient.

Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; SPONTANEOUS ABORTION; INDUCED ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO.

Pricing statements presented by more than one party for the purpose of securing a contract.

Organizational activities previously performed internally that are provided by external agents.

The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.

The process of bargaining in order to arrive at an agreement or compromise on a matter of importance to the parties involved. It also applies to the hearing and determination of a case by a third party chosen by the parties in controversy, as well as the interposing of a third party to reconcile the parties in controversy.

Measurement or recording of contraction activity of the uterine muscle. It is used to determine progress of LABOR, OBSTETRIC and assess status of pregnancy. It is also used in conjunction with FETAL MONITORING to determine fetal response to stress of maternal uterine contractions.

A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.

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.

A scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered.

The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated as the time from the last day of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization.

The neck portion of the UTERUS between the lower isthmus and the VAGINA forming the cervical canal.

The process of negotiation between representatives of an employee organization, association or union, and representatives of the employer.

Delivery of an infant through the vagina in a female who has had a prior cesarean section.

The term "United States" in a medical context often refers to the country where a patient or study participant resides, and is not a medical term per se, but relevant for epidemiological studies, healthcare policies, and understanding differences in disease prevalence, treatment patterns, and health outcomes across various geographic locations.

A method, developed by Dr. Virginia Apgar, to evaluate a newborn's adjustment to extrauterine life. Five items - heart rate, respiratory effort, muscle tone, reflex irritability, and color - are evaluated 60 seconds after birth and again five minutes later on a scale from 0-2, 0 being the lowest, 2 being normal. The five numbers are added for the Apgar score. A score of 0-3 represents severe distress, 4-7 indicates moderate distress, and a score of 7-10 predicts an absence of difficulty in adjusting to extrauterine life.

Excess blood loss from uterine bleeding associated with OBSTETRIC LABOR or CHILDBIRTH. It is defined as blood loss greater than 500 ml or of the amount that adversely affects the maternal physiology, such as BLOOD PRESSURE and HEMATOCRIT. Postpartum hemorrhage is divided into two categories, immediate (within first 24 hours after birth) or delayed (after 24 hours postpartum).

An infant during the first month after birth.

Organizations of health care providers that agree to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it. Assigned means those beneficiaries for whom the professionals in the organization provide the bulk of primary care services. (www.cms.gov/OfficeofLegislation/Downloads/Accountable CareOrganization.pdf accessed 03/16/2011)

Institutional systems consisting of more than one health facility which have cooperative administrative arrangements through merger, affiliation, shared services, or other collective ventures.

Slow or difficult OBSTETRIC LABOR or CHILDBIRTH.

Any drug treatment modality designed to inhibit UTERINE CONTRACTION. It is used in pregnant women to arrest PREMATURE LABOR.

The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.

The organization and operation of the business aspects of a physician's practice.

A complete separation or tear in the wall of the UTERUS with or without expulsion of the FETUS. It may be due to injuries, multiple pregnancies, large fetus, previous scarring, or obstruction.

Compensatory plans designed to motivate physicians in relation to patient referral, physician recruitment, and efficient use of the health facility.

A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.

The last third of a human PREGNANCY, from the beginning of the 29th through the 42nd completed week (197 to 294 days) of gestation.

Labor and delivery without medical intervention, usually involving RELAXATION THERAPY.

The practice of assisting women in childbirth.

Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases.

A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.

Personal satisfaction relative to the work situation.

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.

The outermost extra-embryonic membrane surrounding the developing embryo. In REPTILES and BIRDS, it adheres to the shell and allows exchange of gases between the egg and its environment. In MAMMALS, the chorion evolves into the fetal contribution of the PLACENTA.

Management review designed to evaluate efficiency and to identify areas in need of management improvement within the institution in order to ensure effectiveness in meeting organizational goals.

Process of shifting publicly controlled services and/or facilities to the private sector.

Management control systems for structuring health care delivery strategies around case types, as in DRGs, or specific clinical services.

Planning, organizing, and administering all activities related to personnel.

A widely used local anesthetic agent.

Measurement of the dimensions and capacity of the pelvis. It includes cephalopelvimetry (measurement of fetal head size in relation to maternal pelvic capacity), a prognostic guide to the management of LABOR, OBSTETRIC associated with disproportion.

A nursing specialty involving nursing care given to the pregnant patient before, after, or during childbirth.

That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests.

Unstriated and unstriped muscle, one of the muscles of the internal organs, blood vessels, hair follicles, etc. Contractile elements are elongated, usually spindle-shaped cells with centrally located nuclei. Smooth muscle fibers are bound together into sheets or bundles by reticular fibers and frequently elastic nets are also abundant. (From Stedman, 25th ed)

The hollow thick-walled muscular organ in the female PELVIS. It consists of the fundus (the body) which is the site of EMBRYO IMPLANTATION and FETAL DEVELOPMENT. Beyond the isthmus at the perineal end of fundus, is CERVIX UTERI (the neck) opening into VAGINA. Beyond the isthmi at the upper abdominal end of fundus, are the FALLOPIAN TUBES.

Elements of limited time intervals, contributing to particular results or situations.

An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.

Procedure in which an anesthetic is injected into the epidural space.

Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.

I'm sorry for any confusion, but "Scotland" is not a medical term and does not have a medical definition. Scotland is one of the four constituent countries of the United Kingdom, located in the northern part of Great Britain. If you have any questions related to healthcare or medical terminology, I would be happy to help answer those!

(To the best of my knowledge,) 'Alaska' is not a medical term or concept, it is rather a geographical location, being the largest and northernmost state in the United States.

Great Britain is not a medical term, but a geographical name for the largest island in the British Isles, which comprises England, Scotland, and Wales, forming the major part of the United Kingdom.

I'm sorry for any confusion, but 'England' is not a medical term and does not have a medical definition. England is a country that is part of the United Kingdom, known for its rich history, cultural heritage, and contributions to medical science. However, in a medical context, it may refer to the location of a patient, healthcare provider, or research study, but it is not a term with a specific medical meaning.

A highly vascularized mammalian fetal-maternal organ and major site of transport of oxygen, nutrients, and fetal waste products. It includes a fetal portion (CHORIONIC VILLI) derived from TROPHOBLASTS and a maternal portion (DECIDUA) derived from the uterine ENDOMETRIUM. The placenta produces an array of steroid, protein and peptide hormones (PLACENTAL HORMONES).

Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.

A parameter usually used in PRENATAL ULTRASONOGRAPHY to measure the length of the uterine neck (CERVIX UTERI). Cervical length or its shortening is used to identify and prevent early cervical opening and PRETERM BIRTH.

Cell surface proteins that bind oxytocin with high affinity and trigger intracellular changes which influence the behavior of cells. Oxytocin receptors in the uterus and the mammary glands mediate the hormone's stimulation of contraction and milk ejection. The presence of oxytocin and oxytocin receptors in neurons of the brain probably reflects an additional role as a neurotransmitter.

The co-occurrence of pregnancy and an INFECTION. The infection may precede or follow FERTILIZATION.

Special hospitals which provide care to women during pregnancy and parturition.

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)

CHILDBIRTH before 37 weeks of PREGNANCY (259 days from the first day of the mother's last menstrual period, or 245 days after FERTILIZATION).

Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquefies; the resulting colloid is called a sol.

Prepaid health and hospital insurance plan.

A nonreassuring fetal status (NRFS) indicating that the FETUS is compromised (American College of Obstetricians and Gynecologists 1988). It can be identified by sub-optimal values in FETAL HEART RATE; oxygenation of FETAL BLOOD; and other parameters.

Failure of the UTERUS to contract with normal strength, duration, and intervals during childbirth (LABOR, OBSTETRIC). It is also called uterine atony.

Management of the internal organization of the hospital.

The promotion and maintenance of physical and mental health in the work environment.

The area of a nation's economy that is tax-supported and under government control.

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.

The body region lying between the genital area and the ANUS on the surface of the trunk, and to the shallow compartment lying deep to this area that is inferior to the PELVIC DIAPHRAGM. The surface area is between the VULVA and the anus in the female, and between the SCROTUM and the anus in the male.

Processes or methods of reimbursement for services rendered or equipment.

Health care provided to individuals.

An incision of the posterior vaginal wall and a portion of the pudenda which enlarges the vaginal introitus to facilitate delivery and prevent lacerations.

An adrenergic beta-2 agonist used to control PREMATURE LABOR.

Individuals referred to for expert or professional advice or services.

Death of the developing young in utero. BIRTH of a dead FETUS is STILLBIRTH.

An office in the Department of Labor responsible for developing and establishing occupational safety and health standards.

A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.

Amounts charged to the patient as payer for health care services.

Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)

Surgery restricted to the management of minor problems and injuries; surgical procedures of relatively slight extent and not in itself hazardous to life. (Dorland, 28th ed & Stedman, 25th ed)

Formal relationships established between otherwise independent organizations. These include affiliation agreements, interlocking boards, common controls, hospital medical school affiliations, etc.

Detailed financial plans for carrying out specific activities for a certain period of time. They include proposed income and expenditures.

Exploitation through misrepresentation of the facts or concealment of the purposes of the exploiter.

The interdisciplinary field concerned with the development and integration of behavioral and biomedical science, knowledge, and techniques relevant to health and illness and the application of this knowledge and these techniques to prevention, diagnosis, treatment, and rehabilitation.

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.

Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.

Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.

Extraction of the fetus by abdominal hysterotomy anytime following a previous cesarean.

The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.

A synthetic analog of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties.

Professional medical personnel who provide care to patients in an organized facility, institution or agency.

Inuktitut-speakers generally associated with the northern polar region.

Statement of the position requirements, qualifications for the position, wage range, and any special conditions expected of the employee.

Percutaneous transabdominal puncture of the uterus during pregnancy to obtain amniotic fluid. It is commonly used for fetal karyotype determination in order to diagnose abnormal fetal conditions.

Descriptions and evaluations of specific health care organizations.

Programs designed by management to motivate employees to work more efficiently with increased productivity, and greater employee satisfaction.

The upward or downward mobility in an occupation or the change from one occupation to another.

The state of not being engaged in a gainful occupation.

The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.

Hospital department responsible for the administration and management of services provided for obstetric and gynecologic patients.

The obligations and accountability assumed in carrying out actions or ideas on behalf of others.

Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality.

The hormone-responsive glandular layer of ENDOMETRIUM that sloughs off at each menstrual flow (decidua menstrualis) or at the termination of pregnancy. During pregnancy, the thickest part of the decidua forms the maternal portion of the PLACENTA, thus named decidua placentalis. The thin portion of the decidua covering the rest of the embryo is the decidua capsularis.

That segment of commercial enterprise devoted to the design, development, and manufacture of chemical products for use in the diagnosis and treatment of disease, disability, or other dysfunction, or to improve function.

Payments or services provided under stated circumstances under the terms of an insurance policy. In prepayment programs, benefits are the services the programs will provide at defined locations and to the extent needed.

Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.

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.

Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.

The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.

The interactions between representatives of institutions, agencies, or organizations.

The number of pregnancies, complete or incomplete, experienced by a female. It is different from PARITY, which is the number of offspring borne. (From Stedman, 26th ed)

A glucocorticoid given orally, parenterally, by local injection, by inhalation, or applied topically in the management of various disorders in which corticosteroids are indicated. Its lack of mineralocorticoid properties makes betamethasone particularly suitable for treating cerebral edema and congenital adrenal hyperplasia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p724)

The organization and administration of health services dedicated to the delivery of health care.

Place or physical location of work or employment.

In females, the period that is shortly after giving birth (PARTURITION).

An organized group of three or more full-time physicians rendering services for a fixed prepayment.

Removal of the fetus from the uterus or vagina at or near the end of pregnancy with a metal traction cup that is attached to the fetus' head. Negative pressure is applied and traction is made on a chain passed through the suction tube. (From Stedman, 26th ed & Dorland, 28th ed)

Any enterprise centered on the processing, assembly, production, or marketing of a line of products, services, commodities, or merchandise, in a particular field often named after its principal product. Examples include the automobile, fishing, music, publishing, insurance, and textile industries.

The care of women and a fetus or newborn given before, during, and after delivery from the 28th week of gestation through the 7th day after delivery.

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.

Application of marketing principles and techniques to maximize the use of health care resources.

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)

Administrative units of government responsible for policy making and management of governmental activities.

Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.

The quality or state of being independent and self-directing, especially in making decisions, enabling professionals to exercise judgment as they see fit during the performance of their jobs.

Antimuscarinic quaternary ammonium derivative of scopolamine used to treat cramps in gastrointestinal, urinary, uterine, and biliary tracts, and to facilitate radiologic visualization of the gastrointestinal tract.

The physiological narrowing of BLOOD VESSELS by contraction of the VASCULAR SMOOTH MUSCLE.

The selection, appointing, and scheduling of personnel.

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.

Disorders or diseases associated with PUERPERIUM, the six-to-eight-week period immediately after PARTURITION in humans.

Dedication or commitment shown by employees to organizations or institutions where they work.

Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.

The provision of monetary resources including money or capital and credit; obtaining or furnishing money or capital for a purchase or enterprise and the funds so obtained. (From Random House Unabridged Dictionary, 2d ed.)

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)

Professional nurses who have received postgraduate training in midwifery.

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.

A partnership, corporation, association, or other legal entity that enters into an arrangement for the provision of services with persons who are licensed to practice medicine, osteopathy, and dentistry, and with other care personnel. Under an IPA arrangement, licensed professional persons provide services through the entity in accordance with a mutually accepted compensation arrangement, while retaining their private practices. Services under the IPA are marketed through a prepaid health plan. (From Facts on File Dictionary of Health Care Management, 1988)

Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.

I'm sorry for any confusion, but the term "Arkansas" is a place name and does not have a medical definition. It is a state located in the southern region of the United States.

Diseases caused by factors involved in one's employment.

Unforeseen occurrences, especially injuries in the course of work-related activities.

Childbirth taking place in the home.

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.

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.

The condition in which individuals are financially unable to access adequate medical care without depriving themselves and their dependents of food, clothing, shelter, and other essentials of living.

Diseases of newborn infants present at birth (congenital) or developing within the first month of birth. It does not include hereditary diseases not manifesting at birth or within the first 30 days of life nor does it include inborn errors of metabolism. Both HEREDITARY DISEASES and METABOLISM, INBORN ERRORS are available as general concepts.

Professional medical personnel approved to provide care to patients in a hospital.

Agencies of the FEDERAL GOVERNMENT of the United States.

Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.

A formal financial agreement made between one or more physicians and a hospital to provide ambulatory alternative services to those patients who do not require hospitalization.

A malpresentation of the FETUS at near term or during OBSTETRIC LABOR with the fetal cephalic pole in the fundus of the UTERUS. There are three types of breech: the complete breech with flexed hips and knees; the incomplete breech with one or both hips partially or fully extended; the frank breech with flexed hips and extended knees.

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.

The event that a FETUS is born dead or stillborn.

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.

An absence from work permitted because of illness or the number of days per year for which an employer agrees to pay employees who are sick. (Webster's New Collegiate Dictionary, 1981)