Societies, Medical: Societies whose membership is limited to physicians.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.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).Societies: Organizations composed of members with common interests and whose professions may be similar.Hospitals, Urban: Hospitals located in metropolitan areas.Nursing Staff, Hospital: Personnel who provide nursing service to patients in a hospital.Economics, Hospital: Economic aspects related to the management and operation of a hospital.Societies, Scientific: Societies whose membership is limited to scientists.Hospitals, Pediatric: Special hospitals which provide care for ill children.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, District: Government-controlled hospitals which represent the major health facility for a designated geographic area.Hospitals, Special: Hospitals which provide care for a single category of illness with facilities and staff directed toward a specific service.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)Financial Management, Hospital: The obtaining and management of funds for hospital needs and responsibility for fiscal affairs.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Length of Stay: The period of confinement of a patient to a hospital or other health facility.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 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.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.Hospitalization: The confinement of a patient in a hospital.Hospital Departments: Major administrative divisions of the hospital.Hospitals, Psychiatric: Special hospitals which provide care to the mentally ill patient.Hospital Units: Those areas of the hospital organization not considered departments which provide specialized patient care. They include various hospital special care wards.Hospital Records: Compilations of data on hospital activities and programs; excludes patient medical records.United StatesEquipment and Supplies, Hospital: Any materials used in providing care specifically in the hospital.Libraries, Hospital: Information centers primarily serving the needs of hospital medical staff and sometimes also providing patient education and other services.Patient 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.Surgery Department, Hospital: Hospital department which administers all departmental functions and the provision of surgical diagnostic and therapeutic services.Outpatient Clinics, Hospital: Organized services in a hospital which provide medical care on an outpatient basis.Hospitals, County: Hospitals controlled by the county government.Hospital Bed Capacity, 500 and overProspective 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.Cross Infection: Any infection which a patient contracts in a health-care institution.American Hospital Association: A professional society in the United States whose membership is composed of hospitals.Hospitals, Municipal: Hospitals controlled by the city government.Food Service, Hospital: Hospital department that manages and supervises the dietary program in accordance with the patients' requirements.Societies, Nursing: Societies whose membership is limited to nurses.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.Time Factors: Elements of limited time intervals, contributing to particular results or situations.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.Obstetrics and Gynecology Department, Hospital: Hospital department responsible for the administration and management of services provided for obstetric and gynecologic patients.Infant, Newborn: An infant during the first month after birth.Hospitals, Religious: Private hospitals that are owned or sponsored by religious organizations.Hospitals, Maternity: Special hospitals which provide care to women during pregnancy and parturition.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.Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment.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.Patient Readmission: Subsequent admissions of a patient to a hospital or other health care institution for treatment.Laboratories, Hospital: Hospital facilities equipped to carry out investigative procedures.Nursing Service, Hospital: The hospital department which is responsible for the organization and administration of nursing activities.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Hospital Shared Services: Cooperation among hospitals for the purpose of sharing various departmental services, e.g., pharmacy, laundry, data processing, etc.EnglandCardiology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cardiac patient.American Cancer Society: A voluntary organization concerned with the prevention and treatment of cancer through education and research.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.Hospital Bed Capacity, under 100Outcome 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).Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Anti-Bacterial Agents: Substances that reduce the growth or reproduction of BACTERIA.Hospital Bed Capacity, 100 to 299Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.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.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Hospitals, Military: Hospitals which provide care for the military personnel and usually for their dependents.History, 20th Century: Time period from 1901 through 2000 of the common era.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.Great BritainMedical Audit: A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.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.Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients.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.Hospitals, AnimalTertiary Care Centers: A medical facility which provides a high degree of subspecialty expertise for patients from centers where they received SECONDARY CARE.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Hospitals, Veterans: Hospitals providing medical care to veterans of wars.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.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)Health Facility Size: The physical space or dimensions of a facility. Size may be indicated by bed capacity.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.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.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.)Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Purchasing, Hospital: Hospital department responsible for the purchasing of supplies and equipment.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)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.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)Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.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.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Patient 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.Societies, Hospital: Societies having institutional membership limited to hospitals and other health care institutions.Nurseries, Hospital: Hospital facilities which provide care for newborn infants.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.BrazilEmergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Societies, Pharmaceutical: Societies whose membership is limited to pharmacists.Psychiatric Department, Hospital: Hospital department responsible for the organization and administration of psychiatric services.History, 19th Century: Time period from 1801 through 1900 of the common era.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.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.Housekeeping, Hospital: Hospital department which manages and provides the required housekeeping functions in all areas of the hospital.Medical Records: Recording of pertinent information concerning patient's illness or illnesses.Oncology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cancer patient.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.Emergencies: Situations or conditions requiring immediate intervention to avoid serious adverse results.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.Acute Disease: Disease having a short and relatively severe course.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Cardiology: The study of the heart, its physiology, and its functions.JapanPersonnel Staffing and Scheduling: The selection, appointing, and scheduling of personnel.Economic 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.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.Catchment Area (Health): A geographic area defined and served by a health program or institution.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.Health Facility Merger: The combining of administrative and organizational resources of two or more health care facilities.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Infection Control: Programs of disease surveillance, generally within health care facilities, designed to investigate, prevent, and control the spread of infections and their causative microorganisms.Medication Systems, Hospital: Overall systems, traditional or automated, to provide medication to patients in hospitals. Elements of the system are: handling the physician's order, transcription of the order by nurse and/or pharmacist, filling the medication order, transfer to the nursing unit, and administration to the patient.Hospitals, Chronic Disease: Hospitals which provide care to patients with long-term illnesses.Child, Hospitalized: Child hospitalized for short term care.Personnel Administration, Hospital: Management activities concerned with hospital employees.EuropeMultivariate 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.IndiaFormularies, Hospital: Formularies concerned with pharmaceuticals prescribed in hospitals.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.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.Congresses as Topic: Conferences, conventions or formal meetings usually attended by delegates representing a special field of interest.Spain: Parliamentary democracy located between France on the northeast and Portugual on the west and bordered by the Atlantic Ocean and the Mediterranean Sea.Age Distribution: The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.Admitting Department, Hospital: Hospital department responsible for the flow of patients and the processing of admissions, discharges, transfers, and also most procedures to be carried out in the event of a patient's death.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Nigeria: A republic in western Africa, south of NIGER between BENIN and CAMEROON. Its capital is Abuja.Safety Management: The development of systems to prevent accidents, injuries, and other adverse occurrences in an institutional setting. The concept includes prevention or reduction of adverse events or incidents involving employees, patients, or facilities. Examples include plans to reduce injuries from falls or plans for fire safety to promote a safe institutional environment.Multi-Institutional Systems: Institutional systems consisting of more than one health facility which have cooperative administrative arrangements through merger, affiliation, shared services, or other collective ventures.Risk Adjustment: The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994)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.Health Facility Closure: The closing of any health facility, e.g., health centers, residential facilities, and hospitals.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.SwitzerlandSex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Hospitals, Group Practice: Hospitals organized and controlled by a group of physicians who practice together and provide each other with mutual support.LondonAcademic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Day Care: Institutional health care of patients during the day. The patients return home at night.Physicians: Individuals licensed to practice medicine.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.GermanyRegression 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.Malaysia: A parliamentary democracy with a constitutional monarch in southeast Asia, consisting of 11 states (West Malaysia) on the Malay Peninsula and two states (East Malaysia) on the island of BORNEO. It is also called the Federation of Malaysia. Its capital is Kuala Lumpur. Before 1963 it was the Union of Malaya. It reorganized in 1948 as the Federation of Malaya, becoming independent from British Malaya in 1957 and becoming Malaysia in 1963 as a federation of Malaya, Sabah, Sarawak, and Singapore (which seceded in 1965). The form Malay- probably derives from the Tamil malay, mountain, with reference to its geography. (From Webster's New Geographical Dictionary, 1988, p715 & Room, Brewer's Dictionary of Names, 1992, p329)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.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.Hospital-Patient Relations: Interactions between hospital staff or administrators and patients. Includes guest relations programs designed to improve the image of the hospital and attract patients.CaliforniaUncompensated Care: Medical services for which no payment is received. Uncompensated care includes charity care and bad debts.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.Myocardial Infarction: NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).Benchmarking: Method of measuring performance against established standards of best practice.Disease Outbreaks: Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS.Dental Service, Hospital: Hospital department providing dental care.Hospitals, High-Volume: Hospitals with a much higher than average utilization by physicians and a large number of procedures.France: A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris.Insurance, Hospitalization: Health insurance providing benefits to cover or partly cover hospital expenses.History, 21st Century: Time period from 2001 through 2100 of the common era.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.Governing Board: The group in which legal authority is vested for the control of health-related institutions and organizations.History, 18th Century: Time period from 1701 through 1800 of the common era.Radiology Department, Hospital: Hospital department which is responsible for the administration and provision of x-ray diagnostic and therapeutic services.Transportation of Patients: Conveying ill or injured individuals from one place to another.ScotlandSurvival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.Medical Errors: Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent.Staphylococcal Infections: Infections with bacteria of the genus STAPHYLOCOCCUS.Patient Safety: Efforts to reduce risk, to address and reduce incidents and accidents that may negatively impact healthcare consumers.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.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.Medical Oncology: A subspecialty of internal medicine concerned with the study of neoplasms.Sex Distribution: The number of males and females in a given population. The distribution may refer to how many men or women or what proportion of either in the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.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.Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility.Health Services Misuse: Excessive, under or unnecessary utilization of health services by patients or physicians.Pneumonia: Infection of the lung often accompanied by inflammation.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.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)Maintenance and Engineering, Hospital: Hospital department whose primary function is the upkeep and supervision of the buildings and grounds and the maintenance of hospital physical plant and equipment which requires engineering expertise.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Evidence-Based Medicine: An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.Community-Acquired Infections: Any infection acquired in the community, that is, contrasted with those acquired in a health care facility (CROSS INFECTION). An infection would be classified as community-acquired if the patient had not recently been in a health care facility or been in contact with someone who had been recently in a health care facility.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Thoracic Surgery: A surgical specialty concerned with diagnosis and treatment of disorders of the heart, lungs, and esophagus. Two major types of thoracic surgery are classified as pulmonary and cardiovascular.