Health Facilities: Institutions which provide medical or health-related services.Skilled Nursing Facilities: Extended care facilities which provide skilled nursing care or rehabilitation services for inpatients on a daily basis.Residential Facilities: Long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required.Ambulatory Care Facilities: Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.Facility Design and Construction: Architecture, exterior and interior design, and construction of facilities other than hospitals, e.g., dental schools, medical schools, ambulatory care clinics, and specified units of health care facilities. The concept also includes architecture, design, and construction of specialized contained, controlled, or closed research environments including those of space labs and stations.Assisted Living Facilities: A housing and health care alternative combining independence with personal care. It provides a combination of housing, personalized supportive services and health care designed to meet the needs, both scheduled and unscheduled, of those who need help with activities of daily living. (www.alfa.org)Health Facility Administration: Management of the organization of HEALTH FACILITIES.Health Facilities, Proprietary: Health care institutions operated by private groups or corporations for a profit.Public Facilities: An area of recreation or hygiene for use by the public.Health Facility Planning: Areawide planning for health care institutions on the basis of projected consumer need.Facility Regulation and Control: Formal voluntary or governmental procedures and standards required of hospitals and health or other facilities to improve operating efficiency, and for the protection of the consumer.Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care.Nursing Homes: Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.Aqueous Humor: The clear, watery fluid which fills the anterior and posterior chambers of the eye. It has a refractive index lower than the crystalline lens, which it surrounds, and is involved in the metabolism of the cornea and the crystalline lens. (Cline et al., Dictionary of Visual Science, 4th ed, p319)Toilet Facilities: Facilities provided for human excretion, often with accompanying handwashing facilities.Military Facilities: Areas designated for use by the armed forces personnel.Cancer Care Facilities: Institutions specializing in the care of cancer patients.Homes for the Aged: Geriatric long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required.Intermediate Care Facilities: Institutions which provide health-related care and services to individuals who do not require the degree of care which hospitals or skilled nursing facilities provide, but because of their physical or mental condition require care and services above the level of room and board.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.Trabecular Meshwork: A porelike structure surrounding the entire circumference of the anterior chamber through which aqueous humor circulates to the canal of Schlemm.United StatesAnimals, LaboratoryMaternal Health Services: Organized services to provide health care to expectant and nursing mothers.Health Facility Environment: Physical surroundings or conditions of a hospital or other health facility and influence of these factors on patients and staff.Hospital Design and Construction: The architecture, functional design, and construction of hospitals.Cardiac Care Facilities: Institutions specializing in the care of patients with heart disorders.Fitness Centers: Facilities having programs intended to promote and maintain a state of physical well-being for optimal performance and health.Prisons: Penal institutions, or places of confinement for war prisoners.Housing, AnimalRural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Health Facility Size: The physical space or dimensions of a facility. Size may be indicated by bed capacity.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)Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Tanzania: A republic in eastern Africa, south of UGANDA and north of MOZAMBIQUE. Its capital is Dar es Salaam. It was formed in 1964 by a merger of the countries of TANGANYIKA and ZANZIBAR.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.Home Childbirth: Childbirth taking place in the home.Health Facility Administrators: Managerial personnel responsible for implementing policy and directing the activities of health care facilities such as nursing homes.Rehabilitation Centers: Facilities which provide programs for rehabilitating the mentally or physically disabled individuals.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.Public Sector: The area of a nation's economy that is tax-supported and under government control.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory 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.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.Rural Population: The inhabitants of rural areas or of small towns classified as rural.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 Closure: The closing of any health facility, e.g., health centers, residential facilities, and hospitals.Kenya: A republic in eastern Africa, south of ETHIOPIA, west of SOMALIA with TANZANIA to its south, and coastline on the Indian Ocean. Its capital is Nairobi.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.Nigeria: A republic in western Africa, south of NIGER between BENIN and CAMEROON. Its capital is Abuja.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.Containment of Biohazards: Provision of physical and biological barriers to the dissemination of potentially hazardous biologically active agents (bacteria, viruses, recombinant DNA, etc.). Physical containment involves the use of special equipment, facilities, and procedures to prevent the escape of the agent. Biological containment includes use of immune personnel and the selection of agents and hosts that will minimize the risk should the agent escape the containment facility.Delivery, Obstetric: 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.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.Nursing Staff: Personnel who provide nursing service to patients in an organized facility, institution, or agency.Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests.United States Department of Veterans Affairs: A cabinet department in the Executive Branch of the United States Government concerned with overall planning, promoting, and administering programs pertaining to VETERANS. It was established March 15, 1989 as a Cabinet-level position.Recreation: Activity engaged in for pleasure.Laboratories: Facilities equipped to carry out investigative procedures.Maternal Mortality: Maternal deaths resulting from complications of pregnancy and childbirth in a given population.Laboratory Animal Science: The science and technology dealing with the procurement, breeding, care, health, and selection of animals used in biomedical research and testing.Malaria: A protozoan disease caused in humans by four species of the PLASMODIUM genus: PLASMODIUM FALCIPARUM; PLASMODIUM VIVAX; PLASMODIUM OVALE; and PLASMODIUM MALARIAE; and transmitted by the bite of an infected female mosquito of the genus ANOPHELES. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high FEVER; SWEATING; shaking CHILLS; and ANEMIA. Malaria in ANIMALS is caused by other species of plasmodia.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)Hospitals: Institutions with an organized medical staff which provide medical care to patients.Environment, Controlled: A state in which the environs of hospitals, laboratories, domestic and animal housing, work places, spacecraft, and other surroundings are under technological control with regard to air conditioning, heating, lighting, humidity, ventilation, and other ambient features. The concept includes control of atmospheric composition. (From Jane's Aerospace Dictionary, 3d ed)Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.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.Transportation: The means of moving persons, animals, goods, or materials from one place to another.Zambia: A republic in southern Africa, south of DEMOCRATIC REPUBLIC OF THE CONGO and TANZANIA, and north of ZIMBABWE. Its capital is Lusaka. It was formerly called Northern Rhodesia.Personnel Staffing and Scheduling: The selection, appointing, and scheduling of personnel.Disease Outbreaks: Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS.Organizational Policy: A course or method of action selected, usually by an organization, institution, university, society, etc., from among alternatives to guide and determine present and future decisions and positions on matters of public interest or social concern. It does not include internal policy relating to organization and administration within the corporate body, for which ORGANIZATION AND ADMINISTRATION is available.Ghana: A republic in western Africa, south of BURKINA FASO and west of TOGO. Its capital is Accra.Environment Design: The structuring of the environment to permit or promote specific patterns of behavior.Intraocular Pressure: The pressure of the fluids in the eye.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.Residence Characteristics: Elements of residence that characterize a population. They are applicable in determining need for and utilization of health services.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.Anterior Eye Segment: The front third of the eyeball that includes the structures between the front surface of the cornea and the front of the VITREOUS BODY.Beauty CultureFees and Charges: Amounts charged to the patient as payer for health care services.Hospitals, Psychiatric: Special hospitals which provide care to the mentally ill patient.Infant, Newborn: An infant during the first month after birth.Animal Husbandry: The science of breeding, feeding and care of domestic animals; includes housing and nutrition.Time Factors: Elements of limited time intervals, contributing to particular results or situations.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.Ethiopia: An independent state in eastern Africa. Ethiopia is located in the Horn of Africa and is bordered on the north and northeast by Eritrea, on the east by Djibouti and Somalia, on the south by Kenya, and on the west and southwest by Sudan. Its capital is Addis Ababa.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Uganda: A republic in eastern Africa, south of SUDAN and west of KENYA. Its capital is Kampala.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.PrisonersBritish Columbia: A province of Canada on the Pacific coast. Its capital is Victoria. The name given in 1858 derives from the Columbia River which was named by the American captain Robert Gray for his ship Columbia which in turn was named for Columbus. (From Webster's New Geographical Dictionary, 1988, p178 & Room, Brewer's Dictionary of Names, 1992, p81-2)Anterior Chamber: The space in the eye, filled with aqueous humor, bounded anteriorly by the cornea and a small portion of the sclera and posteriorly by a small portion of the ciliary body, the iris, and that part of the crystalline lens which presents through the pupil. (Cline et al., Dictionary of Visual Science, 4th ed, p109)Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Subacute Care: Medical and skilled nursing services provided to patients who are not in an acute phase of an illness but who require a level of care higher than that provided in a long-term care setting. (JCAHO, Lexikon, 1994)Sanitation: The development and establishment of environmental conditions favorable to the health of the public.AfghanistanHospitals, Military: Hospitals which provide care for the military personnel and usually for their dependents.Hospitals, Veterans: Hospitals providing medical care to veterans of wars.Midwifery: The practice of assisting women in childbirth.Sclera: The white, opaque, fibrous, outer tunic of the eyeball, covering it entirely excepting the segment covered anteriorly by the cornea. It is essentially avascular but contains apertures for vessels, lymphatics, and nerves. It receives the tendons of insertion of the extraocular muscles and at the corneoscleral junction contains the canal of Schlemm. (From Cline et al., Dictionary of Visual Science, 4th ed)IndiaCapital Expenditures: Those funds disbursed for facilities and equipment, particularly those related to the delivery of health care.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.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.Equipment and Supplies, Hospital: Any materials used in providing care specifically in the hospital.Malawi: A republic in southern Africa east of ZAMBIA and MOZAMBIQUE. Its capital is Lilongwe. It was formerly called Nyasaland.Hemodialysis Units, Hospital: Hospital units in which care is provided the hemodialysis patient. This includes hemodialysis centers in hospitals.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.Geographic Information Systems: Computer systems capable of assembling, storing, manipulating, and displaying geographically referenced information, i.e. data identified according to their locations.Environmental Monitoring: The monitoring of the level of toxins, chemical pollutants, microbial contaminants, or other harmful substances in the environment (soil, air, and water), workplace, or in the bodies of people and animals present in that environment.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.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)Medical Laboratory Personnel: Health care professionals, technicians, and assistants staffing LABORATORIES in research or health care facilities.Regional Health Planning: Planning for health resources at a regional or multi-state level.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.Occupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation.South Africa: A republic in southern Africa, the southernmost part of Africa. It has three capitals: Pretoria (administrative), Cape Town (legislative), and Bloemfontein (judicial). Officially the Republic of South Africa since 1960, it was called the Union of South Africa 1910-1960.Equipment and Supplies: Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and experimental procedures.Hospitals, Public: Hospitals controlled by various types of government, i.e., city, county, district, state or federal.Catchment Area (Health): A geographic area defined and served by a health program or institution.Antimalarials: Agents used in the treatment of malaria. They are usually classified on the basis of their action against plasmodia at different stages in their life cycle in the human. (From AMA, Drug Evaluations Annual, 1992, p1585)Organizations, Nonprofit: Organizations which are not operated for a profit and may be supported by endowments or private contributions.Reimbursement Mechanisms: Processes or methods of reimbursement for services rendered or equipment.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.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.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.Prenatal Care: Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Prospective Payment System: A system wherein reimbursement rates are set, for a given period of time, prior to the circumstances giving rise to actual reimbursement claims.Transportation of Patients: Conveying ill or injured individuals from one place to another.Cross Infection: Any infection which a patient contracts in a health-care institution.Architectural Accessibility: Designs for approaching areas inside or outside facilities.Animal Welfare: The protection of animals in laboratories or other specific environments by promoting their health through better nutrition, housing, and care.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.Case Management: A traditional term for all the activities which a physician or other health care professional normally performs to insure the coordination of the medical services required by a patient. It also, when used in connection with managed care, covers all the activities of evaluating the patient, planning treatment, referral, and follow-up so that care is continuous and comprehensive and payment for the care is obtained. (From Slee & Slee, Health Care Terms, 2nd ed)Ventilation: Supplying a building or house, their rooms and corridors, with fresh air. The controlling of the environment thus may be in public or domestic sites and in medical or non-medical locales. (From Dorland, 28th ed)Child Day Care Centers: Facilities which provide care for pre-school and school-age children.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.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.Rural Health: The status of health in rural populations.Financing, Government: Federal, state, or local government organized methods of financial assistance.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Efficiency, Organizational: The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.Hospitalization: The confinement of a patient in a hospital.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.CaliforniaHazardous Substances: Elements, compounds, mixtures, or solutions that are considered severely harmful to human health and the environment. They include substances that are toxic, corrosive, flammable, or explosive.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.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.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Health Facility Merger: The combining of administrative and organizational resources of two or more health care facilities.Emergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Health Care Facilities, Manpower, and Services: The services provided in the delivery of health care, associated facilities in health care, and attendant manpower required or available.Air Pollutants, Occupational: Air pollutants found in the work area. They are usually produced by the specific nature of the occupation.Hospitals, Special: Hospitals which provide care for a single category of illness with facilities and staff directed toward a specific service.Animal Technicians: Assistants to a veterinarian, biological or biomedical researcher, or other scientist who are engaged in the care and management of animals, and who are trained in basic principles of animal life processes and routine laboratory and animal health care procedures. (Facts on File Dictionary of Health Care Management, 1988)Medical Waste Disposal: Management, removal, and elimination of biologic, infectious, pathologic, and dental waste. The concept includes blood, mucus, tissue removed at surgery or autopsy, soiled surgical dressings, and other materials requiring special control and handling. Disposal may take place where the waste is generated or elsewhere.NepalChild Health Services: Organized services to provide health care for children.Academies and Institutes: Organizations representing specialized fields which are accepted as authoritative; may be non-governmental, university or an independent research organization, e.g., National Academy of Sciences, Brookings Institution, etc.Refuse Disposal: The discarding or destroying of garbage, sewage, or other waste matter or its transformation into something useful or innocuous.Length of Stay: The period of confinement of a patient to a hospital or other health facility.Artemisinins: A group of SESQUITERPENES and their analogs that contain a peroxide group (PEROXIDES) within an oxepin ring (OXEPINS).HIV Infections: Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS).Disaster Planning: Procedures outlined for the care of casualties and the maintenance of services in disasters.Ciliary Body: A ring of tissue extending from the scleral spur to the ora serrata of the RETINA. It consists of the uveal portion and the epithelial portion. The ciliary muscle is in the uveal portion and the ciliary processes are in the epithelial portion.BangladeshPatient Discharge: The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.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)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).Population Surveillance: Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.Hospitals, Voluntary: Private, not-for-profit hospitals that are autonomous, self-established, and self-supported.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.Hospitals, Community: Institutions with permanent facilities and organized medical staff which provide the full range of hospital services primarily to a neighborhood area.Fluorenes: A family of diphenylenemethane derivatives.Nursing Assessment: Evaluation of the nature and extent of nursing problems presented by a patient for the purpose of patient care planning.PakistanJapanPatient Isolation: The segregation of patients with communicable or other diseases for a specified time. Isolation may be strict, in which movement and social contacts are limited; modified, where an effort to control specified aspects of care is made in order to prevent cross infection; or reverse, where the patient is secluded in a controlled or germ-free environment in order to protect him or her from cross infection.Clinical Governance: A framework through which the United Kingdom's National Health Service organizations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish. (Scally and Donaldson, BMJ (4 July 1998): 61-65)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.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)Progressive Patient Care: Organization of medical and nursing care according to the degree of illness and care requirements in the hospital. The elements are intensive care, intermediate care, self-care, long-term care, and organized home care.Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.Hygiene: The science dealing with the establishment and maintenance of health in the individual and the group. It includes the conditions and practices conducive to health. (Webster, 3d ed)Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Outpatient Clinics, Hospital: Organized services in a hospital which provide medical care on an outpatient basis.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.Healthcare Disparities: Differences in access to or availability of medical facilities and services.Renal Dialysis: Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency.Veterans: Former members of the armed services.Parturition: The process of giving birth to one or more offspring.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Animal Experimentation: The use of animals as investigational subjects.

Practice patterns, case mix, Medicare payment policy, and dialysis facility costs. (1/1505)

OBJECTIVE: To evaluate the effects of case mix, practice patterns, features of the payment system, and facility characteristics on the cost of dialysis. DATA SOURCES/STUDY SETTING: The nationally representative sample of dialysis units in the 1991 U.S. Renal Data System's Case Mix Adequacy (CMA) Study. The CMA data were merged with data from Medicare Cost Reports, HCFA facility surveys, and HCFA's end-stage renal disease patient registry. STUDY DESIGN: We estimated a statistical cost function to examine the determinants of costs at the dialysis unit level. PRINCIPAL FINDINGS: The relationship between case mix and costs was generally weak. However, dialysis practices (type of dialysis membrane, membrane reuse policy, and treatment duration) did have a significant effect on costs. Further, facilities whose payment was constrained by HCFA's ceiling on the adjustment for area wage rates incurred higher costs than unconstrained facilities. The costs of hospital-based units were considerably higher than those of freestanding units. Among chain units, only members of one of the largest national chains exhibited significant cost savings relative to independent facilities. CONCLUSIONS: Little evidence showed that adjusting dialysis payment to account for differences in case mix across facilities would be necessary to ensure access to care for high-cost patients or to reimburse facilities equitably for their costs. However, current efforts to increase dose of dialysis may require higher payments. Longer treatments appear to be the most economical method of increasing the dose of dialysis. Switching to more expensive types of dialysis membranes was a more costly means of increasing dose and hence must be justified by benefits beyond those of higher dose. Reusing membranes saved money, but the savings were insufficient to offset the costs associated with using more expensive membranes. Most, but not all, of the higher costs observed in hospital-based units appear to reflect overhead cost allocation rather than a difference in real resources devoted to treatment. The economies experienced by the largest chains may provide an explanation for their recent growth in market share. The heterogeneity of results by chain size implies that characterizing units using a simple chain status indicator variable is inadequate. Cost differences by facility type and the effects of the ongoing growth of large chains are worthy of continued monitoring to inform both payment policy and antitrust enforcement.  (+info)

Where do people go for treatment of sexually transmitted diseases? (2/1505)

CONTEXT: Major public health resources are devoted to the prevention of sexually transmitted diseases (STDs) through public STD clinics. However, little is known about where people actually receive treatment for STDs. METHODS: As part of the National Health and Social Life Survey, household interviews were performed from February to September 1992 with 3,432 persons aged 18-59. Weighted population estimates and multinomial response methods were used to describe the prevalence of self-reported STDs and patterns of treatment utilization by persons who ever had a bacterial or viral STD. RESULTS: An estimated two million STDs were self-reported in the previous year, and 22 million 18-59-year-olds self-reported lifetime STDs. Bacterial STDs (gonorrhea, chlamydia, nongonococcal urethritis, pelvic inflammatory disease and syphilis) were more common than viral STDs (genital herpes, genital warts, hepatitis and HIV). Genital warts were the most commonly reported STD in the past year, while gonorrhea was the most common ever-reported STD. Almost half of all respondents who had ever had an STD had gone to a private practice for treatment (49%); in comparison, only 5% of respondents had sought treatment at an STD clinic. Respondents with a bacterial STD were seven times more likely to report going to an STD clinic than were respondents with a viral STD--except for chlamydia, which was more likely to be treated at family planning clinics. Men were significantly more likely than women to go to an STD clinic. Young, poor or black respondents were all more likely to use a family planning clinic for STD treatment than older, relatively wealthy or white respondents. Age, sexual history and geographic location did not predict particular types of treatment-seeking. CONCLUSIONS: The health care utilization patterns for STD treatment in the United States are complex. Specific disease diagnosis, gender, race and income status all affect where people will seek treatment. These factors need to be taken into account when STD prevention strategies are being developed.  (+info)

Evaluation of a smoking cessation intervention for pregnant women in an urban prenatal clinic. (3/1505)

A smoking cessation and relapse prevention intervention was tested in an urban, prenatal clinic serving predominantly low-income, African-American women. At their first prenatal visit, 391 smokers were randomly assigned to an experimental (E) group to receive usual clinic information plus a prenatal and postpartum intervention or to a control (C) group to receive only usual clinic information. The intervention consisted of individual skills instruction and counseling by a peer health counselor on the use of a self-help cessation guide and routine clinic reinforcement. Among the E group (n = 193), 6.2% were cotinine-confirmed quitters at third trimester and among the C group (n = 198) the quit rate was 5.6%. Quitters were light smokers at entry into prenatal care. Many had tried to quit smoking at least once prior to pregnancy.  (+info)

Essential drugs for ration kits in developing countries. (4/1505)

Since the early 1980s drug ration kits have been used to improve the supply of essential drugs to rural health facilities in developing countries. This paper evaluates some of the experiences with kit systems in Angola, Bhutan, Democratic Yemen, Guinea-Conakry, Kenya, Mozambique, Sudan, Tanzania, Uganda and Zambia in relation to the selection of drugs for the kits and their quantities and cost. Data were collected through a review of published papers, annual reports and programme evaluations, by questionnaires among field staff and interviews with key experts. In comparing the 10 programmes, 21 drugs can be identified that are used in at least two-thirds of all kits. This list may be useful for evaluation and planning purposes. Six drugs (ORS, chloroquine and 4 antibiotics) usually account for over 60% of the cost of the kit. Careful monitoring of the price and quantities of these 6 drugs can therefore be very cost-effective. In the absence of reliable data on morbidity and drug needs in the initial phases of a kit system, the median drug quantities in kits from these 10 countries may serve as a starting point. Accumulating surpluses are sometimes perceived as a serious disadvantage of kit systems, ORS, benzylbenzoate solution and iron tablets are the three drugs that have most frequently accumulated. These drugs are relatively cheap and usually have a long shelf-life; in most programmes they have been successfully redistributed to other health facilities while the kit content was being adapted. The overall financial loss due to accumulation of surpluses is therefore limited. Most programmes have reached a stable kit content within two years.  (+info)

The natural history of multiple sclerosis: a geographically based study. 5. The clinical features and natural history of primary progressive multiple sclerosis. (5/1505)

We report a natural history study of 216 patients with primary progressive (PP)- multiple sclerosis defined by at least 1 year of exacerbation-free progression at onset. This represents 19.8% of a largely population-based patient cohort having a mean longitudinal follow-up of 23 years. This subgroup of PP-multiple sclerosis patients had a mean age of onset of 38.5 years, with females predominating by a ratio of 1.3:1.0. The rate of deterioration from disease onset was substantially more rapid than for relapsing-remitting multiple sclerosis, with a median time to disability status score (DSS) 6 and DSS 8 of 8 and 18 years, respectively. Forty-nine percent of patients were followed through to death. Examination of the early disease course revealed two groups with adverse prognostic profiles. Firstly, a shorter time to reach DSS 3 from onset of PP-multiple sclerosis significantly adversely influenced time to DSS 8. Second, involvement of three or more neurological systems at onset resulted in a median time to DSS 10 of 13.5 years in contrast to PP-multiple sclerosis patients with one system involved at onset where median time to death from multiple sclerosis was 33.2 years. However, age, gender and type of neurological system involved at onset appeared to have little influence on prognosis. Life expectancy, cause of mortality and familial history profile were similar in PP-multiple sclerosis and non-PP-multiple sclerosis (all other multiple sclerosis patients from the total population). From clinical onset, rate of progression was faster in the PP-multiple sclerosis group than in the secondary progressive (SP)-multiple sclerosis group. When the rates of progression from onset of the progressive phase to DSS 6, 8 and 10 were compared, SP-multiple sclerosis had a more rapid progressive phase. A substantial minority (28%) of the PP-multiple sclerosis cohort had a distinct relapse even decades after onset of progressive deterioration. These studies establish natural history outcomes for the subgroup of multiple sclerosis patients with primary progressive disease.  (+info)

Sophisticated hospital information system/radiology information system/picture archiving and communications system (PACS) integration in a large-scale traumatology PACS. (6/1505)

Picture archiving and communications system (PACS) in the context of an outpatient trauma care center asks for a high level of interaction between information systems to guarantee rapid image acquisition and distribution to the surgeon. During installation of the Innsbruck PACS, special aspects of traumatology had to be realized, such as imaging of unconscious patients without identification, and transferred to the electronic environment. Even with up-to-date PACS hardware and software, special solutions had to be developed in-house to tailor the PACS/hospital information system (HIS)/radiology information system (RIS) interface to the needs of radiologic and clinical users. An ongoing workflow evaluation is needed to realize the needs of radiologists and clinicians. These needs have to be realized within a commercially available PACS, whereby full integration of information systems may sometimes only be achieved by special in-house solutions.  (+info)

Improving pneumococcal vaccine rates. Nurse protocols versus clinical reminders. (7/1505)

OBJECTIVE: To compare the effectiveness of three interventions designed to improve the pneumococcal vaccination rate. DESIGN: A prospective controlled trial. SETTING: Department of Veterans Affairs ambulatory care clinic. PATIENTS/PARTICIPANTS: There were 3, 502 outpatients with scheduled visits divided into three clinic teams (A, B, or C). INTERVENTIONS: During a 12-week period, each clinic team received one intervention: (A) nurse standing orders with comparative feedback as well as patient and clinician reminders; (B) nurse standing orders with compliance reminders as well as patient and clinician reminders; and (C) patient and clinician reminders alone. Team A nurses (comparative feedback group) received information on their vaccine rates relative to those of team B nurses. Team B nurses (compliance reminders group) received reminders to vaccinate but no information on vaccine rates. MEASUREMENTS AND MAIN RESULTS: Team A nurses assessed more patients than team B nurses (39% vs 34%, p =.009). However, vaccination rates per total patient population were similar (22% vs 25%, p =.09). The vaccination rates for both team A and team B were significantly higher than the 5% vaccination rate for team C (p <.001). CONCLUSIONS: Nurse-initiated vaccine protocols raised vaccination rates substantially more than a physician and patient reminder system. The nurse-initiated protocol with comparative feedback modestly improved the assessment rate compared with the protocol with compliance reminders, but overall vaccination rates were similar.  (+info)

Regional dissemination of vancomycin-resistant enterococci resulting from interfacility transfer of colonized patients. (8/1505)

During early 1997, the Siouxland District Health Department (SDHD; Sioux City, IA) reported an increased incidence of vancomycin-resistant enterococcal (VRE) isolates at area health care facilities. To determine the prevalence and risk factors for colonization with VRE strains at 32 health care facilities in the SDHD region, a prevalence survey and case-control study were performed. Of 2266 patients and residents, 1934 (85%) participated, and 40 (2.1%) were positive for (gastrointestinal) VRE colonization. The prevalence of VRE isolates was significantly higher in acute care facilities (ACFs) than in long-term care facilities (LTCFs) (10/152 [6.6%] vs. 30/1782 [1.7%]; odds ratio [OR], 4.1; 95% confidence interval [CI], 1.8-9.0). LTCF case patients were significantly more likely than controls to have been inpatients at any ACF (19/30 vs. 12/66; OR, 8.0; 95% CI, 2.7-23.8). Of 40 VRE isolates, 34 (85%) were a related strain. The predominant strain was present in all 12 LTCFs that had at least 1 case patient in each facility. Soon after the introduction of VRE isolates into this region, dissemination to multiple LTCFs resulted from resident transfer from ACFs to LTCFs.  (+info)

  • In the NT hospital cardiology focused acute care is only possible in one hospital, the Royal Darwin Hospital, while cardiology supervised subacute care is only possible in Darwin. (omicsonline.org)
  • In the NT the locus of control for a significant number of acute care cases and greater number of subacute cases are not within cardiology control. (omicsonline.org)
  • With five facilities across the Ozarks, the eye care professionals at Mattax Neu Prater offer a wide variety of vision correction choices, including customized bladeless LASIK, and state-of-the-art cataract surgery with lifestyle multifocal replacement lens implants. (prweb.com)
  • "Medicare Payments for Outpatient Urological Surgery by Location of Care," by John M. Hollingsworth, Chris S. Saigal, Julie C. Lai, Rodney L. Dunn, Seth A. Strope, Brent K Hollenbeck, and the Urologic Diseases in America project (DOI: 10.1016/j.juro.2012.08.031). (elsevier.com)
  • They provide guidelines for identifying and avoiding pitfalls in ambulatory surgery. (outpatientsurgery.net)
  • As a recognized pioneer in the concept of Ambulatory Surgery, Dr. Howard Tobin has contributed many innovative notions and ideas to the medical field. (locateadoc.com)
  • After graduating from Princeton University with honors, Dr. Tobin took it upon himself to further progress the field of ambulatory surgery, specifically Cosmetic Surgery. (locateadoc.com)
  • Dr. Tobin is also a past president of the American Society of Liposuction Surgery for several years along with his seat on the Ambulatory Surgery Committee of the American Academy of Facial Plastic and Reconstructive Surgery from 1984 until 1990. (locateadoc.com)
  • The American Society of Plastic Surgery (ASPS) requires member surgeons to use operating facilities that are routinely monitored for quality and safety. (plasticsurgery.org)
  • As a result, some states have defined an ASC for legal purposes as 'a facility primarily organized or established for the purpose of performing surgery for outpatients and… a separate identifiable legal entity from any other health care facility. (surgeryencyclopedia.com)
  • Therefore, with regard to health care financing, as Medicare goes, so goes the nation. (elsevier.com)
  • Under this authority, the minimum requirements that an ASC must meet to participate in Medicare are set forth in regulations at 42 CFR part 416 which determines the basis and scope of ASC covered services, and the conditions for Start Printed Page 67521 Medicare payment for facility services. (federalregister.gov)
  • The planned federal nursing home Value-Based Purchasing Demonstration, for example, will use Medicare savings from reduced avoidable hospitalizations to reward better-performing facilities. (commonwealthfund.org)
  • To ensure that regulated health care facilities comply with all applicable federal and state requirements, HFLC's Survey and Certification team conducts routine federal Medicare certification surveys and state licensure surveys as well as state and federal complaint investigations. (oregon.gov)
  • Telehealth nursing is an integral component of professional ambulatory care nursing that utilizes a variety of telecommunications technologies during encounters to assess, triage, provide nursing consultation, perform follow up and care coordination. (aaacn.org)
  • WHO HQ Library catalog › Results of search for 'su:{Ambulatory care facilities. (who.int)
  • When you see our certificate of accreditation, you will know that the AAAHC, an independent, not-for-profit organization, has closely examined our facility and procedures. (prweb.com)
  • The AAAHC serves as an advocate for the provision of high quality health care through the development of nationally recognized standards and through its survey and accreditation programs. (prweb.com)
  • The 189-bed hospital delivers high quality family- and patient-centered care to children from throughout the Philadelphia area and around the world. (indeed.com)
  • It enhances the delivery of efficient and patient-centered care, improves patient flow, reduces waiting time and maximizes patient comfort. (nyc.gov)
  • MCO enrollees select a primary care provider to provide basic care and make any necessary referrals. (scribd.com)
  • A few of these common presentations include burns, lacerations, trauma to the hand, and wounds, some of which do not require an evaluation by a specialist and can be managed outpatient by primary care clinicians. (jabfm.org)
  • In this article, we share evidence-based tips to avoid common pitfalls in primary care recognition and management of such presentations as well as guide them to manage many of these conditions themselves. (jabfm.org)
  • Burns, lacerations, and wounds are commonly encountered by primary care clinicians. (jabfm.org)
  • 1 Some of these conditions or procedures and managements referred to plastic surgeons could be performed by a primary care clinician. (jabfm.org)
  • In this article, we share evidence-based tips to help primary care clinicians avoid common pitfalls in recognition and management of such presentations. (jabfm.org)
  • Full-thickness burns should be evaluated by a specialist while superficial burns can be managed by a primary care clinician. (jabfm.org)
  • Provide outpatient primary care to medically-underserved populations and areas. (oregon.gov)