Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.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.Drug Delivery Systems: Systems for the delivery of drugs to target sites of pharmacological actions. Technologies employed include those concerning drug preparation, route of administration, site targeting, metabolism, and toxicity.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Health Care Reform: Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Mental Health: The state wherein the person is well adjusted.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.Health: The state of the organism when it functions optimally without evidence of disease.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Health Planning: Planning for needed health and/or welfare services and 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)Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.Health Services: Services for the diagnosis and treatment of disease and the maintenance of health.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.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)World Health: The concept pertaining to the health status of inhabitants of the world.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.Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.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)Delivery of Health Care, Integrated: A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.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).Public Health Administration: Management of public health organizations or agencies.Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Health Status Disparities: Variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically or similar measures.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.Health Care Rationing: Planning for the equitable allocation, apportionment, or distribution of available health resources.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.Public Health Practice: The activities and endeavors of the public health services in a community on any level.Mental Health Services: Organized services to provide mental health care.Rural Health: The status of health in rural populations.Women's Health: The concept covering the physical and mental conditions of women.Health Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Urban Health: The status of health in urban populations.Health Literacy: Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.Child Health Services: Organized services to provide health care for children.World Health Organization: A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples.Health Facilities: Institutions which provide medical or health-related services.Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.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).Community Health Planning: Planning that has the goals of improving health, improving accessibility to health services, and promoting efficiency in the provision of services and resources on a comprehensive basis for a whole community. (From Facts on File Dictionary of Health Care Management, 1988, p299)Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Regional Health Planning: Planning for health resources at a regional or multi-state level.Health Manpower: The availability of HEALTH PERSONNEL. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.Maternal Health Services: Organized services to provide health care to expectant and nursing mothers.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.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.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Infant, Newborn: An infant during the first month after birth.Drug Carriers: Forms to which substances are incorporated to improve the delivery and the effectiveness of drugs. Drug carriers are used in drug-delivery systems such as the controlled-release technology to prolong in vivo drug actions, decrease drug metabolism, and reduce drug toxicity. Carriers are also used in designs to increase the effectiveness of drug delivery to the target sites of pharmacological actions. Liposomes, albumin microspheres, soluble synthetic polymers, DNA complexes, protein-drug conjugates, and carrier erythrocytes among others have been employed as biodegradable drug carriers.Public Health Nursing: A nursing specialty concerned with promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences to develop local, regional, state, and national health policy and research. It is population-focused and community-oriented, aimed at health promotion and disease prevention through educational, diagnostic, and preventive programs.Cesarean Section: Extraction of the FETUS by means of abdominal HYSTEROTOMY.Health Occupations: Professions or other business activities directed to the cure and prevention of disease. For occupations of medical personnel who are not physicians but who are working in the fields of medical technology, physical therapy, etc., ALLIED HEALTH OCCUPATIONS is available.Electronic Health Records: Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.Reproductive Health: The physical condition of human reproductive systems.Health Benefit Plans, Employee: 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.Occupational Health Services: Health services for employees, usually provided by the employer at the place of work.Health Services Administration: The organization and administration of health services dedicated to the delivery of health care.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.Nanoparticles: Nanometer-sized particles that are nanoscale in three dimensions. They include nanocrystaline materials; NANOCAPSULES; METAL NANOPARTICLES; DENDRIMERS, and QUANTUM DOTS. The uses of nanoparticles include DRUG DELIVERY SYSTEMS and cancer targeting and imaging.Health Services for the Aged: Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.Gene Transfer Techniques: The introduction of functional (usually cloned) GENES into cells. A variety of techniques and naturally occurring processes are used for the gene transfer such as cell hybridization, LIPOSOMES or microcell-mediated gene transfer, ELECTROPORATION, chromosome-mediated gene transfer, TRANSFECTION, and GENETIC TRANSDUCTION. Gene transfer may result in genetically transformed cells and individual organisms.Health Plan Implementation: Those actions designed to carry out recommendations pertaining to health plans or programs.State Health Plans: State plans prepared by the State Health Planning and Development Agencies which are made up from plans submitted by the Health Systems Agencies and subject to review and revision by the Statewide Health Coordinating Council.Public Health Informatics: The systematic application of information and computer sciences to public health practice, research, and learning.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.National Institutes of Health (U.S.): An operating division of the US Department of Health and Human Services. It is concerned with the overall planning, promoting, and administering of programs pertaining to health and medical research. Until 1995, it was an agency of the United States PUBLIC HEALTH SERVICE.Politics: Activities concerned with governmental policies, functions, etc.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.Women's Health Services: Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.Health Services, Indigenous: Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.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.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.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Health Maintenance Organizations: 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)Catchment Area (Health): A geographic area defined and served by a health program or institution.Health Care Coalitions: Voluntary groups of people representing diverse interests in the community such as hospitals, businesses, physicians, and insurers, with the principal objective to improve health care cost effectiveness.Health Planning Guidelines: Recommendations for directing health planning functions and policies. These may be mandated by PL93-641 and issued by the Department of Health and Human Services for use by state and local planning agencies.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.Health Records, Personal: Longitudinal patient-maintained records of individual health history and tools that allow individual control of access.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Poverty: A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Men's Health: The concept covering the physical and mental conditions of men.Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Allied Health Personnel: Health care workers specially trained and licensed to assist and support the work of health professionals. Often used synonymously with paramedical personnel, the term generally refers to all health care workers who perform tasks which must otherwise be performed by a physician or other health professional.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.Family Health: The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members.Adolescent Health Services: Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.Rural Population: The inhabitants of rural areas or of small towns classified as rural.Health Planning Support: Financial resources provided for activities related to health planning and development.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Social Justice: An interactive process whereby members of a community are concerned for the equality and rights of all.Healthcare Disparities: Differences in access to or availability of medical facilities and services.Community Mental Health Services: Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.Great BritainPopulation 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.Schools, Public Health: Educational institutions for individuals specializing in the field of public health.Comprehensive Health Care: Providing for the full range of personal health services for diagnosis, treatment, follow-up and rehabilitation of patients.Consumer Participation: Community or individual involvement in the decision-making process.Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)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.School Health Services: Preventive health services provided for students. It excludes college or university students.Financing, Government: Federal, state, or local government organized methods of financial assistance.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.Genetic Therapy: Techniques and strategies which include the use of coding sequences and other conventional or radical means to transform or modify cells for the purpose of treating or reversing disease conditions.United States Dept. of Health and Human Services: A cabinet department in the Executive Branch of the United States Government concerned with administering those agencies and offices having programs pertaining to health and human services.Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.Educational Status: Educational attainment or level of education of individuals.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Pregnancy Outcome: 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.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.Genetic Vectors: DNA molecules capable of autonomous replication within a host cell and into which other DNA sequences can be inserted and thus amplified. Many are derived from PLASMIDS; BACTERIOPHAGES; or VIRUSES. They are used for transporting foreign genes into recipient cells. Genetic vectors possess a functional replicator site and contain GENETIC MARKERS to facilitate their selective recognition.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)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.Health Fairs: Community health education events focused on prevention of disease and promotion of health through audiovisual exhibits.Sex 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.Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).Maternal-Child Health Centers: Facilities which administer the delivery of health care services to mothers and children.Health Food: A non-medical term defined by the lay public as a food that has little or no preservatives, which has not undergone major processing, enrichment or refinement and which may be grown without pesticides. (from Segen, The Dictionary of Modern Medicine, 1992)Social Class: A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income.Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Insurance Coverage: Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)Health Communication: The transfer of information from experts in the medical and public health fields to patients and the public. The study and use of communication strategies to inform and influence individual and community decisions that enhance health.United States Public Health Service: A constituent organization of the DEPARTMENT OF HEALTH AND HUMAN SERVICES concerned with protecting and improving the health of the nation.Dental Health Services: Services designed to promote, maintain, or restore dental health.International Cooperation: The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest.Organizational Objectives: The purposes, missions, and goals of an individual organization or its units, established through administrative processes. It includes an organization's long-range plans and administrative philosophy.Particle Size: Relating to the size of solids.Interinstitutional Relations: The interactions between representatives of institutions, agencies, or organizations.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.Organizational Case Studies: Descriptions and evaluations of specific health care organizations.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)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.Prepaid Health Plans: Contracts between an insurer and a subscriber or a group of subscribers whereby a specified set of health benefits is provided in return for a periodic premium.Residence Characteristics: Elements of residence that characterize a population. They are applicable in determining need for and utilization of health services.Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions.Pregnancy Complications: 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.Maternal Welfare: Organized efforts by communities or organizations to improve the health and well-being of the mother.Health Transition: Demographic and epidemiologic changes that have occurred in the last five decades in many developing countries and that are characterized by major growth in the number and proportion of middle-aged and elderly persons and in the frequency of the diseases that occur in these age groups. The health transition is the result of efforts to improve maternal and child health via primary care and outreach services and such efforts have been responsible for a decrease in the birth rate; reduced maternal mortality; improved preventive services; reduced infant mortality, and the increased life expectancy that defines the transition. (From Ann Intern Med 1992 Mar 15;116(6):499-504)Obstetric Labor Complications: 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.Health Planning Councils: Organized groups serving in advisory capacities related to health planning activities.Universal Coverage: Health insurance coverage for all persons in a state or country, rather than for some subset of the population. It may extend to the unemployed as well as to the employed; to aliens as well as to citizens; for pre-existing conditions as well as for current illnesses; for mental as well as for physical conditions.Australia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.Public Sector: The area of a nation's economy that is tax-supported and under government control.Occupational Health Nursing: The practice of nursing in the work environment.Cooperative Behavior: The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)Government Agencies: Administrative units of government responsible for policy making and management of governmental activities.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.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.History, 20th Century: Time period from 1901 through 2000 of the common era.Education, Public Health Professional: Education and training in PUBLIC HEALTH for the practice of the profession.Financing, Organized: All organized methods of funding.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.EnglandState 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.Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc.Social Determinants of Health: The circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics ( 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.Managed Care Programs: 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.Stress, Psychological: Stress wherein emotional factors predominate.Holistic Health: Health as viewed from the perspective that humans and other organisms function as complete, integrated units rather than as aggregates of separate parts.Employment: The state of being engaged in an activity or service for wages or salary.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships.BrazilIndiaFollow-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.National Health Insurance, United StatesHealth Facility Administration: Management of the organization of HEALTH FACILITIES.Medical Informatics: The field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine.Obstetric Labor, Premature: 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).Medically Uninsured: Individuals or groups with no or inadequate health insurance coverage. Those falling into this category usually comprise three primary groups: the medically indigent (MEDICAL INDIGENCY); those whose clinical condition makes them medically uninsurable; and the working uninsured.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Social Responsibility: The obligations and accountability assumed in carrying out actions or ideas on behalf of others.Dental Health Surveys: A systematic collection of factual data pertaining to dental or oral health and disease in a human population within a given geographic area.Demography: Statistical interpretation and description of a population with reference to distribution, composition, or structure.Financing, Personal: Payment by individuals or their family for health care services which are not covered by a third-party payer, either insurance or medical assistance.Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Personal Health Services: Health care provided to individuals.Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., BIOPOLYMERS; PLASTICS).Patient Education as Topic: The teaching or training of patients concerning their own health needs.Information Services: Organized services to provide information on any questions an individual might have using databases and other sources. (From Random House Unabridged Dictionary, 2d ed)Decision Making, Organizational: The process by which decisions are made in an institution or other organization.Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly.

Good health care: patient and professional perspectives. (1/4815)

Many health needs assessment exercises are professionally led, employing complex epidemiological methods. An alternative method that gives valuable information about patient preferences is a forced-choice questionnaire, which this study used in five practices in the West of Scotland. In each practice, patient-centred care was the most highly valued attribute of service provision.  (+info)

The use of targets to improve the performance of health care providers: a discussion of government policy. (2/4815)

The aim of this discussion paper is to examine the advantages and drawbacks of employing targets, or performance indicators, to improve the performance of those delivering health care services. The paper is based on an examination of two target-setting policies initiated by Government: the 1992 Health of the Nation strategy and the 1990 General Practitioners' Contract. It is argued that the introduction of both the General Practitioners' Contract and the Health of the Nation have indeed been accompanied by improvements in performance, however, there are a number of problems with targets. They tend to focus on those things that are most easily measured, and they may foster complacency on the part of providers who have already achieved upper target limits, and defensiveness on the part of those performing badly. National targets may skew local priorities; they may also be unrealistic and unattainable for particular, less privileged population groups. They may serve to widen inequalities in health, and can exacerbate the 'inverse care law' by encouraging providers to direct their efforts at the more advantaged sections of society, where such efforts are more likely to pay off in terms of overall improvements in the target level achieved. Finally, the achievement of some targets will not necessarily result in better health outcomes. The paper concludes that a target-setting approach to improving the quality of care must be based on the use of appropriate indicators, and must take account of differences between more and less advantaged sections of society.  (+info)

Rider injury rates and emergency medical services at equestrian events. (3/4815)

BACKGROUND: Horse riding is a hazardous pastime, with a number of studies documenting high rates of injury and death among horse riders in general. This study focuses on the injury experience of cross country event riders, a high risk subset of horse riders. METHOD: Injury data were collected at a series of 35 equestrian events in South Australia from 1990 to 1998. RESULTS: Injury rates were found to be especially high among event riders, with frequent falls, injuries, and even deaths. The highest injury rates were among the riders competing at the highest levels. CONCLUSION: There is a need for skilled emergency medical services at equestrian events.  (+info)

Patterns of care and survival for adolescents and young adults with acute leukaemia--a population-based study. (4/4815)

We report a population-based study of patterns of care and survival for people with acute leukaemia diagnosed at age 15-29 years during 1984-94 in regions of England and Wales covered by specialist leukaemia registries. There were 879 patients: 417 with acute lymphoblastic leukaemia (ALL) and 462 with acute myeloid leukaemia (AML). For ALL, actuarial survival rates were 43% at 5 years after diagnosis and 37% at 10 years. Survival improved significantly between 1984-88 and 1989-94 for those aged 15-19 at diagnosis. Patients entered in national clinical trials and those not entered had similar survival rates. Survival rates were similar at teaching and non-teaching hospitals and at hospitals treating different numbers of study patients per year. For AML, survival rates were 42% at 5 years after diagnosis and 39% at 10 years. Survival improved significantly between 1984-88 and 1989-94. Patients entered in the Medical Research Council AML10 trial had a higher survival rate than those who were in the earlier AML9 trial. Survival did not vary with category of hospital. We conclude that survival has improved for adolescents and young adults with acute leukaemia but that there is at present no evidence that centralized treatment results in a survival benefit for patients in this age group.  (+info)

Where do people go for treatment of sexually transmitted diseases? (5/4815)

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)

The just provision of health care: a reply to Elizabeth Telfer. (6/4815)

Dr Hillel Steiner in this reply to Elizabeth Telfer takes each of her arguments for different arrangements of a health service and examines them--'four positions which can be located on a linear ideological spectrum'--and adds a fifth which could have the effect of 'turning the alleged linear spectrum into a circle'. Underlying both Elizabeth Telfer's article and Dr Steiner's reply, the base is inescapably a 'political' one, but cannot be abandoned in favour of purely philosophical concepts. Whatever the attitude of mind of the reader of these two papers to the provision of a health service, the stimulus to more careful assessments of our own National Health Service and its problems can only be good.  (+info)

The present state and future prospects of occupational health in Bangladesh. (7/4815)

Bangladesh is a relatively young and developing country. At the present time, like in most developing countries, a clear demarcation between occupational health care and general medical care is difficult to be recognized in Bangladesh. Occupational health is a fairly new field, as the country is undergoing industrialization and occupational health activities are operated by several ministries, such as Labour, Health, Industry and Transport. Legal foundations of the occupational health-care system based on British India and Pakistani era, were adopted and amended by the Government of Bangladesh after the liberation of the country in 1971. Most of the Labour laws have been rectified by the Government of Bangladesh according to the ILO Conventions. Reconsideration of the occupational health service system avoiding duplication for the 'occupational health' component in several ministries might be helpful to achieve the successful provision of an occupational health service in the developing Bangladesh.  (+info)

Canada's "disasters-R-us" medical platoon a hit in Honduras. (8/4815)

The Canadian Forces Disaster Assistance Response Team did not take long to adapt to the medical needs of 90,000 survivors of Hurricane Mitch last November.  (+info)

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