Health Status
Public Health
Delivery of Health Care
Health Services Accessibility
Residential Treatment
Substance Abuse Treatment Centers
United States Substance Abuse and Mental Health Services Administration
United States Virgin Islands
Micronesia
Palau
Regional organisational audit of district departments of public health. (1/69)
Organisational audit of public health in the United Kingdom is rare. To provide a framework for a structured organisational audit in district public health departments in one region organisational factors contributing to efficient, high quality work were identified and compared between districts, enabling each department to identify its organisational strengths and weaknesses. A draft list of organisational factors, based on the King's Fund organisational audit programme, were rated by 52 public health physicians and trainees in 12 district public health departments in South East Thames region for their importance on a scale of 0 (not relevant) to 5 (vital). Factors with average ratings of > 4, judged to be "vital" and proxies for standards, were then used to compare each district's actual performance, as reported by its director of public health in a self reported questionnaire. In all, 37 responses were received to the rating questionnaire (response rate 71%) and 12 responses to the directors' questionnaire. Of the 54 factors identified as vital factors, 20(37%) were achieved in all 12 districts and 16(30%) in all but one district; 18 were not being achieved by two (33%) districts or more. Overall, vital factors were not being achieved in 9% of cases. The authors concluded that most departments are achieving most vital organisational factors most of the time, but improvement is still possible. The results have been used as a basis for planning the organisation of public health departments in several of the newly formed commissioning agencies. This was the first regional audit of public health of its kind performed in the region and it provided valuable experience for planning future regional audit activity. (+info)Experience measuring performance improvement in multiphase picture archiving and communications systems implementations. (2/69)
When planning a picture archiving and communications system (PACS) implementation and determining which equipment will be implemented in earlier and later phases, collection and analysis of selected data will aid in setting implementation priorities. If baseline data are acquired relative to performance objectives, the same information used for implementation planning can be used to measure performance improvement and outcomes. The main categories of data to choose from are: (1) financial data; (2) productivity data; (3) operational parameters; (4) clinical data; and (5) information about customer satisfaction. In the authors' experience, detailed workflow data have not proved valuable in measuring PACS performance and outcomes. Reviewing only one category of data in planning will not provide adequate basis for targeting operational improvements that will lead to the most significant gains. Quality improvement takes into account all factors in production: human capacity, materials, operating capital and assets. Once we have identified key areas of focus for quality improvement in each phase, we can translate objectives into implementation requirements and finally into detailed functional and performance requirements. Here, Integration Resources reports its experience measuring PACS performance relative to phased implementation strategies for three large medical centers. Each medical center had its own objectives for overcoming image management, physical/geographical, and functional/technical barriers. The report outlines (1) principal financial and nonfinancial measures used as performance indicators; (2) implementation strategies chosen by each of the three medical centers; and (3) the results of those strategies as compared with baseline data. (+info)A novel governance system for enterprise information services. (3/69)
The authors created a novel system for governing the enterprise information services (IS) of a large health care system. The governance organization is comprised of key members of the attending medical staff, hospital and health system administration, and the IS department. A method for defining the requirements and business case for proposed new systems was developed for use by departments requesting new or expanded information services. A Technology Architecture Guideline document was developed and approved to provide a framework for supported hardware and software technologies. IS policies are approved by the main governance council. All project proposals are reviewed by specialized governance committees and, if approved, are launched for further development. Fully developed proposals are reviewed, approved and prioritized for funding by the governance council. This novel organization provides the methodology and structure for enlightened peer review and funding for well developed IS project proposals. (+info)Assessment of infectious disease surveillance--Uganda, 2000. (4/69)
In 1998, member states of the African region of the World Health Organization (WHO-AFRO) adopted the integrated disease surveillance (IDS) strategy to strengthen national infectious disease surveillance systems (1). The first step of the IDS strategy is to assess infectious disease surveillance systems. This report describes the results of the assessment of these systems of the Uganda Ministry of Health (UMoH) and indicates that additional efforts are needed to develop the basic elements of an effective surveillance system. (+info)Structure and performance of infectious disease surveillance and response, United Republic of Tanzania, 1998. (5/69)
OBJECTIVE: To assess the structure and performance of and support for five infectious disease surveillance systems in the United Republic of Tanzania: Health Management Information System (HMIS); Infectious Disease Week Ending; Tuberculosis/Leprosy; Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome; and Acute Flaccid Paralysis/Poliomyelitis. METHODS: The systems were assessed by analysing the core activities of surveillance and response and support functions (provision of training, supervision, and resources). Data were collected using questionnaires that involved both interviews and observations at regional, district, and health facility levels in three of the 20 regions in the United Republic of Tanzania. FINDINGS: An HMIS was found at 26 of 32 health facilities (81%) surveyed and at all 14 regional and district medical offices. The four other surveillance systems were found at <20% of health facilities and <75% of medical offices. Standardized case definitions were used for only 3 of 21 infectious diseases. Nineteen (73%) health facilities with HMIS had adequate supplies of forms; 9 (35%) reported on time; and 11 (42%) received supervision or feedback. Four (29%) medical offices with HMIS had population denominators to use for data analyses; 12 (86%) were involved in outbreak investigations; and 11 (79%) had conducted community prevention activities. CONCLUSION: While HMIS could serve as the backbone for IDSR in the United Republic of Tanzania, this will require supervision, standardized case definitions, and improvements in the quality of reporting, analysis, and feedback. (+info)"Safe sex advice is good - but so difficult to follow". Views and experiences of the youth in a health centre in Kampala. From Kiswa Youth Clinic, Kampala, Uganda. (6/69)
BACKGROUND: Young people in Uganda are advised by the Ministry of Health and other authorities to abstain from sex in order to avoid the human immunodeficiency virus (HIV), other sexually transmitted diseases (STD) and early pregnancies. If they cannot abstain they should use condoms and they should stay faithful to their partner. OBJECTIVE: To find out how young people perceive this advice and if they find it possible and realistic to follow. METHOD: In May and June 2000 twenty informants were selected by purposeful sampling and were interviewed in English. Given items were discussed. The interviews were recorded on tape, transcribed, extracted and sorted into categories in a qualitative research method. RESULTS: Most of the interviewed youth claimed that the advice is good and helpful but there are many obstacles. The results showed that information given in schools about condom use and safer sex behaviour is not always adequate. However, despite lack of clear health education messages, the risk of being HIV positive is of major concern to many youth. In addition, the expected lack of support if the test is positive is a common reason for abstaining from HIV testing. CONCLUSIONS: More discussions in society are needed to create consensus on safe sex messages presented to young people. HIV infection is a major concern but many young people abstain from testing, as they expect to receive inadequate support. (+info)Assessing the performance of primary health centres under decentralized government in Kerala, India. (7/69)
CONTEXT: Kerala's government health-care system functions relatively well compared with other Indian States, but utilization levels are decreasing due to lack of essential facilities. The opportunity cost of seeking medical care from the government sector is high, even for the poor, with 60-70% of the poor seeking care from the private sector and spending disproportionately on health care (about 40% of income compared with 2.4% by the rich). In 1996, the Kerala government brought primary health centres (PHCs) under the control of local governments (panchayats). OBJECTIVE: To provide an approach to assess PHC performance under decentralized government. METHODS: The study was conducted in three stages. The first stage included all 990 village panchayats in Kerala. The second stage covered 10 panchayats (their respective 10 PHCs and 65 sub-centres) occupying the top five and bottom five ranks in terms of resource allocation to health. Two panchayats (their respective PHCs and sub-centres), one each from the top five and the bottom five, were chosen for the third stage. Published and unpublished government data, panchayat development reports, panchayat and PHC records, facility checklist, and key informant and client exit interviews were used for data collection. FINDINGS: Panchayats in Kerala allocated a lower proportion of resources to health than that allocated by the state government prior to decentralization; while panchayat resources grew at an annual rate of 30.7%, health resources grew at 7.9%. PHCs were funded to the extent of 0.7-2.7% of the total cost. An additional 2% in PHC resources was associated with improved patient load (63.5%), cost-effectiveness (50.8%), medicine supply (49.4%), information (32.8%) and patient satisfaction (12.7%). An annual increase of US$940 in PHC resources would help to extend primary care facilities to 3000 (15.5%) more users. CONCLUSION: Decentralization brought no significant change to the health sector. Active panchayat support to PHCs existed in only a few places, but wherever it was present, the result was positive. Kerala should find an alternative strategy to channel panchayats towards health before health loses its battle for resources. (+info)Determinants of innovation within health care organizations: literature review and Delphi study. (8/69)
PURPOSE: When introducing innovations to health care, it is important to gain insight into determinants that may facilitate or impede the introduction, in order to design an appropriate strategy for introducing the innovation. To obtain an overview of determinants of innovations in health care organizations, we carried out a literature review and a Delphi study. The Delphi study was intended to achieve consensus among a group of implementation experts on determinants identified from the literature review. DATA SOURCES: We searched 11 databases for articles published between 1990 and 2000. The keywords varied according to the specific database. We also searched for free text. Forty-four implementation experts (implementation researchers, programme managers, and implementation consultants/advisors) participated in the Delphi study. STUDY SELECTION: The following studies were selected: (i) studies describing innovation processes, and determinants thereof, in health care organizations; (ii) studies where the aim of the innovations was to change the behaviour of health professionals; (iii) studies where the health care organizations provided direct patient care; and (iv) studies where only empirical studies were included. DATA EXTRACTION: Two researchers independently selected the abstracts and analysed the articles. The determinants were divided into four categories: characteristics of the environment, characteristics of the organization, characteristics of the user (health professional), and characteristics of the innovation. When analysing the determinants, a distinction was made between systematically designed and non-systematically designed studies. In a systematic study, a determinant analysis was performed and the innovation strategy was adapted to these determinants. Furthermore, the determinants were associated with the degree of implementation, and both users and non-users of the innovation were asked about possible determinants. In the Delphi study, consensus was defined as agreement among 75% of the experts on both the influence of a determinant and the direction towards which that influence tended (i.e. facilitating, impeding, or neutral). RESULTS: From the initial 2239 abstracts, 57 studies were retrieved and 49 determinants were identified that affected (impeded or facilitated) the innovation process. The experts identified one other determinant. Seventeen studies had a more-or-less systematic design; the others did not. After three rounds, consensus was reached on the influence of 49 out of 50 determinants. CONCLUSION: The results of the literature review matched those found in the Delphi study, and 50 potentially relevant determinants of innovation processes were identified. Many of the innovation studies had several methodological flaws, such as not adjusting innovation strategies to relevant determinants of the innovation process, or that data on determinants were gathered only from non-users. Furthermore, the degree of implementation was evaluated in several ways, which made comparison difficult. (+info)Health facility administration refers to the management and oversight of medical and healthcare facilities, including hospitals, clinics, nursing homes, and other types of healthcare organizations. This involves ensuring that the facility is run efficiently and effectively, with a focus on providing high-quality patient care and maintaining compliance with relevant laws and regulations.
Health facility administration typically includes a wide range of responsibilities, such as:
* Developing and implementing policies and procedures
* Managing budgets and finances
* Overseeing staff recruitment, training, and performance evaluation
* Ensuring compliance with regulatory requirements and standards
* Coordinating with other healthcare professionals and organizations to provide comprehensive care
* Planning and coordinating facility operations and resources
* Developing and implementing quality improvement initiatives
Health facility administrators must have a strong understanding of medical and healthcare practices and procedures, as well as business and management principles. They must be able to communicate effectively with staff, patients, and other stakeholders, and be skilled in problem-solving, decision-making, and leadership. Many health facility administrators have a background in healthcare or business administration, and may hold degrees such as a Master of Health Administration (MHA) or a Master of Business Administration (MBA).
Health facilities, also known as healthcare facilities, are organizations that provide health services, treatments, and care to individuals in need of medical attention. These facilities can include various types of establishments such as hospitals, clinics, doctor's offices, dental practices, long-term care facilities, rehabilitation centers, and diagnostic imaging centers.
Health facilities are designed to offer a range of services that promote health, prevent illness, diagnose and treat medical conditions, and provide ongoing care for patients with chronic illnesses or disabilities. They may also offer educational programs and resources to help individuals maintain their health and well-being.
The specific services offered by health facilities can vary widely depending on the type and size of the facility, as well as its location and target population. However, all health facilities are required to meet certain standards for safety, quality, and patient care in order to ensure that patients receive the best possible treatment and outcomes.
Health status is a term used to describe the overall condition of an individual's health, including physical, mental, and social well-being. It is often assessed through various measures such as medical history, physical examination, laboratory tests, and self-reported health assessments. Health status can be used to identify health disparities, track changes in population health over time, and evaluate the effectiveness of healthcare interventions.
Public health is defined by the World Health Organization (WHO) as "the art and science of preventing disease, prolonging life and promoting human health through organized efforts of society." It focuses on improving the health and well-being of entire communities, populations, and societies, rather than individual patients. This is achieved through various strategies, including education, prevention, surveillance of diseases, and promotion of healthy behaviors and environments. Public health also addresses broader determinants of health, such as access to healthcare, housing, food, and income, which have a significant impact on the overall health of populations.
The "delivery of health care" refers to the process of providing medical services, treatments, and interventions to individuals in order to maintain, restore, or improve their health. This encompasses a wide range of activities, including:
1. Preventive care: Routine check-ups, screenings, immunizations, and counseling aimed at preventing illnesses or identifying them at an early stage.
2. Diagnostic services: Tests and procedures used to identify and understand medical conditions, such as laboratory tests, imaging studies, and biopsies.
3. Treatment interventions: Medical, surgical, or therapeutic treatments provided to manage acute or chronic health issues, including medications, surgeries, physical therapy, and psychotherapy.
4. Acute care services: Short-term medical interventions focused on addressing immediate health concerns, such as hospitalizations for infections, injuries, or complications from medical conditions.
5. Chronic care management: Long-term care and support provided to individuals with ongoing medical needs, such as those living with chronic diseases like diabetes, heart disease, or cancer.
6. Rehabilitation services: Programs designed to help patients recover from illnesses, injuries, or surgeries, focusing on restoring physical, cognitive, and emotional function.
7. End-of-life care: Palliative and hospice care provided to individuals facing terminal illnesses, with an emphasis on comfort, dignity, and quality of life.
8. Public health initiatives: Population-level interventions aimed at improving community health, such as disease prevention programs, health education campaigns, and environmental modifications.
The delivery of health care involves a complex network of healthcare professionals, institutions, and systems working together to ensure that patients receive the best possible care. This includes primary care physicians, specialists, nurses, allied health professionals, hospitals, clinics, long-term care facilities, and public health organizations. Effective communication, coordination, and collaboration among these stakeholders are essential for high-quality, patient-centered care.
Health services accessibility refers to the degree to which individuals and populations are able to obtain needed health services in a timely manner. It includes factors such as physical access (e.g., distance, transportation), affordability (e.g., cost of services, insurance coverage), availability (e.g., supply of providers, hours of operation), and acceptability (e.g., cultural competence, language concordance).
According to the World Health Organization (WHO), accessibility is one of the key components of health system performance, along with responsiveness and fair financing. Improving accessibility to health services is essential for achieving universal health coverage and ensuring that everyone has access to quality healthcare without facing financial hardship. Factors that affect health services accessibility can vary widely between and within countries, and addressing these disparities requires a multifaceted approach that includes policy interventions, infrastructure development, and community engagement.
Maternal health services refer to the preventative, diagnostic, and treatment-based healthcare services provided during pregnancy, childbirth, and postnatal period. These services aim to ensure the best possible health outcomes for mothers throughout their reproductive years, including family planning, preconception care, antenatal care, delivery, postpartum care, and management of chronic conditions or complications that may arise during pregnancy and childbirth.
The World Health Organization (WHO) outlines several critical components of maternal health services:
1. Antenatal care: Regular check-ups to monitor the mother's and fetus's health, identify potential risks, provide essential interventions, and offer counseling on nutrition, breastfeeding, and birth preparedness.
2. Delivery care: Skilled attendance during childbirth, including normal vaginal delivery and assisted deliveries (forceps or vacuum extraction), and access to emergency obstetric care for complications such as hemorrhage, eclampsia, obstructed labor, and sepsis.
3. Postnatal care: Continuum of care for mothers and newborns during the first six weeks after childbirth, focusing on recovery, early detection and management of complications, immunization, family planning, and psychosocial support.
4. Family planning: Access to modern contraceptive methods, counseling on fertility awareness, and safe abortion services where legal, to enable women to plan their pregnancies and space their children according to their reproductive intentions.
5. Management of chronic conditions: Comprehensive care for pregnant women with pre-existing or pregnancy-induced medical conditions such as hypertension, diabetes, HIV/AIDS, and mental health disorders.
6. Preconception care: Identification and management of risk factors before conception to optimize maternal and fetal health outcomes.
7. Prevention and management of gender-based violence: Screening, counseling, and referral services for women experiencing intimate partner violence or sexual violence during pregnancy and childbirth.
8. Health promotion and education: Community-based interventions to raise awareness about the importance of maternal health, promote positive health behaviors, and reduce barriers to accessing healthcare services.
Maternal health services should be accessible, affordable, acceptable, and equitable for all women, regardless of their age, race, ethnicity, socioeconomic status, or geographical location. Adequate investment in maternal health infrastructure, human resources, and service delivery models is essential to achieve universal health coverage and the Sustainable Development Goals (SDGs) by 2030.
Residential treatment, also known as inpatient treatment, refers to a type of healthcare service in which patients receive 24-hour medical and psychological care in a residential setting. This type of treatment is typically provided for individuals who require a higher level of care than what can be provided on an outpatient basis. Residential treatment programs may include a variety of services such as medical and psychiatric evaluations, medication management, individual and group therapy, psychoeducation, and recreational activities. These programs are often used to treat various mental health conditions including substance use disorders, depression, anxiety, bipolar disorder, and other serious mental illnesses. The goal of residential treatment is to provide a safe and structured environment where patients can focus on their recovery and develop the skills they need to manage their condition and improve their overall quality of life.
Substance abuse treatment centers are healthcare facilities that provide a range of services for individuals struggling with substance use disorders (SUDs), including addiction to alcohol, illicit drugs, prescription medications, and other substances. These centers offer comprehensive, evidence-based assessments, interventions, and treatments aimed at helping patients achieve and maintain sobriety, improve their overall health and well-being, and reintegrate into society as productive members.
The medical definition of 'Substance Abuse Treatment Centers' encompasses various levels and types of care, such as:
1. **Medical Detoxification:** This is the first step in treating substance abuse, where patients are closely monitored and managed for withdrawal symptoms as their bodies clear the harmful substances. Medical detox often involves the use of medications to alleviate discomfort and ensure safety during the process.
2. **Inpatient/Residential Treatment:** This level of care provides 24-hour structured, intensive treatment in a controlled environment. Patients live at the facility and receive various therapeutic interventions, such as individual therapy, group counseling, family therapy, and psychoeducation, to address the underlying causes of their addiction and develop coping strategies for long-term recovery.
3. **Partial Hospitalization Programs (PHP):** Also known as day treatment, PHPs offer structured, intensive care for several hours a day while allowing patients to return home or to a sober living environment during non-treatment hours. This level of care typically includes individual and group therapy, skill-building activities, and case management services.
4. **Intensive Outpatient Programs (IOP):** IOPs provide flexible, less intensive treatment than PHPs, with patients attending sessions for a few hours per day, several days a week. These programs focus on relapse prevention, recovery skills, and addressing any co-occurring mental health conditions.
5. **Outpatient Treatment:** This is the least restrictive level of care, where patients attend individual or group therapy sessions on a regular basis while living at home or in a sober living environment. Outpatient treatment often serves as step-down care after completing higher levels of treatment or as an initial intervention for those with milder SUDs.
6. **Aftercare/Continuing Care:** Aftercare or continuing care services help patients maintain their recovery and prevent relapse by providing ongoing support, such as 12-step meetings, alumni groups, individual therapy, and case management.
Each treatment modality has its unique benefits and is tailored to meet the specific needs of individuals at various stages of addiction and recovery. It's essential to consult with a healthcare professional or an addiction specialist to determine the most appropriate level of care for each person's situation.
The United States Substance Abuse and Mental Health Services Administration (SAMHSA) is not a medical term per se, but it is a government agency that focuses on improving the mental health and substance abuse services in the United States. Here's a definition of SAMHSA from a reputable source:
According to the National Library of Medicine's MedlinePlus, SAMHSA is defined as:
> "An agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities."
SAMHSA provides leadership and resources to address issues related to mental health and substance use disorders, including prevention, treatment, and recovery services. The agency works to improve the quality and availability of such services, as well as to promote awareness and understanding of behavioral health issues in the United States.
I'm sorry for any confusion, but the term "United States Virgin Islands" is a geographical location and not a medical concept or condition. It refers to a group of islands in the Caribbean that are an insular area of the United States, consisting of the main islands of Saint Thomas, Saint John, and Saint Croix, as well as several smaller islands. They are known for their beautiful beaches, tropical climate, and rich history.
I'm sorry for any confusion, but "Micronesia" is not a medical term. It is a geographical term that refers to a group of islands in the Pacific Ocean, which includes countries such as the Federated States of Micronesia, Palau, and the Marshall Islands. If you have any questions about medical terms or concepts, I would be happy to help with those!
I'm sorry for any confusion, but "Palau" is not a medical term. It is the name of a country in the Western Pacific Ocean, consisting of around 340 islands. If you have any questions about medical terminology or health-related topics, please let me know and I would be happy to help.
Substance-related disorders, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), refer to a group of conditions caused by the use of substances such as alcohol, drugs, or medicines. These disorders are characterized by a problematic pattern of using a substance that leads to clinically significant impairment or distress. They can be divided into two main categories: substance use disorders and substance-induced disorders. Substance use disorders involve a pattern of compulsive use despite negative consequences, while substance-induced disorders include conditions such as intoxication, withdrawal, and substance/medication-induced mental disorders. The specific diagnosis depends on the type of substance involved, the patterns of use, and the presence or absence of physiological dependence.
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