Emergency Services, Psychiatric: Organized services to provide immediate psychiatric care to patients with acute psychological disturbances.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Emergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Emergencies: Situations or conditions requiring immediate intervention to avoid serious adverse results.Ambulances: A vehicle equipped for transporting patients in need of emergency care.Emergency Nursing: The specialty or practice of nursing in the care of patients admitted to the emergency department.Emergency Medicine: The branch of medicine concerned with the evaluation and initial treatment of urgent and emergent medical problems, such as those caused by accidents, trauma, sudden illness, poisoning, or disasters. Emergency medical care can be provided at the hospital or at sites outside the medical facility.Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured.Emergency Medical Technicians: Paramedical personnel trained to provide basic emergency care and life support under the supervision of physicians and/or nurses. These services may be carried out at the site of the emergency, in the ambulance, or in a health care institution.Crisis Intervention: Brief therapeutic approach which is ameliorative rather than curative of acute psychiatric emergencies. Used in contexts such as emergency rooms of psychiatric or general hospitals, or in the home or place of crisis occurrence, this treatment approach focuses on interpersonal and intrapsychic factors and environmental modification. (APA Thesaurus of Psychological Index Terms, 7th ed)Commitment of Mentally Ill: Legal process required for the institutionalization of a patient with severe mental problems.Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.AccidentsHospitals, County: Hospitals controlled by the county government.Emergency Medical Service Communication Systems: The use of communication systems, such as telecommunication, to transmit emergency information to appropriate providers of health services.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 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.Air Ambulances: Fixed-wing aircraft or helicopters equipped for air transport of patients.Hospitals, Psychiatric: Special hospitals which provide care to the mentally ill patient.Wounds and Injuries: Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.Utilization Review: An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.State Medicine: A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.After-Hours Care: Medical care provided after the regular practice schedule of the physicians. Usually it is designed to deliver 24-hour-a-day and 365-day-a-year patient care coverage for emergencies, triage, pediatric care, or hospice care.Patient Admission: The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.Mental Health Services: Organized services to provide mental health care.Great BritainRetrospective 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.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.EnglandUnited StatesHospitals, Teaching: Hospitals engaged in educational and research programs, as well as providing medical care to the patients.Hospitalization: The confinement of a patient in a hospital.FiresHospitals, General: Large hospitals with a resident medical staff which provides continuous care to maternity, surgical and medical patients.Health Services: Services for the diagnosis and treatment of disease and the maintenance of health.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Hospitals, University: Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.Hospitals, Urban: Hospitals located in metropolitan areas.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.Hospital Costs: The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).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)BrazilSpain: Parliamentary democracy located between France on the northeast and Portugual on the west and bordered by the Atlantic Ocean and the Mediterranean Sea.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.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.Family Planning Services: Health care programs or services designed to assist individuals in the planning of family size. Various methods of CONTRACEPTION can be used to control the number and timing of childbirths.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.Home Care Services: Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Hospitals, Pediatric: Special hospitals which provide care for ill children.Nursing Staff, Hospital: Personnel who provide nursing service to patients in a hospital.Hospitals, District: Government-controlled hospitals which represent the major health facility for a designated geographic area.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.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.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Hospitals, Special: Hospitals which provide care for a single category of illness with facilities and staff directed toward a specific service.Economics, Hospital: Economic aspects related to the management and operation of a hospital.Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Hospital Departments: Major administrative divisions of the hospital.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)Health Services for the Aged: Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.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.Length of Stay: The period of confinement of a patient to a hospital or other health facility.Child Health Services: Organized services to provide health care for children.Maternal Health Services: Organized services to provide health care to expectant and nursing mothers.Financial Management, Hospital: The obtaining and management of funds for hospital needs and responsibility for fiscal affairs.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Hospital Charges: The prices a hospital sets for its services. HOSPITAL COSTS (the direct and indirect expenses incurred by the hospital in providing the services) are one factor in the determination of hospital charges. Other factors may include, for example, profits, competition, and the necessity of recouping the costs of uncompensated care.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Patient Discharge: The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.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.Hospital Units: Those areas of the hospital organization not considered departments which provide specialized patient care. They include various hospital special care wards.Outpatient Clinics, Hospital: Organized services in a hospital which provide medical care on an outpatient basis.Equipment and Supplies, Hospital: Any materials used in providing care specifically in the hospital.Community Mental Health Services: Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Surgery Department, Hospital: Hospital department which administers all departmental functions and the provision of surgical diagnostic and therapeutic services.Contract Services: Outside services provided to an institution under a formal financial agreement.Hospital Records: Compilations of data on hospital activities and programs; excludes patient medical records.Transportation of Patients: Conveying ill or injured individuals from one place to another.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Infant, Newborn: An infant during the first month after birth.Libraries, Hospital: Information centers primarily serving the needs of hospital medical staff and sometimes also providing patient education and other services.Library Services: Services offered to the library user. They include reference and circulation.Diagnostic Services: Organized services for the purpose of providing diagnosis to promote and maintain health.Nursing Services: A general concept referring to the organization and administration of nursing activities.LondonPatient 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.Hospital Bed Capacity, 500 and overAdolescent Health Services: Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.Health Services Misuse: Excessive, under or unnecessary utilization of health services by patients or physicians.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.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).Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Disaster Planning: Procedures outlined for the care of casualties and the maintenance of services in disasters.Health Services Administration: The organization and administration of health services dedicated to the delivery of health care.Food Service, Hospital: Hospital department that manages and supervises the dietary program in accordance with the patients' requirements.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.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.Contraceptives, Postcoital: Contraceptive substances to be used after COITUS. These agents include high doses of estrogenic drugs; progesterone-receptor blockers; ANTIMETABOLITES; ALKALOIDS, and PROSTAGLANDINS.Contraception, Postcoital: Means of postcoital intervention to avoid pregnancy, such as the administration of POSTCOITAL CONTRACEPTIVES to prevent FERTILIZATION of an egg or implantation of a fertilized egg (OVUM IMPLANTATION).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.Nursing Service, Hospital: The hospital department which is responsible for the organization and administration of nursing activities.Cardiology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cardiac patient.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.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.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.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.Obstetrics and Gynecology Department, Hospital: Hospital department responsible for the administration and management of services provided for obstetric and gynecologic patients.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.Patient Readmission: Subsequent admissions of a patient to a hospital or other health care institution for treatment.Catchment Area (Health): A geographic area defined and served by a health program or institution.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)Women's Health Services: Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.Laboratories, Hospital: Hospital facilities equipped to carry out investigative procedures.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.Hospital Information Systems: Integrated, computer-assisted systems designed to store, manipulate, and retrieve information concerned with the administrative and clinical aspects of providing medical services within the hospital.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.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.Acute Disease: Disease having a short and relatively severe course.Hospitals, Religious: Private hospitals that are owned or sponsored by religious organizations.Hospitals, Municipal: Hospitals controlled by the city government.American Hospital Association: A professional society in the United States whose membership is composed of hospitals.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.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)Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.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.Dental Health Services: Services designed to promote, maintain, or restore dental health.Genetic Services: Organized services to provide diagnosis, treatment, and prevention of genetic disorders.Hospital Shared Services: Cooperation among hospitals for the purpose of sharing various departmental services, e.g., pharmacy, laundry, data processing, etc.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.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.ScotlandBed Occupancy: A measure of inpatient health facility use based upon the average number or proportion of beds occupied for a given period of time.Cross Infection: Any infection which a patient contracts in a health-care institution.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Medical Audit: A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.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.CaliforniaCost-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.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.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.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Psychiatric Department, Hospital: Hospital department responsible for the organization and administration of psychiatric services.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.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.Hospitals, Maternity: Special hospitals which provide care to women during pregnancy and parturition.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)Continuity of Patient Care: Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.Oncology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cancer patient.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.Physicians: Individuals licensed to practice medicine.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.Medical Records: Recording of pertinent information concerning patient's illness or illnesses.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Health Services, Indigenous: Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.Ambulatory Care Facilities: Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.Evidence-Based Emergency Medicine: A way of providing emergency medical care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise in EMERGENCY MEDICINE. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement.Surgical Procedures, Operative: Operations carried out for the correction of deformities and defects, repair of injuries, and diagnosis and cure of certain diseases. (Taber, 18th ed.)Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies.Hospital Bed Capacity, under 100Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Occupational Health Services: Health services for employees, usually provided by the employer at the place of work.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.Personnel Staffing and Scheduling: The selection, appointing, and scheduling of personnel.Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.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)Hospitals, Veterans: Hospitals providing medical care to veterans of wars.Medical Staff, Hospital: Professional medical personnel approved to provide care to patients in a hospital.Workload: The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.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 Distribution: The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Heart Arrest: Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.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)Hospitals, Military: Hospitals which provide care for the military personnel and usually for their dependents.Dental Service, Hospital: Hospital department providing dental care.Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.Fees and Charges: Amounts charged to the patient as payer for health care services.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.Personal Health Services: Health care provided to individuals.Ontario: A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)Ancillary Services, Hospital: Those support services other than room, board, and medical and nursing services that are provided to hospital patients in the course of care. They include such services as laboratory, radiology, pharmacy, and physical therapy services.Emergency Responders: Personnel trained to provide the initial services, care, and support in EMERGENCIES or DISASTERS.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.Home Care Services, Hospital-Based: Hospital-sponsored provision of health services, such as nursing, therapy, and health-related homemaker or social services, in the patient's home. (Hospital Administration Terminology, 2d ed)Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE.Specialization: An occupation limited in scope to a subsection of a broader field.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.Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.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.

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Do you know where to turn during a pet emergency? Did you know that because we are AAHA accredited, we offer emergency services ... Blue Pearl Emergency Vet Clinic (formerly - VSEC). 11950 West 110. St.. Overland Park, KS 66210. (1/2 block west of Quivira ... However, if it is after our usual business hours, please call one of the below services.. VCA (formerly - Mission MedVet) 5914 ... Animal Emergency Clinic. 8141 N. Oak Trafficway. North Kansas City, MO 64118. 816-455-5430 ...
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*  Emergency Medical Services (EMS) - South Shore Hospital, South Weymouth - Boston, Massachusetts (MA)
... and support staff who are expert in emergency care and treatment. ... and support staff who are expert in emergency care and treatment. ... South Shore Hospital's Emergency Center is staffed 24 hours a day with emergency medical physicians, nurses, physician ... South Shore Hospital's Emergency Center is staffed 24 hours a day with emergency medical physicians, nurses, physician ...
  https://www.southshorehospital.org/emergency-medical-services-ems
*  Petition · Re-instate and continue to maintain 24/7 emergency surgery services at Caithness General Hospital Wick · Change.org
Re-instate and continue to maintain 24/7 emergency surgery services at Caithness General Hospital Wick. Carol Mckie Thurso, ... Shona Robison: Re-instate and continue to maintain 24/7 emergency surgery services at Caithness General Hospital Wick ... Re-instate and continue to maintain 24/7 emergency surgery services at Caithness General Hospital Wick ... Re-instate and maintain 24/7 emergency surgery services at Caithness General Hospital Wick ...
  https://www.change.org/p/shona-robison-re-instate-and-continue-to-maintain-24-7-emergency-surgery-services-at-caithness-general-hospital-wick
*  Hospital Revamping Department Changes Aim To Improve Emergency Services - tribunedigital-orlandosentinel
The emergency department at Munroe Regional Medical Center is undergoing some major changes to meet patient needs and compete ... with quick treatment offered at emergency care clinics.Most of the ... service 24-hour emergency department, LaGrone said.. Hospital officials hope to improve convenience and comfort of emergency ... Hospital Revamping Department Changes Aim To Improve Emergency Services. October 1, 1985,By Adam Yeomans of The Sentinel Staff ...
  http://articles.orlandosentinel.com/1985-10-01/news/0330260044_1_emergency-department-department-physicians-emergency-patients
*  Emergency Medical Services (EMS) - Meadowlands Hospital Medical Center (MHMC)
... provides 24-hour emergency care and transportation in Secaucus and the surrounding Hudson county region. Our fast, reliable and ... Emergency Medical Services (EMS) For medical emergencies, call 911 immediately. The Emergency Medical Services (EMS) of MHMC ... Meadowlands Hospital Medical Center's Emergency Medical Services (EMS) provides 24-hour emergency care and transportation in ... I will always go to Meadowlands Hospital. I was treated like a queen!". - Barbara D., Meadowlands Hospital Ambulatory Services ...
  https://meadowlandshospital.org/emergency-room/emergency-medical-services-ems
*  Meeting 4: Future of Emergency Care in the United States Health System Subcommittee on Hospital-Based Emergency Care Services ...
... Meeting 4: Future of Emergency Care in the United States Health System Subcommittee on Hospital-Based Emergency Care Services. ... Board on Health Care Services. This meeting was a closed session. The committee reviewed the progress of their reports, raised ... The Future of Emergency Care in the United States Health System. Board:. ...
  http://nationalacademies.org/hmd/Activities/Quality/emergencycare/2005-JUN-23.aspx
*  Animal Referral Hospital & Emergency Services In 5 Locations
Emergency. Call or drop in - we'll fit you in. *Love your Pet. So do we! They'll live longer, happier & healthier with expert ... Welcome to the Animal Referral Hospital. 7 Ways We Make Owning Your Pet A Breeze. *Quick Question. Call our friendly staff for ... Our nursing staff are dedicated to the care and well-being of pets in the hospital. Our staff are all devoted pet owners ... The Animal Referral Hospital is a veterinary pet industry leader, running regular workshops and seminars to provide continuing ...
  http://arhvets.com
*  Emergency Services | Fairfield Memorial Hospital
Everyone who presents to the Emergency Department has an emergency; however, our Emergency Department Staff do their best to ... Social Service staff is available to the Emergency Department when needed. FMH is also the training center for area ambulance ... 2018 Fairfield Memorial Hospital - Excellence in Community Healthcare. Fairfield Memorial Hospital , 303 N. W. 11th St. , ... Can we make your Emergency Room Experience Better? Your Emergency Department Staff during your visit are identified by name at ...
  http://fairfieldmemorial.org/content/emergency-services
*  Abstract 13823: Use of Emergency Medical Services Expedites In-Hospital Care Processes in Patients Presenting With ST-Segment...
Abstract 13823: Use of Emergency Medical Services Expedites In-Hospital Care Processes in Patients Presenting With ST-Segment ... Abstract 13823: Use of Emergency Medical Services Expedites In-Hospital Care Processes in Patients Presenting With ST-Segment ... Abstract 13823: Use of Emergency Medical Services Expedites In-Hospital Care Processes in Patients Presenting With ST-Segment ... Abstract 13823: Use of Emergency Medical Services Expedites In-Hospital Care Processes in Patients Presenting With ST-Segment ...
  http://circ.ahajournals.org/content/128/Suppl_22/A13823
*  Emergency Services | Ohio County Hospital
The Emergency Department provides emergency care to all patients, regardless of their ability to pay. A physician oversees the ... For more information, contact Travis Howard, RN, Director of Clinical Services, at 270-298-5452. ... Emergency Department twenty-four hours a day, working with a team of highly trained healthcare professionals and a wide range ...
  http://ohiocountyhospital.com/?q=emergency-services
*  Box Butte General Hospital : Services : Medical Services : Emergency Department
Box Butte General Hospital is an equal opportunity provider and employer.. Privacy Policy *What Information Do We Collect?. ... providing service and support and making available other products and services to our customers and prospective customers. ... Notice of New Services and Changes. Occasionally, we may use the information we collect to notify you about important changes ... Occasionally, we may also use the information we collect to notify you about important changes to our website, new services and ...
  http://www.bbgh.org/services/medical-services/emergency-department.html/title/mark-chu-m-d-
*  Emergency Medical Service Dispatch Cardiopulmonary Resuscitation Prearrival Instructions to Improve Survival From Out-of...
Medical Service Dispatch Cardiopulmonary Resuscitation Prearrival Instructions to Improve Survival From Out-of-Hospital Cardiac ... Emergency Medical Service Dispatch Cardiopulmonary Resuscitation Prearrival Instructions to Improve Survival From Out-of- ... Emergency Medical Service Dispatch Cardiopulmonary Resuscitation Prearrival Instructions to Improve Survival From Out-of- ... Emergency Medical Service Dispatch Cardiopulmonary Resuscitation Prearrival Instructions to Improve Survival From Out-of- ...
  http://circ.ahajournals.org/content/early/2012/01/09/CIR.0b013e31823ee5fc
*  CLINICAL NURSE II - EMERGENCY SERVICES - ST. JOSEPH'S HOSPITAL SOUTH job with BayCare Health System | 2069636
JOSEPH'S HOSPITAL SOUTH in Emergency Department with BayCare Health System. Apply Today. ... BayCare Health System currently consists of 14 community-based hospitals, a long-term acute care facility, home health services ...
  https://www.nurse.com/jobs/job/2069636/clinical-nurse-ii-emergency-services-st-joseph-s-hospital-south/
*  Central Carolina Hospital Announces Fast Track Emergency Services | Central Carolina
Central Carolina Hospital Announces Fast Track Emergency Services. December 22, 2016. Central Carolina Hospital opened its new ... About Central Carolina Hospital. Central Carolina Hospital, a DukeLifepoint Hospital, is a 137-bed acute care hospital that ... Hospital services include emergency room, physical and occupational therapy, ophthalmology, cardiac rehabilitation, diagnostic ... John Maxwell, the hospital's CEO, said the emergency department Fast Track -- which is the first step in a long-term expansion ...
  http://centralcarolinahosp.com/hospital-news/central-carolina-hospital-announces-fast-track-emergency-services
*  Sree Chithra Ayur Home Thrissur Domestic, Household, Hospital & Emergency Services
Suppliers Manufacturers Wholesalers of Ayurvedic Massage Services Domestic, Household, Hospital & Emergency Services ... Ayurvedic Massage Services. Medical Assistance Services. Naturopathy, Herbal, Accu-pressure & Ayurvedic Services. ... Ayurvedic Massage Services. We are engage in offering services like beauty salon, beauty training services, body care lotion, ... Ayurvedic Massage Services. We are engage in offering services like ayurvedic panchkarma, ayurvedic skin care services, ...
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*  Emergency Services Toy Hospital - Early Years (EYFS) - Page 1
Professional Emergency Services teaching resources for Early Years pupils - download in seconds! ... high quality printable Toy Hospital teaching resources - created for teachers, by teachers! ... Back to: Emergency Services Toy Hospital. Upgrade to Classic to download all of these resources! ... 3D Hospital Paper Model Activity. Get creative with this fantastic paper craft 3D Hospital, simply cut and fold to create a ...
  https://www.twinkl.co.uk/resources/early-years-role-play-area-role-play-display-packs/early-years-role-play-area-role-play-display-packs-emergency-services-role-play/toy-hospital-emergency-services-role-play-display-packs-role-play-area-classroom-areas-classroom-signs-and-labels-early-years
*  Director of Emergency Services - Heart Hospital of Austin - Austin, TX | LocalJobs.com
No Weekends The Director of Emergency Services Department assures service, growth, development, personnel management, and... ... The Director of Emergency Services Department assures service, growth, development, personnel management, and resource ... and evaluates an ongoing emergency services program which assures quality patient care consistent with the Hospital mission.. ... 3+ years of experience in emergency services Required. • 3+ years of experience in a leadership role Preferred. o r equivalent ...
  https://www.localjobs.com/job/121856/director-of-emergency-services-heart-hospital-of-austin-austin-tx/

Emergency psychiatrySenior Emergency Department: The senior emergency department is a recent hospital innovation to build separate geriatric emergency rooms for older adults akin to pediatric emergency rooms designed for children. The trend comes in response to the nation's rapidly growing population of older adults and overcrowding of emergency departments.Paramedic: A paramedic is a healthcare professional, predominantly in the pre-hospital and out-of-hospital environment, and working mainly as part of emergency medical services (EMS), such as on an ambulance.Emergency: An emergency is a situation that poses an immediate risk to health, life, property, or environment. Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and agencies may only be able to offer palliative care for the aftermath.Great Western Ambulance Service: The Great Western Ambulance Service NHS Trust (GWAS) was a UK National Health Service (NHS) trust providing emergency and nonemergency patient transport services to Bath and North East Somerset, Bristol, Gloucestershire, North Somerset, Swindon and Wiltshire in the South West England region. It was formed on 1 April 2006, from the merger of the Avon, Gloucestershire and Wiltshire ambulance services.List of emergency medicine courses: This list of emergency medicine courses contains programs often required to be taken by emergency medical providers, including emergency medical technicians, paramedics, and emergency physicians.List of EMS provider credentials: An EMS provider's post-nominal (listed after the name) credentials usually follow his or her name in this order:Ontario Correctional ServicesInvoluntary commitment: Involuntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a psychiatric hospital (inpatient) or in the community (outpatient).Computer-aided simple triage: Computer-Aided Simple Triage (CAST) are computerized methods or systems that assist physicians in initial interpretation and classification of medical images. CAST is a sub-class of Computer-Aided Diagnosis (CAD).List of film accidents: This is intended to be a list of notable accidents which occurred during the shooting of films and television, such as cast or crew fatalities or serious accidents which plagued production. It is not intended to be a list of every minor injury an actor or stuntman suffered during filming.Middlesex County Hospital: Middlesex County Hospital was a hospital operated by Middlesex County which was operational from the 1930s until 2001 in Waltham and Lexington, Massachusetts. Originally opened as a tuberculosis hospital, the hospital eventually became the county hospital for Middlesex until its closure in 2001.Advanced Medical Priority Dispatch SystemChildren's Air AmbulanceTwo Rivers Psychiatric Hospital: Two Rivers Behavioral Health System is a psychiatric hospital located in Kansas City, Missouri.National Center for Injury Prevention and Control: The U.S.National Collaborating Centre for Mental Health: The National Collaborating Centre for Mental Health (NCCMH) is one of several centres of the National Institute for Health and Care Excellence (NICE) tasked with developing guidance on the appropriate treatment and care of people with specific conditions within the National Health Service (NHS) in England and Wales. It was established in 2001.National Cancer Research Institute: The National Cancer Research Institute (NCRI) is a UK-wide partnership between cancer research funders, which promotes collaboration in cancer research. Its member organizations work together to maximize the value and benefit of cancer research for the benefit of patients and the public.Referral (medicine): In medicine, referral is the transfer of care for a patient from one clinician to another.García Olmos L, Gervas Camacho J, Otero A, Pérez Fernández M.Red Moss, Greater Manchester: Red Moss is a wetland mossland in Greater Manchester, located south of Horwich and east of Blackrod. (Grid Reference ).List of Parliamentary constituencies in Kent: The ceremonial county of Kent,National Fire Academy: The National Fire Academy (NFA)National Fire Academy Mission Accessed: 6/12/2012 is one of two schools in the United States operated by the Federal Emergency Management Agency (FEMA) at the National Emergency Training Center (NETC) in Emmitsburg, Maryland. Operated and governed by the United States Fire Administration (USFA) as part of the U.Wansbeck General Hospital: Wansbeck General Hospital is a district general hospital based in Ashington, Northumberland. It is one of two "low energy" built hospitals in the United Kingdom, and is the most northerly General hospital in England.Temporal analysis of products: Temporal Analysis of Products (TAP), (TAP-2), (TAP-3) is an experimental technique for studyingSoonchunhyang University Hospital: Soonchunhyang University Hospital is a hospital in Bucheon, South Korea. It is affiliated with Soonchunhyang University.Mental disorderUniversity of CampinasList of lighthouses in Spain: This is a list of lighthouses in Spain.Closed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Akron Children's Hospital: The Akron Children's Hospital is a children's hospital located in Akron, Ohio.Thayet District: Thayet District (; also Thayetmyo District) is a district of the Magway Division in central Burma (Myanmar)."Burma: Second-Order Administrative Divisions (Districts)" The Permanent Committee of Geographic Names (PCGN), United Kingdom, from Internet Archive of 25 September 2007 The administrative centre is the town of Thayetmyo.Comprehensive Rural Health Project: The Comprehensive Rural Health Project (CRHP) is a non profit, non-governmental organization located in Jamkhed, Ahmednagar District in the state of Maharashtra, India. The organization works with rural communities to provide community-based primary healthcare and improve the general standard of living through a variety of community-led development programs, including Women's Self-Help Groups, Farmers' Clubs, Adolescent Programs and Sanitation and Watershed Development Programs.Royal National Orthopaedic Hospital: The Royal National Orthopaedic Hospital (informally the RNOH) is a specialist orthopaedic hospital located in Greater London, United Kingdom and a part of Royal National Orthopaedic Hospital NHS Trust. It provides the most comprehensive range of neuro-musculoskeletal health care in the UK, including acute spinal injury, complex bone tumour treatment, orthopaedic medicine and specialist rehabilitation for chronic back pain.Society for Education Action and Research in Community Health: Searching}}Jessie McPherson Private HospitalU.S.C. Institute of Safety and Systems Management: == History ==Maternal Health Task ForceList of SEPTA Trolley and Interurban stations: The Southeastern Pennsylvania Transportation Authority contains more than several trolley lines and one interurban line; These include five Subway–Surface Trolley Lines, and one Heritage trolley (Route 15), all of which were inherited from the former Philadelphia Transportation Company, and originally built by the Philadelphia Rapid Transit Company. Both systems are officially part of the City Transit Division.Community mental health service: Community mental health services (CMHS), also known as Community Mental Health Teams (CMHT) in the United Kingdom, support or treat people with mental disorders (mental illness or mental health difficulties) in a domiciliary setting, instead of a psychiatric hospital (asylum). The array of community mental health services vary depending on the country in which the services are provided.Global Health Delivery ProjectEphraim McDowell Regional Medical CenterRoyal London Hospital for Integrated MedicineQRISK: QRISK2 (the most recent version of QRISK) is a prediction algorithm for cardiovascular disease (CVD) that uses traditional risk factors (age, systolic blood pressure, smoking status and ratio of total serum cholesterol to high-density lipoprotein cholesterol) together with body mass index, ethnicity, measures of deprivation, family history, chronic kidney disease, rheumatoid arthritis, atrial fibrillation, diabetes mellitus, and antihypertensive treatment.Pavement life-cycle cost analysis: In September 1998, the United States Department of Transportation (DoT) introduced risk analysis, a probabilistic approach to account for the uncertainty of the inputs of the cost/benefit evaluation of pavement projects, into its decision-making policies. The traditional (deterministic) approach did not consider the variability of inputs.Strategic National Stockpile: The Strategic National Stockpile (SNS) is the United States' national repository of antibiotics, vaccines, chemical antidotes, antitoxins, and other critical medical equipment and supplies. In the event of a national emergency involving bioterrorism or a natural pandemic, the SNS has the capability to supplement and re-supply local health authorities that may be overwhelmed by the crisis, with response time as little as 12 hours.Kitchen: A kitchen is a room or part of a room used for cooking and food preparation in a dwelling or in a commercial establishment. In the West, a modern residential kitchen is typically equipped with a stove, a sink with hot and cold running water, a refrigerator, counters and kitchen cabinets arranged according to a modular design.Therapy cap: In 1997 the Balanced Budget Act established annual per-beneficiary Medicare spending limits, or therapy cap, for outpatient therapy services covered under Medicare Part B. Medicare Provisions in Balanced Budget Act of 1997.Hospital-acquired condition: A hospital-acquired condition (HAC) is an undesirable situation or condition that affects a patient and that arose during a stay in a hospital or medical facility. It is a designation used by Medicare/Medicaid in the US for determining MS-DRG reimbursement beginning with version 26 (October 1, 2008).

(1/4877) Patterns of local and tourist use of an emergency department.

Illness patterns of local and tourist patients in an emergency department of a medium-sized Ontario city with a single hospital were compared. Frequencies of specific and broad categories of ailments and rates of admission to the hospital were similar in the two groups. However, non-Canadian tourists were admitted to hospital at a much lower rate than Canadian tourists. Rates of visits to the emergency department within certain age categories were remarkably similar, as were rates within the sexes. It is concluded that, in view of the striking similarity in the illness pattern of a group of patients not professionally referred to the hospital and that of local patients, who have potential contact with a more extensive medical network, public attitudes, rather than availability of health professionals, determine the pattern of illness observed in an emergency department.  (+info)

(2/4877) Asthma visits to emergency rooms and soybean unloading in the harbors of Valencia and A Coruna, Spain.

Soybean unloading in the harbor of Barcelona, Spain, has been associated with large increases in the numbers of asthma patients treated in emergency departments between 1981 and 1987. In this study, the association between asthma and soybean unloading in two other Spanish cities, Valencia and A Coruna, was assessed. Asthma admissions were retrospectively identified for the period 1993-1995, and harbor activities were investigated in each location. Two approaches were used to assess the association between asthma and soybean unloading: One used unusual asthma days (days with an unusually high number of emergency room asthma visits) as an effect measure, and the other estimated the relative increase in the daily number of emergency room visits by autoregressive Poisson regression, adjusted for meteorologic variables, seasonality, and influenza incidence. No association between unusual asthma days and soya unloading was observed in either Valencia or A Coruna, except for one particular dock in Valencia. When the association between unloaded products and the daily number of emergency asthma visits was studied, a statistically significant association was observed for unloading of soya husk (relative risk = 1.50, 95% confidence interval 1.16-1.94) and soybeans (relative risk = 1.31, 95% confidence interval 1.08-1.59) in A Coruna. In Valencia, a statistical association was found only for the unloading of soybeans at two particular docks. Although these findings support the notion that asthma outbreaks are not a common hidden condition in most harbors where soybeans are unloaded, the weak associations reported are likely to be causal. Therefore, appropriate control measures should be implemented to avoid soybean dust emissions, particularly in harbors with populations living in the vicinity.  (+info)

(3/4877) Short-term associations between outdoor air pollution and visits to accident and emergency departments in London for respiratory complaints.

Many epidemiological studies have shown positive short-term associations between health and current levels of outdoor air pollution. The aim of this study was to investigate the association between air pollution and the number of visits to accident and emergency (A&E) departments in London for respiratory complaints. A&E visits include the less severe cases of acute respiratory disease and are unrestricted by bed availability. Daily counts of visits to 12 London A&E departments for asthma, other respiratory complaints, and both combined for a number of age groups were constructed from manual registers of visits for the period 1992-1994. A Poisson regression allowing for seasonal patterns, meteorological conditions and influenza epidemics was used to assess the associations between the number of visits and six pollutants: nitrogen dioxide, ozone, sulphur dioxide, carbon monoxide, and particles measured as black smoke (BS) and particles with a median aerodynamic diameter of <10 microm (PM10). After making an allowance for the multiplicity of tests, there remained strong associations between visits for all respiratory complaints and increases in SO2: a 2.8% (95% confidence interval (CI) 0.7-4.9) increase in the number of visits for a 18 microg x (-3) increase (10th-90th percentile range) and a 3.0% (95% CI 0.8-5.2) increase for a 31 microg x m(-3) increase in PM10. There were also significant associations between visits for asthma and SO2, NO2 and PM10. No significant associations between O3 and any of the respiratory complaints investigated were found. Because of the strong correlation between pollutants, it was difficult to identify a single pollutant responsible for the associations found in the analyses. This study suggests that the levels of air pollution currently experienced in London are linked to short-term increases in the number of people visiting accident and emergency departments with respiratory complaints.  (+info)

(4/4877) Drug problems dealt with by 62 London casualty departments. A preliminary report.

A study of the whole spectrum of drug incidents dealt with in one month by 62 casualty departments in the Greater London area was carried out in the summer of 1975. Apart from demonstrating the large number of such incidents, this preliminary report presents an analysis of the drugs responsible for these episodes, basic demographic characteristics of the drug users, and an estimate of the contribution of drug dependence.  (+info)

(5/4877) Audit of thrombolysis initiated in an accident and emergency department.

Early thrombolytic therapy after acute myocardial infarction is important in reducing mortality. To evaluate a system for reducing in-hospital delays to thrombolysis pain to needle and door to needle times to thrombolysis were audited in a major accident and emergency (A and E) department of a district general hospital and its coronary care unit (CCU), situated about 5 km away. Baseline performance over six months was assessed retrospectively from notes of 43 consecutive patients (group 1) transferred to the CCU before receiving thrombolysis. Subsequently, selected patients (23) were allowed to receive thrombolysis in the A and E department before transfer to the CCU. The agent was administered by medical staff in the department after receiving oral confirmation of myocardial infarction from the admitting medical officer in the CCU on receipt of fax transmission of the electrocardiogram. A second prospective audit during six months from the start of the new procedure established time intervals in 23 patients eligible to receive thrombolysis in the A and E department (group 2b) and 30 ineligible patients who received thrombolysis in the CCU (group 2a). The groups did not differ significantly in case mix, pre-hospital delay, or transfer time to the CCU. In group 2b door to needle time and pain to needle time were reduced significantly (geometric mean 38 min v 121 min (group 2a) and 128 min (group 1); 141 min v 237 min (group 2a) and 242 min (group 1) respectively, both p < 0.0001). The incidence of adverse effects was not significantly different. Nine deaths occurred (six in group 1, three in group 2b), an in-hospital mortality of 9.9%. Thrombolysis can be safely instituted in the A and E department in selected patients, significantly reducing delay to treatment.  (+info)

(6/4877) Use of an east end children's accident and emergency department for infants: a failure of primary health care?

OBJECTIVE: To ascertain why parents use an accident and emergency department for health care for their infants. DESIGN: Prospective one month study. SETTING: One accident and emergency department of a children's hospital in the east end of London. SUBJECTS: Parents of 159 infants aged < 9 months attending as self referrals (excluding infants attending previously or inpatients within one month, parents advised by the hospital to attend if concerned about their child's health, infants born abroad and arrived in Britain within the previous month). MAIN MEASURES: Details of birth, postnatal hospital stay, contact with health professionals, perceptions of roles of community midwife and health visitor, and current attendance obtained from a semistructured questionnaire administered in the department by a research health visitor; diagnosis, discharge, and follow up. RESULTS: 152(96%) parents were interviewed, 43(28%) of whom were single parent and 68(45%) first time mothers. Presenting symptoms included diarrhoea or vomiting, or both (34, 22%), crying (21, 14%), and feeding difficulties (10, 7%). Respiratory or gastrointestinal infection was diagnosed in 70(46%) infants. Only 17(11%) infants were admitted; hospital follow up was arranged for 27(20%) infants not admitted. Most (141, 94%) parents were registered with a general practitioner; 146(27%) had contact with the community midwife and 135(89%) the health visitor. CONCLUSION: Most attendances were for problems more appropriately dealt with by primary care professionals owing to patients' perceptions of hospital and primary health care services. IMPLICATIONS: Closer cooperation within the health service is needed to provide a service responsive to the real needs of patients.  (+info)

(7/4877) Effect of guidelines on management of head injury on record keeping and decision making in accident and emergency departments.

OBJECTIVE: To compare record keeping and decision making in accident and emergency departments before and after distribution of guidelines on head injury management as indices of implementation. DESIGN: Before (1987) and after (1990) study of accident and emergency medical records. SETTING: Two accident and emergency departments in England. PATIENTS: 1144 adult patients with head injury in department 1 (533 in 1987, 613 in 1990) and 734 in department 2 (370, 364 respectively). MAIN MEASURES: Recording of relevant symptoms and signs as determined in the guidelines; presence of, indications for, and rates and appropriateness of skull x ray examination and admission. RESULTS: The median number of guidelines variables recorded for all study periods ranged from 7 to 9 out of a possible maximum of 27. For key decision making variables the presence or absence of penetrating injury was least likely to be recorded (< or = 1%) and that of loss of consciousness most likely (> or = 75%). Altogether, the proportion of patients receiving skull x ray examination or admitted varied from 25%-60% and 7%-23% respectively; overall, 69% (1280/1856) and 64% (1177/1851) of patients were managed appropriately. However, no consistent change occurred in the departments between the study periods. For instance, in department 1 the proportion of appropriate x ray examinations rose significantly after distribution of the guidelines (from 61% (202/330) to 73% (305/417)) and appropriate decisions on whether to x ray or not also rose (from 65% (340/522) to 72% (435/608)). There was no significant change in department 2, although the proportion of appropriate admissions fell (from 33% (55/166) to 15% (19/130)). CONCLUSIONS: Recording practice and decision making were variable and had not consistently improved after dissemination of the guidelines. Strategies are required to ensure effective implementation of guidelines.  (+info)

(8/4877) Ethnicity, nationality and health care accessibility in Kuwait: a study of hospital emergency room users.

In mid-1994, non-Kuwaiti expatriates constituted 61.7% of the total population of Kuwait (1.75 million). Despite this numerical majority, non-Kuwaitis exist as a social minority. Non-Kuwaitis may be grouped into three broad categories along ethnic/nationality lines into Bidoon (without nationality), Arabs, and Asians. The objective of this paper was to compare the relative accessibility of the various groups to health care services in Kuwait. The study is based on data collected as part of a survey of 2184 Emergency Room (ER) users in January-February 1993. All patients attending the hospital ERs between 7:30 am and 9:00 pm were interviewed about their reasons for coming to the ER instead of going to the primary health care (PHC) centres, as required. The major reason given was low accessibility of the PHCs. Compared to Kuwaiti nationals, 92% of whom were registered at the PHC centres, only 62% of the Arabs and 39% of the Asians were registered. Multiple logistic regression of the factors in registration indicated that nationality was the most important reason for lack of registration, with Asians only about one-quarter as likely to be registered as Kuwaitis. Also, people who had been in Kuwait for shorter durations (< 5 years) were less likely to be registered than the Kuwaiti nationals or expatriates who had been here for 10 years or longer. In the absence of registration at the PHC centre, the civil identification card (ID) may be used as a valid means to enter the health system. Among the Arabs and Asians, 22% and 29% did not have a civil ID card. Thus, for many expatriates, the hospital ER, which does not provide the necessary follow-up care is often the only source of health care available.  (+info)