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)Research Personnel: Those individuals engaged in research.Health Services: Services for the diagnosis and treatment of disease and the maintenance of health.Mental Health Services: Organized services to provide mental health care.Research Support as Topic: Financial support of research activities.United StatesHealth 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.Social Sciences: Disciplines concerned with the interrelationships of individuals in a social environment including social organizations and institutions. Includes Sociology and Anthropology.United States Department of Veterans Affairs: A cabinet department in the Executive Branch of the United States Government concerned with overall planning, promoting, and administering programs pertaining to VETERANS. It was established March 15, 1989 as a Cabinet-level position.Research: Critical and exhaustive investigation or experimentation, having for its aim the discovery of new facts and their correct interpretation, the revision of accepted conclusions, theories, or laws in the light of newly discovered facts, or the practical application of such new or revised conclusions, theories, or laws. (Webster, 3d ed)Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Ethnology: The comparative and theoretical study of culture, often synonymous with cultural anthropology.Decision Making, Organizational: The process by which decisions are made in an institution or other organization.Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.Politics: Activities concerned with governmental policies, functions, etc.United States Agency for Healthcare Research and Quality: An agency of the PUBLIC HEALTH SERVICE established in 1990 to "provide indexing, abstracting, translating, publishing, and other services leading to a more effective and timely dissemination of information on research, demonstration projects, and evaluations with respect to health care to public and private entities and individuals engaged in the improvement of health care delivery..." It supersedes the National Center for Health Services Research. The United States Agency for Health Care Policy and Research was renamed Agency for Healthcare Research and Quality (AHRQ) under the Healthcare Research and Quality Act of 1999.Interinstitutional Relations: The interactions between representatives of institutions, agencies, or organizations.Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly.Health Services for the Aged: Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.Administrative Personnel: Individuals responsible for the development of policy and supervision of the execution of plans and functional operations.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.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.Hospitals, Veterans: Hospitals providing medical care to veterans of wars.Directories as Topic: Lists of persons or organizations, systematically arranged, usually in alphabetic or classed order, giving address, affiliations, etc., for individuals, and giving address, officers, functions, and similar data for organizations. (ALA Glossary of Library and Information Science, 1983)Ethics Committees, Research: Hospital or other institutional committees established to protect the welfare of research subjects. Federal regulations (the "Common Rule" (45 CFR 46)) mandate the use of these committees to monitor federally-funded biomedical and behavioral research involving human subjects.Evidence-Based Medicine: An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Great BritainChild Health Services: Organized services to provide health care for children.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)Medical Informatics: The field of information science concerned with the analysis and dissemination of medical data through the application of computers to various aspects of health care and medicine.Diffusion of Innovation: The broad dissemination of new ideas, procedures, techniques, materials, and devices and the degree to which these are accepted and used.Cooperative Behavior: The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)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)Community Mental Health Services: Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.Catchment Area (Health): A geographic area defined and served by a health program or institution.Comparative Effectiveness Research: Conduct and synthesis of systematic research comparing interventions and strategies to prevent, diagnose, treat, and monitor health conditions. The purpose of this research is to inform patients, providers, and decision-makers, responding to their expressed needs, about which interventions are most effective for which patients under specific circumstances. ( accessed 6/12/2009)Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.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.Clinical Coding: Process of substituting a symbol or code for a term such as a diagnosis or procedure. (from Slee's Health Care Terms, 3d ed.)Interdisciplinary Communication: Communication, in the sense of cross-fertilization of ideas, involving two or more academic disciplines (such as the disciplines that comprise the cross-disciplinary field of bioethics, including the health and biological sciences, the humanities, and the social sciences and law). Also includes problems in communication stemming from differences in patterns of language usage in different academic or medical disciplines.Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Health Maintenance Organizations: Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)Nursing Research: Research carried out by nurses, generally in clinical settings, in the areas of clinical practice, evaluation, nursing education, nursing administration, and methodology.Confidentiality: The privacy of information and its protection against unauthorized disclosure.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.Databases, Factual: Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.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).Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Guidelines as Topic: A systematic statement of policy rules or principles. Guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by convening expert panels. The text may be cursive or in outline form but is generally a comprehensive guide to problems and approaches in any field of activity. For guidelines in the field of health care and clinical medicine, PRACTICE GUIDELINES AS TOPIC is available.PubMed: A bibliographic database that includes MEDLINE as its primary subset. It is produced by the National Center for Biotechnology Information (NCBI), part of the NATIONAL LIBRARY OF MEDICINE. PubMed, which is searchable through NLM's Web site, also includes access to additional citations to selected life sciences journals not in MEDLINE, and links to other resources such as the full-text of articles at participating publishers' Web sites, NCBI's molecular biology databases, and PubMed Central.Maternal Health Services: Organized services to provide health care to expectant and nursing mothers.Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.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.Periodicals as Topic: A publication issued at stated, more or less regular, intervals.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.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Adolescent Health Services: Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.Health Planning: Planning for needed health and/or welfare services and facilities.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Mental Health: The state wherein the person is well adjusted.Health Services Administration: The organization and administration of health services dedicated to the delivery of health care.Occupational Health Services: Health services for employees, usually provided by the employer at the place of work.International Classification of Diseases: A system of categories to which morbid entries are assigned according to established criteria. Included is the entire range of conditions in a manageable number of categories, grouped to facilitate mortality reporting. It is produced by the World Health Organization (From ICD-10, p1). The Clinical Modifications, produced by the UNITED STATES DEPT. OF HEALTH AND HUMAN SERVICES, are larger extensions used for morbidity and general epidemiological purposes, primarily in the U.S.Attitude to Health: Public attitudes toward health, disease, and the medical care system.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.GermanyNurse Administrators: Nurses professionally qualified in administration.Data Interpretation, Statistical: Application of statistical procedures to analyze specific observed or assumed facts from a particular study.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.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.Public Health Administration: Management of public health organizations or agencies.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.Evaluation Studies as Topic: Studies determining the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. For drugs and devices, CLINICAL TRIALS AS TOPIC; DRUG EVALUATION; and DRUG EVALUATION, PRECLINICAL are available.Women's Health Services: Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.Models, Theoretical: Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment.Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Health Services, Indigenous: Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.United States Public Health Service: A constituent organization of the DEPARTMENT OF HEALTH AND HUMAN SERVICES concerned with protecting and improving the health of the nation.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)Health: The state of the organism when it functions optimally without evidence of disease.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.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)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.Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.Capacity Building: Organizational development including enhancement of management structures, processes and procedures, within organizations and among different organizations and sectors to meet present and future needs.Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.World Health: The concept pertaining to the health status of inhabitants of the world.Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.Health Care Rationing: Planning for the equitable allocation, apportionment, or distribution of available health resources.United States Indian Health Service: A division of the UNITED STATES PUBLIC HEALTH SERVICE that is responsible for the public health and the provision of medical services to NATIVE AMERICANS in the United States, primarily those residing on reservation lands.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.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.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Curriculum: A course of study offered by an educational institution.National Library of Medicine (U.S.): An agency of the NATIONAL INSTITUTES OF HEALTH concerned with overall planning, promoting, and administering programs pertaining to advancement of medical and related sciences. Major activities of this institute include the collection, dissemination, and exchange of information important to the progress of medicine and health, research in medical informatics and support for medical library development.Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.Public Health Practice: The activities and endeavors of the public health services in a community on any level.Rural Health: The status of health in rural populations.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.Regional Health Planning: Planning for health resources at a regional or multi-state level.Health Status Disparities: Variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically or similar measures.Dental Health Services: Services designed to promote, maintain, or restore dental health.EnglandHealth Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.Financing, Government: Federal, state, or local government organized methods of financial assistance.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.Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.Health Facilities: Institutions which provide medical or health-related services.Community Health Planning: Planning that has the goals of improving health, improving accessibility to health services, and promoting efficiency in the provision of services and resources on a comprehensive basis for a whole community. (From Facts on File Dictionary of Health Care Management, 1988, p299)Cuba: An island in the Greater Antilles in the West Indies, south of Florida. With the adjacent islands it forms the Republic of Cuba. Its capital is Havana. It was discovered by Columbus on his first voyage in 1492 and conquered by Spain in 1511. It has a varied history under Spain, Great Britain, and the United States but has been independent since 1902. The name Cuba is said to be an Indian name of unknown origin but the language that gave the name is extinct, so the etymology is a conjecture. (From Webster's New Geographical Dictionary, 1988, p302 & Room, Brewer's Dictionary of Names, 1992, p132)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.Health Manpower: The availability of HEALTH PERSONNEL. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.Contract Services: Outside services provided to an institution under a formal financial agreement.Ethics, Research: The moral obligations governing the conduct of research. Used for discussions of research ethics as a general topic.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.Healthcare Disparities: Differences in access to or availability of medical facilities and services.Women's Health: The concept covering the physical and mental conditions of women.Personal Health Services: Health care provided to individuals.Urban Health: The status of health in urban populations.School Health Services: Preventive health services provided for students. It excludes college or university students.Marketing of Health Services: Application of marketing principles and techniques to maximize the use of health care resources.Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.Student Health Services: Health services for college and university students usually provided by the educational institution.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.World Health Organization: A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples.Rural Population: The inhabitants of rural areas or of small towns classified as rural.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests.Emergency Medical Services: Services specifically designed, staffed, and equipped for the emergency care of patients.Public Sector: The area of a nation's economy that is tax-supported and under government control.Reproductive Health: The physical condition of human reproductive systems.Poverty: A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.Financing, Organized: All organized methods of funding.Health Plan Implementation: Those actions designed to carry out recommendations pertaining to health plans or programs.Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).Health Literacy: Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.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.Consumer Participation: Community or individual involvement in the decision-making process.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.Maternal-Child Health Centers: Facilities which administer the delivery of health care services to mothers and children.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Translational Medical Research: The application of discoveries generated by laboratory research and preclinical studies to the development of clinical trials and studies in humans. A second area of translational research concerns enhancing the adoption of best practices.Diagnostic Services: Organized services for the purpose of providing diagnosis to promote and maintain health.Organizational Case Studies: Descriptions and evaluations of specific health care organizations.History, 20th Century: Time period from 1901 through 2000 of the common era.Infant, Newborn: An infant during the first month after birth.Organizational Objectives: The purposes, missions, and goals of an individual organization or its units, established through administrative processes. It includes an organization's long-range plans and administrative philosophy.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Biomedical Research: Research that involves the application of the natural sciences, especially biology and physiology, to medicine.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.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.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Australia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.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.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.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.LondonLibrary Services: Services offered to the library user. They include reference and circulation.Privatization: Process of shifting publicly controlled services and/or facilities to the private sector.Models, Organizational: Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.National Institutes of Health (U.S.): An operating division of the US Department of Health and Human Services. It is concerned with the overall planning, promoting, and administering of programs pertaining to health and medical research. Until 1995, it was an agency of the United States PUBLIC HEALTH SERVICE.Community-Institutional Relations: The interactions between members of a community and representatives of the institutions within that community.Fees and Charges: Amounts charged to the patient as payer for health care services.Community-Based Participatory Research: Collaborative process of research involving researchers and community representatives.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Efficiency, Organizational: The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.Public Health Nursing: A nursing specialty concerned with promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences to develop local, regional, state, and national health policy and research. It is population-focused and community-oriented, aimed at health promotion and disease prevention through educational, diagnostic, and preventive programs.State Health Plans: State plans prepared by the State Health Planning and Development Agencies which are made up from plans submitted by the Health Systems Agencies and subject to review and revision by the Statewide Health Coordinating Council.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.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Comprehensive Health Care: Providing for the full range of personal health services for diagnosis, treatment, follow-up and rehabilitation of patients.Nursing Services: A general concept referring to the organization and administration of nursing activities.Social Justice: An interactive process whereby members of a community are concerned for the equality and rights of all.Bias (Epidemiology): Any deviation of results or inferences from the truth, or processes leading to such deviation. Bias can result from several sources: one-sided or systematic variations in measurement from the true value (systematic error); flaws in study design; deviation of inferences, interpretations, or analyses based on flawed data or data collection; etc. There is no sense of prejudice or subjectivity implied in the assessment of bias under these conditions.Health Occupations: Professions or other business activities directed to the cure and prevention of disease. For occupations of medical personnel who are not physicians but who are working in the fields of medical technology, physical therapy, etc., ALLIED HEALTH OCCUPATIONS is available.Medically Underserved Area: A geographic location which has insufficient health resources (manpower and/or facilities) to meet the medical needs of the resident population.Health Benefit Plans, Employee: Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.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.Insurance Coverage: Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)Electronic Health Records: Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.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.International Cooperation: The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.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.

*  Patients' age as a determinant of care received following acute stroke: A systematic review | BMC Health Services Research |...

... quality of health care; quality; process indicator; access; health services accessibility. An example of the MEDLINE search ... To determine whether access to stroke care, delivery of health services, and clinical outcomes after stroke are affected by age ... Level 1 of the Australian National Health & Medical Research Council's Evidence Hierarchy) [16]. Compliance with these process ... Age disparities in stroke quality of care and delivery of health services. Stroke. 2009, 40: 3328-3335. 10.1161/STROKEAHA. ...

*  Timothy Card - The University of Nottingham

BMC health services research. 12, 392 ... Calculating Total Health Service Utilisation and Costs from ... Calculating Total Health Service Utilisation and Costs from Routinely Collected Electronic Health Records Using the Example of ... Research Summary. Dr Card's main areas of research interest are epidemiology of gastrointestinal disease, inflammatory bowel ... Current Research. Dr Card's main areas of research interest are epidemiology of gastrointestinal disease, inflammatory bowel ...

*  How much is BioMed Central charging?

BMC Health Services Research. £1,370. €1,745. US$2.145. BMC Hematology. £1,370. €1,745 ...

*  Spacing Lidcombe Program Clinic Visits - Full Text View -

Primary Purpose: Health Services Research. Official Title:. The Effect of Spacing of Lidcombe Program Clinic Visits. ... To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For ... To learn more about this study, you or your doctor may contact the study research staff using the contact information provided ... Professor Mark Onslow, Australian Stuttering Research Centre, The University of Sydney. Identifier:. ...

*  Evaluation of a Computer-Based System Using Cell Phones for HIV People in Peru - Full Text View -

Primary Purpose: Health Services Research. Official Title:. Evaluation of a Computer-Based System Using Cell Phones for HIV ... Public Health Informatics. Randomized. Randomized Controlled Clinical Trials. Randomized Controlled Trials. Research. Secondary ... Health Informatics. Health behavior. Information Technology. Internet. Intervention. Medication. Patient Satisfaction. Patient ... To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For ...

*  Analysis of malaria surveillance data in Ethiopia: what can be learned from the Integrated Disease Surveillance and Response...

Health Services Research*. Humans. Incidence. Infant. Infant, Newborn. Malaria / diagnosis, drug therapy, epidemiology*, ... 1Public Health Emergency Management, Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia. ... but now at the Public Health Emergency Management (PHEM) center at Ethiopian Health and Nutrition Research Institute. ... Health stations and health posts were not formally included in the initial phase. While IDSR data exist on paper at the ...

*  This is why policy should be evidence based | The Incidental Economist

The health services research blog. *. *About the blog. *FAQ. *Podcast archive. *Site policies ... employer-sponsored health insurance health care costs Healthcare Triage health insurance health insurance mandates health ... The have research kitchens which spend countless hours perfecting the special sauce. Telling us the calories in a Big Mac, and ... I'm not aware of any research on the impact of nutrition labels on foods we buy in the grocery store. However, it's safe to say ...

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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.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,Vinnytsia Institute of Economics and Social Sciences: Vinnytsia Institute of Economics and Social Sciences – structural unit of Open International University of Human Development “Ukraine” (OIUHD “Ukraina”).Andrew Dickson WhiteGlobal Health Delivery ProjectHealth policy: Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific health care goals within a society."World Health Organization.Shunri: Shunris () are a Bengali Hindu caste whose traditional occupation is the distillation and selling of country wine. The Shunris, except those having family name Saha are listed as Scheduled Castes by the Government of India and Government of West Bengal.Chronic care: Chronic care refers to medical care which addresses pre-existing or long term illness, as opposed to acute care which is concerned with short term or severe illness of brief duration. Chronic medical conditions include asthma, diabetes, emphysema, chronic bronchitis, congestive heart disease, cirrhosis of the liver, hypertension and depression.Public Health Act: Public Health Act is a stock short title used in the United Kingdom for legislation relating to public health.Opinion polling in the Philippine presidential election, 2010: Opinion polling (popularly known as surveys in the Philippines) for the 2010 Philippine presidential election is managed by two major polling firms: Social Weather Stations and Pulse Asia, and several minor polling firms. The polling firms conducted surveys both prior and after the deadline for filing of certificates of candidacies on December 1, 2009.Healthcare Cost and Utilization Project: The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of health care databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ). What is HCUP?Canandaigua Veterans Hospital Historic DistrictNational Resource DirectoryBestbets: BestBETS (Best Evidence Topic Reports) is a system designed by emergency physicians at Manchester Royal Infirmary, UK. It was conceived as a way of allowing busy clinicians to solve real clinical problems using published evidence.Self-rated health: Self-rated health (also called Self-reported health, Self-assessed health, or perceived health) refers to both a single question such as “in general, would you say that you health is excellent, very good, good, fair, or poor?” and a survey questionnaire in which participants assess different dimensions of their own health.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.Essex School of discourse analysis: The Essex School constitutes a variety of discourse analysis, one that combines theoretical sophistication – mainly due to its reliance on the post-structuralist and psychoanalytic traditions and, in particular, on the work of Lacan, Foucault, Barthes, Derrida, etc. – with analytical precision, since it focuses predominantly on an in-depth analysis of political discourses in late modernity.Translational bioinformatics: Translational Bioinformatics (TBI) is an emerging field in the study of health informatics, focused on the convergence of molecular bioinformatics, biostatistics, statistical genetics, and clinical informatics. Its focus is on applying informatics methodology to the increasing amount of biomedical and genomic data to formulate knowledge and medical tools, which can be utilized by scientists, clinicians, and patients.Document-centric collaboration: Document-centric collaboration is a new approach to working together on projects online which puts the document and its contents at the centre of the process.Halfdan T. MahlerCommunity 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.Integrated catchment management: Integrated catchment management is a subset of environmental planning which approaches sustainable resource management from a catchment perspective, in contrast to a piecemeal approach that artificially separates land management from water management.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.Society for Education Action and Research in Community Health: Searching}}Medix UK Limited: Medix UK Limited is a UK-based market research consultancy providing online research in healthcare.Rock 'n' Roll (Status Quo song)Maternal Health Task ForceIncremental cost-effectiveness ratio: The incremental cost-effectiveness ratio (ICER) is a statistic used in cost-effectiveness analysis to summarise the cost-effectiveness of a health care intervention. It is defined by the difference in cost between two possible interventions, divided by the difference in their effect.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.British Journal of Diabetes and Vascular Disease: The British Journal of Diabetes and Vascular Disease is a peer-reviewed academic journal that publishes papers six times a year in the field of Cardiovascular medicine. The journal's editors are Clifford J Bailey (Aston University), Ian Campbell (Victoria Hospital) and Christoph Schindler (Dresden University of Technology).Psychiatric interview: The psychiatric interview refers to the set of tools that a mental health worker (most times a psychiatrist or a psychologist but at times social workers or nurses) uses to complete a psychiatric assessment.Lifestyle management programme: A lifestyle management programme (also referred to as a health promotion programme, health behaviour change programme, lifestyle improvement programme or wellness programme) is an intervention designed to promote positive lifestyle and behaviour change and is widely used in the field of health promotion.Basic Occupational Health Services: The Basic Occupational Health Services are an application of the primary health care principles in the sector of occupational health. Primary health care definition can be found in the World Health Organization Alma Ata declaration from the year 1978 as the “essential health care based on practical scientifically sound and socially accepted methods, (…) it is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work (…)”.International Statistical Classification of Diseases and Related Health Problems: The International Statistical Classification of Diseases and Related Health Problems, usually called by the short-form name International Classification of Diseases (ICD), is the international "standard diagnostic tool for epidemiology, health management and clinical purposes". The ICD is maintained by the World Health Organization (WHO), the directing and coordinating authority for health within the United Nations System.Baden, Lower Saxony: Baden is a town near Bremen, in Lower Saxony, Germany. It is known to Africanists and Phoneticians as the place where Diedrich Hermann Westermann was born and died.Nurse-managed health center: A nurse-managed health center provides health care services in medically underserved rural and urban areas in the United States where there is limited access to health care.S.The Final Decision: The Final Decision is an episode from season 1 of the animated TV series X-Men Animated Series.Contraceptive mandate (United States): A contraceptive mandate is a state or federal regulation or law that requires health insurers, or employers that provide their employees with health insurance, to cover some contraceptive costs in their health insurance plans. In 1978, the U.Von Neumann regular ring: In mathematics, a von Neumann regular ring is a ring R such that for every a in R there exists an x in R such that . To avoid the possible confusion with the regular rings and regular local rings of commutative algebra (which are unrelated notions), von Neumann regular rings are also called absolutely flat rings, because these rings are characterized by the fact that every left module is flat.United States Public Health ServiceGeneralizability theory: Generalizability theory, or G Theory, is a statistical framework for conceptualizing, investigating, and designing reliable observations. It is used to determine the reliability (i.Behavior: Behavior or behaviour (see spelling differences) is the range of actions and [made by individuals, organism]s, [[systems, or artificial entities in conjunction with themselves or their environment, which includes the other systems or organisms around as well as the (inanimate) physical environment. It is the response of the system or organism to various stimuli or inputs, whether [or external], [[conscious or subconscious, overt or covert, and voluntary or involuntary.School health education: School Health Education see also: Health Promotion is the process of transferring health knowledge during a student's school years (K-12). Its uses are in general classified as Public Health Education and School Health Education.Aging (scheduling): In Operating systems, Aging is a scheduling technique used to avoid starvation. Fixed priority scheduling is a scheduling discipline, in which tasks queued for utilizing a system resource are assigned a priority each.

(1/4753) Practice patterns, case mix, Medicare payment policy, and dialysis facility costs.

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

(2/4753) Incidence and duration of hospitalizations among persons with AIDS: an event history approach.

OBJECTIVE: To analyze hospitalization patterns of persons with AIDS (PWAs) in a multi-state/multi-episode continuous time duration framework. DATA SOURCES: PWAs on Medicaid identified through a match between the state's AIDS Registry and Medicaid eligibility files; hospital admission and discharge dates identified through Medicaid claims. STUDY DESIGN: Using a Weibull event history framework, we model the hazard of transition between hospitalized and community spells, incorporating the competing risk of death in each of these states. Simulations are used to translate these parameters into readily interpretable estimates of length of stay, the probability that a hospitalization will end in death, and the probability that a nonhospitalized person will be hospitalized within 90 days. PRINCIPAL FINDINGS: In multivariate analyses, participation in a Medicaid waiver program offering case management and home care was associated with hospital stays 1.3 days shorter than for nonparticipants. African American race and Hispanic ethnicity were associated with hospital stays 1.2 days and 1.0 day longer than for non-Hispanic whites; African Americans also experienced more frequent hospital admissions. Residents of the high-HIV-prevalence area of the state had more frequent admissions and stays two days longer than those residing elsewhere in the state. Older PWAs experienced less frequent hospital admissions but longer stays, with hospitalizations of 55-year-olds lasting 8.25 days longer than those of 25-year-olds. CONCLUSIONS: Much socioeconomic and geographic variability exists both in the incidence and in the duration of hospitalization among persons with AIDS in New Jersey. Event history analysis provides a useful statistical framework for analysis of these variations, deals appropriately with data in which duration of observation varies from individual to individual, and permits the competing risk of death to be incorporated into the model. Transition models of this type have broad applicability in modeling the risk and duration of hospitalization in chronic illnesses.  (+info)

(3/4753) Making Medicaid managed care research relevant.

OBJECTIVE: To help researchers better understand Medicaid managed care and the kinds of research studies that will be both feasible and of value to policymakers and program staff. The article builds on our experience researching Medicaid managed care to provide insight for researchers who want to be policy relevant. PRINCIPAL FINDINGS: We draw four lessons from our work on Medicaid managed care in seven states. First, these are complex programs that differ substantially across states. Second, each program faces common challenges and issues. The need to address common design elements involving program eligibility, managed care and provider contracting, beneficiary enrollment, education, marketing, and administration and oversight provides a vehicle that researchers can use to help understand states and to provide them with relevant insight. Third, well-designed case studies can provide invaluable descriptive insights. Such case studies suggest that providing effective descriptions of state programs and experience, monitoring information on program performance and tradeoffs, and insight on implementation and design are all valuable products of such studies that have considerable potential to be converted into policy-actionable advice. And fourth, some questions demand impact studies but the structure of Medicaid managed care poses major barriers to such studies. CONCLUSIONS: Many challenges confront researchers seeking to develop policy-relevant research on managed care. Researchers need to confront these challenges in turn by developing second-best approaches that will provide timely insight into important questions in a relatively defensible and rigorous way in the face of many constraints. If researchers do not, others will, and researchers may find their contributions limited in important areas for policy debate.  (+info)

(4/4753) A taxonomy of health networks and systems: bringing order out of chaos.

OBJECTIVE: To use existing theory and data for empirical development of a taxonomy that identifies clusters of organizations sharing common strategic/structural features. DATA SOURCES: Data from the 1994 and 1995 American Hospital Association Annual Surveys, which provide extensive data on hospital involvement in hospital-led health networks and systems. STUDY DESIGN: Theories of organization behavior and industrial organization economics were used to identify three strategic/structural dimensions: differentiation, which refers to the number of different products/services along a healthcare continuum; integration, which refers to mechanisms used to achieve unity of effort across organizational components; and centralization, which relates to the extent to which activities take place at centralized versus dispersed locations. These dimensions were applied to three components of the health service/product continuum: hospital services, physician arrangements, and provider-based insurance activities. DATA EXTRACTION METHODS: We identified 295 health systems and 274 health networks across the United States in 1994, and 297 health systems and 306 health networks in 1995 using AHA data. Empirical measures aggregated individual hospital data to the health network and system level. PRINCIPAL FINDINGS: We identified a reliable, internally valid, and stable four-cluster solution for health networks and a five-cluster solution for health systems. We found that differentiation and centralization were particularly important in distinguishing unique clusters of organizations. High differentiation typically occurred with low centralization, which suggests that a broader scope of activity is more difficult to centrally coordinate. Integration was also important, but we found that health networks and systems typically engaged in both ownership-based and contractual-based integration or they were not integrated at all. CONCLUSIONS: Overall, we were able to classify approximately 70 percent of hospital-led health networks and 90 percent of hospital-led health systems into well-defined organizational clusters. Given the widespread perception that organizational change in healthcare has been chaotic, our research suggests that important and meaningful similarities exist across many evolving organizations. The resulting taxonomy provides a new lexicon for researchers, policymakers, and healthcare executives for characterizing key strategic and structural features of evolving organizations. The taxonomy also provides a framework for future inquiry about the relationships between organizational strategy, structure, and performance, and for assessing policy issues, such as Medicare Provider Sponsored Organizations, antitrust, and insurance regulation.  (+info)

(5/4753) Organizational and environmental factors associated with nursing home participation in managed care.

OBJECTIVE: To develop and test a model, based on resource dependence theory, that identifies the organizational and environmental characteristics associated with nursing home participation in managed care. DATA SOURCES AND STUDY SETTING: Data for statistical analysis derived from a survey of Directors of Nursing in a sample of nursing homes in eight states (n = 308). These data were merged with data from the On-line Survey Certification and Reporting System, the Medicare Managed Care State/County Data File, and the 1995 Area Resource File. STUDY DESIGN: Since the dependent variable is dichotomous, the logistic procedure was used to fit the regression. The analysis was weighted using SUDAAN. FINDINGS: Participation in a provider network, higher proportions of resident care covered by Medicare, providing IV therapy, greater availability of RNs and physical therapists, and Medicare HMO market penetration are associated with a greater likelihood of having a managed care contract. CONCLUSION: As more Medicare recipients enroll in HMOs, nursing home involvement in managed care is likely to increase. Interorganizational linkages enhance the likelihood of managed care participation. Nursing homes interested in managed care should consider upgrading staffing and providing at least some subacute services.  (+info)

(6/4753) Explicit guidelines for qualitative research: a step in the right direction, a defence of the 'soft' option, or a form of sociological imperialism?

Within the context of health service research, qualitative research has sometimes been seen as a 'soft' approach, lacking scientific rigour. In order to promote the legitimacy of using qualitative methodology in this field, numerous social scientists have produced checklists, guidelines or manuals for researchers to follow when conducting and writing up qualitative work. However, those working in the health service should be aware that social scientists are not all in agreement about the way in which qualitative work should be conducted, and they should not be discouraged from conducting qualitative research simply because they do not possess certain technical skills or extensive training in sociology, anthropology or psychology. The proliferation of guidelines and checklists may be off-putting to people who want to undertake this sort of research, and they may also make it even more difficult for researchers to publish work in medical journals. Consequently, the very people who may be in a position to change medical practice may never read the results of important qualitative research.  (+info)

(7/4753) The future of managed care organization.

This paper analyzes the transformation of the central organization in the managed care system: the multiproduct, multimarket health plan. It examines vertical disintegration, the shift from ownership to contractual linkages between plans and provider organizations, and horizontal integration--the consolidation of erstwhile indemnity carriers, Blue Cross plans, health maintenance organizations (HMOs), and specialty networks. Health care consumers differ widely in their preferences and willingness to pay for particular products and network characteristics, while providers differ widely in their willingness to adopt particular organization and financing structures. This heterogeneity creates an enduring role for health plans that are diversified into multiple networks, benefit products, distribution channels, and geographic regions. Diversification now is driving health plans toward being national, full-service corporations and away from being local, single-product organizations linked to particular providers and selling to particular consumer niches.  (+info)

(8/4753) Commercialization of BRCA1/2 testing: practitioner awareness and use of a new genetic test.

It was our purpose to determine the characteristics of practitioners in the United States who were among the first to inquire about and use the BRCA1 and BRCA2 (BRCA1/2) genetic tests outside of a research protocol. Questionnaires were mailed to all practitioners who requested information on or ordered a BRCA1/2 test from the University of Pennsylvania (UPenn) Genetic Diagnostics Laboratory (GDL) between October 1, 1995 and January 1, 1997 (the first 15 months the test was available for clinical use). The response rate was 67% of practitioners; 54% (121/225) were genetic counselors, 39% (87/225) were physicians or lab directors. Most physicians were oncologists, pathologists, or obstetrician/gynecologists, but 20% practiced surgery or internal or general medicine. Fifty-six percent (125/225) had ordered a BRCA1/2 test for a patient; most of the rest had offered or were willing to offer testing. Of those who had offered testing, 70% had a patient decline BRCA1/2 testing when offered. Practitioners perceived that patients' fear of loss of confidentiality was a major reason for declining. Nearly 60% of practitioners reported that their patients had access to a genetic counselor, but 28% of physicians who ordered a BRCA1/2 test reported having no such access, despite the GDL's counseling requirement. The proportion of physicians reporting no access to genetic counselors for their patients increased from 22.4% in the first half of the study to 50% in the last half. Many practitioners have an interest in BRCA1/2 testing, despite policy statements that discourage its use outside of research protocols. Practitioner responses suggest that patient interest in testing seems to be tempered by knowledge of potential risks. An apparent increase in patient concern about confidentiality and inability to pay for testing could indicate growing barriers to testing. Although most practitioners reported having access to counseling facilities, perceived lack of such access among an increasing proportion of practitioners indicates that lab requirements for counseling are difficult to enforce and suggests that an increasing proportion of patients may not be getting access to counseling.  (+info)


  • They are developing and testing interventions and translating research into practice. (
  • To describe unexpected challenges and strategies to overcome them when conducting randomized controlled trials (RCT) of health services research interventions in retail pharmacies. (
  • Health services researchers should conduct RCTs in a variety of nonacademic practice settings to increase generalizability and better reflect the true impact of interventions. (
  • Health services researchers who conduct randomized controlled trials (RCT) evaluate interventions to improve the organization, delivery, quality, and/or outcomes of care. (
  • Our experiences may be useful to other investigators who plan to evaluate health services interventions in nonacademic practice settings. (
  • Also the costs involved in medical and nursing care, (surgical) interventions, and diagnostic procedures as an estimate of the demand for hospital care services per hospitalised patient were calculated and cumulated. (
  • Findings from this study can inform targeted interventions and lay the groundwork for health policy decisions that may impact hepatitis and HIV risk reduction and recidivism in this group who are a reservoir for these viruses in the general population, and are returning to prison at unprecedented numbers. (


  • Occupational health services research: evaluating the outcomes, cost and quality of care among employees. (
  • Pat McGovern will provide an overview to the session, which will address the urgent need identified by the National Institute for Occupational Safety and Health (NIOSH) for applying approaches from health services research to questions about the outcomes, cost and quality of health services provided to working adults. (
  • Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. (
  • This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. (
  • Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions. (
  • This paper explores the outcomes from inviting community members to participate in designing primary healthcare services for remote rural places. (
  • Better Health Outcomes through Mentoring and Assessment (BHOMA) is a 5-year, randomized stepped-wedge trial of improved clinical service delivery underway in 46 rural Zambian clinics. (


  • This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches-insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS). (


  • A model to quantify the demand for hospital care services among various clinical specialties would avail healthcare professionals and managers to anticipate the demand and costs for clinical care. (
  • A set of predictors of the demand for hospital care services was found applicable to different clinical specialties. (


  • Major modifications in research design were necessitated by factors such as corporate restructuring, heightened sensitivity to patient confidentiality, and difficulties altering employees' behavior. (
  • Therefore, it is critical to engage paroled adults in comprehensive intervention programs that not only protect them from hepatitis B, but also reduce risky behavior, promote access to health care, social and employment services, and enable positive coping and communication skills. (


  • Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs' healthcare system. (


  • This prospective time and motion study was conducted to find factors related to the demand for hospital care services, based on a previously developed set of factors [ 4 ], for some of the most representative clinical patient populations (Surgery, Pediatrics and Obstetrics & Gynecology) in a university hospital. (


  • Another challenge in India is health workforce shortages and difficulties in recruiting and retaining them especially in rural and remote areas as in most low and middle income countries (LMICs). (


  • Homeless parolees pose a particular challenge for successful reentry into the community as they have underlying mental health issues combined with substance use and abuse and must contend with unstable housing situations, disorganized lives, unemployment, and limited access to health care and social services. (


  • We overcame these barriers by conducting research that is consistent with corporate goals, involving appropriate corporate administrators and technical personnel early in the process, and being flexible. (
  • Universal health insurance coverage has eliminated many barriers to receiving appropriate, high quality health care, however geography remains a potential barrier to access. (
  • The Canada Health Act (CHA) lists access as one of its five main tenants stating that "persons must have reasonable and uniform access to insured health services, free of financial or other barriers. (
  • Our findings suggest that numerous barriers stand in the way of hypertension diagnosis and management in Zambian primary health facilities. (


  • Program faculty are involved locally, nationally, and internationally in health services research and policy. (


  • This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. (
  • Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. (
  • The community participation process we used involves local people in service decision-making as is desired within contemporary healthcare policy. (
  • With regard to services, larger regional centres tend to have a range of primary healthcare and a general hospital, while smaller towns might have a hub of more limited primary healthcare services and a community hospital. (
  • Suitable service arrangements for small remote settlements are hard to define [ 3 ] and remote places are vulnerable to small changes in population and healthcare providers. (
  • 1-3 ] Healthcare systems have responded to this demand by offering a range of CAM services in outpatient and inpatient settings. (
  • 4, 5 ] Patients enrolled in the US Department of Veterans Affairs (VA) healthcare delivery system often use CAM services outside of VA but have a strong interest in receiving these services within the VA system. (


  • This study found that residents of small cities not adjacent to major centres, had the highest reported utilisation rates of influenza vaccines and family physician services, were most likely to have a regular medical doctor, and were most likely to report unmet need. (
  • Residents of the most urban centres were more likely to report using specialist physician services. (


  • It is therefore important for hospitals to be able to anticipate the upcoming demand for hospital care services, in qualitative and quantitative terms. (
  • Quantitative data was used to develop guides for qualitative in-depth interviews, conducted with health care providers at a proportional sample of half (20) of clinics. (


  • Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. (


  • The adoption of an electronic health record (EHR) represents a major undertaking for those who provide health care in the United States. (


  • Bryan Dowd will present the second paper, which evaluates the impact of a coordinated health care and disability program on indemnity, medical and workers' compensation costs. (


  • They play an important role in improving health and shaping health care systems and policy world-wide. (
  • She co-directs a NIOSH training grant in occupational health services research and policy at the University of Minnesota. (
  • Address correspondence to Morris Weinberger, Ph.D., Vergil N. Slee Distinguished Professor of Health Care Quality Management, Department of Health Policy and Administration, University of North Carolina at Chapel Hill, 1105c McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC 27599-7411. (
  • Waiting times for elective surgery have been, and still are, an important health policy concern in many advanced industrial countries. (
  • Canadian policy makers have long struggled with how best to provide timely and appropriate access to high quality health care to all Canadians especially those who live in the rural areas of the country. (


  • Studies comparing the access to health care of rural and urban populations have been contradictory and inconclusive. (


  • Sustainability of contracting in arrangements, their effect on increasing coverage of EmOC services in rural areas and overlapping provisions for contracting in EmOC specialists are issues for future consideration. (


  • Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. (


  • Professor McGovern is a health services researcher and occupational health nurse. (
  • Professor Amick currently serves as co-leader of the National Occupational Research Agenda (NORA) team addressing health services research in occupational health and safety. (
  • Professor Wickheizer is an economist who is the co-director of a NIOSH training grant in occupational health services research at the University of Washington. (


  • Workshops were intended to produce hypothetical designs for future service provision. (
  • The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). (
  • The five most common causes of maternal mortality in India are direct obstetric complications which can be well managed by provision of emergency obstetric care (EmOC) services. (
  • The Indian government subscribed to the EmOC provision strategy and in 2005 included access to 24 hour EmOC as one of the 'service guarantees' of its public health programme-the National Rural Health Mission (NRHM). (


  • The purpose of this page is to make available to researchers, stakeholders, and other interested parties project materials and the results of research that may inform or provide context for CE redesign discussions. (

mental health

  • The acknowledgement and understanding of mental health conditions has changed over time and across cultures. (
  • Benjamin Rush (1746-1813) was considered the Father of American Psychiatry for his many works and studies in the mental health field. (


  • The programme logic is increased access to institutional care during delivery would decrease delays in accessing EmOC services if required and thus save lives. (


  • This tension between internal and external validity is especially important to health services researchers. (

Public Health

  • Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. (
  • Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. (


  • There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. (
  • Community-based participatory action research was applied in four Scottish case study communities in 2008-10. (
  • One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. (
  • This is a cross-sectional study of the population of the 10 provinces of Canada using data from the Canadian Community Health Survey (CCHS 2.1). (
  • location of residence at the levels of province, health region, and community is also controlled for. (


  • After describing our RCT as originally designed, we present some unexpected situations that are unlikely to be experienced by health services researchers who conduct RCTs in more traditional venues. (


  • These factors can all be identified during hospitalization and be used as a managerial tool to monitor the patients' demand for hospital care services and to detect trends in time. (

drug treatment

  • This study will advance the research team's knowledge about drug treatment and HBV vaccine completion and recidivism among homeless parolees. (


  • In the United States access is often synonymous with health insurance. (
  • This implies that once everyone has insurance there will be some degree of equality in the utilization of health care services. (
  • How, then is access defined in an environment, such as Canada, where everyone has health insurance? (


  • Topics included examination of the impact life events have as reminders of spending, research on whether asking questions about other household members improves proxy reporting, and an overview of how measurement error might be assessed in CE. (


  • or 3) a Usual Care (UC) control program, which includes brief general health information, one-on-one coaching and the HAV/HBV vaccine. (
  • or 3) a Usual Care (UC) control program, which includes brief general health information, and the HAV/HBV vaccine. (


  • This study assesses the equity of access to health care services across the rural-urban continuum in Canada before and after taking other determinants of access into account. (
  • It is this definition on which the Health Behaviour Model, the conceptual framework for this study is based. (


  • Communities designed different service models to address health priorities. (


  • Please reuse your e-mail download analysis of waiting-time data in health built with your relevant fisheries are. (
  • The download analysis of waiting-time data in health making the book of sea looks preventive on the top altimeter of the security and green texts. (


  • UPDATED Gemini Research Agenda ( PDF ). (


  • Considering the attention that is placed on access to health care services it is surprising the degree of ambiguity in defining it. (
  • Andersen has operationalized a definition of access to be used in health services research. (
  • In this definition, access consists of two components "the use of health services" and "everything that facilitates or impedes the use. (


  • Among the rural categories there was a gradient with the most rural being least likely to have had a flu shot, use specialist physicians services, or have a regular medical doctor. (


  • 12 ] VA's most substantial undertaking in delivering any CAM-related service has been its introduction of chiropractic services. (


  • Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. (


  • We have received approval for this from the ethic committees at Kwame Nkrumah University of Science and Technology, Ghana Health Service and Navrongo Health Research Centre. (