Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.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.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.Delphi Technique: An iterative questionnaire designed to measure consensus among individual responses. In the classic Delphi approach, there is no interaction between responder and interviewer.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Consensus: General agreement or collective opinion; the judgment arrived at by most of those concerned.Benchmarking: Method of measuring performance against established standards of best practice.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Quality Control: A system for verifying and maintaining a desired level of quality in a product or process by careful planning, use of proper equipment, continued inspection, and corrective action as required. (Random House Unabridged Dictionary, 2d ed)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.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)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)Quality Improvement: The attainment or process of attaining a new level of performance or quality.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.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.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.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).Consensus Development Conferences as Topic: Presentations of summary statements representing the majority agreement of physicians, scientists, and other professionals convening for the purpose of reaching a consensus--often with findings and recommendations--on a subject of interest. The Conference, consisting of participants representing the scientific and lay viewpoints, is a significant means of evaluating current medical thought and reflects the latest advances in research for the respective field being addressed.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Reimbursement, Incentive: A scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered.Mental Health: The state wherein the person is well adjusted.Health Care Reform: Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Health: The state of the organism when it functions optimally without evidence of disease.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)Total Quality Management: The application of industrial management practice to systematically maintain and improve organization-wide performance. Effectiveness and success are determined and assessed by quantitative quality measures.Hospitals: Institutions with an organized medical staff which provide medical care to patients.Mental Health Services: Organized services to provide mental health care.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)Attitude to Health: Public attitudes toward health, disease, and the medical care system.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.International Agencies: International organizations which provide health-related or other cooperative services.Health Planning: Planning for needed health and/or welfare services and facilities.Process Assessment (Health Care): An evaluation procedure that focuses on how care is delivered, based on the premise that there are standards of performance for activities undertaken in delivering patient care, in which the specific actions taken, events occurring, and human interactions are compared with accepted standards.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.United StatesHealth 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.Nursing Service, Hospital: The hospital department which is responsible for the organization and administration of nursing activities.Health Services: Services for the diagnosis and treatment of disease and the maintenance of health.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.World Health: The concept pertaining to the health status of inhabitants of the world.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.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.Interdisciplinary Studies: Programs of study which span the traditional boundaries of academic scholarship.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.Nursing Homes: Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.Health Services for the Aged: Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Physician Incentive Plans: Compensatory plans designed to motivate physicians in relation to patient referral, physician recruitment, and efficient use of the health facility.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.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.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Medical Audit: A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.Public Health Administration: Management of public health organizations or agencies.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).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.Patient Care: The services rendered by members of the health profession and non-professionals under their supervision.Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.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.Great BritainNetherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources.Documentation: Systematic organization, storage, retrieval, and dissemination of specialized information, especially of a scientific or technical nature (From ALA Glossary of Library and Information Science, 1983). It often involves authenticating or validating information.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.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.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.EuropePatient Acceptance of Health Care: The seeking and acceptance by patients of health service.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.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 Care Rationing: Planning for the equitable allocation, apportionment, or distribution of available health resources.International Cooperation: The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Delivery of Health Care, Integrated: A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.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.Public Health Practice: The activities and endeavors of the public health services in a community on any level.Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.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)Rural Health: The status of health in rural populations.Health Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.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.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Information Services: Organized services to provide information on any questions an individual might have using databases and other sources. (From Random House Unabridged Dictionary, 2d ed)Women's Health: The concept covering the physical and mental conditions of women.GermanyWorld 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.Urban Health: The status of health in urban populations.Child, Hospitalized: Child hospitalized for short term care.Child Health Services: Organized services to provide health care for children.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Cancer Care Facilities: Institutions specializing in the care of cancer patients.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.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.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.Risk Adjustment: The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994)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 Facilities: Institutions which provide medical or health-related services.Drug Prescriptions: Directions written for the obtaining and use of DRUGS.Healthcare Disparities: Differences in access to or availability of medical facilities and services.Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).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.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.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)Hospitals, Veterans: Hospitals providing medical care to veterans of wars.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.Safety Management: The development of systems to prevent accidents, injuries, and other adverse occurrences in an institutional setting. The concept includes prevention or reduction of adverse events or incidents involving employees, patients, or facilities. Examples include plans to reduce injuries from falls or plans for fire safety to promote a safe institutional environment.EnglandFee-for-Service Plans: Method of charging whereby a physician or other practitioner bills for each encounter or service rendered. In addition to physicians, other health care professionals are reimbursed via this mechanism. Fee-for-service plans contrast with salary, per capita, and prepayment systems, where the payment does not change with the number of services actually used or if none are used. (From Discursive Dictionary of Health Care, 1976)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.BelgiumRegional Health Planning: Planning for health resources at a regional or multi-state level.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.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Drug Utilization: The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.Diabetes Mellitus: A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.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.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.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.Water Quality: A rating of a body of water based on measurable physical, chemical, and biological characteristics.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.Hospital Units: Those areas of the hospital organization not considered departments which provide specialized patient care. They include various hospital special care wards.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.Medical Records: Recording of pertinent information concerning patient's illness or illnesses.Infant, Newborn: An infant during the first month after birth.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.Hospitalization: The confinement of a patient in a hospital.Disease Management: A broad approach to appropriate coordination of the entire disease treatment process that often involves shifting away from more expensive inpatient and acute care to areas such as preventive medicine, patient counseling and education, and outpatient care. This concept includes implications of appropriate versus inappropriate therapy on the overall cost and clinical outcome of a particular disease. (From Hosp Pharm 1995 Jul;30(7):596)Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Nursing Care: Care given to patients by nursing service personnel.Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon.Gout Suppressants: Agents that increase uric acid excretion by the kidney (URICOSURIC AGENTS), decrease uric acid production (antihyperuricemics), or alleviate the pain and inflammation of acute attacks of gout.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)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.Polypharmacy: The use of multiple drugs administered to the same patient, most commonly seen in elderly patients. It includes also the administration of excessive medication. Since in the United States most drugs are dispensed as single-agent formulations, polypharmacy, though using many drugs administered to the same patient, must be differentiated from DRUG COMBINATIONS, single preparations containing two or more drugs as a fixed dose, and from DRUG THERAPY, COMBINATION, two or more drugs administered separately for a combined effect. (From Segen, Dictionary of Modern Medicine, 1992)Maternal Health Services: Organized services to provide health care to expectant and nursing mothers.Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care.Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.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.Quebec: A province of eastern Canada. Its capital is Quebec. The region belonged to France from 1627 to 1763 when it was lost to the British. The name is from the Algonquian quilibek meaning the place where waters narrow, referring to the gradually narrowing channel of the St. Lawrence or to the narrows of the river at Cape Diamond. (From Webster's New Geographical Dictionary, 1988, p993 & Room, Brewer's Dictionary of Names, 1992, p440)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.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.Infertility: Inability to reproduce after a specified period of unprotected intercourse. Reproductive sterility is permanent infertility.Depression: Depressive states usually of moderate intensity in contrast with major depression present in neurotic and psychotic disorders.Health Status Indicators: The measurement of the health status for a given population using a variety of indices, including morbidity, mortality, and available health resources.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.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.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.Reproductive Health: The physical condition of human reproductive systems.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.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.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.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.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis.Public Health Informatics: The systematic application of information and computer sciences to public health practice, research, and learning.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.Data Interpretation, Statistical: Application of statistical procedures to analyze specific observed or assumed facts from a particular study.IsraelOccupational Health Services: Health services for employees, usually provided by the employer at the place of work.Health Plan Implementation: Those actions designed to carry out recommendations pertaining to health plans or programs.Sensitivity and Specificity: Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)Patients: Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.France: A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris.Health Services Administration: The organization and administration of health services dedicated to the delivery of health care.Poverty: A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.Cardiology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cardiac patient.Length of Stay: The period of confinement of a patient to a hospital or other health facility.Sex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Hospitals, Pediatric: Special hospitals which provide care for ill children.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.Catchment Area (Health): A geographic area defined and served by a health program or institution.Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.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.Politics: Activities concerned with governmental policies, functions, etc.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Health Care Coalitions: Voluntary groups of people representing diverse interests in the community such as hospitals, businesses, physicians, and insurers, with the principal objective to improve health care cost effectiveness.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.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.Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.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)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.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Food Quality: Ratings of the characteristics of food including flavor, appearance, nutritional content, and the amount of microbial and chemical contamination.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Women's Health Services: Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.Health Planning Guidelines: Recommendations for directing health planning functions and policies. These may be mandated by PL93-641 and issued by the Department of Health and Human Services for use by state and local planning agencies.Health Services, Indigenous: Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.Rural Population: The inhabitants of rural areas or of small towns classified as rural.
Time-trade-off: Time-Trade-Off (TTO) is a tool used in health economics to help determine the quality of life of a patient or group. The individual will be presented with a set of directions such as:Delphi Greenlaw: Delphine "Delphi" Greenlaw is a fictional character on the New Zealand soap opera Shortland Street, who was portrayed by Anna Hutchison between 2002 and 2004.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.Global Health Delivery ProjectAnalytical quality control: Analytical quality control, commonly shortened to AQC refers to all those processes and procedures designed to ensure that the results of laboratory analysis are consistent, comparable, accurate and within specified limits of precision.analytical quality control (AQC) program to ensure the highest level of confidence in reported data Constituents submitted to the analytical laboratory must be accurately described to avoid faulty interpretations, approximations, or incorrect results.Public Health Act: Public Health Act is a stock short title used in the United Kingdom for legislation relating to public health.Halfdan T. MahlerHealthcare 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?International Panel on Fissile Materials: The International Panel on Fissile Materials (IPFM), established in 2006, is a group of independent nuclear experts from 16 countries. It aims to advance international initiatives to “secure and to sharply reduce all stocks of highly enriched uranium and separated plutonium, the key materials in nuclear weapons, and to limit any further production”.Health 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.Rock 'n' Roll (Status Quo song)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.HydrosilaNational 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.Bestbets: 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.Timeline of the nuclear program of Iran: This is the timeline of the nuclear program of Iran.National Clinical Guideline CentreList of Parliamentary constituencies in Kent: The ceremonial county of Kent,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.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.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.Q Division Studios: Q Division Studios is a recording studio located in Somerville, Massachusetts, United States, at the heart of the Boston area's music scene. Founded in 1986, Q Division was originally located at 443 Albany Street in Boston, but moved to its current two-studio facility in 2000.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.Home of the future: The home of the future, similar to the office of the future, is a concept that has been popular to explore since the early 20th century, or perhaps earlier. There have been many exhibits, such as at World's Fairs and theme parks, purporting to show how future homes will look and work, as well as standalone model "homes of the future" sponsored by builders, developers, or technology companies.Toyota NZ engine: The Toyota NZ engine family is a straight-4 piston engine series. The 1NZ series uses aluminum engine blocks and DOHC cylinder heads.Bio Base EuropeCentral Cardiac Audit DatabaseBehavior change (public health): Behavior change is a central objective in public health interventions,WHO 2002: World Health Report 2002 - Reducing Risks, Promoting Healthy Life Accessed Feb 2015 http://www.who.Great Lakes Environmental Research Laboratory: right|300px|thumb|Great Lakes Environmental Research Laboratory logo.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.Netherlands national rollball team: Vishwaraj JadejaPoint of care: Clinical point of care is when clinicians deliver healthcare products and services to patients at the time of care.Information at the Point of Care: Answering Clinical Questions.WHO collaborating centres in occupational health: The WHO collaborating centres in occupational health constitute a network of institutions put in place by the World Health Organization to extend availability of occupational health coverage in both developed and undeveloped countries.Network of WHO Collaborating Centres in occupational health.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).Standard evaluation frameworkGA²LENInternational Network of Prison Ministries: The International Network of Prison Ministries (INPM) is a Dallas, Texas based crime prevention and rehabilitation trans-national organization. INPM functions through a website that serves as a clearinghouse for information about various Christian prison ministries.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.Generalizability 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.Feasibility Study (The Outer Limits): "Feasibility Study" is an episode of The Outer Limits television show. It was first broadcast on 11 July 1997, during the third season.Chronic disease in Northern OntarioComprehensive 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.Emergency Digital Information Service: Emergency Digital Information Service (EDIS) is a wireless datacast based emergency and disaster information service operated by the State of California Governor's Office of Emergency Services. In operation since 1990 the system was upgraded in 1999 to support image and sound capabilities via satellite broadcast.Women's Health Initiative: The Women's Health Initiative (WHI) was initiated by the U.S.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.European Immunization Week: European Immunization Week (EIW) is an annual regional initiative, coordinated by the World Health Organization Regional Office for Europe (WHO/Europe), to promote immunization against vaccine-preventable diseases. EIW activities are carried out by participating WHO/Europe member states.
(1/1748) Raising the bar: the use of performance guarantees by the Pacific Business Group on Health.
In 1996 the Pacific Business Group on Health (PBGH) negotiated more than two dozen performance guarantees with thirteen of California's largest health maintenance organizations (HMOs) on behalf the seventeen large employers in its Negotiating Alliance. The negotiations put more than $8 million at risk for meeting performance targets with the goal of improving the performance of all health plans. Nearly $2 million, or 23 percent of the premium at risk, was refunded to the PBGH by the HMOs for missed targets. The majority of plans met their targets for satisfaction with the health plan and physicians, as well as cesarean section, mammography, Pap smear, and prenatal care rates. However, eight of the thirteen plans missed their targets for childhood immunizations, refunding 86 percent of the premium at risk. (+info)
(2/1748) Indicators of the appropriateness of long-term prescribing in general practice in the United Kingdom: consensus development, face and content validity, feasibility, and reliability.
OBJECTIVES: To develop valid, reliable indicators of the appropriateness of long-term prescribing in general practice medical records in the United Kingdom. DESIGN: A nominal group was used to identify potential indicators of appropriateness of prescribing. Their face and content validity were subsequently assessed in a two round Delphi exercise. Feasibility and reliability between raters were evaluated for the indicators for which consensus was reached and were suitable for application. PARTICIPANTS: The nominal group comprised a disciplinary mix of nine opinion leaders and prominent academics in the field of prescribing. The Delphi panel was composed of 100 general practitioners and 100 community pharmacists. RESULTS: The nominal group resulted in 20 items which were refined to produce 34 statements for the Delphi exercise. Consensus was reached on 30, from which 13 indicators suitable for application were produced. These were applied by two independent raters to the records of 49 purposively sampled patients in one general practice. Nine indicators showed acceptable reliability between raters. CONCLUSIONS: 9 indicators of prescribing appropriateness were produced suitable for application to the medical record of any patient on long term medication in United Kingdom general practice. Although the use of the medical record has limitations, this is currently the only available method to assess a patient's drug regimen in its entirety. (+info)
(3/1748) Health authority commissioning for quality in contraception services.
OBJECTIVE: To compare the commissioning of contraception services by London health authorities with accepted models of good practice. DESIGN: Combined interview and postal surveys of all health authorities and National Health Service (NHS) trusts responsible for running family planning clinics in the Greater London area. MAIN OUTCOME MEASURES: Health authority commissioning was assessed on the presence of four key elements of good practice--strategies, coordination, service specifications, and quality standards in contracts--by monitoring activity and quality. RESULTS: Less than half the health authorities surveyed had written strategies or service specifications for contraception services. Arrangements for coordination of services were limited and monitoring was underdeveloped. CONCLUSION: The process of commissioning services for contraception seems to be relatively underdeveloped despite the importance of health problems associated with unplanned pregnancy in London. These findings raise questions about the capacity of health authorities to improve the quality of these services through the commissioning process. (+info)
(4/1748) Trust in performance indicators?
The 1980s and 90s have seen the proliferation of all forms of performance indicators as part of attempts to command and control health services. The latest area to receive attention is health outcomes. Published league tables of mortality and other health outcomes have been available in the United States for some time and in Scotland since the early 1990s; they have now been developed for England and Wales. Publication of these data has proceeded despite warnings as to their limited meaningfulness and usefulness. The time has come to ask whether the remedy is worse than the malady: are published health outcomes contributing to quality efforts or subverting more constructive approaches? This paper argues that attempts to force improvements through publishing health outcomes can be counterproductive, and outlines an alternative approach which involves fostering greater trust in professionalism as a basis for quality enhancements. (+info)
(5/1748) Assessment of management in general practice: validation of a practice visit method.
BACKGROUND: Practice management (PM) in general practice is as yet ill-defined; a systematic description of its domain, as well as a valid method to assess it, are necessary for research and assessment. AIM: To develop and validate a method to assess PM of general practitioners (GPs) and practices. METHOD: Relevant and potentially discriminating indicators were selected from a systematic framework of 2410 elements of PM to be used in an assessment method (VIP = visit instrument PM). The method was first tested in a pilot study and, after revision, was evaluated in order to select discriminating indicators and to determine validity of dimensions (factor and reliability analysis, linear regression). RESULTS: One hundred and ten GPs were assessed with the practice visit method using 249 indicators; 208 of these discriminated sufficiently at practice level or at GP level. Factor analysis resulted in 34 dimensions and in a taxonomy of PM. Dimensions and indicators showed marked variation between GPs and practices. Training practices scored higher on five dimensions; single-handed and dispensing practices scored lower on delegated tasks, but higher on accessibility and availability. CONCLUSION: A visit method to assess PM has been developed and its validity studied systematically. The taxonomy and dimensions of PM were in line with other classifications. Selection of a balanced number of useful and relevant indicators was nevertheless difficult. The dimensions could discriminate between groups of GPs and practices, establishing the value of the method for assessment. The VIP method could be an important contribution to the introduction of continuous quality improvement in the profession. (+info)
(6/1748) Conditional Length of Stay.
OBJECTIVE: To develop and test a new outcome measure, Conditional Length of Stay (CLOS), to assess hospital performance when deaths are rare and complication data are not available. DATA SOURCES: The 1991 and 1992 MedisGroups National Comparative Data Base. STUDY DESIGN: We use engineering reliability theory traditionally applied to estimate mechanical failure rates to construct a CLOS measure. Specifically, we use the Hollander-Proschan statistic to test if LOS distributions display an "extended" pattern of decreasing hazards after a transition point, suggesting that "the longer a patient has stayed in the hospital, the longer a patient will likely stay in the hospital" versus an alternative possibility that "the longer a patient has stayed in the hospital, the faster a patient will likely be discharged from the hospital." DATA COLLECTION/EXTRACTION METHODS: Abstracted records from 7,777 pediatric pneumonia cases and 3,413 pediatric appendectomy cases were available for analysis. PRINCIPAL FINDINGS: For both conditions, the Hollander-Proschan statistic strongly displays an "extended" pattern of LOS by day 3 (p<.0001) associated with declining rates of discharge. This extended pattern coincides with increasing patient complication rates. Worse admission severity and chronic disease contribute to lower rates of discharge after day 3. CONCLUSIONS: Patient stays tend to become prolonged after complications. By studying CLOS, one can determine when the rate of hospital discharge begins to diminish--without the need to directly observe complications. Policymakers looking for an objective outcome measure may find that CLOS aids in the analysis of a hospital's management of complicated patients without requiring complication data, thereby facilitating analyses concerning the management of patients whose care has become complicated. (+info)
(7/1748) Developing quality measures for adolescent care: validity of adolescents' self-reported receipt of preventive services.
OBJECTIVE: To demonstrate the feasibility of directly surveying adolescents about the content of preventive health services they have received and to assess the validity of adolescent self-reported recall. DATA SOURCES/SETTING: Audiotaped encounters, telephone interviews, and chart reviews with 14-21 year olds being seen for preventive care visits at 15 pediatric and family medicine private practices, teaching hospital clinics, and health centers. DESIGN: 537 adolescents presenting for well visits were approached, 400 (75 percent) consented, 374 (94 percent) were audiotaped, and 354 (89 percent) completed telephone interviews either two to four weeks or five to seven months after their visits. Audiotapes were coded for screening and counseling across 34 preventive service content areas. Intraobserver reliability (Cohen's kappa) ranged from 0.45 for talking about peers to 0.94 for discussing tobacco. The sensitivity and specificity of the adolescent self-reports were assessed using the audiotape coding as the gold standard. RESULTS: Almost all adolescents surveyed (94 percent) remembered having had a preventive care visit, 93 percent identified the site of care, and most (84 percent) identified the clinician they had seen. There was wide variation in the prevalence of screening, based on the tape coding. Adolescent self-report was moderately or highly sensitive and specific at two weeks and six months for 24 of 34 screening and counseling items, including having discussed: weight, diet, body image, exercise, seatbelts, bike helmet use, cigarettes/smoking, smokeless tobacco, alcohol, drugs, steroids, sex, sexual orientation, birth control, condoms, HIV, STDs, school, family, future plans, emotions, suicidality, and abuse. Self-report was least accurate for blood pressure/cholesterol screening, immunizations, or for having discussed fighting, violence, weapon carrying, sleep, dental care, friends, or over-the-counter drug use. CONCLUSION: Adolescents' self-report of the care they have received is a valid method of determining the content of preventive health service delivery. Although recall of screening and counseling is more accurate within two to four weeks after preventive care visits, adolescents can report accurately on the care they had received five to seven months after the preventive health care visits occurred. (+info)
(8/1748) The development of a quality information system: a case study of Mexico.
One of the primary obstacles in the implementation of continuous quality improvement (CQI) programmes in developing countries is the lack of timely and appropriate information for decentralized decision-making. The integrated quality information system (QIS) described herein demonstrates Mexico's unique effort to package four separate, yet mutually reinforcing, tools for the generation and use of quality-related information at all levels of the Mexican national health care system. The QIS is one element of the continuous quality improvement programme administered by the Secretariat of Health in Mexico. Mexico's QIS was designed to be flexible and capable of adapting to local needs, while at the same time allowing for the standardization of health care quality assurance indicators, and subsequent ability to measure and compare the quality performance of health facilities nationwide. The flexibility of the system extends to permit the optimal use of available data by health care managers at all levels of the health care system, as well as the generation of new information in important areas often neglected in more traditional information systems. Mexico's QIS consists of four integrated components: 1) a set of client and provider surveys, to assess specific issues in the quality of health services delivered; 2) client and provider national satisfaction surveys; 3) a sentinel health events strategy; and 4) a national Comparative Performance Evaluation System, for use by the Secretariate of Health for the quality assessment of state and provincial health care services (internal benchmarking). The QIS represents another step in Mexico's ongoing effort to use data for effective decision-making in the planning, monitoring and evaluation of services delivered by the national health care system. The design and application of Mexico's QIS provides a model for decentralized decision-making that could prove useful for developing countries, where the effective use of quality indicators is often limited. Further, the system could serve as a mechanism for motivating positive change in the way information is collected and used in the process of ensuring high quality health care service delivery. (+info)