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Community Services for the Elderly

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33101. Why do patients seek family physicians' services for cold symptoms? Full Text available with Trip Pro

using a checklist attached to each chart.Proportion of patients presenting with cold symptoms, reasons for presentation, number of days patients had had symptoms, billing code.A total of 1421 checklists were analyzed, 822 from academic practices and 599 from community practices. Proportion of presentations for cold symptoms was 14.8%, but visits coded as common cold represented 5.7%. Median number of days patients waited before presentation was 7.0; older patients tended to wait longer. Many (...) Why do patients seek family physicians' services for cold symptoms? To examine the frequency of presentation to family physicians' offices for cold symptoms, the reasons for presentation, and the duration of symptoms before presentation.Prospective cross-sectional survey.One hundred consecutive patient encounters in each of 15 family practices from January 27 to February 3, 1994, involving both academic and non-academic family physicians in the London region. Data were collected prospectively

1999 Canadian Family Physician

33102. Payment by salary or fee-for-service. Effect on health care resource use in the last year of life. Full Text available with Trip Pro

of Victoria, BC.A total of 582 patients in their last year of life: 106 were attended by salaried family physicians at a community health clinic; 476 were attended by fee-for-service practitioners. Groups were comparable in age, sex, and geographical location.Number and cost of specialist and diagnostic services and medications, number of days in hospital (acute and extended care), and main causes of death.None of the dependent measures showed any statistically significant differences based on comparisons (...) Payment by salary or fee-for-service. Effect on health care resource use in the last year of life. To investigate the effect of physician payment method on use of health care resources.Retrospective analysis of patient health care data collected for 3 years (1994 to 1996) from the Vital Statistics Department of the British Columbia Ministry of Health. Billing numbers identified physician payment method.Salaried and fee-for-service primary care practices in the Capital Region District

1999 Canadian Family Physician

33103. Factors explaining the use of psychiatric services by general practices. Full Text available with Trip Pro

by general practices.Cross-sectional data from computerized records used in managing clinical care on all patients aged 16 to 64 years who had been in contact with any mental health service staff over a two-year period. Twenty-three practices in Huntingdon Health District were studied, with a list population of 87,643 patients aged 16 to 64 years, served by one inpatient ward and three community mental health teams. The main outcome measures were the relation between age-standardized utilization ratio (...) and markers of morbidity, deprivation, community mental health provision, and practice prescribing.Variation between practices in the use of mental health services was relatively limited, especially compared with the use of other secondary medical and surgical services. Three factors together explained 60.8% of the variance in use between practices: a census-based index of long-term limiting illness in females registered with the practice, use of one of the three community mental health teams, and average

1999 The British Journal of General Practice

33104. Health and social services “locked in a vicious circle” Full Text available with Trip Pro

Health and social services “locked in a vicious circle” 10864539 2000 07 26 2016 11 24 0959-8138 320 7251 2000 Jun 24 BMJ (Clinical research ed.) BMJ Health and social services "locked in a vicious circle". 1692 Ferriman A A eng News England BMJ 8900488 0959-8138 AIM IM Aged Bed Occupancy Community Health Services supply & distribution Humans Stroke Rehabilitation United Kingdom 2000 6 23 11 0 2000 8 1 11 0 2000 6 23 11 0 ppublish 10864539 PMC1127476

2000 BMJ : British Medical Journal

33105. Health Care for Latino Children: Impact of Child and Parental Birthplace on Insurance Status and Access to Health Services Full Text available with Trip Pro

Health Care for Latino Children: Impact of Child and Parental Birthplace on Insurance Status and Access to Health Services This study sought to assess the impact of child and parental birthplace on insurance status and access to health care among Latino children in the United States.A cross-sectional, in-person survey of 376 random households with children aged 1 to 12 years was conducted in a predominantly Latino community. Children's insurance status and access to routine health care were

2001 American Journal of Public Health

33106. Core and comprehensive health care services: 3. Ethical issues. Full Text available with Trip Pro

and the other with the process to be followed. The five ethical criteria discussed are fairness, age, lifestyle, the identifiable versus the statistical patient, and futility. An ethical process incorporates appropriate roles for the public physicians and payers (government) and accountability of all participants. A provided checklist for determining a fair process asks such questions as Do potential users of a service, its providers and the public have an adequate say in the decision about whether (...) the service should be publicly funded? Are the reasons for the decision communicated to those affected by it? and is the service being denied to potential users on the basis of unfair discrimination or lifestyle?

1995 CMAJ: Canadian Medical Association Journal

33107. The effect of an Rx-to-OTC switch on medication prescribing patterns and utilization of physician services: the case of vaginal antifungal products. Full Text available with Trip Pro

The effect of an Rx-to-OTC switch on medication prescribing patterns and utilization of physician services: the case of vaginal antifungal products. We examined the impact of over-the-counter (OTC) availability of vaginal antifungal products, beginning in January 1991, on medication prescribing patterns and utilization of physician services.Data on utilization of health care services and prescription medications by female members (ages 11 and older) of the Fallon Community Health Plan (FCHP (...) of the study period. We also identified the number of physician office visits characterized by the ICD-9-CM code 616.10 ("vaginitis and vulvovaginitis, unspecified") occurring during each month of the study period.For the one-year period after OTC availability of vaginal antifungal products (January 1991 through December 1991), we estimated that the number of prescriptions dispensed for these products was reduced by 6.42 per 100 female FCHP members ages 11 and older. Physician visits for vaginitis were

1995 Health Services Research

33108. Do physician-payment mechanisms affect hospital utilization? A study of Health Service Organizations in Ontario. Full Text available with Trip Pro

practices in Ontario.Thirty-nine physicians whose method of payment was converted from fee-for-service to capitation during the period from June 1985 to January 1989 and 7 physicians who remained in fee-for-service practice, two of whom were matched with one physician in capitation-based practice on the basis of practice location, type of practice (academic v. community), hours of practice (part-time v. full-time), years since graduation, physician group size, practice size (number of patients), type (...) of group (primary care v. multispecialty), sex, certification in family medicine, country of graduation (Canada v. other) and age. One physician in capitation-based practice was matched with only one physician in fee-for-service practice.Annual hospital-utilization rates (hospital separations or hospital days per 1000 patients in each practice) for the physicians paid on a capitation basis 3 years before, 1 year before and 3 years after they converted from fee-for-service payment and at corresponding

1996 CMAJ: Canadian Medical Association Journal

33109. Quality of service provision for anticoagulation in atrial fibrillation. Patients and doctors play it safe. Full Text available with Trip Pro

Quality of service provision for anticoagulation in atrial fibrillation. Patients and doctors play it safe. 8555868 1996 02 26 2018 11 13 0959-8138 312 7022 1996 Jan 06 BMJ (Clinical research ed.) BMJ Quality of service provision for anticoagulation in atrial fibrillation. Patients and doctors play it safe. 51-2 Scott M E ME Wallace W F WF eng Comment Letter England BMJ 8900488 0959-8138 0 Anticoagulants 5Q7ZVV76EI Warfarin AIM IM BMJ. 1995 Aug 26;311(7004):558-60 7663216 Adult Aged Aged, 80 (...) and over Anticoagulants administration & dosage therapeutic use Atrial Fibrillation drug therapy Communication Female Humans Male Middle Aged Physician-Patient Relations Warfarin administration & dosage therapeutic use 1996 1 6 1996 1 6 0 1 1996 1 6 0 0 ppublish 8555868 PMC2349689 BMJ. 1995 Aug 26;311(7004):558-60 7663216

1996 BMJ : British Medical Journal

33110. Preschool vision screening: outcome of children referred to the hospital eye service. Full Text available with Trip Pro

Preschool vision screening: outcome of children referred to the hospital eye service. To assess the outcome of children referred to the hospital eye service (HES) from an orthoptist based preschool vision screening programme.A retrospective study was conducted of children referred from screening during a 2 year period. Children were screened by community orthoptists at 3 1/2 years of age. The main outcome measures were (1) HES findings for children referred from screening, and (2) visual

1996 The British journal of ophthalmology

33111. A survey of access to medical services in nursing and residential homes in England. Full Text available with Trip Pro

A survey of access to medical services in nursing and residential homes in England. Residential and nursing homes make major demands on NHS services.To investigate patterns of access to medical services for residents in homes for older people.Telephone survey.All nursing and dual registered homes and one in four residential homes located in a stratified random sample of 72 English primary care group/trust (PCG/T) areas.A structured questionnaire investigating home characteristics, numbers (...) ' policies and local GP services raise serious questions about patient choice, levels of GP services and, above all, about equity between residents within homes, between homes and between those in homes and in the community.

2002 The British Journal of General Practice

33112. Providers of Complementary and Alternative Health Services in Boston Respond to September 11 Full Text available with Trip Pro

Public Health 1254074 0090-0036 AIM IM Adolescent Adult Ambulatory Care Facilities organization & administration statistics & numerical data Boston Child Community-Institutional Relations Complementary Therapies organization & administration Crisis Intervention Female Humans Male Middle Aged New York City Organizations, Nonprofit Public Health Stress Disorders, Post-Traumatic therapy Terrorism psychology Urban Health Services organization & administration statistics & numerical data 2002 10 3 4 0 (...) Providers of Complementary and Alternative Health Services in Boston Respond to September 11 12356601 2002 10 22 2018 11 30 0090-0036 92 10 2002 Oct American journal of public health Am J Public Health Providers of complementary and alternative health services in Boston respond to September 11. 1597-8 Sommers Elizabeth E AIDS Care Project, 140 Clarendon Street, 7th Floor, Boston, MA 02116, USA. bsommers@pathwaystcm.prg Porter Kristen K DeGurski Stephen S eng Journal Article United States Am J

2002 American Journal of Public Health

33113. 1. The Organization and Financing of Health Services for Persons with Disabilities Full Text available with Trip Pro

1. The Organization and Financing of Health Services for Persons with Disabilities Americans with disabilities are rarely considered a distinct group of health care users in the same way as are older Americans, children, racial and ethnic minorities, and others who are perceived to have different needs and access issues. Indeed, to some extent individuals with disabilities overlap with all these groups. But they also have distinct needs with material implications for the organization, delivery (...) , and financing of health care services. Despite the disproportionate health care needs and expenditures of many--though not all--individuals with disabilities, the mainstream health services research community has largely neglected them. This article outlines the most pressing health service research issues in addressing the health care needs of individuals with disabilities.

2002 The Milbank quarterly

33114. Provision of Sexual Health Services to Adolescent Enrollees in Medicaid Managed Care Full Text available with Trip Pro

Provision of Sexual Health Services to Adolescent Enrollees in Medicaid Managed Care This Seattle project measured sexual health services provided to 1112 Medicaid managed care enrollees aged 14 to 18 years.Three health maintenance organizations (HMOs) that provide Medicaid services for a capitated rate agreed to participate. These included a non-profit staff-model HMO, a for-profit independent practice association (IPA), and a non-profit alliance of community clinics. Analyses used health (...) the for-profit independent practice association on most measures.Substantial room for improvement exists in sexual health services delivery to adolescent Medicaid managed care enrollees.

2002 American Journal of Public Health

33115. Outcome measures for routine use in dementia services: some practical considerations. Full Text available with Trip Pro

Outcome measures for routine use in dementia services: some practical considerations. To work with specialist community teams to assess the practicality and acceptability of identified outcome measures for routine use in dementia services.Seven specialist dementia services: four multidisciplinary teams, a specialist service for carers, a community psychiatric nurse team, and a day hospital.20 members of staff from the specialist dementia services including psychiatry, community psychiatric (...) nursing, social work, occupational therapy, Admiral nursing, ward management, geriatric nursing.A questionnaire designed to assess staff views on the use of six outcome measures in routine practice in terms of practicality, relevance, acceptability, and use in improving care.Each of the outcome measures took 15 to 30 minutes to administer. All were rated as easy to use and as relevant to dementia services and to carers. Staff commented that the measures could be useful in routine practice

1997 Quality In Health Care

33116. Diabetes and hypertension in Britain's ethnic minorities: implications for the future of renal services. Full Text available with Trip Pro

patients receiving such treatment. Their greater need for renal replacement treatment is accompanied by difficulties of tissue matching in cross racial transplants and a shortage of donor organs. The aging of ethnic minority populations will increase local need for renal services significantly. Measures to control diabetes, hypertension, and secondary complications in Asian and African-Caribbean communities will contribute both to safeguarding health and to economies in spending on renal services (...) Diabetes and hypertension in Britain's ethnic minorities: implications for the future of renal services. Diabetes and hypertension are much more prevalent among Britain's 2.5 million Asian and African-Caribbean population than among the white population and are major contributors to end stage renal failure. Asians and African-Caribbeans have threefold to fourfold higher acceptance rates on to renal replacement therapy than white people, and in some districts they comprise up to half of all

1997 BMJ : British Medical Journal

33117. Tuberculosis in National Health Service hospital staff in the west Midlands region of England, 1992-5 Full Text available with Trip Pro

in the local social class 2 working age population (0.6 (0.5 to 0.7)).Case ascertainment via the registry was complete. Most cases of TB were in nurses and doctors, more commonly in doctors. However, all but one of the doctors were foreign born and probably had reactivation of infection acquired abroad rather than infection occupationally acquired in the UK. All but one of the nurses, however, were UK born and may have had occupationally acquired disease, their incidence being higher than in the community (...) Tuberculosis in National Health Service hospital staff in the west Midlands region of England, 1992-5 This study was designed to assess the current incidence of tuberculosis (TB) in National Health Service hospital staff in the West Midlands region of England and to evaluate the effectiveness of occupational health screening and surveillance procedures.A four year prospective study (1992-5) was carried out with case ascertainment through occupational health departments and the Midlands Thoracic

1997 Thorax

33118. Geographic analysis of pertussis infection in an urban area: a tool for health services planning. Full Text available with Trip Pro

Geographic analysis of pertussis infection in an urban area: a tool for health services planning. This study examined whether incident cases of pertussis cluster in urban census tracts and identified community characteristics that predict high-incidence areas.An ecological study design was used. The study population included all persons diagnosed with pertussis from January 1, 1986, through December 31, 1994. Maps of rates were constructed via a geographic information system and clustering (...) was statistically confirmed. Associations between pertussis rates and community characteristics were tested.Mapping and statistical analysis revealed spatial clustering of pertussis. Higher age-adjusted rates of pertussis infection were associated with higher proportions of residents below poverty level.In urban areas pertussis infection clusters in areas of poverty.

1997 American Journal of Public Health

33119. Coping and health service utilisation in a UK study of paediatric sickle cell pain Full Text available with Trip Pro

for children with sickle cell disease). Medical data on complications, haemoglobin (Hb) levels, and foetal haemoglobin (HbF) percentage were also collected.Pain accounted for about 24% of hospital service use, independent of age, sex, number of with sickle cell disease complications, and Hb levels. However, 42% of patients had not utilised hospital services in the past 12 months. Three higher order factors emerged from analysis of the CSQ (active coping, affective coping, passive adherence coping). Pain (...) severity was predicted by passive adherence coping, while utilisation of hospital services was predicted by active coping.Sickle cell disease in children involves severe recurrent pain leading to hospitalisation in some cases. Psychological coping patterns are relevant to both pain experience, and the use of acute hospital services. It is likely that children would benefit from community based interventions that incorporate both medical and psychological assessments.

2002 Archives of Disease in Childhood

33120. A self-help intervention for African American smokers: tailoring cancer information service counseling for a special population. (Abstract)

African American smokers (n = 1,422) who called four regional CIS offices in response to a radio-based media campaign in 14 communities. Callers were randomly assigned to receive either the standard CIS quit smoking counseling and guide (Clearing the Air) or counseling and a guide (Pathways to Freedom) tailored to the quitting needs and barriers of African American smokers. Callers were predominantly female (63.6%). ages 20-49 (88%), with a high school education or more (84%). Median smoking history (...) A self-help intervention for African American smokers: tailoring cancer information service counseling for a special population. African Americans remain a critically underserved group for smoking cessation interventions. This study tested the effectiveness of a tailored, culturally sensitive intervention for African American smokers who called the NCI Cancer Information Service (CIS) for help to quit smoking.This paper presents results of a 2-year study of tailored counseling strategies among

1998 Preventive Medicine Controlled trial quality: uncertain

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