Sample records for army health service

  1. The Army Primary Health Care Service: from foundation to future. (United States)

    Burgess, J


    Following the British Government's implementation of policies to improve quality and introduce clinical governance into healthcare delivery in the late 1990s, the British Army commissioned a study into how primary healthcare for the Regular Army should best be delivered in UK. The study recommended a unitary command structure, with more central control based upon a model of a main headquarters and seven regions. The change has been largely successful and has been subject to external scrutiny. Areas still to be developed include improving information management and benchmarking standards against the NHS, improvements in practice management, plus developments in occupational health and the nursing cadres. The forthcoming Strategic Defence and Security Review and other ongoing studies are likely to have a profound influence on how the current Army Primary Health Care Service develops.

  2. [The army of the East and health services]. (United States)

    Guivarc'h, Marcel


    A medical disaster due to the failure of a plan intended to free Belfort by an army of 90 000 men, formed by Bourbaki in Nevers, joined in Besancon by 40 000 men from Lyon and from Dijon. Envisaged in three days, the regrouping lasts three weeks. A gigantic railway blocking, by an icy cold, leaves in the trains of the soldiers without food, of the horses without irons nor fodder. A third of manpower is from the start inapt for the fights. The utter exhaustion of the men don't make possible to exploit the success of Villersexel's battle (January 9), nor to cross Lizaine. The medical army officers joined those of the civil ambulances formed in South-east, and that of Pamard. The care given with delay on the covered with snow ground, in precarious shelters or encumbered hospitals, is summary. Cold, gelures, walk feet, infection, associated variola, are the cause of a high mortality: 8 500 died, and much of casualties. Ordered by Bourbaki, the dramatic routed to Switzerland by Pontarlier and the Cluse collar, under the Prussian shells will add 15 000 killed. The Swiss ones collect sick and wounded in 200 ambulances along the border, and on 87 000 men to be disarmed in 9 000 hospitalize. Pamard will remain until March 18 at the Pontarlier' hospital.

  3. U. S. Army Directory of Technical Information Holdings and Services. (United States)

    Vincent, Dale L.

    The directory identifies 111 Army sources of technical information that include 2200 specialized subject areas. The sources are indexed by subject matter, and name of holding, so that a searcher can find a description of all available indexed Army information services, with details on scope and size of collections, services available, and means of…

  4. Rear Area Security In The Field Army Service Area. (United States)


    his ma.jor subordinate Commanders, the arm support brigade commander. Rear are? ecurity doctrine requires the area coriander to coordin- ate unit...field army service area. Response The army support brigade coriander conducts phase I rear area security operations within the limits of current

  5. Commentary on "The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)": Army STARRS: a Framingham-like study of psychological health risk factors in soldiers. (United States)

    Ressler, Kerry J; Schoomaker, Eric B


    Although historically the Army suicide rate has been significantly lower than the civilian rate, in 2004, the suicide and accidental death rates began trending upward. By 2008, the Army suicide rate had risen above the national average (20.2 per 100,000). In 2009, 160 active duty Soldiers took their lives, making suicide the third leading cause of death among the Army population. If accidental death, frequently the result of high-risk behavior, is included, then more Soldiers died by their own actions than in combat in 2009. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) was thus created in 2009 to begin to address these problems. The Army STARRS project is a large consortium of seven different studies to develop data-driven methods for mitigating or preventing suicide behaviors and improving the overall mental health and behavioral functioning of Army Soldiers during and after their Army service. The first research articles from the Army STARRS project were published in late 2013 and early 2014. This work has already begun to outline important facets of risk in the military, and it is helping to drive an empirically derived approach to improvements in understanding mental disorders and risk behavior and to improve prevention and support of mental health and resilience. The Framingham Heart Study, started in the 1940s, marked a watershed event in utilizing large cross-sectional and prospective longitudinal collaborative research to identify and understand risk factors for cardiovascular disease. The Army STARRS project, through its collaborative, prospective, and robust innovative design and implementation, may provide the beginning of a similar scientific cohort in mental disorders. The work of this project will help understand biological and psychological aspects of military service, including those leading to suicide. When coupled with timely feedback to Army leadership, it permits near real-time steps to diagnose, mitigate, and

  6. Estimating active Army and Army Reserve competition for high quality recruits with other military services


    Demyanovich, James M.


    The analysis concentrated primarily on the recruiting of high quality recruits for the period FY 1987 through 2d Quarter FY 1995. The U.S. Military Entrance Processing Command (USMEPCOM) data used contained sufficiently accurate figures on Active Army and Army Reserve accessions. The data appears to represent a relatively accurate historical record of the number of non prior service enlistments into the Military Services, with the exception of the Air National Guard and Ai...

  7. Army Information Technology Enterprise Solutions-2 Services Contract (United States)


    Contracting personnel from the Army and other Federal agencies who are involved in information technology service acquisition decisions should read...IDIQ) contracts. The Inspector General (IG), DoD initiated the audit of the Army Information Technology Enterprise Solutions-2 Services (ITES-2S...contract because of the material impact this contract will have on the acquisition of information technology resources within DoD and the Federal Government

  8. [The humanitarian work of France in the Sahara. The Health Service of the army in the territories of Southern Algeria (1900-1976]. (United States)

    Savelli, André


    Medical assistance to the Saharian populations (1900-1976) is viewed through its organization. The management of the Health Service in the Southern Territories, doctors, nursing staff, medical districts, centred on infirmary-hospitals and rural first-aid posts. We insist on the everrising free consultations and the care to sick and wounded patients in infirmaries; the fight against epidemics and social scourges. Then on French medical mission from 1963 to 1976, and on the humanitarian work by the Health Service throughout the five continents.

  9. 32 CFR 516.14 - Service of process on DA or Secretary of Army. (United States)


    ... 32 National Defense 3 2010-07-01 2010-07-01 true Service of process on DA or Secretary of Army. 516.14 Section 516.14 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF... or Secretary of Army. The Chief, Litigation Division, shall accept service of process for...

  10. Trade in health services. (United States)

    Chanda, Rupa


    In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services.

  11. Legal Services: The Army Legal Assistance Program (United States)


    legal services providedpro bono publico are not always on a no-fee basis because a reduced fee for professional services may be permissible in such...y f o u n d w i t h i n a p r i n c i p a l residence. Pro bono publico Legal services provided by civilian attorneys “for the public good or activities, 3–6, 3–8 P r i v i l e g e , a t t o r n e y - c l i e n t , 3 – 8 , 4 – 3 , 4 – 8 , 5–5 Prisoners, 2–5 Pro bono publico , 3–7

  12. Technology complementing military behavioral health efforts at tripler army medical center. (United States)

    Stetz, Melba C; Folen, Raymond A; Yamanuha, Bronson K


    The purpose of this article is to provide a short narrative on the ways that behavioral health professionals and their patients are currently benefitting from the use of technology. Examples stem from applications of technology to patients/research participants at the Tripler Army Medical Center. The paper also discusses how current use of this technology has made it possible to serve individuals in their own cultural environment, providing a cost-effective means of providing mental health services.

  13. Indian Health Service: Find Health Care (United States)

    ... and Human Services Indian Health Service The Federal Health Program for American Indians and Alaska Natives Feedback ... Forgot Password IHS Home Find Health Care Find Health Care IMPORTANT If you are having a health ...

  14. [The seven wounds Ernst Jünger at the time of the Great War. Reflection of the health service of the imperial army]. (United States)

    Ségal, Alain; Ferrandis, Jean-Jacques


    Thanks to Ernt Junger's amazing career--and despite his many injuries--we have a great view of the German Imperial Army's sanitary corps. This can be observed from the actions of the stretcher-bearers to German hospitals in general, and with the organization of their sanitary transport, as well as their medico-surgical concerns. We can see, therefore, that very few differences existed with the French medico-surgical structures except for the fact that,from the very beginning, Imperial medical warfare was able to adjust to the changes from field to trench situations. Thanks to its adaptable system of triage, and its ability to offer the most coherent medico-surgical choices and options, it was possible to save time. It enabled surgical actions in places that were close to the battlefield. Furthermore, we have been able to find out about the personal experience of an exceptional 20th century writer who later became a great European citizen.

  15. [Marketing in health service]. (United States)

    Ameri, Cinzia; Fiorini, Fulvio


    The gradual emergence of marketing activities in public health demonstrates an increased interest in this discipline, despite the lack of an adequate and universally recognized theoretical model. For a correct approach to marketing techniques, it is opportune to start from the health service, meant as a service rendered. This leads to the need to analyse the salient features of the services. The former is the intangibility, or rather the ex ante difficulty of making the patient understand the true nature of the performance carried out by the health care worker. Another characteristic of all the services is the extreme importance of the regulator, which means who performs the service (in our case, the health care professional). Indeed the operator is of crucial importance in health care: being one of the key issues, he becomes a part of the service itself. Each service is different because the people who deliver it are different, furthermore there are many variables that can affect the performance. Hence it arises the difficulty in measuring the services quality as well as in establishing reference standards.

  16. [A spectacular revolution: evolution of French military health service]. (United States)

    Lefort, Hugues; Ferrandis, Jean-Jacques; Tabbagh, Xavier; Lanoe, Vincent; Tourtier, Jean-Pierre


    After the sanitary disaster caused by the first months of the conflict, the Health service of the French armies undertook a true revolution. By 1918, it had become the most efficient of all the opposing armies. At the end of 1914, through the spacing out of the evacuating hospitals within the zone of the armies, the most efficient teams were placed as close as possible to the front. Injured soldiers were categorized at every step of the chain. Technical progress, especially in war surgery, pushed medicine into the moderne era.

  17. A Study to Establish Baseline Data on the Retiree Population’s Perceptions of Access and Health Care Delivered through Outpatient Services at Ireland Army Community Hospital (United States)


    common household products, there are many ideas and principles that are used in marketing consumer products that can be applied to primary health care...Design & Analysis, Chicago: Free Press, 1955. Kotler , Phillip., Marketing for Nonprofit Organizations, Englewood Cliffs, NJ: Prentice-Hall, Inc., recapture ’the retiree population around IACH, Ft. Knox, KY. and to implement a marketing strategy which would attempt to recapture a portion of

  18. The 1991 Department of the Army Service Response Force exercise: Procedural Guide SRFX-91

    Energy Technology Data Exchange (ETDEWEB)

    Madore, M.A.; Thomson, R.S.; Haffenden, R.A.; Baldwin, T.E.; Meleski, S.A.


    This procedural guide was written to assist the US Army in planning for a chemical emergency exercise at Tooele Army Depot in Utah. The roles of various members of the emergency response community are described for various accident scenarios, and the relationships between the various responders are identified. For the June 1991 exercise at Tooele, the emergency response community includes the command structure at Tooele Army Depot; the US Army Service Response Force and other Department of Defense agencies; emergency response personnel from Tooele, Salt Lake, and Utah counties and municipal governments; the Utah Comprehensive Emergency Management Agency and other state agencies; and various federal agencies.

  19. Conceptions of health service robots

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang


    Technology developments create rich opportunities for health service providers to introduce service robots in health care. While the potential benefits of applying robots in health care are extensive, the research into the conceptions of health service robot and its importance for the uptake...... of robotics technology in health care is limited. This article develops a model of the basic conceptions of health service robots that can be used to understand different assumptions and values attached to health care technology in general and health service robots in particular. The article takes...... a discursive approach in order to develop a conceptual framework for understanding the social values of health service robots. First a discursive approach is proposed to develop a typology of conceptions of health service robots. Second, a model identifying four basic conceptions of health service robots...

  20. Predictors of Army National Guard and Reserve members' use of Veteran Health Administration health care after demobilizing from OEF/OIF deployment. (United States)

    Harris, Alex H S; Chen, Cheng; Mohr, Beth A; Adams, Rachel Sayko; Williams, Thomas V; Larson, Mary Jo


    This study described rates and predictors of Army National Guard and Army Reserve members' enrollment in and utilization of Veteran Health Administration (VHA) services in the 365 days following demobilization from an index deployment. We also explored regional and VHA facility variation in serving eligible members in their catchment areas. The sample included 125,434 Army National Guard and 48,423 Army Reserve members who demobilized after a deployment ending between FY 2008 and FY 2011. Demographic, geographic, deployment, and Military Health System eligibility were derived from Defense Enrollment Eligibility Reporting System and "Contingency Tracking System" data. The VHA National Patient Care Databases were used to ascertain VHA utilization and status (e.g., enrollee, TRICARE). Logistic regression models were used to evaluate predictors of VHA utilization as an enrollee in the year following demobilization. Of the study members demobilizing during the observation period, 56.9% of Army National Guard members and 45.7% of Army Reserve members utilized VHA as an enrollee within 12 months. Demographic, regional, health coverage, and deployment-related factors were associated with VHA enrollment and utilization, and significant variation by VHA facility was found. These findings can be useful in the design of specific outreach efforts to improve linkage from the Military Health System to the VHA.

  1. Barriers to Initiating and Continuing Mental Health Treatment Among Soldiers in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). (United States)

    Naifeh, James A; Colpe, Lisa J; Aliaga, Pablo A; Sampson, Nancy A; Heeringa, Steven G; Stein, Murray B; Ursano, Robert J; Fullerton, Carol S; Nock, Matthew K; Schoenbaum, Michael; Zaslavsky, Alan M; Kessler, Ronald C


    U.S. Army soldiers with mental disorders report a variety of barriers to initiating and continuing treatment. Improved understanding of these barriers can help direct mental health services to soldiers in need. A representative sample of 5,428 nondeployed Regular Army soldiers participating in the Army Study to Assess Risk and Resilience in Servicemembers completed a self-administered questionnaire and consented to linking self-administered questionnaire data with administrative records. We examined reported treatment barriers (perceived need, structural reasons, attitudinal reasons) among respondents with current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, mental disorders who either did not seek treatment in the past year (n = 744) or discontinued treatment (n = 145). About 82.4% of soldiers who did not initiate treatment and 69.5% of those who discontinued treatment endorsed at least two barriers; 69.8% of never-treated soldiers reported no perceived need. Attitudinal reasons were cited more frequently than structural reasons among never-treated soldiers with perceived need (80.7% vs. 62.7%) and those who discontinued treatment (71.0% vs. 37.8%). Multivariate associations with sociodemographic, Army career, and mental health predictors varied across barrier categories. These findings suggest most soldiers with mental disorders do not believe they need treatment and those who do typically face multiple attitudinal and, to a lesser extent, structural barriers.

  2. Individual health services

    Directory of Open Access Journals (Sweden)

    Schnell-Inderst, Petra


    Full Text Available Background: The German statutory health insurance (GKV reimburses all health care services that are deemed sufficient, appropriate, and efficient. According to the German Medical Association (BÄK, individual health services (IGeL are services that are not under liability of the GKV, medically necessary or recommendable or at least justifiable. They have to be explicitly requested by the patient and have to be paid out of pocket. Research questions: The following questions regarding IGeL in the outpatient health care of GKV insurants are addressed in the present report: What is the empirical evidence regarding offers, utilization, practice, acceptance, and the relation between physician and patient, as well as the economic relevance of IGeL? What ethical, social, and legal aspects are related to IGeL? For two of the most common IGeL, the screening for glaucoma and the screening for ovarian and endometrial cancer by vaginal ultrasound (VUS, the following questions are addressed: What is the evidence for the clinical effectiveness? Are there sub-populations for whom screening might be beneficial? Methods: The evaluation is divided into two parts. For the first part a systematic literature review of primary studies and publications concerning ethical, social and legal aspects is performed. In the second part, rapid assessments of the clinical effectiveness for the two examples, glaucoma and VUS screening, are prepared. Therefore, in a first step, HTA-reports and systematic reviews are searched, followed by a search for original studies published after the end of the research period of the most recent HTA-report included. Results: 29 studies were included for the first question. Between 19 and 53% of GKV members receive IGeL offers, of which three-quarters are realised. 16 to 19% of the insurants ask actively for IGeL. Intraocular tension measurement is the most common single IGeL service, accounting for up to 40% of the offers. It is followed by

  3. The role of the US Army Veterinary Corps in military family pet health. (United States)

    Vincent-Johnson, Nancy A


    Even though privately-owned pet care is a lower priority mission than military working dog care, food inspection,and the public health mission, it is still very important,and the one that many Veterinary Corps officers, civil-ian veterinarians, and technicians enjoy the most. The vast majority of veterinarians and technicians went into veterinary medicine because of a love for animals. It is fulfilling to offer guidance to a client with a new puppy or kitten, see a sick pet improve after treatment, and interact with dozens of animals and clients in a day. The services provided by the Army Veterinary Corps in car-ing for pets has expanded over the years and the standard of care has improved as well. It is truly a privilege to serve those who dedicate themselves to the protection of our Nation. The Army Veterinary Corps is indeed proud to provide care to the pets of Warfighters of the Army,Navy, Marine Corps, Air Force, and Coast Guard; their family members; and our military retirees.

  4. [The historical experience of therapeutic service in the Army and Navy during the Great Patriotic War]. (United States)

    Ovchinnikov, Yu V


    The author presents the experience of therapeutic services of the army and navy during the Great Patriotic War (1941-1945) and its importance for the present. This experience became a-general methodological framework-for the development of principles for the organization of work of military physicians in a modern warfare and the application of new weapons. The history of development, aims and objectives of the new section of Military Medicine--the Military Field Therapy as a unified system of organization and delivery of health care to servicemen based on the principles of a unified military field medical doctrine. A problem of organization of new health facilities (hospitals, hospital databases), their acquisition of trained personnel, especially the structure of internal medicine in the war years, the treatment and the early rehabilitation of wounded and sick, between the military and civilian medical institutions-is highlighted. There is an information that 90.6%, or more than 6.5 million soldiers and officers who were treated in hospitals with various diseases, were returned to duty. The experience of the medical service in World War II and the actual demand and is now planning for a package of measures aimed at further improvement of the health status of military-personnel.

  5. Correlation of psychosomatic health and situation idiosyncratic coping of army men garrisoned at islands

    Directory of Open Access Journals (Sweden)

    Wei NIU


    Full Text Available Objective To explore the correlation between psychosomatic health and situation idiosyncratic coping of army men garrisoned at islands. Methods By randomized cluster sampling, a total of 499 service men garrisoned at islands were designated as experimental group, and 615 service men garrisoned out of islands were as control group. The both groups were assessed by Chinese Military Psychosomatic Health Scale and Chinese Military Situational Characteristics Scale in the Chinese Soldiers Mental Health Evaluation Instrument (TR-09, and the influencing factors were analyzed. Results The scores of each psychosomatic health factor of service men in experimental group were higher than those in control group (t=7.513-24.028, P<0.01. In the service men of experimental group, the scores of psychotic, anxiety and depression were higher than other factors, and the scores of cardiovascular and skin were lower. With exception of the factors of eye-ear and nervous system, the score of psychosomatic health was lower in the service men with college and above educational background than in those with junior and senior school educational background (F=0.526-3.245, P<0.05. The psychosomatic health were better in married service men than in unmarried ones (t=0.663-2.869, P<0.05. With exception of the cardiovascular system, the psychosomatic health score was higher in officers than in soldiers and non-commissioned officers (t=–1.434 - –4.381, P<0.05. With exception of psychotic factor, the psychosomatic health score in service men garrisoned at islands was negatively related to the active coping style (r=–0.065 - –0.121, P<0.05, and positively related to the inactive coping style (r=0.062-0.067, P<0.05. Conclusions The psychosomatic health of service men garrisoned at islands is worse. The psychosomatic health of service men with higher educational level, married and low ranked is better. Active coping style is beneficial to psychosomatic health of

  6. Accessibility of adolescent health services

    Directory of Open Access Journals (Sweden)

    S Richter


    Full Text Available Adolescents represent a large proportion of the population. As they mature and become sexually active, they face more serious health risks. Most face these risks with too little factual information, too little guidance about sexual responsibility and multiple barriers to accessing health care. A typical descriptive and explanatory design was used to determine what the characteristics of an accessible adolescent health service should be. Important results and conclusions that were reached indicate that the adolescent want a medical doctor and a registered nurse to be part of the health team treating them and they want to be served in the language of their choice. Family planning, treatment of sexually transmitted diseases and psychiatric services for the prevention of suicide are services that should be included in an adolescent accessible health service. The provision of health education concerning sexual transmitted diseases and AIDS is a necessity. The service should be available thought out the week (included Saturdays and within easy reach. It is recommended that minor changes in existing services be made, that will contribute towards making a health delivery service an adolescent accessible service. An adolescent accessible health service can in turn make a real contribution to the community’s efforts to improve the health of its adolescents and can prove to be a rewarding professional experience to the health worker.

  7. [Terrorism, public health and health services]. (United States)

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge


    Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

  8. Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army (United States)


    Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army 21 September...Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army 5a. CONTRACT NUMBER 5b...Service Supply Chain , Services Acquisition, Service Lifecycle, Contract Management, Project Management, Program Management = = ^Åèìáëáíáçå=oÉëÉ~êÅÜ

  9. Health care's service fanatics. (United States)

    Merlino, James I; Raman, Ananth


    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.

  10. Army Guide to Deployment Health: Health Threat Information and Countermeasures (United States)


    flu, tuberculosis, colds) and sexually transmitted diseases (HiV, chlamydia, herpes ). usaPHc technical Guide 281 - Guide to female soldier readiness...awareness in a tactical environment. Oral Health the risk of tooth decay and gum disease increases during deployments...High amounts of starch and sugar in rations and limited opportunity to brush make it difficult to maintain good oral health. ` Floss once a day

  11. The fiction of health services

    Directory of Open Access Journals (Sweden)

    Oscar Echeverry


    Full Text Available 14.00 800x600 Normal 0 21 false false false ES-CO X-NONE X-NONE MicrosoftInternetExplorer4 What we know today as Health Services is a fiction, perhaps shaped involuntarily, but with deep health repercussions, more negative than positive. About 24 centuries ago, Asclepius god of medicine and Hygeia goddess of hygiene and health, generated a dichotomy between disease and health that remains until today. The confusing substitution of Health Services with Medical Services began by the end of the XIX century. But it was in 1948 when the so called English National Health Service became a landmark in the world and its model was adopted by many countries, having distorted the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by its name not to deceive society and to correct the serious imbalance between Medical Services and Health Services. Hygeia and Asclepius must become a brotherhood.

  12. Relationship between Burnout Syndrome and health conditions among Army Military.

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    Bruno Mendes de Jesus


    Full Text Available Objective: to identify the relationship between Burnout Syndrome and demographic, socioeconomic, health, lifestyle habits/attitudes/behaviors and working conditions among Brazilian Army soldiers. Methods: cross-sectional study of a military battalion in Minas Gerais. Evaluated the Burnout syndrome through Maslach Burnout Inventory, validated instrument for use in Brazil, and the data collected by researchers calibrated. This study was approved by the Ethics Committee of the Brazilian Educational Association. Results: the study involved 121 soldiers, of whom 119 answered the Maslach Burnout Inventory. Reported a prevalence of BS in 89.1% (n=106 of the military. Through the analysis of multiple logistic regression found a higher chance of developing burnout, military with low perception on Life Quality in the physical level (OR: 6.95, CI: 1.08 to 44.82; p: 0.042 and psychological (OR : 5.12, CI: 1.03 to 25.50; p: 0.046. Less likely to occur Burnout was found between military with low perception of life quality level in the environmental field (OR: 0.16; CI: from 0.03 to 0.82; p: 0.027 and those who make continued use of medicine (OR: 0.16, CI: 0.03 to 0.83; p: 0.029. Conclusion: a relationship was identified between burnout and health conditions (low perception of life quality level in the physical, psychological and environmental and use of medication.

  13. NATO survey of mental health training in army recruits

    NARCIS (Netherlands)

    Adler, A.B.; Delahaij, R.; Bailey, S.M.; Berge, C. van den; Parmak, M.; Tussenbroek, B. van; Puente, J.M.; Landratova, S.; Kral, P.; Kreim, G.; Rietdijk, D.; McGurk, D.; Castro, C.A.


    To-date, there has been no international review of mental health resilience training during Basic Training nor an assessment of what service members perceive as useful from their perspective. In response to this knowledge gap, the North Atlantic Treaty Organization (NATO) Human Factors & Medicine Re

  14. Mobile Health (mHealth) Services and Online Health Educators. (United States)

    Anshari, Muhammad; Almunawar, Mohammad Nabil


    Mobile technology enables health-care organizations to extend health-care services by providing a suitable environment to achieve mobile health (mHealth) goals, making some health-care services accessible anywhere and anytime. Introducing mHealth could change the business processes in delivering services to patients. mHealth could empower patients as it becomes necessary for them to become involved in the health-care processes related to them. This includes the ability for patients to manage their personal information and interact with health-care staff as well as among patients themselves. The study proposes a new position to supervise mHealth services: the online health educator (OHE). The OHE should be occupied by special health-care staffs who are trained in managing online services. A survey was conducted in Brunei and Indonesia to discover the roles of OHE in managing mHealth services, followed by a focus group discussion with participants who interacted with OHE in a real online health scenario. Data analysis showed that OHE could improve patients' confidence and satisfaction in health-care services.

  15. Pre-deployment Year Mental Health Diagnoses and Treatment in Deployed Army Women. (United States)

    Wooten, Nikki R; Adams, Rachel Sayko; Mohr, Beth A; Jeffery, Diana D; Funk, Wendy; Williams, Thomas V; Larson, Mary Jo


    We estimated the prevalence of select mental health diagnoses (MHDX) and mental health treatment (MHT), and identified characteristics associated with MHT during the pre-deployment year (365 days before deployment) in active duty Army women (N = 14,633) who returned from Iraq or Afghanistan deployments in FY2010. Pre-deployment year prevalence estimates were: 26.2 % for any select MHDX and 18.1 % for any MHT. Army women who had physical injuries since FY2002 or any behavioral health treatment between FY2002 and the pre-deployment year had increased odds of pre-deployment year MHT. During the pre-deployment year, a substantial percentage of Army women had MHDX and at least one MHT encounter or stay. Future research should determine if pre-deployment MHDX among Army women reflect vulnerability to future MHDX, or if pre-deployment MHT results in protection from chronic symptoms.

  16. Application of multimedia services in the broadband environment to improve logistic needs of the army

    Directory of Open Access Journals (Sweden)

    Radiša R. Stefanović


    Full Text Available The paper analyzes the flow of some multimedia services, and points to the possibility of applying some of the services in the broadband environment to improve the logistic needs of the army. The need to convey information in different forms (from text, data, graphics, still pictures to video motion pictures is increasing continually. Requests for information transfer in high resolution require increasing the flow to several dozens of Mb/s. Broadband represents the platform for a wide range of multimedia services. Each multimedia service requires a certain flow which can be partially decreased with advanced coding techniques.

  17. Human Rights and Health Services

    DEFF Research Database (Denmark)

    Skitsou, Alexandra; Bekos, Christos; Charalambous, George


    , ongoing education of health professionals along with relevant education of the community and the broad application of triage in the emergency departments will all contribute to delivering health services more effectively. Keywords: Cyprus, health services, patient rights...... and their families to be essential. Conclusions: The paper concludes that implementing guidelines in accordance with international best practices, the establishment of at-home treatment and nursing facilities, counseling the mentally ill in a way that promotes their social integration and occupational rehabilitation......Background: It has been observed that health services provided to certain patients in Cyprus do not fully meet their human rights. Objective: This study was conducted to identify the main shortcomings of the Health System in Cyprus. Methodology: The relevant administrative decisions...

  18. Social insurance for health service. (United States)

    Roemer, M I


    Implementation of social insurance for financing health services has yielded different patterns depending on a country's economic level and its government's political ideology. By the late 19th century, thousands of small sickness funds operated in Europe, and in 1883 Germany's Chancellor Bismarck led the enactment of a law mandating enrollment by low-income workers. Other countries followed, with France completing Western European coverage in 1928. The Russian Revolution in 1917 led to a National Health Service covering everyone from general revenues by 1937. New Zealand legislated universal population coverage in 1939. After World War II, Scandinavian countries extended coverage to everyone and Britain introduced its National Health Service covering everyone with comprehensive care and financed by general revenues in 1948. Outside of Europe Japan adopted health insurance in 1922, covering everyone in 1946. Chile was the first developing country to enact statutory health insurance in 1924 for industrial workers, with extension to all low-income people with its "Servicio Nacional de Salud" in 1952. India covered 3.5 percent of its large population with the Employees' State Insurance Corporation in 1948, and China after its 1949 revolution developed four types of health insurance for designated groups of workers and dependents. Sub-Saharan African countries took limited health insurance actions in the late 1960s and 1970s. By 1980, some 85 countries had enacted social security programs to finance or deliver health services or both.

  19. Inequities in Chinese Health Services

    Directory of Open Access Journals (Sweden)

    Heather Mullins-Owens


    Full Text Available The Chinese health system was once held up as a model for providing universal health care in the developing world in the 1970s, only to have what is now considered one of the least equitable systems in the world according to the World Health Organization. This article begins with a brief look at what equity in health services entails, and considers the inequities in access to health services in China among different segments of the population. This article will consider challenges the current inequities may present to China in the near future if reforms are not implemented. Finally, it will take a look at reforms made by China’s neighbors, Singapore and Thailand, which made their health care more equitable, affordable, and sustainable.

  20. The Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight (United States)


    E M B E R 1 8 , 2 0 1 3 The Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More...Department of Defense and Veteran Affairs Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight 5a. CONTRACT NUMBER...Health Care Joint Venture at Tripler Army Medical Center Needs More Management Oversight Objective Our audit objective was to determine whether the

  1. Broadcast Service Areas, Cable, Published in Not Provided, US Army. (United States)

    NSGIC GIS Inventory (aka Ramona) — This Broadcast Service Areas, Cable dataset as of Not Provided. Data by this publisher are often provided in Not Applicable coordinate system; in a Not Applicable...

  2. MedlinePlus Health Topic Web Service (United States)

    U.S. Department of Health & Human Services — A search-based Web service that provides access to disease, condition and wellness information via MedlinePlus health topic data in XML format. The service accepts...

  3. The Role of the U.S. Army in Health System Reconstruction and Development During Counterinsurgency (United States)


    Securing Health: Lessons from Nation-Building Missions, 246. 29Scott Feil, “Building Better Foundations: Security in Postconflict Reconstruction ......THE ROLE OF THE U.S. ARMY IN HEALTH SYSTEM RECONSTRUCTION AND DEVELOPMENT DURING COUNTERINSURGENCY A thesis presented to the

  4. Statistical Process Control for Evaluating Contract Service at Army Installations (United States)


    Technical Information Service, 5285 Port Royal Road, Springfield, VA 22161 12a. DISTRIBUTION/ AVAILABILTY STATEMENT 12b. DISTRIBUTION CODE Approved for...requirements. In addition to their usage in fault diagnosis and process improvement, process control methods are recommended for supporting acceptance




  6. Juvenile justice mental health services. (United States)

    Thomas, Christopher R; Penn, Joseph V


    As the second century of partnership begins, child psychiatry and juvenile justice face continuing challenges in meeting the mental health needs of delinquents. The modern juvenile justice system is marked by a significantly higher volume of cases, with increasingly complicated multiproblem youths and families with comorbid medical, psychiatric, substance abuse disorders, multiple family and psychosocial adversities, and shrinking community resources and alternatives to confinement. The family court is faced with shrinking financial resources to support court-ordered placement and treatment programs in efforts to treat and rehabilitate youths. The recognition of high rates of mental disorders for incarcerated youth has prompted several recommendations for improvement and calls for reform [56,57]. In their 2000 annual report, the Coalition for Juvenile Justice advocated increased access to mental health services that provide a continuum of care tailored to the specific problems of incarcerated youth [58]. The specific recommendations of the report for mental health providers include the need for wraparound services, improved planning and coordination between agencies, and further research. The Department of Justice, Office of Juvenile Justice and Delinquency Prevention has set three priorities in dealing with the mental health needs of delinquents: further research on the prevalence of mental illness among juvenile offenders, development of mental health screening assessment protocols, and improved mental health services [59]. Other programs have called for earlier detection and diversion of troubled youth from juvenile justice to mental health systems [31,56]. Most recently, many juvenile and family courts have developed innovative programs to address specific problems such as truancy or substance use and diversionary or alternative sentencing programs to deal with first-time or nonviolent delinquents. All youths who come in contact with the juvenile justice system

  7. Army Health Promotion, Risk Reduction, Suicide Prevention: Report 2010 (United States)


    the combat readiness of Soldiers by ensuring a drug free environment.69 ASAP provides commanders with a mechanism for testing and treating those who...describes the processes in place to detect potentially high risk behavior. It is the duty of every leader to understand the mechanisms in place that are...amphetamines such as ecstasy . ARMY HP/RR/SP REPORT 2010 54 The Department of Defense requires a minimum of 20% of all samples be tested against the

  8. Military Health Service System Ambulatory Work Unit (AWU). (United States)


    probability of a value outside 2.0 standard deviations ranges from .0456 for A-3 -Al" 122 NILITRY HEALTH SERVICE SYSTEM AMULRTORY MORKe UurNT CANdU )(U) ARMY...00 2 w w >4 &4~ ~z til 0n0 rz~ co00 P - xU) I : 0 ) ) %z E-4 z U) HHw H~~ ~ ~ 0 olf4 E1E- 004 H U) UDm 0 4 E- H wE- ~ H E-4 H 04 H Z U H Q z HO H % x z

  9. NATO survey of mental health training in army recruits. (United States)

    Adler, Amy B; Delahaij, Roos; Bailey, Suzanne M; Van den Berge, Carlo; Parmak, Merle; van Tussenbroek, Barend; Puente, José M; Landratova, Sandra; Kral, Pavel; Kreim, Guenter; Rietdijk, Deirdre; McGurk, Dennis; Castro, Carl Andrew


    To-date, there has been no international review of mental health resilience training during Basic Training nor an assessment of what service members perceive as useful from their perspective. In response to this knowledge gap, the North Atlantic Treaty Organization (NATO) Human Factors & Medicine Research & Technology Task Group "Mental Health Training" initiated a survey and interview with seven to twenty recruits from nine nations to inform the development of such training (N = 121). All nations provided data from soldiers joining the military as volunteers, whereas two nations also provided data from conscripts. Results from the volunteer data showed relatively consistent ranking in terms of perceived demands, coping strategies, and preferences for resilience skill training across the nations. Analysis of data from conscripts identified a select number of differences compared to volunteers. Subjects also provided examples of coping with stress during Basic Training that can be used in future training; themes are presented here. Results are designed to show the kinds of demands facing new recruits and coping methods used to overcome these demands to develop relevant resilience training for NATO nations.

  10. Effect of the Army Oral Health Maintenance Program on the Dental Health Status of Army Personnel (AOHMP Evaluation) Executive Summary (United States)


    numbers of restorations, extrt.zt1-,ns, teeth needing endodontic therapy, units of crown and bridge, complete dentures, partial dentures, prophylaxis...closely parallels the 1976 study findivgs. However, the endodontics , crown and bridge, removable prosthodontics, and periodontal care needs were less than...Army Recruits, Preliminary Report." Armud Forces Madical Journal , 7:648. May 1956. 6. Cassidy, J.I.; Parker, W.A.; and Hutchins, D.W. "Dental Care

  11. [Catering services bases in the Russian army under military regulation of Peter the Great]. (United States)

    Konyshev, I S; adamenko, A M; Koshelev, V P


    At Peter I the regular army was organized and the system of target state deliveries to troops of the food is created. Provisioning and fodder was normalized as portion and ration. Portion was contained the products forpeoplefood, and ration - fodder for horses food who were used by the serviceman. Portion and ration unit was identical to all categories of the military personnel. Difference in food level consisted in that, how many portions and rations serviceman received. Up to the end of existence of Russian army in 1918 in each rota there were contractor and the cook who were engaged in foodstuff and cooking under sergeant-major and one of rota officers supervision. According to the Charter it was necessary to carry with respect and attention to officers and soldiers, their needs, including in the field of supply and catering services and providing with the food: Despite the lack of scientific justification, soldiers' nutrition was sufficient to provide fighting capacity of the Russian army.

  12. Prevention and dental health services. (United States)

    Widström, Eeva


    There has been, and still is a firm belief that regular use of dental services is beneficial for all. Thus governments in most European countries have shown some interest in training oral health care professionals, distributing the dental workforce and cost sharing. Constantly evolving treatment options and the introduction of new methods make dental clinicians feel uncertain as to which treatments are most useful, who would benefit from them, and which treatments will achieve cost-effective health gain. Although there is a considerable quantity of scientific literature showing that most available preventive measures are effective, and the number of sensible best-practice guidelines in prevention is growing, there are few studies on cost-efficiency of different methods and, secondly, the prevention and treatment guidelines are poorly known among general practitioners. In the eyes of the public, it is obvious that preventive methods practised by patients at home have been eclipsed by clinical procedures performed in dental clinics. Reliance on an increasingly individualistic approach to health care leads to the medicalisation of issues that are not originally health or medical problems. It is important to move general oral disease prevention back to the people who must integrate this in their daily routines. Prevention primarily based on healthy lifestyles, highlighted in the new public health strategy of the European Union (EU), is the key to future health policy.

  13. Predicting suicides after outpatient mental health visits in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) (United States)

    Kessler, Ronald C.; Stein, Murray B.; Petukhova, Maria V.; Bliese, Paul; Bossarte, Robert M.; Bromet, Evelyn J.; Fullerton, Carol S.; Gilman, Stephen E.; Ivany, Christopher; Lewandowski-Romps, Lisa; Bell, Amy Millikan; Naifeh, James A.; Nock, Matthew K.; Reis, Benjamin Y.; Rosellini, Anthony J.; Sampson, Nancy A.; Zaslavsky, Alan M.; Ursano, Robert J.


    The 2013 U.S. Veterans Administration/Department of Defense Clinical Practice Guidelines (VA/DoD CPG) require comprehensive suicide risk assessments for VA/DoD patients with mental disorders but provide minimal guidance on how to carry out these assessments. Given that clinician-based assessments are known not to be strong predictors of suicide, we investigated whether a precision medicine model using administrative data after outpatient mental health specialty visits could be developed to predict suicides among outpatients. We focused on male non-deployed Regular U.S. Army soldiers because they account for the vast majority of such suicides. Four machine learning classifiers (naïve Bayes, random forests, support vector regression, elastic net penalized regression) were explored. 41.5% of Army suicides in 2004-2009 occurred among the 12.0% of soldiers seen as outpatient by mental health specialists, with risk especially high within 26 weeks of visits. An elastic net classifier with 10-14 predictors optimized sensitivity (45.6% of suicide deaths occurring after the 15% of visits with highest predicted risk). Good model stability was found for a model using 2004-2007 data to predict 2008-2009 suicides, although stability decreased in a model using 2008-2009 data to predict 2010-2012 suicides. The 5% of visits with highest risk included only 0.1% of soldiers (1047.1 suicides/100,000 person-years in the 5 weeks after the visit). This is a high enough concentration of risk to have implications for targeting preventive interventions. An even better model might be developed in the future by including the enriched information on clinician-evaluated suicide risk mandated by the VA/DoD CPG to be recorded. PMID:27431294

  14. Homeless health needs: shelter and health service provider perspective. (United States)

    Hauff, Alicia J; Secor-Turner, Molly


    The effects of homelessness on health are well documented, although less is known about the challenges of health care delivery from the perspective of service providers. Using data from a larger health needs assessment, the purpose of this study was to describe homeless health care needs and barriers to access utilizing qualitative data collected from shelter staff (n = 10) and health service staff (n = 14). Shelter staff members described many unmet health needs and barriers to health care access, and discussed needs for other supportive services in the area. Health service providers also described multiple health and service needs, and the need for a recuperative care setting for this population. Although a variety of resources are currently available for homeless health service delivery, barriers to access and gaps in care still exist. Recommendations for program planning are discussed and examined in the context of contributing factors and health care reform.

  15. The Danish National Health Service Register

    DEFF Research Database (Denmark)

    Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan


    Abstract Introduction: To describe the Danish National Health Service Register in relation to research. Content: The register contains data collected for administrative and scientific purposes from health contractors in primary health care. It includes information about citizens, providers...

  16. Evaluation of the US Army Institute of Public Health Destination Monitoring Program, a food safety surveillance program. (United States)

    Rapp-Santos, Kamala; Havas, Karyn; Vest, Kelly


    The Destination Monitoring Program, operated by the US Army Public Health Command (APHC), is one component that supports the APHC Veterinary Service's mission to ensure safety and quality of food procured for the Department of Defense (DoD). This program relies on retail product testing to ensure compliance of production facilities and distributors that supply food to the DoD. This program was assessed to determine the validity and timeliness by specifically evaluating whether sample size of items collected was adequate, if food samples collected were representative of risk, and whether the program returns results in a timely manner. Data was collected from the US Army Veterinary Services Lotus Notes database, including all food samples collected and submitted from APHC Region-North for the purposes of destination monitoring from January 1, 2013 to December 31, 2013. For most food items, only one sample was submitted for testing. The ability to correctly identify a contaminated food lot may be limited by reliance on test results from only one sample, as the level of confidence in a negative test result is low. The food groups most frequently sampled by APHC correlated with the commodities that were implicated in foodborne illness in the United States. Food items to be submitted were equally distributed among districts and branches, but sections within large branches submitted relatively few food samples compared to sections within smaller branches and districts. Finally, laboratory results were not available for about half the food items prior to their respective expiration dates.

  17. The health of the American slave examined by means of Union Army medical statistics. (United States)

    Freemon, F R


    The health status of the American slave in the 19th century remains unclear despite extensive historical research. Better knowledge of slave health would provide a clearer picture of the life of the slave, a better understanding of the 19th-century medicine, and possibly even clues to the health problems of modern blacks. This article hopes to contribute to the literature by examining another source of data. Slaves entering the Union Army joined an organization with standardized medical care that generated extensive statistical information. Review of these statistics answers questions about the health of young male blacks at the time American slavery ended.

  18. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings (United States)

    Dixon, Decia Nicole


    Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

  19. Improving Coordination of Addiction Health Services Organizations with Mental Health and Public Health Services. (United States)

    Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick


    In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.

  20. 42 CFR 93.220 - Public Health Service or PHS. (United States)


    ... RESEARCH MISCONDUCT Definitions § 93.220 Public Health Service or PHS. Public Health Service or PHS means... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  1. [Communication in the health service]. (United States)

    Panini, Roberta; Fiorini, Fulvio


    In the last twenty years, the hospitals have become firms, therefore they have had the necessity to differentiate from each other.Thus, as it is done in the commercial firms, in the health service different formality of communication are studied and introduced in order to attract new consumers and to maintain their trust. Furthermore, due to the introduction of the digitization in the Public Administrations, the communication has become more transparent.A systematic application of communication tools is more and more spread among the Sanitary Firms, whether they are Local Firm or Hospital Firm.Regarding the reference population, communication tools are used with different purposes such as educational and informative. In addition, they are applied as institutional marketing tool, in order to show the offered potentialities and also to increase the level of satisfaction in the patients/consumers who perceive the typology of reception and treatment during the sanitary performance.

  2. The United States Army Medical Department Journal. Force Health Protection April - June 2009 (United States)


    Command (MEDCOM) Automated Staffing Assessment Model for Preventive Medicine ( ASAM PM) currently recommends one Army audiologist and 2.5 audiology...technicians for every 18,000 Soldiers as a minimum staffing model.5 The ASAM PM model reflects the garrison-based AHCP, and is not compatible with...audiologists and 5 audiometric/ hearing health technicians for our approximately 18,500 Soldiers organic to Fort Carson (double what the current ASAM PM

  3. Acceptance of Swedish e-health services

    Directory of Open Access Journals (Sweden)

    Mary-Louise Jung


    Full Text Available Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM, in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted.Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use.Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide.Keywords: health services, elderly, technology, Internet, TAM, patient acceptance, health-seeking behavior

  4. Establishing Reproductive Health Education and Counseling in Military Services: The Turkish Model for Male Involvement

    Directory of Open Access Journals (Sweden)

    Anne Brigitte Albrectsen


    Full Text Available Ministry of Health, Mother and Child Health and Family Planning General Directorate; Turkey Field Office of UNFPA, and Gulhane Military Medical Academy (GMMA of Turkish Armed Forces have been conducting a program to increase male concern and participation in sexual and reproductive health in a positive and supporting way. Specialist physicians and nurses from military hospitals were trained by Ministry of Health as trainers (October 2002- September 2003 by one-week courses on interactive training skills. Primary physicians, nurses and medical petty officers were trained as field trainers and counselors (March 2003-April 2004. Training rooms with standardized training material were established in all of the military garrisons. Soldiers were given the one-day participatory course. Trained medical staff also provided individual counseling and services. All training rooms were coded and connected to Reproductive Health Network established within the Intranet of Army. Reproductive Health activities were included in the regular supervision scheme of the army. Since April 2004 740.000 soldiers were given the one-day course. A total of 4000 military medical staff was educated as Trainers. A total of 580 training rooms were established. Twenty of Military Hospitals became a center of reproductive health training and service delivery. Since large-scale intervention is necessary to reach male population, the army seems to be the best possible venue in Turkey. [TAF Prev Med Bull 2008; 7(2.000: 97-106

  5. Military Services Fitness Database: Development of a Computerized Physical Fitness and Weight Management Database for the U.S. Army (United States)

    Williamson, Donald A.; Bathalon, Gaston P.; Sigrist, Lori D.; Allen, H. Raymond; Friedl, Karl E.; Young, Andrew J.; Martin, Corby K.; Stewart, Tiffany M.; Burrell, Lolita; Han, Hongmei; Hubbard, Van S.; Ryan, Donna


    The Department of Defense (DoD) has mandated development of a system to collect and manage data on the weight, percent body fat (%BF), and fitness of all military personnel. This project aimed to (1) develop a computerized weight and fitness database to track individuals and Army units over time allowing cross-sectional and longitudinal evaluations and (2) test the computerized system for feasibility and integrity of data collection over several years of usage. The computer application, the Military Services Fitness Database (MSFD), was designed for (1) storage and tracking of data related to height, weight, %BF for the Army Weight Control Program (AWCP) and Army Physical Fitness Test (APFT) scores and (2) generation of reports using these data. A 2.5-year pilot test of the MSFD indicated that it monitors population and individual trends of changing body weight, %BF, and fitness in a military population. PMID:19216292

  6. Preventing Health Damaging Behaviors in Male and Female Army Recruits (United States)


    information about non-prescription methods of contraceptives , including condoms, spermicides, and the Morning After Pill • Analyze and discuss...examine the association of sociodemographic, sexual health behaviors, contraceptive and condom use and a history of unintended pregnancy in soldiers... contraceptive methods among male and female adolescent and young adult soldiers in training.” This abstract focused on factors associated with

  7. The 71F Advantage: Applying Army Research Psychology for Health and Performance Gains (United States)


    Duval, T.S. and Wicklund, R.A. (1972). A theory of objective self-awareness. New York: Academic. Ellis, W. (1997). A source book of Gestalt psychology ...Research Psychology for Health and Performance Gains 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 The 71F Advantage: Applying Army Research Psychology for Health and Performance Gains Edited by

  8. Comparison of Family Clinic Community Health Service Model with State-owned Community Health Service Model

    Institute of Scientific and Technical Information of China (English)

    万方荣; 卢祖洵; 张金隆


    Summary: Based on a survey of community health service organization in several cities, communi-ty health service model based on the family clinic was compared with state-owned communityhealth service model, and status quo, advantages and problems of family community health serviceorganization were analyzed. Furthermore, policies for the management of community health ser-vice organization based on the family clinic were put forward.

  9. A Health Facility Planning Methodology for Army Troop Medical Clinics. (United States)


    Herbert H. Hyman, Basic Health Planning Methods, (Germantown, Md: Aspen Systems Corp., 1978), p.14 . 16 17 1 3James A. Rice, " Interinstitutional Planning...another for collaboration throughout the developmental process in order for that project to come to fruition. In the final analysis, the planning...Space Needs." Hospitals 54 (December 16, 1980): 109-112. Rice, James A. " Interinstitutional Planning Process, Part 1. Free Standing Hospitals." Hospitals

  10. Assessment of Health Behaviors, Health Education Interests, and Injuries among Employees at the General Leonard Wood Army Community Hospital, October 2014 - December 2014 (United States)


    Technical Report No. S.0032417-16, May 2016 Epidemiology and Disease Surveillance Portfolio Injury Prevention Program Assessment of Health...Behaviors, Health Education Interests, and Injuries among Employees at the General Leonard Wood Army Community Hospital, October 2014 – December 2014... Education Interests, and Injuries among Employees at General Leonard Wood Army Community Hospital, October- December 2014 5a. CONTRACT NUMBER n/a

  11. Value added telecommunication services for health care. (United States)

    Danelli-Mylonas, Vassiliki


    The successful implementation and operation of health care networks and the efficient and effective provision of health care services is dependent upon a number of different factors: Telecommunications infrastructure and technology, medical applications and services, user acceptance, education and training, product and applications/services development and service provision aspects. The business model and market development regarding policy and legal issues also must be considered in the development and deployment of telemedicine services to become an everyday practice. This chapter presents the initiatives, role and contribution of the Greek Telecommunications Company in the health care services area and also refers to specific case-studies focusing upon the key factors and issues of applications related to the telecommunications, informatics, and health care sectors, which can also be the drivers to create opportunities for Citizens, Society and the Industry.

  12. Total quality management and the Army health care system. (United States)

    Jeffer, E K


    Total quality management (TQM) is the newest in a long line of magic formulas which have been touted as saviors for American industry and medicine. The author discusses the basic concepts of TQM and notes that much of it resembles philosophical beliefs long held by the medical community. TQM does offer many opportunities to refine old concepts and further those goals of quality care to which health care providers have always aspired. If, however, it becomes simply another codified bureaucracy, then a great deal of time and money will be invested for very little gain.

  13. Mental Health Care in a High School Based Health Service. (United States)

    Jepson, Lisa; Juszczak, Linda; Fisher, Martin


    Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…

  14. Mission and Installation Contracting Command Services Acquisition: Empirical Analysis of Army Service Contract Management Practices (United States)


    The two theories we discuss are the agency and transaction cost theory. We present the conceptual framework of these theories and discuss how... transaction cost theory takes into account indirect costs associated with a product or service (Williamson, 2010). In application, analyzing the costs...explanation for why LPTA was the preferred method can be attributed to the transaction cost theory, which may explain why contracting offices may

  15. Health, wartime stress, and unit cohesion: evidence from Union Army veterans. (United States)

    Costa, Dora L; Kahn, Matthew E


    We find that Union Army veterans of the American Civil War who faced greater wartime stress (as measured by higher battlefield mortality rates) experienced higher mortality rates at older ages, but that men who were from more cohesive companies were statistically significantly less likely to be affected by wartime stress. Our results hold for overall mortality, mortality from ischemic heart disease and stroke, and new diagnoses of arteriosclerosis. Our findings represent one of the first long-run health follow-ups of the interaction between stress and social networks in a human population in which both stress and social networks are arguably exogenous.

  16. Mission and Installation Contracting Command Services Acquisition: Empirical Analysis of Army Service Contract Management Practices (United States)


    reform procurement and oversight of services acquisition. Furthermore, another important motive for reform is the current budget crisis the United...63 154 ch i ‐square d  S tat 13.6206 d f 1 p ‐value    0.0002 ch i ‐square d   Critica l   3.8415 Use  o f  IGEs  fo r Contracts  Ove r $  100K

  17. Including customers in health service design. (United States)

    Perrott, Bruce E


    This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.

  18. Developing internet-based health services in health care organizations. (United States)

    Leskinen, Salme; Häyrinen, Kristiina; Saranto, Kaija; Ensio, Anneli


    It is often said that we are living in an information society and information technology (IT) is a normal part of life in many fields. But IT is not used effectively in health care. The purpose of this study was to survey what kind of Internet-based health services and related electronic services are offered to clients by the web-pages of health care organizations in Finland.

  19. Service network analysis for agricultural mental health

    Directory of Open Access Journals (Sweden)

    Fuller Jeffrey D


    Full Text Available Abstract Background Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements. Methods A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development. Results 87 agencies from 111 (78% completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p Conclusion Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.

  20. Indicators of mental health services evaluation process

    Directory of Open Access Journals (Sweden)

    Ana Caroline Gonçalves Cavalcante


    Full Text Available This descriptive, exploratory and qualitative study was performed with the objective to evaluate the structure of the Mental Health Service Network of the Municipal Health Department of Goiania, the capital city of Goias state, Brazil. Data were collected using a semi-structured instrument and photographic records, and analyzed using Atlas.ti 6.2, and based on Donabedian’s theoretical framework. Various conditions were observed for service facilities; from structures that were precarious and unsuitable for therapy, to facilities that were welcoming and had good accessibility. The main positive aspect was the diversity of multidisciplinary teams. Making service facilities appropriate is imperative, although it is recognized that the municipality is currently undergoing reformulation, aiming at meeting the needs of the National Policy for Mental Health. Furthermore, intersectoral partnerships should be established for evaluation processes, particularly in the academia and service domains, which could generate the desired impact on health care to clients of specialized services. Descriptors: Health Services Evaluation; Mental Health; Structure of Services.

  1. The politics of evaluating Aboriginal Health Services. (United States)

    Moodie, R


    Evaluation of Aboriginal Health Services (AHSs) has become a topic of importance to service providers and governments in recent years. This paper examines some of the difficulties AHSs have in conducting evaluation and presents an example of an inappropriate evaluation methodology as proposed by the Commonwealth Department of Aboriginal Affairs (DAA) in 1986. The paper examines the contradictory nature of the DAA proposal and the mistrust it has engendered in many AHSs. It then highlights some of the political difficulties in developing meaningful national and community health objectives as a basis for sound evaluation of health services. The paper concludes by identifying some of the processes whereby more appropriate evaluation methodologies might be developed and suggests that negotiation and consultation with the Aboriginal communities and their health services are imperative to successful evaluation.

  2. [About mental health outreach services in Japan]. (United States)

    Furukawa, Shunichi; Fujieda, Yumiko; Shimizu, Kimiko; Ishibashi, Aya; Eguchi, Satoshi


    Outreach services are very important in community mental health care. There are two types for outreach services. One is mental health activities, such as early intervention and consultation, and the other is intended to prevent recurrence and readmission by supporting the daily living activities of a patient in a community. We have 2.73 psychiatric care beds in hospitals per 1,000 population. So, it is just the beginning in changing from hospital centered psychiatry to community mental health care. Outreach services are being tried in several places in our country. In this essay, we describe mental health outreach services in Japan and we have illustrated vocational rehabilitation and outreach job support in our day treatment program.

  3. 77 FR 76052 - Health Resources and Services Administration (United States)


    ... HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... and Services Administration (HRSA) publishes periodic summaries of proposed projects being developed...: The Health Resources and Services Administration (HRSA) plans to conduct a survey of the...

  4. 78 FR 14806 - Health Resources and Services Administration (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Statement of Organization, Functions and Delegations of Authority; Correction AGENCY: Health Resources and Services Administration (HRSA), HHS....

  5. Body mass index and health among Union Army veterans: 1891-1905. (United States)

    Linares, Claudia; Su, Dejun


    This paper explores the relationship between BMI and several health conditions among Union Army veterans who had medical examinations between 1891 and 1905. We find that BMI, when used as a proxy of nutrition, helps to explain morbidity and mortality differentials among veterans. There is evidence suggesting that among Union Army veterans extremely low or high BMIs were both associated with poor health, as indicated by a higher level of disability rating, higher risk of developing certain diseases, and higher mortality risk than those associated with having normal weight. Compared to veterans with normal weight, underweight veterans were more likely to be diagnosed with cardiovascular, respiratory and gastrointestinal diseases, but were less likely to be diagnosed with rheumatic and musculo-skeletal conditions at the first examination. High BMI levels are also associated with a higher risk of developing cardiovascular and rheumatic diseases, and higher mortality in the 20 years after the first examination. We performed a longitudinal analysis to study the association between earlier BMI as well as weight change and later development of diseases. The results suggest that, as a predictor of diseases, the explanatory power of BMI becomes lower the farther into the future we try to predict. Compared with those who maintained the same weight, veterans who gained weight were associated with a lower risk of being diagnosed with gastrointestinal diseases at their second examination.

  6. Green Infrastructure, Ecosystem Services, and Human Health. (United States)

    Coutts, Christopher; Hahn, Micah


    Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.

  7. [Quality assurance in occupational health services]. (United States)

    Michalak, J


    The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.

  8. 42 CFR 136a.15 - Health Service Delivery Areas. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a... Receive Care? § 136a.15 Health Service Delivery Areas. (a) The Indian Health Service will designate and... Federal Indian reservations and areas surrounding those reservations as Health Service Delivery Areas....

  9. The History of Turkish Military Health Services

    Directory of Open Access Journals (Sweden)

    Muharrem Ucar


    Full Text Available One of the main objectives of military health services is to prevent suffering, injuries and death caused by wars which lead to great destructions on societies as much as possible. If the subject is considered for Turkish history, it is noted that personnel and duty processes of health services had an institutional feature and that duty was controlled by the government at Ottoman Empire. Public health practices, as a main component of military health services at both peace and war, has great importance. These practices should be determined thoroughly at peacetime by managers and preparations in that direction should be done and implemented. [TAF Prev Med Bull 2012; 11(1.000: 103-118

  10. A Cost Analysis for Deciding Service Levels in Korean Army with a Constraint for Single Period (United States)


    LEVELS IN KOREAN ARMY WITH A CONSTRAINT FOR SINGLE PERIOD by Yoo, Choong Keun Major, Republic of Korea Army B.S., Korea Military Academy, 1981...Sciences ABSTRACT Since the Korean War there has been a fierce military competition between the Republic of Korea (ROK) and the Democratic People’s...Republic of Korea (DPRK). The DPRK has committed over 10 percent of its GNP since 1963 to defense expenditures, whereas, the ROK has spent a relatively

  11. [Marketing mix in health service]. (United States)

    Ameri, Cinzia; Fiorini, Fulvio


    The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing).

  12. School Mental Health Resources and Adolescent Mental Health Service Use (United States)

    Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.


    Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…

  13. Climate services to improve public health. (United States)

    Jancloes, Michel; Thomson, Madeleine; Costa, María Mánez; Hewitt, Chris; Corvalan, Carlos; Dinku, Tufa; Lowe, Rachel; Hayden, Mary


    A high level expert panel discussed how climate and health services could best collaborate to improve public health. This was on the agenda of the recent Third International Climate Services Conference, held in Montego Bay, Jamaica, 4-6 December 2013. Issues and challenges concerning a demand led approach to serve the health sector needs, were identified and analysed. Important recommendations emerged to ensure that innovative collaboration between climate and health services assist decision-making processes and the management of climate-sensitive health risk. Key recommendations included: a move from risk assessment towards risk management; the engagement of the public health community with both the climate sector and development sectors, whose decisions impact on health, particularly the most vulnerable; to increase operational research on the use of policy-relevant climate information to manage climate- sensitive health risks; and to develop in-country capacities to improve local knowledge (including collection of epidemiological, climate and socio-economic data), along with institutional interaction with policy makers.

  14. Integrated personal health and care services deployment

    DEFF Research Database (Denmark)

    Villalba, E.; Casas, I.; Abadie, F.


    Objectives: The deployment and adoption of Integrated Personal Health and Care Services in Europe has been slow and fragmented. There have been many initiatives and projects of this kind in different European regions, many of which have not gone beyond the pilot stage. We investigated the necessary...... conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... for successful health systems integration. Results: Out of the 27 cases, we focused on 11 which continued beyond the pilot stage. The key facilitators that are necessary for successful deployment and adoption in the European regions of our study are reorganisation of services, patient focus, governance...

  15. Community financed and operated health services: the case of the Ajo-Lukeville Health Service District. (United States)

    Lopes, P M; Nichols, A W


    The concept of a health service district, as a variation of the special tax district, is described and discussed. Tax districts have traditionally been used to support both capital construction (revenue bonds) and operational expenses of single-purpose governmental entities. The health service district, where authorized by state laws, may be used by local areas to subsidize the delivery of ambulatory health care. A particular case, the Ajo-Lukeville Health Service District in Arizona, illustrates what can be accomplished by this mechanism with the cooperation of local residents and outside agencies. Both the process of establishing such a district and the outcome of the Ajo-Lukeville experience is described. Reasons why health service districts may prove potentially attractive at this time are reviewed. Impediments to the development of more health service districts are also explored, including the lack of technical assistance, an inadequate awareness of the potential of health service districts, and the absence of a widespread orientation toward community financed and controlled health care. Movement in this direction should facilitate the development of additional health service districts.

  16. Human resource issues in university health services. (United States)

    Meilman, P W


    To provide first-rate services to students, college health services need the best possible staff. Managers and supervisors play a critical role in guiding the work of their employees so as to enhance performance. Reference checks for new employees and regular performance appraisal dialogues for ongoing employees are important tools in this process. The author discusses these issues and suggests formats for reference checks and performance appraisals.

  17. Program management of telemental health care services. (United States)

    Darkins, A


    Telemedicine is a new adjunct to the delivery of health care services that has been applied to a range of health care specialties, including mental health. When prospective telemedicine programs are planned, telemedicine is often envisaged as simply a question of introducing new technology. The development of a robust, sustainable telemental health program involves clinical, technical, and managerial considerations. The major barriers to making this happen are usually how practitioners and patients adapt successfully to the technology and not in the physical installation of telecommunications bandwidth and the associated hardware necessary for teleconsultation. This article outlines the requirements for establishing a viable telemental health service, one that is based on clinical need, practitioner acceptance, technical reliability, and revenue generation. It concludes that the major challenge associated with the implementation of telemental health does not lie in having the idea or in taking the idea to the project stage needed for proof of concept. The major challenge to the widespread adoption of telemental health is paying sufficient attention to the myriad of details needed to integrate models of remote health care delivery into the wider health care system.

  18. 77 FR 62243 - Health Resources and Services Administration (United States)


    ... No: 2012-25192] DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration... Resources and Services Administration (HRSA), Parklawn Building (and via audio conference call), 5600... Service, Health Resources and Services Administration, Parklawn Building, Room 13-64, 5600 Fishers...

  19. 41 CFR 101-5.307 - Public Health Service. (United States)


    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  20. Women as managers in the health services

    Directory of Open Access Journals (Sweden)

    Jocelyne Kane Berman


    Full Text Available Despite their numerical superiority women do not occupy positions o f power and authority in the health services generally. This is perceived as being due to a variety of factors which prevent women from realising their ful l potential as managers. In other parts of the world, as well as in South Africa, middle class white males have dominated health services, since medicine became a form al science, usurping the traditional role of women healers. Some research indicates that women are inclined to practice “feminine " management styles. It is suggested that the femine I masculine dichotomy is artificial and that qualities which ensure effective management should not be regarded as genderlinked. Leaders in the health services should strive for interdisciplinary, mixed-gender education and training at all levels. Identification and development of management potential in women health-care professionals, role-modelling and sponsor-mentor relationships should be encouraged to allow women to acquire the full range of management skills and to achieve positions of power and authority in the health services.

  1. [nutritional Education In Public Health Services].


    Boog, M.C.


    The purpose of this study was to discuss the implementation of nutritional education in public health services from the perspective of health professionals (physicians and nurses) working in them. The study was conducted in the Municipality of Campinas, São Paulo State, Brazil, from October 1993 to July 1995, using action-based research methodology. The results describe the construction of nutritional knowledge in training and professional institutions; behavior towards food-related problems ...

  2. Army Overdependency on Contractors (United States)


    Army Overdependency on Contrators EWS 2005 Subject Area Topical Issues Contemporary Issues Paper Submitted by Captain HL Morris...aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services , Directorate for Information... service would not be interrupted if the contractor failed to perform. The guidelines also mandated that the Army had to be capable of providing

  3. National Mental Health Services Survey (N-MHSS), 2010 (United States)

    U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is designed to collect information from all specialty mental health facilities in the United States, both public...

  4. College Health: Health Services and Common Health Problems (United States)

    ... chronic health conditions, learning disabilities, nutrition issues or eating disorders, relationship problems, sexual health issues, alcohol or drug ... Permission Requests Teen Talk Newsletter Like us on Facebook Follow us on Twitter © 1998-2017 | Young Men's ...

  5. Robots and service innovation in health care. (United States)

    Oborn, Eivor; Barrett, Michael; Darzi, Ara


    Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation.


    Directory of Open Access Journals (Sweden)

    Lusi Herawati Sunyoto Usman Mark Zuidgeest


    as indicators. Flowmap tool is used to analyze catchment area of each health facility using different transport modes choice:becak and public transport for poor group and motorcycle and car for non-poor group with different travel time within 30, 60 and more than 60 minutes. It is concluded that there was an accessibility difference between poor and non-poor group. The accessibility to the health facilities of poor group was lower than non-poor group. This condition occurred because the government policy of equitable access to health service facility did not pay attention to accessibility of poor group.

  7. Who Killed the English National Health Service?

    Directory of Open Access Journals (Sweden)

    Martin Powell


    Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.

  8. Marketing service guarantees for health care. (United States)

    Levy, J S


    The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises.

  9. Women's health centers and specialized services. (United States)

    LaFleur, E K; Taylor, S L


    More than 75% of the female respondents in this study would choose a women's health center (WHC) over a standard health facility. Women who worked outside the home perceived a greater WHC need. And almost all respondents were interested in communications from the center via a quarterly newsletter. Significant test results related to age, income, education, and work status as segmentation variables, offering WHC's an opportunity to target their patients with specialized services such as cosmetic surgery, infertility treatment, breast imaging, etc. If enough resources are allocated, a WHC can design itself to attract highly lucrative patients. Little difference was found in the opinions of women regarding the need for a WHC or the core services desired, but the specific service mix decision must be carefully considered when designing a WHC.

  10. Air Weather Service Support to the United States Army Tet and the Decade After (United States)


    Emdo API Scott API Virginia Gem’Jew Alke ltnl Provide or Provides or himods or Ftevides or Provde o oranges for anugu for eworgss for elsgsfor oerr’s...confessed that it was a rein- carnation , really, a realization among Army commanders reborn with each war but buried during peace- Cot Edwin E. Carnel time


    Directory of Open Access Journals (Sweden)

    Manea Liliana


    Full Text Available The state policy in the health care area must take into account the complexity and specificity of the domain. Health means not only “to treat”, but also “to prevent” and “to recover and rehabilitate the individual physically”. Regardless of the adopted health insurance system, the health system is facing a big problem and this is the insufficient funds necessary to function properly. The underfunding may have various causes, from a wrong health policy, based on “treating” instead of “preventing”, by the misuse of funds. This papers intended to formulate assumptions that underpin the research I am conducting within the Doctoral Research Program held at the Valahia University of Targoviste, which aims at using the management control in increasing the health services performance. The application of the accounting and management control methods in determining health costs can be a beginning to streamline the system. This is also a result of the fact that health care is a public service with specific characteristics: it can not be subject only to market requirements but at the same time he must undergo an administrative savings, representing a typical case of market failure. The increased cost of treatment, as well as the decline in their quality can be determined by the discrepancy between the funding and payment mechanisms. Different payment systems currently available do nothing but perpetuate the shortcomings in the system. Switching to the introduction of cost and budgets by cost centers or object (if solved can be a step forward for a better management of resources. In this context, we consider as a necessity to be imposed the cost analysis on responsibility centers, the definition of the cost object and cost center identification and determination of direct costs and those indirect services to choose the basis for the allocation of cost centers and the determination of each actual cost per diagnosis.

  12. Service delivery for e-Health applications. (United States)

    Staemmler, Martin


    E-Health applications have to take the business perspective into account. This is achieved by adding a fourth layer reflecting organizational and business processes to an existing three layer model for IT-system functionality and management. This approach is used for designing a state-wide e-Health service delivery allowing for distributed responsibilities: clinical organizations act on the fourth layer and have established mutual cooperation in this state-wide approach based on collectively outsourced IT-system services. As a result, no clinical organization can take a dominant role based on operating the IT-system infrastructure. The implementation relies on a central infrastructure with extended means to guarantee service delivery: (i) established redundancy within the system architecture, (ii) actively controlled network and application availability, (iii) automated routine performance tests fulfilling regulatory requirements and (iv) hub-to-spoke and end-to-end authentication. As a result, about half of the hospitals and some practices of the state have signed-up to the services and guarantee long-term sustainability by sharing the infrastructural costs. Collaboration takes place for more than 1000 patients per month based on second opinion, online consultation and proxy services for weekend and night shifts.

  13. [Health services waste management: a biosafety issue]. (United States)

    Garcia, Leila Posenato; Zanetti-Ramos, Betina Giehl


    The subject of "health services waste" is controversial and widely discussed. Biosafety, the principles of which include safeguarding occupational health, community health, and environmental safety, is directly involved in the issue of medical waste management. There are controversies as to the risks posed by medical waste, as evidenced by diverging opinions among authors: some advocate severe approaches on the basis that medical waste is hazardous, while others contend that the potential for infection from medical waste is nonexistent. The Brazilian National Health Surveillance Agency (ANVISA) has published resolution RDC 33/2003 to standardize medical waste management nationwide. There is an evident need to implement biosafety procedures in this area, including heath care workers' training and provision of information to the general population.

  14. Prior Health Care Utilization Patterns and Suicide among U.S. Army Soldiers (United States)

    Bell, Nicole S.; Harford, Thomas C.; Amoroso, Paul J.; Hollander, Ilyssa E.; Kay, Ashley B.


    Suicides among U.S. Army soldiers are increasing and, in January 2009, outpaced deaths due to combat. For this study, 1,873 army suicides identified through death, inpatient, and emergency room records were matched with 5,619 controls. In multivariate models, older, male, White, single, and enlisted soldiers with a prior injury (OR = 2.04, 95% CI…

  15. Acceptance of Swedish e-health services


    Mary-Louise Jung; Karla Loria


    Mary-Louise Jung1, Karla Loria11Division of Industrial Marketing, e-Commerce and Logistics, Lulea University of Technology, SwedenObjective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health.Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of...

  16. 42 CFR 417.101 - Health benefits plan: Basic health services. (United States)


    ...-term evaluative or crisis intervention mental health services, or both; (5) Diagnosis, medical... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH...

  17. [Universal coverage of health services in Mexico]. (United States)


    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people.

  18. Home health services in New Hampshire. (United States)

    Hale, F A; Jacobs, A R


    While home health services have traditionally been an underused component of the health care system, current trends suggest the desirability of expanding these services. These trends include an increase in the number of elderly who need the benefits of home care, the recognition that long-term chronic illnesses require appropriate management at home, and concern that patients have access to care at the level most appropriate to their illnesses. In New Hampshire, 41 certified home health agencies offer services. Little systematic research has been conducted on the kinds of services they provide and the patients seen by their staffs. Patient encounter data were collected from a sample of eight agencies for a 4-week period. Staff of the agencies used the patient contact record developed by the National Functional Task Analysis Cooperative Study to collect data. The data reflected differences among the agencies in the size of the populations they serve, organizational characteristics, reasons for patients' visits, expected sources of the revenue that supported them, and the diagnosis of the patients they cared for. The agencies served areas with populations ranging from 1,000 to 40,000. The staffs ranged from 1 to 14 full-time persons. Two were public agencies; the others had voluntary sponsorship. When data on reasons for visits were averaged for the eight agencies, it was shown that 72% of the visits were made for disease control activities such as care for a chronic or acute condition or for treatment or a laboratory test. Disease prevention activities such as a checkup for adults, children, prenatal or postnatal care, or health education accounted for only 24% of the visits. This result may indicate that, in areas short of physician manpower, the community health nurse is taking on increasing responsibility for medical care as well as health and education. Reimbursement for the visits came from Medicare, 25%; Medicaid-welfare, 14%; the patients, 18%; and health

  19. National Mental Health Services Survey (N-MHSS-2010) (United States)

    U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...

  20. Most Individuals Receive Health Services a Year Before Suicide Death (United States)

    ... Individuals Receive Health Services a Year Before Suicide Death March 27, 2014 • Science Update Source: iStock Undetected ... care services in the year prior to suicide death and half did not have a mental health ...

  1. Area health education centers and health science library services. (United States)

    West, R T; Howard, F H


    A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.

  2. Army Technology (United States)


    capabilities that results in rapid and efficient biosurveillance . The program uses an information portal similar to a health surveillance web...and quickly.” The D3 program is part of the broader Joint U.S. Forces Korea Portal and Integrated Threat Reduction Advanced Technology Demonstration... biosurveillance capabilities. Army researchers traveled to Korea with a suite of equipment, including nine commercial detector systems. Some of the systems are

  3. 基层部队健康教育分众传播伦理学思考%Ethical Reflection on Focus Communication of Health Education at Grassroots Level Army

    Institute of Scientific and Technical Information of China (English)

    卢月云; 孙桂巍; 张永忠


    运用分众传播理念在基层部队开展健康教育,对于促进部队健康教育工作意义重大.运用伦理学原则分析了分众传播在基层部队健康教育中的作用:有利于满足官兵个性化需求,注重健康教育资源的公平性,有利于节约健康教育成本.在此基础上提出了实际工作开展中应注意的问题:把握官兵特点,细分目标受众;加强组织领导,搞好部门协调;提升服务效果,提供健康管理.%It's of great importance to improve army health education by using focus communication at grassroots level army. We analyzed the effect of focus communication in health education at grassroots level army. It contributes to satisfy the individualized requirement of soldiers, improve resource equity and economize the cost of health education. Issues should be attached importance to are also proposed in this paper, including subdividing the target audience based on the characteristics of officers and soldiers, enforcing organizational leadership and coordination between different departments, upgrading service and providing health management.

  4. The United States Army Operating Concept, 2016-2028 (United States)


    retrograde operations. f. Theater armies may also include a medical command for deployment support that provides health services to Army and other...tenets of jus in bello ,120 discrimination (between combatants and noncombatants), and proportionality in the use of force,121 measured against the...Barracks, PA, 19. (Used with permission.) 119 Biddle, 9. 120 Jus in bello , translated as justice in war, are agreements defining limits on acceptable

  5. The impact of health insurance on health services utilization and health outcomes in Vietnam. (United States)

    Guindon, G Emmanuel


    In recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam's recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam's commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam's unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance--for the poor, for children and for students--impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services.

  6. Conscription in the Afghan Army. Compulsory Service Versus an All Volunteer Force (United States)


    of Developing Nations: A Comparative Analysis oflndia and Nigeria ," Aimed Forcesand Society, Vol. 19, No. 1 Fall 1992, pp. 123-137 (131). 70 Barua...Military of Developing Nations: A Compara- tive Analysis of India and Nigeria ," Armed Eorces and Society, Vol. 19, No. 1, Fall 1992. "Egypt Protests: Army...Camp Leather - neck, 03 Dec 2010 Members of 215’’’ Corps Embedded Advisor Team, Camp Shorabak, 03 Dec 2010 Advisor to 215" Corps Inspector General, Camp Shorabak, 03 Dec 2010 58

  7. Psychosocial Dynamics of College Students' Use of Mental Health Services (United States)

    Rosenthal, Beth Spenciner; Wilson, William Cody


    The authors present and empirically test a multivariate model of the use of mental health counseling services. Use of such services by 1st-year college students is directly a result of need for these services and willingness to use them. Beliefs about mental health services and demographic characteristics are not directly related to use, but…

  8. 19 CFR 4.70 - Public Health Service requirements. (United States)


    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....

  9. 38 CFR 3.753 - Public Health Service. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...

  10. 38 CFR 17.98 - Mental health services. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran, bereavement... mental health services in connection with treatment of the veteran under 38 U.S.C. 1710, 1712,...

  11. CORBA security services for health information systems. (United States)

    Blobel, B; Holena, M


    The structure of healthcare systems in developed countries is changing to 'shared care', enforced by economic constraints and caused by a change in the basic conditions of care. That development results in co-operative health information systems across the boundaries of organisational, technological, and policy domains. Increasingly, these distributed and, as far as their domains are concerned, heterogeneous systems are based on middleware approaches, such as CORBA. Regarding the sensitivity of personal and medical data, such open, distributed, and heterogeneous health information systems require a high level of data protection and data security, both with respect to patient information and with respect to users. This paper, relying on experience gained through our activities in CORBAmed, describes the possibilities the CORBA middleware provides to achieve application and communication security. On the background of the overall CORBA architecture, it outlines the different security services previewed in the adopted CORBA specifications which are discussed in the context of the security requirements of healthcare information systems. Security services required in the healthcare domain but not available at the moment are mentioned. A solution is proposed, which on the one hand allows to make use of the available CORBA security services and additional ones, on the other hand remains open to other middleware approaches, such as DHE or HL7.

  12. 78 FR 9705 - National Advisory Council on the National Health Service Corps; Request for Nominations (United States)


    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Request for Nominations AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice. SUMMARY: The Health Resources and Services Administration (HRSA) is...

  13. Dysfunctional health service conflict: causes and accelerants. (United States)

    Nelson, H Wayne


    This article examines the causes and accelerants of dysfunctional health service conflict and how it emerges from the health system's core hierarchical structures, specialized roles, participant psychodynamics, culture, and values. This article sets out to answer whether health care conflict is more widespread and intense than in other settings and if it is, why? To this end, health care power, gender, and educational status gaps are examined with an eye to how they undermine open communication, teamwork, and collaborative forms of conflict and spark a range of dysfunctions, including a pervasive culture of fear; the deny-and-defend lawsuit response; widespread patterns of hierarchical, generational, and lateral bullying; overly avoidant conflict styles among non-elite groups; and a range of other behaviors that lead to numerous human resource problems, including burnout, higher staff turnover, increased errors, poor employee citizenship behavior, patient dissatisfaction, increased patient complaints, and lawsuits. Bad patient outcomes include decreased compliance and increased morbidity and mortality. Health care managers must understand the root causes of these problems to treat them at the source and implement solutions that avoid negative conflict spirals that undermine organizational morale and efficiency.

  14. Macroeconomic Reasons of Debts in Polish Health Service

    Directory of Open Access Journals (Sweden)

    Kamila Szymańska


    Full Text Available The article deals with the problem of debts in polish health service. Author analyzes the macroeconomic reasons of this situation. As a main reasons are indicated: a specificity of the health service market, which leads to a inefficient allocation of health services, lack of reliable data on health care system, too low level of public expenditure on a health care, inappropriate allocation of public capital and a monopolistic position of the payer.

  15. Mortality Surveillance in the U.S. Army 20052014 (United States)


    expansion and standardization of behavioral health services through the Behavioral Health Service Line (BHSL). 2 References Appendix A lists...pending). The term “manner” has a specific definition so the word “category” will be used in this publication. The terms used in this publication...worker effect. 9 That is, as the U.S. Army has begun its drawdown, Soldiers at greater risk of death may have separated from Service . For

  16. Participation in planning and evaluating mental health services: building capacity. (United States)

    Restall, Gayle; Strutt, Carolyn


    The participation of people who use mental health services in service planning and evaluation has become increasingly important in recent years. Health planners and people who use services are seeking information about how to enable participation that is meaningful and impacts positively on service delivery. This qualitative study explored the perspectives of people who use mental health services on participation in mental health service planning and evaluation. Sixty-three people from diverse backgrounds participated in either a focus group or interview. Themes were extracted from the data and resulted in a conceptual framework that can be used to guide the development and evaluation of participation.

  17. Health services research doctoral core competencies

    Directory of Open Access Journals (Sweden)

    Holve Erin


    Full Text Available Abstract This manuscript presents an initial description of doctoral level core competencies for health services research (HSR. The competencies were developed by a review of the literature, text analysis of institutional accreditation self-studies submitted to the Council on Education for Public Health, and a consensus conference of HSR educators from US educational institutions. The competencies are described in broad terms which reflect the unique expertise, interests, and preferred learning methods of academic HSR programs. This initial set of core competencies is published to generate further dialogue within and outside of the US about the most important learning objectives and methods for HSR training and to clarify the unique skills of HSR training program graduates.

  18. Marriage, Cohabitation, and Men's Use of Preventive Health Care Services (United States)

    ... Order from the National Technical Information Service NCHS Marriage, Cohabitation, and Men's Use of Preventive Health Care ... health care visit in the past 12 months. Marriage was associated with greater likelihood of a health ...

  19. Behavioral Health and Substance Abuse Treatment Services Locator (United States)

    ... Contact Us Help Home Behavioral Health Links + Federal Government Health and Human Services Agencies Behavioral Health Agencies ... an e-mail to , by calling the I-BHS Project Office at 1-888- ...

  20. Inpatient Behavioral Health Recapture A Busiess Case Analysis at Evans Army Community Hospital Fort Carson, Colorado (United States)


    68 Appendix B: Personnel Data 70 Automated Staffing Assessment Model ( ASAM ) 70 Fort Hood MEPRS 73 Rates 77 Appendix C: units. The closest information available comes from the Automated Staffing Assessment Model ( ASAM ), which considers this service largely a nursing...function. Therefore, the ASAM model utilizes the Workload Management System for Nursing (WMSN) to assist in determining suggested nursing staffing

  1. 78 FR 50144 - Health Services Research and Development Service, Scientific Merit Review Board; Notice of Meeting (United States)


    ... AFFAIRS Health Services Research and Development Service, Scientific Merit Review Board; Notice of Meeting.... App. 2, that the Health Services Research and Development Service (HSR&D) Scientific Merit Review..., Washington, DC; HSR 7--Aging and Diminished Capacity in the Context of Aging on Tuesday, August 27, 2013,...

  2. 78 FR 6854 - Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting (United States)


    ..., the testing of new methods of health care delivery and management, and nursing research. Applications... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting.... App. 2, that the Centers of Innovation subcommittee of the Health Services Research and...

  3. Specialization and competition in dental health services. (United States)

    Grytten, Jostein; Skau, Irene


    The number of specialists within dental health services has increased over the last few years. This raises the issue of how the services should be organized and funded. We describe the effect of one way of organizing the services, which is by relying on competition. In Norway, some oral specialists face real competition with general dental practitioners for the same patients (prosthetists, periodontists and endodontists), while other specialists do not (orthodontists and oral surgeons). The latter specialists have skills that give them exclusive possibilities to practice their profession. We find that competition can be effective for the specialists who experience real competition with general dental practitioners for patients. In situations where real competition does not exist, specialists can obtain market power and raise their fees. Our results are based on an analysis of a representative set of data from general dental practitioners and specialists in Norway. The specialities in which practitioners can exercise market power raise challenges related to the type of public policy that can reduce this market power in an appropriate way, and without involving too large costs for the authorities.

  4. What would a socialist health service look like? (United States)

    Brecher, B


    A socialist health service cannot be a socialist island in a sea of capitalism, as the record of the British National Health Service shows. Nonetheless, since health is a basic need, it can be a key component of the advocacy of socialism. I propose two central socialist principles. On the basis of these I suggest that a socialist health system would emphasise care rather than service; insist on democratic structures and control of resources; and require the prohibition of private medicine.

  5. 45 CFR 1308.18 - Disabilities/health services coordination. (United States)


    ... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND... medications dispensed and review the record regularly with the child's parents. (3) Record changes in a child... 45 Public Welfare 4 2010-10-01 2010-10-01 false Disabilities/health services coordination....

  6. Mental Health Service Providers: College Student Perceptions of Helper Effectiveness (United States)

    Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.


    Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…

  7. Telephone survey of service-user experiences of a telephone-based mental health triage service. (United States)

    Elsom, Stephen; Sands, Natisha; Roper, Cath; Hoppner, Cayte; Gerdtz, Marie


    The participation of service users in all aspects of mental health service delivery including policy development, service planning and evaluation is increasingly an expectation of contemporary mental health care. Although there are a growing number of publications reporting service-user perspectives in the evaluation of mental health services, little attention has been paid to the views of service users about mental health triage services. The purpose of the study reported here was to examine service-users' (consumers and informal carers) experiences of a telephone-based mental health triage service. Using a framework developed from the World Health Organisation's elements of responsiveness, we conducted structured telephone interviews with service users who had contacted a telephone-based mental health triage service in regional Victoria, Australia. The main findings of the study were that consumers experienced more difficulty than carers in accessing the service and that, although most participants were satisfied, only a minority reported being involved in decision-making. Further work is needed to improve accessibility of mental health triage services and to investigate barriers to consumer self-referral. Professional development and practice support systems should be established to support mental health triage nurses in the development of collaborative, consumer-focused care.

  8. [Health conditions and physical development of soldiers during enrollment in the Armed Forces of Ukraine and military service in 2001-2010]. (United States)

    Didenko, L V; Ustinova, L A; Khyzhniak, M I


    Fitness of soldiers in military reserve for military service at the stage in the Armed Forces of Ukraine has been studied in the article. It has been established that the growing number of soldiers in military reserve with changes in health and physical condition indicates insufficient level of their health which has a negative impact on their capability and gradually on their fitness for military service. Priorities of changes in organization of the process of completion by human resources of the soldiers' military reserve in the Armed Forces of Ukraine during their transition towards professional army have been defined, to include optimization of criteria of fitness for military service.

  9. The health production function of oral health services systems

    DEFF Research Database (Denmark)

    Vlad, R.S.; Petersen, P.E.


    Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life......Attitudes, dental status, socioeconomic factors, oral health care, production of oral health, health status, quality of life...

  10. Health workers' attitudes toward sexual and reproductive health services for unmarried adolescents in Ethiopia


    Tilahun Mesfin; Mengistie Bezatu; Egata Gudina; Reda Ayalu A


    Abstract Background Adolescents in developing countries face a range of sexual and reproductive health problems. Lack of health care service for reproductive health or difficulty in accessing them are among them. In this study we aimed to examine health care workers' attitudes toward sexual and reproductive health services to unmarried adolescents in Ethiopia. Methods We conducted a descriptive cross-sectional survey among 423 health care service providers working in eastern Ethiopia in 2010....

  11. 75 FR 27348 - Public Health Services Act; Delegation of Authority (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health...

  12. Use of mental health services among disaster survivors: predisposing factors.

    NARCIS (Netherlands)

    Ouden, D.J. den; Velden, P.G. van der; Grievink, L.; Morren, M.; Dirkzwager, A.J.E.; Yzermans, C.J.


    BACKGROUND: Given the high prevalence of mental health problems after disasters it is important to study health services utilization. This study examines predictors for mental health services (MHS) utilization among survivors of a man-made disaster in the Netherlands (May 2000). METHODS: Electronic

  13. Implementing the System for Health in the US Army Reserves Through the Performance Triad (United States)


    Nutrition. After Officer Basic Course and the Army Dietetic Internship, she served five years in several dietitian positions at Fort Sill , Oklahoma...created considering USAR challenges. 51 With some clarification of the demands, resources and outcomes in terms that speak to reserve units, this

  14. Tri-Service Center for Oral Health Studies (TSCOHS) (United States)

    Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...

  15. Efficiency in health public services provision and market failure

    Directory of Open Access Journals (Sweden)

    Carlos Arturo Meza Carvajalino


    Full Text Available This document studies the theoretical foundations, the different controversies regarding the health service and the conceptions adopted from the hypotheses related to the market efficiency in the provision of a public service and the consequent market failures. The author thinks that when the health public service was delegated to the market in Colombia they originated failures in the competition, externalities, preference goods and services, asymmetry and redistribution, among the most relevant ones.


    Directory of Open Access Journals (Sweden)

    Muharrem UCAR


    Full Text Available While objective parameters like sufficiency of the resources and the number of people benefiting from services are considered to evaluate the health services, the attitudes and behaviors which patients meet during taking this health service and ethical issues like patient rights are considered as second importance. But ethical parameters are more important for patients. Military health organizations have much responsibility about ethical issues; because they are usually the only institutions for the personnel who they serve to took health service, requested health service are usually indispensable and the patient couldn?t select the physician because of the structure of the organization and military conditions. It is necessary to educate personnel in military health organizations as well as in all of the health institutions about gaining communication skills and patient rights in order to reach the desired level in ethical issues. [TAF Prev Med Bull 2005; 4(1.000: 37-45

  17. Development of a Facility Management and Improvement Manual for Army Service Schools. (United States)


    RE D R C RD 7.. RADER F SERVICE WINDOW "’’iPAPER L SUPPLY DESK b a x b- sq. ft. required a,12 ft. b, 18 ft. 12 x 18- 216 sq. ft. Figure C-3. An...voltage from 480 to 120/208 for convenience outlets. Primary elec- tric service should be placed underground . Cables should feed from the nearest pole

  18. 78 FR 12422 - Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting (United States)


    ... Services Research (HSR) subcommittees and its Nursing Research Initiative (NRI) subcommittee. The HSR... testing of new methods of health care delivery and management, and nursing research. Applications are... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board, Notice of...

  19. 提高陆军战术运输勤务演习效益对策研究%Research on Improve Army Tactics Transportation Service Exercises

    Institute of Scientific and Technical Information of China (English)

    刘冰; 袁富国; 姚爱祥; 李强; 曾令国


    通过对当前我陆军战术运输勤务演习存在问题的剖析,就如何提高陆军战术运输勤务演习效益,从演习准备、演习重难点问题演练、演习组训方式、演习评估四个方面进行了对策探讨。%Based on the analysis of the current problems of the army tactics transportation service exercises,this paper explored some countermeasures to Improve army tactics transportation service exercises,such as preparing exercises,exercising important and difficult subjects,exercising the ways and means of training,and evaluating exercises.

  20. Community mental health services and the elderly: retrenchment or expansion? (United States)

    Swan, J H; Fox, P J; Estes, C L


    Data gathered from a recent survey of CMHC's suggest that the elderly are increasing their utilization of CMHC services. As more responsibility for mental health services is shifted to the states, a commitment to mental health services for the elderly increasingly becomes an issue of state discretion, and of state finances. This makes it probable that accessibility to mental health services for the elderly will become more variable and problematic on a national basis. This is especially important in light of data that indicates an increasing awareness by CMHC's of the mental health needs of the elderly.

  1. Telemental Health Technology in Deaf and General Mental-Health Services: Access and Use (United States)

    Austen, Sally; McGrath, Melissa


    Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or…

  2. Service planning in the Victorian community health sector. (United States)

    Roussy, Véronique; Livingstone, Charles


    Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne's outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.

  3. Design of Shore-range Psychotherapy and Self-service System for the Army%军人短程心理治疗自助系统设计

    Institute of Scientific and Technical Information of China (English)

    赵汉清; 过伟; 李宁; 余海鹰; 苏宗荣


    探索建立一套帮助部队心理医师进行短程心理治疗和自助维护军人心理健康的应用系统。短程心理治疗系统由访谈计划、相关作业和实验、诊断标准4个模块构成,通过20次访谈,根据情绪认知成长理论引导治疗者进行规范操作。心理自助系统由认识情绪、理解情绪和自助视频3个模块构成,根据认知原理对自己的负性情绪进行重新认识,并可正确地理解和帮助身边有心理疾病者。经部队心理医师使用可以顺利地完成治疗过程,并获得了较好的效果。自助系统经部队116个心理咨询室使用,可有效地缓解求助者的负性情绪。系统将临床心理医师的经验转化成容易掌握的治疗工具,且设计合理,展示形式多样,操作简单,携带方便,为部队开展专业化心理服务提供了一种实用的辅助工具。%Explore the establishment of a set of help troops psychological doctor to undertake short-term psychotherapy and application system for self-help of army soldier's mental health.Short term psychotherapy sys-tem is part for interview program, the related work and experimental, diagnostic classification and standard of 4 modules.Through the 20 interviews, to regulate the operation according to the cognitive development theory of emo-tion to guide therapy.Mental self-help system consists of understanding emotions, understanding emotions and video of 3 modules.According to the cognitive theory to re-know the negative emotions of their own, and correctly understand and help with mental disease patients.The army psychiatrist can successfully completed the course of treatment, and get good effect.Self-service system is used by 116 psychological consultation room, can effectively ease the negative emotional seeking help.The system changes psychological doctor's experience to easy treatment tool.The system has reasonable design, display a variety of forms, simple operation and

  4. Maternal Health-Seeking Behavior: The Role of Financing and Organization of Health Services in Ghana


    Aboagye, Emmanuel; Agyemang, Otuo Serebour


    This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's hea...

  5. [Vulnerable children detected by the school health service: the forgotten?]. (United States)

    Noirhomme-Renard, F; Bullens, Q; Malchair, A; Gosset, C


    The current health needs of children largely exceeds the biomedical model. The school doctor occupies a special position where he can take into account the social determinants of health and identify vulneirable children. After the detection by the school health service, the harmonious development of, the child requires that health professionals cooperate in a "preventive network".

  6. 42 CFR 410.10 - Medical and other health services: Included services. (United States)


    ... other diagnostic tests. (f) X-ray therapy and other radiation therapy services. (g) Medical supplies, appliances, and devices. (h) Durable medical equipment. (i) Ambulance services. (j) Rural health...

  7. Services Supply Chain in the Department of Defense: Drivers of Acquisition Management Practices in the Army (United States)


    corhb/Files/Training_Reference_Guidance/ACC%20Pamph let%2070-1%20Final%20Sig%20032610.pdf Williamson, O. E. (1979). Transaction - cost economics: The...Theory and Principal-Agent Problem – Transaction Cost Economics – Service Operations Management – Contractual Theory: How contracts are planned

  8. Establishment of a Separate Psychology Service at Walter Reed Army Medical Center (United States)


    Sheila Forsythe, Barbara J. Morgan); the Department of Psychology at the National Naval Medical Center, Bethesda, Maryland (CAPT Frank Mullins and...Services w2 1l have to be configured to specific staffs, available resources, and missions. To enhance leadership opportunities and carper rr𔄁-0ssion fe

  9. Mental Health Services in School-Based Health Centers: Systematic Review (United States)

    Bains, Ranbir Mangat; Diallo, Ana F.


    Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

  10. School Health Services for Children with Special Health Care Needs in California (United States)

    Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S.; Knauer, Heather


    Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study…

  11. Hardiness as a predictor of mental health and well-being of Australian army reservists on and after stability operations. (United States)

    Orme, Geoffrey J; Kehoe, E James


    This study tested whether cognitive hardiness moderates the adverse effects of deployment-related stressors on health and well-being of soldiers on short-tour (4-7 months), peacekeeping operations. Australian Army reservists (N = 448) were surveyed at the start, end, and up to 24 months after serving as peacekeepers in Timor-Leste or the Solomon Islands. They retained sound mental health throughout (Kessler 10, Post-Traumatic Checklist-Civilian, Depression Anxiety Stress Scale 42). Ratings of either traumatic or nontraumatic stress were low. Despite range restrictions, scores on the Cognitive Hardiness Scale moderated the relationship between deployment stressors and a composite measure of psychological distress. Scatterplots revealed an asymmetric pattern for hardiness scores and measures of psychological distress. When hardiness scores were low, psychological distress scores were widely dispersed. However, when hardiness scores were higher, psychological distress scores became concentrated at a uniformly low level.

  12. Understanding the moderating role of the professional service encounter in consumer perceptions of health service risks



    Correct understanding of the risks of treatments is essential for consumers of health services. Yet, existing research has not examined how consumers understand risk in mixed-market health service environments, where private sector firms operate alongside established public sector providers, such as is the case in the UK. As the range and complexity of private sector health services increases, there remains uncertainty about how individuals will perceive, and respond to, the ri...

  13. Web-services-based resource discovery model and service deployment on HealthGrids. (United States)

    Naseer, Aisha; Stergioulas, Lampros K


    HealthGrids represent the next generation of advanced healthcare IT and hold the promise to untangle complex healthcare-data problems by integrating health information systems and healthcare entities. Healthcare could benefit from a new delivery approach using HealthGrids to better meet the biomedical and health-related needs. Specialized services are needed to provide unified discovery of and ubiquitous access to available HealthGrid resources. The different types of services available on HealthGrids are classified into two levels, the operational-level services and the management-level services. This paper takes a fresh approach to address the problems of resource discovery in HealthGrids based on Web services (WS) and WS technologies and proposes a WS-based resource discovery model.

  14. Adolescents perception of reproductive health care services in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Agampodi Thilini C


    Full Text Available Abstract Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners

  15. Multidisciplinary Health Services as External Agents of Change

    DEFF Research Database (Denmark)

    Westerholm, Peter; Hasle, Peter; Fortuin, Rick


    A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises.......A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises....

  16. Providing Mental Health Services to Arab Americans: Recommendations and Considerations. (United States)

    Erickson, Chris D.; Al-Timimi, Nada R.


    This paper presents background information on the cultural sociopathology of the Arab American experience. It discusses how, in order to effectively deliver services, mental health workers need to be aware of their own biases. It explores ways to provide culturally relevant mental health services to Arab Americans. (JDM)

  17. Clinical Issues in Mental Health Service Delivery to Refugees. (United States)

    Gong-Guy, Elizabeth; And Others


    Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process: fragmentation, instability, language barriers, culturally inappropriate treatment methods, and severe staff shortages. Suggested improvements for refugee mental health services emphasize outreach, prevention, treatment approaches,…

  18. 78 FR 61367 - Health Resources and Services Administration (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... development of a technical assistance tracker for RWHAP grantees to monitor and assess changes in the mix...

  19. 75 FR 21508 - Health and Human Services Acquisition Regulation; Corrections (United States)


    ... maintenance, and other activities involving live vertebrate animals conducted under contract (see Public Health Service Policy on Humane Care and Use of Laboratory Animals (PHS Policy), Rev. 1986, Repr. 1996... Compliance with the Public Health Service Policy on Humane Care and Use of Laboratory Animals,...

  20. [Further improvement of transport immobilization in the czechoslovak army.]. (United States)

    Urminský, E; Beznoska, J; Fanta, D


    The authors inform about a new traction frame for the lower extremity to be used by the health service in the Czechoslovak Army. They present fundamental requirements set for the development of this plate and perspectives of its series production. Key words: metal traction frame, lower extremity, immobilization.

  1. 75 FR 3906 - Request for Public Comment: 30-Day Proposed Information Collection: Indian Health Service... (United States)


    ...: Indian Health Service Customer Satisfaction Survey AGENCY: Indian Health Service, HHS. ACTION: Notice... Service Customer Satisfaction Survey.'' Type of Information Collection Request: Three year approval of this new information collection, 0917-NEW, ``Indian Health Service Customer Satisfaction Survey.''...

  2. 77 FR 11557 - National Advisory Council on the National Health Service Corps; Request for Nominations (United States)


    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps; Request for Nominations AGENCY: Health Resources and Services Administration... Administration (HRSA) is requesting nominations to fill five vacancies on the National Advisory Council (NAC)...

  3. The Technological Growth in eHealth Services

    Directory of Open Access Journals (Sweden)

    Shilpa Srivastava


    Full Text Available The infusion of information communication technology (ICT into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.

  4. Trade in health services in the ASEAN region. (United States)

    Arunanondchai, Jutamas; Fink, Carsten


    Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.

  5. International survey of occupational health nurses' roles in multidisciplinary teamwork in occupational health services. (United States)

    Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie


    Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries.

  6. The ethics of advertising for health care services. (United States)

    Schenker, Yael; Arnold, Robert M; London, Alex John


    Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health care institutions. Using examples, we illustrate how common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions, and society. We conclude by proposing that these risks justify new standards for advertising when considered as part of the moral obligation of health care institutions and suggest that mechanisms currently in place to regulate advertising for prescription pharmaceuticals should be applied to advertising for health care services more broadly.

  7. Commissioning services and Primary Health Networks. (United States)

    Booth, Mark; Boxall, Anne-Marie


    Commissioning is set to become a stronger feature in the Australian health system as Primary Health Networks embrace it as a tool for improving population health outcomes. International experience shows that developing into a commissioning organisation is not always easy. Drawing on international experiences of commissioning, as well as those from the Australian hospital sector, will help smooth the path for Primary Health Networks.

  8. Assessing uncertainty in outsourcing clinical services at tertiary health centers. (United States)

    Billi, John E; Pai, Chih-Wen; Spahlinger, David A


    When tertiary health centers face capacity constraint, one feasible strategy to meet service demand is outsourcing clinical services to qualified community providers. Clinical outsourcing enables tertiary health centers to meet the expectations of service timeliness and provides good opportunities to collaborate with other health care providers. However, outsourcing may result in dependence and loss of control for the tertiary health centers. Other parties involved in clinical outsourcing such as local partners, patients, and payers may also encounter potential risks as well as enjoy benefits in an outsourcing arrangement. Recommendations on selecting potential outsourcing partners are given to minimize the risks associated with an outsourcing contract.

  9. Service needs of families of adolescents with mental health difficulties



    Introduction: For families of children with mental illness, adolescence is a major struggle and few parents find service systems to be helpful during this period [1]. These difficulties seem to span across various dimensions such as availability of health, educational and community resources, barriers to accessing services, understanding of health care providers and specially those related to the transition to adult healthcare service system and the restrictions imposed by confidentially. Par...

  10. Digital reference service: trends in academic health science libraries. (United States)

    Dee, Cheryl R


    Two years after the initial 2002 study, a greater number of academic health science libraries are offering digital reference chat services, and this number appears poised to grow in the coming years. This 2004 follow-up study found that 36 (27%) of the academic health science libraries examined provide digital chat reference services; this was an approximately 6% increase over the 25 libraries (21%) located in 2002. Trends in digital reference services in academic health science libraries were derived from the exploration of academic health science library Web sites and from digital correspondence with academic health science library personnel using e-mail and chat. This article presents an overview of the current state of digital reference service in academic health science libraries.

  11. SMS for Sexual Health: A Comparison of Service Types and Recommendations for Sexual Health Text Message Service Providers (United States)

    Willoughby, Jessica Fitts; Muldrow, Adrienne


    Objectives: Text message-based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which…

  12. Privatisation in reproductive health services in Pakistan: three case studies. (United States)

    Ravindran, T K Sundari


    Privatisation in Pakistan's health sector was part of the Structural Adjustment Programme that started in 1998 following the country's acute foreign exchange crisis. This paper examines three examples of privatisation which have taken place in service delivery, management and capacity-building functions in the health sector: 1) large-scale contracting out of publicly-funded health services to private, not-for-profit organisations; 2) social marketing/franchising networks providing reproductive health services; and 3) a public-private partnership involving a consortium of private players and the government of Pakistan. It assesses the extent to which these initiatives have contributed to promoting equitable access to good quality, comprehensive reproductive health services. The paper concludes that these forms of privatisation in Pakistan's health sector have at best made available a limited range of fragmented reproductive health services, often of sub-optimal quality, to a fraction of the population, with poor returns in terms of health and survival, especially for women. This analysis has exposed a deep-rooted malaise within the health system as an important contributor to this situation. Sustained investment in health system strengthening is called for, where resources from both public and private sectors are channelled towards achieving health equity, under the stewardship of the state and with active participation by and accountability to members of civil society.

  13. 为军服务模式的创新与效果评价%Innovation and Effect Evaluation on Medical Service Mode for the Army

    Institute of Scientific and Technical Information of China (English)



    The article summarized the basic methods of innovating the mode of serving the army.Through the mode innovation, the quality of service the army was getting better and better, the sanatorium was functioning adequate-ly, the general mood of sanatorium was purified,the management of sanatorium became more scientific and standardized.%总结为军服务模式持续创新的基本做法。通过模式创新,为军服务质量越来越好、疗养院的功能作用得到充分发挥、疗养院内部风气得到净化、疗养院管理更加科学规范。

  14. U.S. Army Medical Department (United States)

    ... Excerpt-3 Building partnerships through military medicine Tripler Army Medical Center assists in medical missions. Read more ... their age, height, and weight. Healthy Living Videos Army Medicine Health Minute View More Videos

  15. Allocating Inpatient Expenses to Each DRG in All Clinical Services at Darnall Army Community Hospital (United States)


    BC/BS implements drg system. Health Care Advocate Diomede, B., (1985). DRGs and surgical procedures. Association of Operatinq Room Nurses Journal...PROCEDURES WITH CC 4.4412 15.5 1 48 192 PANCREAS, LIVER & SHUNT PROCEDURES W/O CC 1.7379 8.5 1 41 193 BILIARY TRACT PROC W CC EXCEPT ONLY CHOLECYST W OR W/G...C.D.E. 3.0275 14.0 1 46 194 BILIARY TRACT PROC W/O CC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. 1.6189 8.8 1 41 195 CHOLECYSTECTOMY WITH C.D.E. WITH CC

  16. Variables Affecting Patient Satisfaction with Health Care Services in the College Health Setting. (United States)

    Gillette, Joyce L.; And Others


    Five hundred college students who had used Kent State University's School Health Service were surveyed to determine patient satisfaction with health care services. Overall satisfaction with the services was high, and satisfaction was significantly influenced by patients' perceptions of practitioners' technical competence and by the adequacy of the…

  17. Students' community health service delivery: experiences of involved parties. (United States)

    Greeff, M; van der Walt, E; Strydom, C; Wessels, C; Schutte, P J


    For several years the School of Nursing Science and the School of Psychosocial Behavioural Science, of a specific university, have been offering health care services in response to some of the health needs of a disadvantaged community as part of their students' experiential learning. However, these health care services were rendered independently by these two schools, implying that no feedback system existed to evaluate the worth and quality of these student-rendered health care services. The objectives of this research were to explore and describe the experiences of senior nursing and social work students, the experiences of health service delivery organisations concerned and the experiences of the disadvantaged community members receiving such health care services, as well as to investigate which communication models were apparent with regard to the major factors within health communication. An exploratory descriptive qualitative research design was used. Focus group discussions were held, interviews were conducted and field notes taken. Focus group discussions and interviews were transcribed and analysed by the research team to determine themes and sub-themes using the open coding technique. The results of the three groups showed similarities. The health service delivery organisations also identified a communication barrier, although the students were prepared to bridge it. The health service delivery organisations and the community felt positive towards the students and what they offered to the organisations and to the patients. A greater need for multi-disciplinary team work was recognised by al parties concerned. Recommendations focus on improved student accompaniment by lecturers; extending health care delivery to include a multi-disciplinary team approach by students; as well as improving the delivery of health care services.

  18. Collaboration in the provision of mental health care services

    DEFF Research Database (Denmark)

    Jaruseviciene, L.; Valius, L.; Lazarus, J.V.


    Background. General practitioners (GPs) often become the first point of care for mental health issues. Improved collaboration between GPs and mental health teams can make a GP's mental health services more efficient. Objective. The aim of this study was to assess the collaboration between GPs and...

  19. 75 FR 39734 - Health Services Research and Development Service Merit Review Board; Notice of Meeting (United States)


    ... testing of new methods of health care delivery and management, and nursing research. Applications are... Research and Development Officer. On August 31, the subcommittee on Nursing Research Initiative will... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting...

  20. 76 FR 42168 - Health Services Research and Development Service Merit Review Board; Notice of Meeting (United States)


    ... methods of health care delivery and management, and nursing research. Applications are reviewed for... Development Officer. On August 30, the subcommittees on Nursing Research Initiatives and Research Best... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting...

  1. 77 FR 42365 - Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting (United States)


    ... health care delivery and management, and nursing research. Applications are reviewed for scientific and... Officer. On August 28, the following subcommittees will convene: Nursing Research Initiatives from 8 a.m... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board, Notice of...

  2. 75 FR 4453 - Health Services Research and Development Service Merit Review Board; Notice of Meeting (United States)


    ... methods of health care delivery and management, and nursing research. Applications are reviewed for... Development Officer. On March 2, the subcommittee on Nursing Research Initiative will convene from 8 a.m. to... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting...

  3. Service user involvement in mental health practitioner education in Ireland. (United States)

    Higgins, A; Maguire, G; Watts, M; Creaner, M; McCann, E; Rani, S; Alexander, J


    In recent years, there is an ever increasing call to involve people who use mental health services in the development, delivery and evaluation of education programmes. Within Ireland, there is very little evidence of the degree of service user involvement in the educational preparation of mental health practitioners. This paper presents the findings on service user involvement in the education and training of professionals working in mental health services in Ireland. Findings from this study indicate that in the vast majority of courses curricula are planned and delivered without consultation or input from service users. Currently the scope of service user involvement is on teaching, with little involvement in curriculum development, student assessment and student selection. However, there is evidence that this is changing, with many respondents indicating an eagerness to move this agenda forward.

  4. Quality of Health Services Provided to Iraqis at Jordan Red Crescent Health Centers

    Directory of Open Access Journals (Sweden)

    Taghrid S. Suifan


    Full Text Available Problem statement: Quality of services measurement has been the concern of many scholars who have tried to develop scales for it. The most popular scale used was SERVQUAL. Hence the aim of this study is to discover the quality of health services provided to Iraqis at Jordan Red Crescent Health Centers in Amman. Approach: A sample study was derived from (1652 male and female patients from five health centers: Ashrafieh Health Center; Al-Hashemi Health Center; Marka Health Center; Al-Taj Health Center and AL-Hussein Health Center. Means, Standard Deviation, Independent Sample T-Test, simple regression and the Scheffe Test were used to answer the study's main questions. Results: It was found that the quality of health services provided to the Iraqis at Jordan Red Crescent health centers was high in all dimensions, the highest quality dimensions displayed among the health service available at Jordan Red Crescent health centers were tangibles and assurance, whereas the lowest quality dimensions were empathy and responsiveness, there was a significant difference in the quality of health services provided to Iraqis at Jordan Red Crescent Health Centers (Ashrafieh Health Center, Al-Hashemi Health Center, Marka Health Center, Al-Taj Health Center and AL-Hussein Health Center from one center to another and there was a significant difference in the quality of health services provided to Iraqis at Jordan Red Crescent health centers based on the number of visits the Iraqis made to the center. Conclusion: The main recommendation presented in this study is that there is a need to expand the health services in cooperation with international humanitarian organizations in order to accommodate the rising number of Iraqis frequenting the centers.

  5. Support for Offering Sexual Health Services through School-Based Health Clinics (United States)

    Moore, Michele Johnson; Barr, Elissa; Wilson, Kristina; Griner, Stacey


    Background: Numerous studies document support for sexuality education in the schools. However, there is a dearth of research assessing support for sexual health services offered through school-based health clinics (SBHCs). The purpose of this study was to assess voter support for offering 3 sexual health services (STI/HIV testing, STI/HIV…

  6. Clinical issues in mental health service delivery to refugees. (United States)

    Gong-Guy, E; Cravens, R B; Patterson, T E


    Serious limitations exist in the delivery of mental health services to refugees throughout the resettlement process. Having survived harrowing physical and psychological traumas prior to reaching refugee camps, many refugees encounter mental health services in overseas camps that are characterized by fragmentation, instability, language barriers, and severe staff shortages. Refugees requiring mental health intervention after resettlement in the United States confront additional barriers, including frequent misdiagnosis, inappropriate use of interpreters and paraprofessionals, and culturally inappropriate treatment methods. Suggestions for improving mental health services for refugee populations emphasize modifying diagnostic assumptions and treatment approaches, recognizing potential problems associated with using interpreters and paraprofessionals, and examining the role of consultation, prevention, and outreach services in addressing refugee mental health concerns.

  7. Honoring their service: behavioral health services in North Carolina for military service members, veterans, and their families. (United States)

    Alexander-Bratcher, Kimberly M; Martin, Grier; Purcell, William R; Watson, Michael; Silberman, Pam


    The North Carolina Institute of Medicine Task Force on Behavioral Health Services for the Military and Their Families examined the adequacy of Medicaid- and state-funded services for mental health conditions, developmental disabilities (including traumatic brain injury), and substance abuse that are currently available in North Carolina to military service members, veterans, and their families. The task force determined that there are several gaps in services and made 13 recommendations related to federal, state, and local community resources. This article reviews the work of the task force and current efforts to improve services in North Carolina.

  8. Knowledge and Service Demand of Reproductive Health among Migrant Population

    Institute of Scientific and Technical Information of China (English)

    Wen-ji YANG; Bi-huan MAI; Min ZhOU; Qi-min SHI; Xin CAO; Wen-ying HE; Feng-ying ZOU; Xiao YING


    Objective To understand the sexual and reproductive health knowledge among unmarried migrant population and their service demands as well as current services delivered by local family planning departments, so as to provide scientific evidences on conducting reproductive health education and appropriate service for migrant population in the district.Methods A questionnaire survey was conducted among a convenient sample of unmarried young migrant population between 15 and 25 years old in Dongshan District. All data were entered into database with the software Foxpro6.0 and analyzed with the statistics software SPSS10.0.Results Unmarried migrant population had some kinds of sexual and reproductive health knowledge and was eager to access to reproductive health service. They hoped that relevant governmental departments could provide them more information,education and service on sexuality and reproductive health.Conclusion Relevant departments should work together to popularize reproductive health knowledge among unmarried migrant population and meet their demands on reproductive health service, so as to improve their current reproductive health situation.

  9. Principles of youth participation in mental health services. (United States)

    James, Anthony M


    Young people with mental illness face many barriers in accessing care and often have different needs to those of adult consumers. Young people's participation in mental health services is one way of addressing quality and access issues, through receiving feedback and implementing youth-driven and youth-friendly strategies. headspace, the National Youth Mental Health Foundation, established in July 2006, highlights the mental health care sector's commitment to young people. Existing youth participation programs provide examples of what can be achieved at national and local levels and with varying levels of financial and other support. These include: Ybblue, the youth program of beyondblue; Reach Out!, a web-based service; Headroom, providing health promotion and a website; and Platform Team (ORYGEN Youth Health), comprising current and past clients who advise the service and provide peer support. Current practice in youth participation in mental health services involves a variety of methods, such as ensuring information and education is appropriate for a youth audience, and participating in peer-support programs and staff selection panels. Challenges in the future development of youth participation in mental health services include avoiding tokenism, acknowledging that young people are not a uniform group, translating national strategies into local improvements in services, and gaining the support and cooperation of health care workers in genuine participation.

  10. Database search services as a basic service in academic health sciences libraries.


    Jankowski, T A; Martin, E. R.


    Mediated search services, usually offered for a fee, are commonplace in academic health sciences libraries. At the same time, users of these services have numerous self-service options available to them; for example, CD-ROMs and locally mounted databases. In keeping with its philosophy of access to rather than ownership of information, the University of Washington Health Sciences Library and Information Center (HSLIC) changed its policy from charging clients for mediated searching to offering...

  11. User/consumer involvement in mental health service delivery. (United States)

    Chamberlin, Judi


    The involvement of mental health service users in service delivery is a new and growing phenomenon. Such involvement is complex, given the history of paternalism in the mental health system, the power differential between service providers and service users, and the very differing views each group holds on multiple issues. Unless such differences are addressed, there can be no meaningful involvement. Service user involvement needs to apply to all aspects of the service delivery system, including professional training, service design, delivery, evaluation, and research. User/survivors, and their organizations, have developed a body of experience and knowledge that needs to be recognized and respected. Unless there are multiple opportunities for ongoing and open dialogue on these many difficult issues, real user involvement will not occur.

  12. Integrating emergency services in an urban health system. (United States)

    Radloff, D; Blouin, A S; Larsen, L; Kripp, M E


    When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.

  13. Making customer-service a priority in health care organizations. (United States)

    O'Hagan, Joshua; Persaud, David


    Improving customer-service in health care organizations has been linked to better patient care, satisfied staff, a reduction in preventable medical errors, fewer malpractice lawsuits and improved revenue. However, it has been observed that there is sometimes a gap between the level of customer-service provided by health care organizations and their clients' expectations. This paper integrates, synthesizes and extends theory and practice from existing literature to provide health care organizations with strategies for closing this gap. Methods are also outlined for creating, implementing and evaluating an organizational plan for improving customer-service.

  14. Experiences in the health services network and in the street: Captures and detours in psychology training for public health services. (United States)

    Severo, Ana Kalliny de Sousa; Amorim, Ana Karenina de Melo Arraes; Romagnoli, Roberta Carvalho


    This article discusses the internships at the psychosocial health system of Natal, Northeast region of Brazil, as part of training in psychology. The objective of these internships is to offer students work experiences in public health both inside and outside health services. Based on Institutional Analysis and Schizoanalysis, these experiences were examined through two analysers: (1) the power of knowledge and (2) the need for by-passes. We conclude that health provokes tensions between instituted practices in health services and those instituted in psychology training.

  15. Health services research: the gradual encroachment of ideas. (United States)

    Black, Nick


    There is increasing pressure on researchers and research funding bodies to demonstrate the value of research. Simple approaches, consistent with the biomedical paradigm, based on relating the cost of research to its supposed impact are being investigated and adopted in laboratory and clinical research. While this may be appropriate in such research areas, it should not be applied to health services research which aims to alter the ways policy-makers and managers think about health, disease and health care or, as John Maynard Keynes put it, 'the gradual encroachment of ideas'. By considering six fundamental assumptions about health care that have been successfully challenged and overturned over the past few decades, the profound and sustained impact of health services research can be demonstrated. The application of economic models of 'payback' would fail to recognize such contributions which, in turn, could threaten future funding of health services research.

  16. US Army Public Health Command’s (Prov) (Formly USACHPPM) Process to Screen Chemicals in Support of DoD’s CMRM Emerging Contaminants Program (United States)


    US Army Public Health Command’s (Prov) (Formly USACHPPM) Process to Screen Chemicals in Support of DoD’s CMRM Emerging Contaminants Program...CMRM Emerging Contaminants Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER...Occupational Health • DoD Instruction 5000.2 Operation of the Defense Acquisition System • DoD Instruction 4715.18 Emerging Contaminants (EC

  17. Sexual health service providers' perceptions of transgender youth in England. (United States)

    Lefkowitz, Ayla R F; Mannell, Jenevieve


    Transgender youth often face difficulties when accessing sexual health services. However, few studies investigate health service providers' perceptions of transgender youth, and fewer focus on sexual health. To fill this gap, our study draws on social representations theory to examine sexual health service providers' perceptions of transgender youth and how this influences the provision of health services for this marginalised population in England. A thematic analysis of 20 semi-structured interviews with service providers, conducted between March and June 2014, resulted in five main themes centred on: binary representations of transgender; transgender as homosexuality; uncertain bodies; unstable mental states; and too young to know. Of the service providers interviewed, many understood transgender within a male/female binary, and perceived being transgender to be synonymous with being gay. There was confusion among service providers regarding transgender youths' sexual organs, and most of those interviewed saw transgender youth as mentally unstable and confused. Finally, many service providers perceived that transgender youth are too young to know that they are transgender and make decisions about their body. Some of these representations were potentially stigmatising and many conflicted with transgender youths' representations of themselves. Training by transgender people is recommended to help address these misunderstandings.

  18. P-1139 - Increased utilization of health care services after psychotherapy

    DEFF Research Database (Denmark)

    Fenger, Morten Munthe; Mortensen, Erik Lykke; Poulsen, Stig Bernt;


    Background Psychotherapeutic treatment is associated with significant reduction of symptoms in patients, and it is generally assumed that treatment improves health and decreases the need for additional health care. The present study investigates the long-term changes in utilization of health care...... a long-term period psychotherapy patients increased their utilization of health care services with a factor 3 compared to a control group....

  19. The management of health care service quality. A physician perspective. (United States)

    Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L


    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective.

  20. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services. (United States)


    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who...

  1. [Tuberculosis screening in school health services in Geneva, Switzerland]. (United States)

    Meynard, Anne; Pfarrwaller, Eva; Lazarevic, Claire-Anne Wyler


    Recent immigrantyouth have multiple health needs that need to be adapted to the context of migration. School health services provide a systematic health check to allyoung immigrants starting school in Geneva, including a tuberculin skin test if coming from a middle or high incidence country. Positive tests are confirmed with Interferon Gamma Release Assay (IGRA) and if indicated, offered treatment of latent tuberculosis even in the absence of clear guidelines. Collective and individual benefits outweigh the difficult logistics: reducing risk of reactivation of latent tuberculosis for populations living in promiscuity, effective collaboration between primary care and school health services to answer the needs of these underserved youth.

  2. Can Access to Data Prevent Army Suicides Identifying Optimal Response Strategies for Army Leaders (United States)


    Providers Collaboration between leaders and behavioral health providers is essential to preventing suicide . Some panelists emphatically stressed that...adolescents, service members and veterans, and minority populations. He has a specific interest in the epidemiology of suicide and its prevention...SUMMARY ■ Among the many efforts under way to prevent suicide in the U.S. Army is a program to develop an information system that would provide

  3. Evaluating Comorbidity Scores Based on Health Service Exp... (United States)

    U.S. Department of Health & Human Services — The use of Charlson related expenditures did not result in improved mortality prediction. CCI models perform less well in population subgroups with higher underlying...

  4. Streptococcal Infections, Rheumatic Fever and School Health Services. (United States)

    Markowitz, Milton


    Because rheumatic fever is a potentially serious complication of a streptococcal sore throat which can lead to permanent heart disease, this article advocates the expansion of school health services in medically underserved areas. (JMF)

  5. Is the British Army medical grading functional assessment tool effective? (United States)

    Mackie, Isobel


    Decision Support Aids (DSAs) have been widely used throughout industry and one (known as Table 7) is available to support British Army Medical Officers (MOs) grade soldiers against the Joint Medical Employment Standards. It is unknown how useful this DSA is in practice. An electronic questionnaire was distributed to British Army MOs working within Defence Primary Care facilities enquiring about MOs views on the usefulness of the DSA. Although the response rate was low, informative data were obtained. Between a half and a third of respondents felt that their judgement was affected in the application of the grading system when there were career implications to the grading MOs felt that the DSA allowed subjectivity in the grading. The results of this research suggest that although minor changes to Table 7 may improve service provision, an improvement in training in the application of Table 7 would be of greater benefit to the quality of occupational health service provision in the British Army.

  6. Public health genomics Relevance of genomics for individual health information management, health policy development and effective health services.

    Directory of Open Access Journals (Sweden)

    Angela Brand


    Full Text Available Healthcare delivery systems are facing fundamental challenges. New ways of organising theses systems based on the different needs of stakeholders’ are required to meet these challenges. While medicine is currently undergoing remarkable developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, the discussion about the relevance of genome-based information and technologies for the health care system as a whole and especially for public health is still in its infancy. The following article discusses the relevance of genome-based information and technologies for individual health information management, health policy development and effective health services.

  7. Financing reform and structural change in the health services industry. (United States)

    Higgins, C W; Phillips, B U


    This paper reviews the major trends in financing reform, emphasizing their impact on those characteristics of the market for health services that economists have viewed as monopolistic, and discusses the implications of structural change for the allied health professions. Hopefully, by understanding the fundamental forces of change and responding to uncertainty with flexibility and imagination, the allied health professions can capitalize on the opportunities afforded by structural change. Overall, these trends should result in the long-term outlook for use of allied health services to increase at an average annual rate of 9% to 10%. Allied health professionals may also witness an increase in independent practice opportunities. Finally, redistribution of jobs will likely occur in favor of outpatient facilities, home health agencies, and nontraditional settings. This in turn will have an impact on allied health education, which will need to adapt to these types of reforms.

  8. Mental Health Services for People with Intellectual Disability: Current Developments. (United States)

    Molony, Helen


    This report gives an update on the status of planning and delivery of mental health services for people with intellectual disability who have psychiatric disorders in Australia and New Zealand. A number of innovative approaches in policy and planning, legislative support, education, consultation, and coordination among services are discussed.…

  9. Southeast Asian Mental Health: Treatment, Prevention, Services, Training and Research. (United States)

    Owan, Tom Choken, Ed.

    This sourcebook contains 19 papers which discuss the mental health service needs of Southeast Asian refugees in the United States. The volume is divided into five sections: Treatment; Prevention; Services; Training; and Research. The papers (and their authors) are: (1) "Psychiatric Care for Southeast Asians: How Different Is Different?"…

  10. Accountability of specialist child and adolescent mental health services. (United States)

    Garralda, Elena M


    Outcome auditing of specialist child and adolescent mental health services (CAMHS) is now well under way internationally. There is, however, debate about objectives and tools. A case is made for the achievable goal of enhancing service accountability through user satisfaction information and clinician-rated contextualised measures of improvements in symptoms and impairment.

  11. The use of videoconferencing for mental health services in Finland. (United States)

    Ohinmaa, Arto; Roine, Risto; Hailey, David; Kuusimäki, Marja-Leena; Winblad, Ilkka


    The utilization of telemental health (TMH) services in Finland was surveyed in 2006. In total, 135 health-care units provided responses. Eighty-four responses were received from primary care units (health-care centres and clinics) and eight from other clinics, in all hospital districts. The overall rate of TMH consultations was 4 per 100,000 population. The highest TMH consultation per population ratio, 22 per 100,000, was in northern Finland. Most of the sites used telepsychiatry services for less than 10% of clinical outpatient services. The sites with over 20% utilization of clinical TMH services from all psychiatric consultations were all rural health centres. Compared with Finland, the utilization rates of TMH were higher in Canada; that might be due to differences between the countries in the organization of mental health services in primary and specialized care. In Finland TMH consultations made up only a very small proportion of all mental health services. The use of TMH was particularly common in remote areas; however, there were many rural centres that did not utilize clinical TMH. TMH was widely utilized for continuing and medical education.

  12. Army Training Study: Concepts of the Army Training System. (United States)


    Combat Units. 1 March 1971. Harher, Robert A. and Coleman, Charlie C. Application of Simulation Training Exercises to Crisis Relocation Planning...product or outpit of the Army’s helth -. Ssinn. 0 ro)gram qM is a go example of hw pr hugra-. udgetinc’ is intro-. to work. The Army’s health care

  13. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services. (United States)


    ... 32 National Defense 5 2010-07-01 2010-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64...

  14. The effect of trends in health and longevity on health services use by older adults

    NARCIS (Netherlands)

    Wouterse, B.; Huisman, M.; Meijboom, Bert; Deeg, D.J.H.; Polder, Johan


    Background The effect of population aging on future health services use depends on the relationship between longevity gains and health. Whether further gains in life expectancy will be paired by improvements in health is uncertain. We therefore analyze the effect of population ageing on health servi

  15. The Role of Bilingual Workers without Professional Mental Health Training in Mental Health Services for Refugees. (United States)

    Egli, Eric

    This paper discusses the use of bilingual workers who do not have formal mental health training as mediators and providers of mental health care for refugees. The introduction provides a background discussion of the need for refugee mental health services, the characteristics of bilingual mental health workers, and the work places and expectations…

  16. Health care of persons with disabilities in public health services: a literature study

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Vargas


    Full Text Available Background and Objectives: Health care for people with disabilities (PwD must be guaranteed by the state, health professionals and community involved, covering a multidisciplinary approach. This study aims to discuss the assistance to persons with disabilities in public health services. Method: This is a literature review of the descriptive study type with scientific publications on search sites Scielo, LILACS and Pubmed from descriptors: accessibility, people with disabilities, access to health services, totaling 514 articles, which fall under 22 the themes addressed. Results: Accessibility is a result of the availability of professionals and health services as well as access of Persons with Disabilities these services offered. We need planning actions by the multidisciplinary team, in order to seek to minimize the front inequalities behavioral barriers, architectural, geographical, which form gaps that prevent an egalitarian, unanimous and universal care as recommended by the health system. In oral health the principle of comprehensiveness includes the promotion, recovery and oral rehabilitation. Conclusion: Health promotion activities need to be encouraged so that it promotes the welfare of the health service user and that such actions occur in an integrated manner, adding resources from the comprehensive and multidisciplinary work. Accessibility to health services in conjunction with actions aimed at promoting the health of PwD can provide higher quality in health care and higher quality of life.

  17. Index System of Health Services Quality Evaluation on Township Health Centers

    Institute of Scientific and Technical Information of China (English)

    徐明生; 王静


    THERE IS ABOUT 80% of total population in ruralChina. Rural health care is an important content ofbuilding socialism new villages, and is a big thing tosafeguard peasants’ health and protect agricultureproductivity, invigorate rural economy and maintainsocial stability. So, rural health acre is a pivot ofChina’s health development. In 1997, the policy “tostrengthen rural health organization constructionand to perfect three-level health services systemincluding the county, the town and the village” wasdefini...

  18. [Youth mental health at the cross roads of service organization]. (United States)

    Rousseau, Cécile; Nadeau, Lucie; Pontbriand, Annie; Johnson-Lafleur, Janique; Measham, Toby; Broadhurst, Joanna


    The importance of children and youth mental health is increasingly recognized. This rapidly developing field cannot be conceptualized as an extension of adult services to a younger age group and its developmental and organizational specificities are the object of debate. Reviewing recent literature in this domain and some preliminary information about the Quebec Mental Health Plan implementation, this paper addresses some of the questions which structure this debate in Quebec.Quebec mental health plan has put at the forefront collaboration among disciplines and partnership among institutions. In spite of having produced significant improvement in the field, discontinuities in services, which interfere with an ecosystemic model of care, persist. Recent studies suggest that the organisational climate which surrounds youth mental health services has a direct impact on the quality of services and on youth health outcomes. A flexible management structure, which engages clinicians and health workers, favors empowerment, minimizes work stress and facilitates partnership, is needed to foster successful interdisciplinary and intersectorial collaboration. This collaboration is the cornerstone of youth mental health services.

  19. Digital Health Services and Digital Identity in Alberta. (United States)

    McEachern, Aiden; Cholewa, David


    The Government of Alberta continues to improve delivery of healthcare by allowing Albertans to access their health information online. Alberta is the only province in Canada with provincial electronic health records for all its citizens. These records are currently made available to medical practitioners, but Alberta Health believes that providing Albertans access to their health records will transform the delivery of healthcare in Alberta. It is important to have a high level of assurance that the health records are provided to the correct Albertan. Alberta Health requires a way for Albertans to obtain a digital identity with a high level of identity assurance prior to releasing health records via the Personal Health Portal. Service Alberta developed the MyAlberta Digital ID program to provide a digital identity verification service. The Ministry of Health is leveraging MyAlberta Digital ID to enable Albertans to access their personal health records through the Personal Health Portal. The Government of Alberta is advancing its vision of patient-centred healthcare by enabling Albertans to access a trusted source for health information and their electronic health records using a secure digital identity.

  20. Evaluation of community mental health services: comparison of a primary care mental health team and an extended day hospital service. (United States)

    Secker, J; Gulliver, P; Peck, E; Robinson, J; Bell, R; Hughes, J


    Alongside mental health policies emphasising the need to focus on people experiencing serious, long-term problems, recent general healthcare policy is leading to the development in the UK of a primary care-led National Health Service. While most primary care-led mental health initiatives have focused on supporting general practitioners (GPs) in managing milder depression and anxiety, this article describes an evaluation comparing primary care-based and secondary care-based services for people with serious long-term problems. A survey of service users was carried out at three points in time using three measures: the Camberwell Assessment of Need, the Verona Satisfaction with Services Scales and the Lancashire Quality of Life Profile. Staff views were sought at two time intervals and carers' views were obtained towards the end of the 2-year study period. The results indicate that both services reduced overall needs and the users' need for information. The primary care service also reduced the need for help with psychotic symptoms whereas the secondary care service reduced users' need for help with benefits and occupation. There were no major differences in terms of satisfaction or quality of life. Primary care-based services therefore appear to have the potential to be as effective as more traditional secondary care services. However, a more comprehensive range of services is required to address the whole spectrum of needs, a conclusion supported by the views of staff and carers.

  1. Building the national health information infrastructure for personal health, health care services, public health, and research

    Directory of Open Access Journals (Sweden)

    Detmer Don E


    Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin

  2. Resource Reallocation Methodology for the U.S. Army Center for Health Promotion and Preventive Medicine. (United States)


    review 8.3 55 NDUSTRIAL HYGIENE FIELD SERVICES Ergonomie study 8.2 16 PEST MANAGEMENT Training classes and materials 8.0 37 HAZARDOUS AND MEDICAL WASTE...INDUSTRIAL HYGIENE FIELD SERVICES 9.2 Field study 8.8 0.1 0.9 15 55 INDUSTRIAL HYGIENE FIELD SERVICES 9.2 Ergonomie study 8.2 0.05 0.5 7 37 HAZARDOUS AND

  3. Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times. (United States)

    Murcott, W J


    A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services.

  4. Integrating reproductive health services into family planning programs. (United States)


    A recent Population Council publication, Reproductive Health Approach to Family Planning, discusses integration of reproductive health into family planning programs in a series of edited presentations that Council staff and colleagues gave at a 1994 meeting of the US Agency for International Development (USAID) cooperating agencies. The presentations reflect the Council's view that family planning programs ought to help individuals achieve their own reproductive goals in a healthful manner. The report discusses four areas of reproductive health: reproductive tract infections (RTIs), including sexually transmitted diseases; prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. Christopher Elias (Senior Associate, Programs Division) argued that family planning programs ought to provide services that target RTIs, given that these illnesses afflict a significant proportion of reproductive-age women. The family planning community has an ethical responsibility to provide services to women who experience an unwanted pregnancy. They must have access to high-quality postabortion care, including family planning services. Professional midwives are ideally suited to serve as integrated reproductive health workers trained to combat the five major maternal killers: hemorrhage, sepsis, pregnancy-induced hypertension, obstructed labor, and unsafe abortion. This was demonstrated in a highly successful Life-Saving Skills for Midwives program undertaken in Ghana, Nigeria, and Uganda, and soon to start in Vietnam in conjunction with the Council's Safe Motherhood research program. Family planning services should be viewed as part of a comprehensive set of health services needed by postpartum women, which include appropriate contraception, maternal health checks, well-baby care, and information about breastfeeding, infant care, and nutrition. Family planning programs should incorporate breastfeeding counseling into their services. When

  5. Enhanced Army Airborne Forces: A New Joint Operational Capability (United States)


    Operational Capability John Gordon IV, Agnes Gereben Schaefer, David A. Shlapak, Caroline Baxter , Scott Boston, Michael McGee, Todd Nichols, Elizabeth...a public service of the RAND Corporation. CHILDREN AND FAMILIES EDUCATION AND THE ARTS ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE quality and objectivity. Enhanced Army Airborne Forces A New Joint Operational Capability John Gordon IV, Agnes Gereben Schaefer, David A

  6. A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

    Directory of Open Access Journals (Sweden)

    Candida Graham


    Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

  7. Ethical Issues in Health Services: A Report and Annotated Bibliography. (United States)

    Carmody, James

    This publication identifies, discusses, and lists areas for further research for five ethical issues related to health services: 1) the right to health care; 2) death and euthanasia; 3) human experimentation; 4) genetic engineering; and, 5) abortion. Following a discussion of each issue is a selected annotated bibliography covering the years 1967…

  8. Immigrants as users of primary health services in Greece

    Directory of Open Access Journals (Sweden)

    Roupa Ε.


    Full Text Available The migration is a multidimensional and complex problem of modern times. The social, political, economic and cultural negative circumstances prevailing in many states and communities of the world are pushing people into new places and destinations to permanent or temporary residence. In recent years, Greece is a country of immigration destination resulting in a entrance of people with different national and racial characteristics. The installation of the population in the country and use of structures and services of the state has a big change in the political, economic and social developments affecting major systems and subsystems of the state including the health system.The use of social structures and particularly of Primary Health Care, by immigrants occurs quite reduced compared to the native people. The use of Primary Health Care limited in emergencies situations and less in health prevention. Factors such as language, the high economic cost of providing medical services and remote Primary Health Care services seems to have a negative impact on search on medical treatment and nursing care. Important seen the role of the state and health professionals to use the Primary Health Care services from the immigrant population. Actions such as removing social exclusion and implementation of specialized prevention programs, can contribute greatly to the health of immigrants

  9. Service Learning and Community Health Nursing: A Natural Fit. (United States)

    Miller, Marilyn P.; Swanson, Elizabeth


    Community health nursing students performed community assessments and proposed and implemented service learning projects that addressed adolescent smoking in middle schools, home safety for elderly persons, industrial worker health, and sexual abuse of teenaged girls. Students learned to apply epidemiological research methods, mobilize resources,…

  10. How Health Relationship Management Services (HRMS Benefits the Elderly

    Directory of Open Access Journals (Sweden)

    Cynthia Meckl-Sloan


    Full Text Available Remote health monitoring and Health Relationship Management Services (HRMS can provide health care solutions for the elderly, the fastest-growing segment of the U.S. population. The year 2030 Problem questions whether enough resources and an operative service system will be available fourteen years from now when the elderly population will be greater than what it is today. One solution for reducing elder health care costs is home care, which is a preferable alternative to institutionalization. Many elderly have access to health services or outreach medical care, but do not use them due to lack of accessibility to safe transportation. The elderly often have problems with medication misuse stemming from the aging process, such as loss of memory, poor vision, and fixed-incomes. Seniors have dietary problems that weaken immune systems, leading to dehydration and other health issues. They also experience depression and loneliness from living alone or even with family members. The elderly who experience these problems can benefit from Health Relationship Management Services (HRMS, a new healthcare paradigm using remote health monitoring in the home.

  11. The Impact of Economic Stress on Community Mental Health Services. (United States)

    Hagan, Brian J.; And Others


    Warns that community mental health services are threatened by reductions in federal support and increased numbers of clients. Reviews literature on the effect of adverse economic events on mental health. Identifies issues and answers for managing this dilemma including planning, financial diversification, and inter-agency cooperation. (Author/JAC)

  12. A health analytics semantic ETL service for obesity surveillance. (United States)

    Poulymenopoulou, M; Papakonstantinou, D; Malamateniou, F; Vassilacopoulos, G


    The increasingly large amount of data produced in healthcare (e.g. collected through health information systems such as electronic medical records - EMRs or collected through novel data sources such as personal health records - PHRs, social media, web resources) enable the creation of detailed records about people's health, sentiments and activities (e.g. physical activity, diet, sleep quality) that can be used in the public health area among others. However, despite the transformative potential of big data in public health surveillance there are several challenges in integrating big data. In this paper, the interoperability challenge is tackled and a semantic Extract Transform Load (ETL) service is proposed that seeks to semantically annotate big data to result into valuable data for analysis. This service is considered as part of a health analytics engine on the cloud that interacts with existing healthcare information exchange networks, like the Integrating the Healthcare Enterprise (IHE), PHRs, sensors, mobile applications, and other web resources to retrieve patient health, behavioral and daily activity data. The semantic ETL service aims at semantically integrating big data for use by analytic mechanisms. An illustrative implementation of the service on big data which is potentially relevant to human obesity, enables using appropriate analytic techniques (e.g. machine learning, text mining) that are expected to assist in identifying patterns and contributing factors (e.g. genetic background, social, environmental) for this social phenomenon and, hence, drive health policy changes and promote healthy behaviors where residents live, work, learn, shop and play.

  13. Incorporating Integrative Health Services in Social Work Education (United States)

    Gant, Larry; Benn, Rita; Gioia, Deborah; Seabury, Brett


    More than one third of Americans practice complementary and alternative medicine (CAM). Social workers continue to provide most first-line health, mental health, and psychological referral and direct practice services in the United States, despite a lack of systematic education and training opportunities in CAM. Schools of social work are…

  14. Cognitive Appraisals of Specialty Mental Health Services and Their Relation to Mental Health Service Utilization in the Rural Population (United States)

    Deen, Tisha L.; Bridges, Ana J.; McGahan, Tara C.; Andrews, Arthur R., III


    Purpose: Rural individuals utilize specialty mental health services (eg, psychiatrists, psychologists, counselors, and social workers) at lower rates than their urban counterparts. This study explores whether cognitive appraisals (ie, individual perceptions of need for services, outcome expectancies, and value of a positive therapeutic outcome) of…

  15. Child & Adolescent Mental Health Services - first annual report 2008

    LENUS (Irish Health Repository)


    This Annual Report provides the first comprehensive survey carried out on community CAMHS teams and includes preliminary data collected by The Health Research Board on the admission of young people under the age of 18 years to inpatient mental health facilities. As many measures in this report do not have historic comparators it provides a baseline foundation that will be built upon in subsequent years providing an indication of trends that cannot yet be drawn on the basis of this report. The next report will include day hospital, liaison and inpatient services. Subsequent reports will further extend the mapping of mental health services for young people.

  16. Problems for Paraprofessionals in Mental Health Services. (United States)

    Bayes, Marjorie; Neill, T. Kerby


    Issues of changing positions and roles for paraprofessionals are considered in the context of the hierarchical structure and process of mental health organizations. Discussion focuses on problems arising when paraprofessionals are promoted in the functional hierarchy while continuing to occupy the lowest level in the professional caste system.…

  17. 42 CFR 489.29 - Special requirements concerning beneficiaries served by the Indian Health Service, Tribal health... (United States)


    ... served by the Indian Health Service, Tribal health programs, and urban Indian organization health programs. 489.29 Section 489.29 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION PROVIDER AGREEMENTS AND...

  18. La Sanidad en la Base Antártica del E.T. "Gabriel de Castilla" The Medical Service in the Army's Antarctic Base "Gabriel de Castilla"

    Directory of Open Access Journals (Sweden)

    F. De Diego Lousa


    the First International Polar Year (1887-1888, the 75th Anniversary of the Second International Polar Year (1932-1933 and the 50th Anniversary of the International Geophysical Year (1957-1958 which led to the establishment of the SCAR and the Antarctic Treaty. The IPY 2007-2009 is promoted by the International Council for Science (ICSU and the World Meteorological Organization (WMO. Spain has actively participated, for the first time, in this event with the first Arctic Campaign of the BIO "Hespérides" and the two operational Antarctic bases. For the Army's Antarctic base "Gabriel de Castilla" the year 2008 is special as it combines the celebration of the IPY with the commemoration of the 20th anniversary of the Spanish presence in Deception Island. It was in 1988 when the first shelter was established, although it was not considered an Antarctic Base until 1998. The aim of this article is to present the Environment and Health fields, as they are called in the structure of the Army Antarctic Campaign and which are the responsibility of Medical Service officers, as well as commemorate this significant date and remember the participants in the different Antarctic Campaigns.

  19. Management system of organizational and economic changes in health services

    Directory of Open Access Journals (Sweden)

    Natalya Vasilyevna Krivenko


    Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market

  20. Policy paradox and political neglect in community health services. (United States)

    Hudson, Bob


    Community health services (CHSs) have never had a settled organisational existence but the turmoil has intensified since the publication of Transforming Community Services in 2009. CHSs are now beset by three dilemmas: ongoing organisational fragmentation; the extension of competition law and the spread of privatisation; inadequate workforce development and lack of clarity on the nature of CHS activity. This has left the services in a position of policy and political vulnerability. The solution may be for the service to be part of horizontal integration models such as the accountable care organisation, with a focus on locality and multi-professional teams wrapped around patient pathways.

  1. The Implementation of Mental Health Clinical Triage Systems in University Health Services (United States)

    Rockland-Miller, Harry S.; Eells, Gregory T.


    The increase in the level of severity of student psychological difficulties and the growing need for psychological services in higher education settings has placed considerable pressure on college and university mental health services to respond effectively to this demand. One way several of these services have responded has been to implement…

  2. International trade of health services: global trends and local impact. (United States)

    Lautier, Marc


    Globalization is a key challenge facing health policy-makers. A significant dimension of this is trade in health services. Traditionally, the flow of health services exports went from North to South, with patients travelling in the opposite direction. This situation is changing and a number of papers have discussed the growth of health services exports from Southern countries in its different dimensions. Less attention has been paid to assess the real scope of this trade at the global level and its potential impact at the local level. Given the rapid development of this area, there are little empirical data. This paper therefore first built an estimate of the global size and of the growth trend of international trade in health services since 1997, which is compared with several country-based studies. The second purpose of the paper is to demonstrate the significant economic impact of this trade at the local level for the exporting country. We consider the case of health providers in the South-Mediterranean region for which the demand potential, the economic effects and the consequence for the health system are presented. These issues lead to the overall conclusion that different policy options would be appropriate, in relation to the nature of the demand.

  3. Enhancing early engagement with mental health services by young people

    Directory of Open Access Journals (Sweden)

    Burns J


    Full Text Available Jane Burns, Emma Birrell Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia Abstract: International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence

  4. Marketing health services: the engineering of satisfaction. (United States)

    MacStravic, R S


    Service marketing is the engineering of satisfaction, and the key to success is to identify and influence potential customers' expectations and then to fulfill those expectations. Patient satisfaction largely determines both a program's revenues and expenditures and the effectiveness of care received by patients. A program's ability to satisfy patients rests upon three basic elements: research, design, and communication. Research should be on two levels. The first is basic market assessment and analysis, and should reveal overall market potential by focusing on consumers' expectations, unmet needs, and level of satisfaction. From this stage of research, the organization should be able to identify current programs that are secure and stable, those which have significant growth potential, those which are threatened by competition, and those which have little future. This research also should indicate the potential for new programs and for new markets for existing programs. The second level of research focuses on a specific program (whether current or proposed) and is the basis for program design. The organization can tailor the program to consumers' expectations in everything from services provided to price of parking and other amenities. Research also provides a basis for communications. Not only can communications influence a potential customer to try a provider, but also care providers can use communications during and after the service experience to reinforce what might have been a casual decision. Ideally, all communication that occurs between patients and providers should serve marketing as well as diagnostic and therapeutic purposes. It can shape patients' expectations, reinforce satisfaction when those expectations have been fulfilled, and convey the provider's caring and concern.

  5. Participative management in health care services

    Directory of Open Access Journals (Sweden)

    M. Muller


    Full Text Available The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

  6. [Suicide rates and mental health services in Greece]. (United States)

    Giotakos, O; Tsouvelas, G; Kontaxakis, V


    Some studies have shown that access to mental health services can have an impact on mental health outcomes, including the suicide rates. The aim of the present study was to examine the relationship between regional and prefecture suicide rates (suicides per 100.000 residents) and both the number of primary and mental health-care service providers and the number of mental health infrastructures in Greece. Data were taken mainly from the Hellenic Statistical Authority (EL.STAT.) and the Ministry of Health for the period 2002-2009. Spearman correlations were used to examine the relationship between primary health-care, mental health providers and suicide rates per 100,000 residents at the prefecture, administrative region and geographical region levels. Men showed significantly higher suicide rates than women (U=-7.20, pGreece: Crete (4.76 vs 3.65), Thrace (4.45 vs 2.02) Central Greece (3.61 vs 1.39) Aegean Islands (3.03 vs 1.28). The highest correlations between suiciderutes and health services at the geographic regional level were found to be during the period 2007-2009, where suicide rates showed a significant negative correlation with privately practicing psychiatrists (rho=-0.71, pGreece. It should be noted that the running financial crisis in Greece seems to have many effects on quality of life, since the most common effects of an economic crisis are unemployment, spending power cuts,general insecurity and public spending retrenchment, including health related budget cuts. Having in mind the above situation, further analyses are needed to determine the relationship between mental health-care services, suicide rates and other psychosocial indices, in order to provide a strategic plan for a better design of mental health-care policy in Greece.

  7. Delivering Better Health Services to Pakistan's Poor


    World Bank


    Pakistan is not on track to achieve most Millennium Development Goals (MDGs) related to health, nutrition and population. Given its current rate of progress, in 2015 Pakistan's infant mortality rate (IMR) will be 65 deaths per 1,000 live births and the under-five mortality rate (U5MR) will be 78, considerably above the MDG4 targets of 33 and 43 deaths per 1000 births respectively. Pakistan...

  8. Restructuring public mental health and substance abuse service systems. (United States)

    Godbole, A; Temkin, T; Cradock, C


    The authors originally circulated the concepts in this proposal during May 1995. The purpose was to support an open, public dialogue regarding the restructuring of the mental health and substance abuse services in Illinois in anticipation of Medicaid funding changes. Restructuring mental health and substance abuse service systems should follow certain key principles. These principles are applicable to other states, particularly those large in territory and population. The authors propose the temporary use of multiple managed care companies serving as administrative services only (ASO) organizations, each of whom would have responsibility for a given geographic portion of a state. The role of the ASOs would be to organize providers into networks on a regional basis and transfer managed care expertise in financing and clinical management to the relevant state departments and provider groups. Changes in the service delivery system would be phased in over time with reorganization of key components of the system during each phase. Where the provision of mental health, substance abuse, and social services is split among multiple state agencies, these agencies would be merged to achieve unified funding and administrative efficiency. Patients and advocacy organizations would play a key role in overseeing and shaping system restructuring at all levels, including a governmental board reporting to the governor, overseeing ASO organizations' operations and assuring quality and access at the provider level. The authors propose funding of public behavioral health services through use of a tiered, integrated funding model.

  9. Variations in prison mental health services in England and Wales. (United States)

    Forrester, Andrew; Exworthy, Tim; Olumoroti, Olumuyiwa; Sessay, Mohammed; Parrott, Janet; Spencer, Sarah-Jane; Whyte, Sean


    In responding to high levels of psychiatric morbidity amongst prisoners and recognising earlier poor quality prison mental health care, prison mental health in-reach teams have been established in England and Wales over the last decade. They are mostly provided by the National Health Service (NHS), which provides the majority of UK healthcare services. Over the same period, the prison population has grown to record levels, such that prisons in England and Wales now contain almost 90,000 of the world's overall prison population of over 10 million people (roughly the size of Paris or Istanbul). This study provides an overview of mental health in-reach services in prisons in England and Wales, including variations between them, through a telephone survey of senior staff in all prisons and young offender institutions in England and Wales. 73% of prisons took part; of them 13% had no in-reach team at all (usually low security establishments) and the majority of services were run by NHS teams, usually according to a generic community mental health team (CMHT) model rather than other specialist models. Team size was unrelated to prison size. Each nurse covered around 500 prisoners, each doctor over 3700. Many provided few or no healthcare cells and 24-h psychiatric cover (including on-call cover) was uncommon. Despite developments in recent years, mental health in-reach services still fall short of community equivalence and there is wide variation in service arrangements that cannot be explained by prison size or function. The aim of community equivalence has not yet been reached in prison healthcare and a more sophisticated measure of service improvement and standardisation would now be useful to drive and monitor future development.

  10. Enhancing Health-Care Services with Mixed Reality Systems (United States)

    Stantchev, Vladimir

    This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

  11. Delivering Better Health Services to Pakistan's Poor


    Belay, Tekabe; Couffinhal, Agnes; Haq, Inaam; Kazi, Shahnaz; Loevinsohn, Benjamin


    Pakistan is not on track to achieve most Millennium Development Goals (MDGs) related to health, nutrition and population. Given its current rate of progress, in 2015 Pakistan's infant mortality rate (IMR) will be 65 deaths per 1,000 live births and the under-five mortality rate (U5MR) will be 78, considerably above the MDG4 targets of 33 and 43 deaths per 1000 births respectively. Pakistan will not achieve the MDG related to nutrition. The review aims to develop a limited set of practical opt...

  12. Desigualdades y servicios de salud Inequalities and health services

    Directory of Open Access Journals (Sweden)

    Carme Borrell


    Full Text Available Los objetivos de este trabajo son tres: en primer lugar, se revisan las causas de las desigualdades sociales en salud incluyendo el papel que juegan los servicios sanitarios en las mismas; posteriormente se analiza la influencia de la financiación y la organización de los servicios sanitarios en las desigualdades y finalmente, se muestra un ejemplo de las desigualdades en la utilización de los servicios sanitarios en Cataluña, comunidad autónoma del Estado Español donde existe un Sistema Nacional de Salud. Se analizan las siguientes causas de las desigualdades en salud: los estilos de vida o conductas relacionadas con la salud, los servicios sanitarios, los factores materiales o estructurales, las desigualdades de renta y los factores políticos. Los servicios sanitarios no son los determinantes principales de la salud ni de las desigualdades en salud. Pero la existencia de servicios sanitarios adecuados es una necesidad fundamental y el acceso a los mismos debería ser un derecho de todas las personas sin distinciones sociales. Tanto la calidad como la cobertura de los servicios sanitarios son una parte integral de la definición del desarrollo en sí mismo y constituyen unos de los principales indicadores de bienestar social. Finalmente, se muestra un ejemplo sobre las desigualdades según clase social en la utilización de servicios sanitarios en Cataluña en 1994 y en 2002, desigualdades que son prácticamente inexistentes en el caso de los servicios sanitarios curativos, pero que se mantienen en los servicios preventivos.The objectives of this paper are three: first to review the causes of inequalities in health and the role played by health services; second, to analyze the influence of health care financing and the organization of health services on inequalities in health and to show an example of the study of inequalities in health services utilization in Catalonia, an autonomous community of Spain where a National Health System

  13. A balanced scorecard for health services in Afghanistan. (United States)

    Peters, David H; Noor, Ayan Ahmed; Singh, Lakhwinder P; Kakar, Faizullah K; Hansen, Peter M; Burnham, Gilbert


    The Ministry of Public Health (MOPH) in Afghanistan has developed a balanced scorecard (BSC) to regularly monitor the progress of its strategy to deliver a basic package of health services. Although frequently used in other health-care settings, this represents the first time that the BSC has been employed in a developing country. The BSC was designed via a collaborative process focusing on translating the vision and mission of the MOPH into 29 core indicators and benchmarks representing six different domains of health services, together with two composite measures of performance. In the absence of a routine health information system, the 2004 BSC for Afghanistan was derived from a stratified random sample of 617 health facilities, 5719 observations of patient-provider interactions, and interviews with 5597 patients, 1553 health workers, and 13,843 households. Nationally, health services were found to be reaching more of the poor than the less-poor population, and providing for more women than men, both key concerns of the government. However, serious deficiencies were found in five domains, and particularly in counselling patients, providing delivery care during childbirth, monitoring tuberculosis treatment, placing staff and equipment, and establishing functional village health councils. The BSC also identified wide variations in performance across provinces; no province performed better than the others across all domains. The innovative adaptation of the BSC in Afghanistan has provided a useful tool to summarize the multidimensional nature of health-services performance, and is enabling managers to benchmark performance and identify strengths and weaknesses in the Afghan context.

  14. The Distribution of Health Services in Iran Health Care System: A Case Study at East Azerbaijan

    Directory of Open Access Journals (Sweden)

    Hassan Almaspoor-khangah


    Full Text Available Background: It is necessary that various aspects of health information and statistics are identified and measured since health problems are getting more complex day by day. Objective: This study is aimed to investigate the distribution of health services in the health care system in Iran and the case of study is East Azerbaijan province. Methods: This research was a retrospective, descriptive, cross-sectional study. The statistical population included all health service providers in East Azerbaijan Province in the public, private, charity, military, social security, and NGO sectors. In this study, the data from all functional health sectors, including hospitals, health centers, and clinical, rehabilitation centers and all clinics and private offices were studied during 2014. The data relevant to performance were collected according to a pre-determined format (researcher- built checklist which was approved by five professionals and experts Health Services Management (content validity. Results: The study findings showed that the public sector by 45.28% accounted for the highest share of provided services and the private sector, social security, military institutions, charities and NGOs institutions by 25.47%, 18.92%, 4.37%, 3.3%, and 2.66% next rank in providing health services in East Azerbaijan province have been allocated. Conclusion: The results show that most of the health services in East Azerbaijan Province belongs to the public sector and the private sector has managed to develop its services in some parts surpassed the public sector. According to the study findings, Policies should be aimed to create balance and harmony in the provision of services among all service providers.

  15. Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health Disaster Response App. (United States)

    Seligman, Jamie; Felder, Stephanie S; Robinson, Maryann E


    The Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services offers extensive disaster behavior health resources to assist disaster survivors in preparing for, responding to, and recovering from natural and manmade disasters. One of SAMHSA's most innovative resources is the SAMHSA Behavioral Health Disaster Response App (SAMHSA Disaster App). The SAMHSA Disaster App prepares behavioral health responders for any type of traumatic event by allowing them to access disaster-related materials and other key resources right on their phone, at the touch of a button. The SAMHSA Disaster App is available on iPhone, Android, and BlackBerry devices.

  16. Designing role of online health educators in healthcare services. (United States)

    Anshari, Muhammad; Almunawar, Mohammad Nabil


    Web technology provides healthcare organizations the ability to broaden services beyond usual practices, and thus provides a particularly advantageous environment to achieve complex e-health goals. Furthermore, introducing web technology in healthcare services may add value to the overall healthcare process. Web technology helps healthcare organizations to extend the online health services (e-health) beyond their traditional mechanism. The changes enable customers (patients) to participate more in the process of healthcare, such as through their ability to generate personal health data to their personalized web-based interface. It allows patients to have greater control of information flow between healthcare organizations and customers, and among customers themselves. In this study the authors investigate the extended role of healthcare staff that provide e-health services. The authors have developed e-health models that accommodate customers' participation to engage more actively in the healthcare system. Through the model the authors developed a prototype--namely Clinic 2.0. Clinic 2.0 is set up to facilitate interactions between healthcare providers and customers. In the proposed systems, the authors introduced Online Health Educator (OHE)--a healthcare staff that is specifically responsible for administering Clinic 2.0. The authors have conducted a survey in Indonesia to draw the expectation of participants regarding the important role of OHE in Clinic 2.0 through a semi-structured interview conducted with participants to further investigate the pivotal roles of OHE. The authors found that e-health services need OHE to achieve customers' satisfaction.

  17. Integrating Human and Ecosystem Health Through Ecosystem Services Frameworks. (United States)

    Ford, Adriana E S; Graham, Hilary; White, Piran C L


    The pace and scale of environmental change is undermining the conditions for human health. Yet the environment and human health remain poorly integrated within research, policy and practice. The ecosystem services (ES) approach provides a way of promoting integration via the frameworks used to represent relationships between environment and society in simple visual forms. To assess this potential, we undertook a scoping review of ES frameworks and assessed how each represented seven key dimensions, including ecosystem and human health. Of the 84 ES frameworks identified, the majority did not include human health (62%) or include feedback mechanisms between ecosystems and human health (75%). While ecosystem drivers of human health are included in some ES frameworks, more comprehensive frameworks are required to drive forward research and policy on environmental change and human health.

  18. Service to the Nation, Strength for the Future. Fiscal Year 2013 United States Army Annual Financial Report (United States)


    recognizes excess, obsolete, and unserviceable OM&S at a net realizable value of $0 pending development of an effective means of valuing such materiel...0 NRV D. Total $ 31,059,913 $ (235,838) $ 30,824,075 Legend for Valuation Methods: LAC = Latest Acquisition Cost NRV = Net Realizable Value MAC...Financial Improvement Plan have been addressed. The Army WCF recognizes excess, obsolete, and unserviceable inventory at net realizable value of $0

  19. Mary Wakefield: Health Resources and Services Administrator. Interview. (United States)

    Wakefield, Mary


    Dr. Mary Wakefield is the administrator of the Health Resources and Services Administration. She came from the University of North Dakota, where she directed the Center for Rural Health. She has served as director of the Center for Health Policy, Research and Ethics at George Mason University and has worked with the World Health Organization's Global Programme on AIDS in Geneva, Switzerland. She is a fellow in the American Academy of Nursing and was elected to the Institute of Medicine of the National Academies. A native of North Dakota, Wakefield holds a doctoral degree in nursing from the University of Texas.

  20. Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services. (United States)

    Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances


    In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues.

  1. Community involvement in health services at Namayumba and Bobi health centres: A case study

    Directory of Open Access Journals (Sweden)

    Jane F. Namatovu


    Full Text Available Background: Community involvement has been employed in the development of both vertical and horizontal health programmes. In Uganda, there is no empirical evidence on whether and how communities are involved in their health services.Aim and Setting: The aim of this study was to establish the existence of community involvement in health services and to identify its support mechanisms in Namayumba and Bobi health centres in Wakiso and Gulu districts, respectively.Methods: Participants were selected with the help of a community mobiliser. Key informants were selected purposively depending on their expertise and the roles played in their respective communities. The focus group discussions and key informant interviews were audio-recorded and transcribed verbatim. The transcripts were analysed manually for emerging themes and sub-themes.Results: Several themes emerged from the transcripts and we categorised them broadly into those that promote community involvement in health services and those that jeopardise it. Easy community mobilisation and several forms of community and health centre efforts promote community involvement, whilst lack of trust for health workers and poor communication downplay community involvement in their health services.Conclusion: Community involvement is low in health services in both Namayumba and Bobi health centres.

  2. Is an early retirement offer good for your health? Quasi-experimental evidence from the army. (United States)

    Hallberg, Daniel; Johansson, Per; Josephson, Malin


    This paper studies empirically the consequences on health of an early retirement offer. To this end we use a targeted retirement offer to military officers 55 years of age or older. Before the offer was implemented, the normal retirement age in the Swedish defense was 60 years of age. Estimating the effect of the offer on individuals' health within the age range 56-70, we find support for a reduction in both mortality and in inpatient care as a consequence of the early retirement offer. Increasing the mandatory retirement age may thus not only have positive government income effects but also negative effects on increasing government health care expenditures.

  3. Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service. (United States)

    McFarlane, Kathryn; Devine, Sue; Judd, Jenni; Nichols, Nina; Watt, Kerrianne


    Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.

  4. A systematic review of help-seeking and mental health service utilization among military service members. (United States)

    Hom, Melanie A; Stanley, Ian H; Schneider, Matthew E; Joiner, Thomas E


    Research has demonstrated that military service members are at elevated risk for a range of psychiatric problems, and mental health services use is a conduit to symptom reduction and remission. Nonetheless, there is a notable underutilization of mental health services in this population. This systematic review aimed to identify and critically examine: (1) rates of service use; (2) barriers and facilitators to care; and (3) programs and interventions designed to enhance willingness to seek care and increase help-seeking behaviors among current military personnel (e.g., active duty, National Guard, Reserve). Overall, 111 peer-reviewed articles were identified for inclusion. Across studies, the rate of past-year service use among service members with mental health problems during the same time frame was 29.3% based on weighted averages. Studies identified common barriers to care (e.g., concerns regarding stigma, career impact) and facilitators to care (e.g., positive attitudes toward treatment, family/friend support, military leadership support) among this population. Although programs (e.g., screening, gatekeeper training) have been developed to reduce these barriers, leverage facilitators, and encourage service use, further research is needed to empirically test the effectiveness of these interventions in increasing rates of service utilization. Critical areas for future research on treatment engagement among this high-risk population are discussed.

  5. Tuberculosis control and occupational health services

    Directory of Open Access Journals (Sweden)

    J.T. Mets


    Full Text Available The W.H.O. (1982 estimates that the annual risk of infection with tuberculosis in most developing countries is in the order of 3 to 5%. Every year 4-million to 5-million highly infectious cases of tuberculosis occur in those countries, according to the WHO Technical Report No. 671. This report also states that case finding and chemotherapy, combined as one entity, must be considered to be the most powerful weapon in tuberculosis control. Since case finding in those countries depends principally on the examination of patients presenting with relevant symptoms to a health facility, it is recommended that all staff at such facilities should be properly trained and motivated to identify potential tuberculosis patients.

  6. [Health care practice needs health services research: pros and cons of health services research from the perspective of health insurance funds]. (United States)

    Stuppardt, R


    Health insurance funds need the results of health services research more than ever due to the socio-legal and socio-economic conditions currently prevailing. This should be possible by taking transparency and data protection into consideration, by cooperating with outside researchers while ensuring flexible use of routine data and if necessary gathering additional data, and by establishing links to epidemiological and registry data. It should become normative to clear the way for health insurance funds to regularly include this type of research in budget planning and to this end provide access to a suitable source of funds. In conclusion, it can simply be stated that it no longer suffices to effectively make a new clinically tested procedure, product, and service available because health insurance funds and their partners must know more precisely what this all accomplishes in practice.

  7. Evaluating quality of health services in health centres of Zanjan district of Iran. (United States)

    Mohammadi, Ali; Mohammadi, Jamshid


    To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.

  8. Developing supplemental activities for primary health care maternity services. (United States)

    Panitz, E


    Supplemental health care activities are described in the context of the augmented product. The potential benefits of supplemental services to recipients and provider are discussed. The author describes a study that was the basis for (re)developing a supplemental maternity service. The implementation of the results in terms of changes in the marketing mix of this supplemental program is discussed. The effects of the marketing mix changes on program participation are presented.

  9. Health science library and information services in the hospital. (United States)

    Wakeley, P J; Marshall, S B; Foster, E C


    In an increasingly information-based society, hospitals need a variety of information for multiple purposes--direct patient care, staff development and training, continuing education, patient and community education, and administrative decision support. Health science library and information services play a key role in providing broad-based information support within the hospital. This guide identifies resources that will help administrators plan information services that are appropriate to their needs.


    Pfefferle, Susan G; Spitznagel, Edward L


    OBJECTIVE: This observational study explores pathways towards any past year use of child mental health services. METHODS: Data from the 2002 National Survey of American Families were used to explore the relationship between past month maternal mental health and past year child mental health services use. Observations were limited to the 8072 most knowledgeable adults who were the mothers of target children aged 6-11. Logistic regressions were performed to determine the odds of any child mental health service use followed by path analyses using Maximum Likelihood estimation with robust standard errors. RESULTS: Multiple factors were associated with odds of any child mental health service use. In the path analytic model poor past month maternal mental health was associated with increased aggravation which in turn was associated with increased use of mental health visits. Negative child behaviors as reported by the mother were also associated with increased maternal aggravation and increased service use. CONCLUSIONS: Parental perception of child behaviors influences treatment seeking, both directly and indirectly through parental aggravation. Parental mental health influences tolerance for child behaviors. Findings are consistent with other studies. Interventions should address the entire family and their psychosocial circumstances through collaboration between multiple service sectors.

  11. Decentralisation of Health Services in Fiji: A Decision Space Analysis

    Directory of Open Access Journals (Sweden)

    Jalal Mohammed


    Full Text Available Background Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach reflects a model of deconcentration of outpatient services from the tertiary level hospital to the peripheral health centres in the Suva subdivision. Methods Using a modified decision space approach developed by Bossert, this study measures decision space created in five broad categories (finance, service organisation, human resources, access rules, and governance rules within the decentralised services. Results Fiji’s centrally managed historical-based allocation of financial resources and management of human resources resulted in no decision space for decentralised agents. Narrow decision space was created in the service organisation category where, with limited decision space created over access rules, Fiji has seen greater usage of its decentralised health centres. There remains limited decision space in governance. Conclusion The current wave of decentralisation reveals that, whilst the workload has shifted from the tertiary hospital to the peripheral health centres, it has been accompanied by limited transfer of administrative authority, suggesting that Fiji’s deconcentration reflects the transfer of workload only with decision-making in the five functional areas remaining largely centralised. As such, the benefits of decentralisation for users and providers are likely to be limited.

  12. The Influence of Training, Reluctance, Efficacy, and Stigma on Suicide Intervention Behavior Among NCOs in the Army and Marine Corps. (United States)

    Ayer, Lynsay; Ramchand, Rajeev; Geyer, Lily; Burgette, Lane; Kofner, Aaron


    The Army and Marine Corps have consistently experienced the highest rates of suicide relative to the other services. In both the Army and Marine Corps, the service members responsible for identifying and referring individuals at risk for suicide are called "gatekeepers" and are typically noncommissioned officers (NCOs). We used structural equation modeling on survey responses from 1184 Army soldiers and 796 marines to estimate the relationships between training, intervention efficacy, reluctance, and mental health stigma on NCO intervention behaviors. Efficacy and reluctance were independently associated with intervention behaviors, and stigma was only associated with intervention behaviors among Army NCOs. Study results suggest that while quantity of training may help NCOs feel more confident about their ability to intervene, other efforts such as changing training content and delivery mode (e.g., interactive vs. didactic training) may be necessary in order to reduce reluctance and stigma to intervene with service members at risk for suicide.

  13. Preparing health services for climate change in Australia. (United States)

    Blashki, Grant; Armstrong, Greg; Berry, Helen Louise; Weaver, Haylee J; Hanna, Elizabeth G; Bi, Peng; Harley, David; Spickett, Jeffery Thomas


    Although the implications of climate change for public health continue to be elucidated, we still require much work to guide the development of a comprehensive strategy to underpin the adaptation of the health system. Adaptation will be an evolving process as impacts emerge. The authors aim is to focus on the responses of the Australian health system to health risks from climate change, and in particular how best to prepare health services for predicted health risks from heat waves, bushfires, infectious diseases, diminished air quality, and the mental health impacts of climate change. In addition, the authors aim to provide some general principles for health system adaptation to climate change that may be applicable beyond the Australian setting. They present some guiding principles for preparing health systems and also overview some specific preparatory activities in relation to personnel, infrastructure, and coordination. Increases in extreme weather-related events superimposed on health effects arising from a gradually changing climate will place additional burdens on the health system and challenge existing capacity. Key characteristics of a climate change-prepared health system are that it should be flexible, strategically allocated, and robust. Long-term planning will also require close collaboration with the nonhealth sectors as part of a nationwide adaptive response.

  14. 42 CFR 136.22 - Establishment of contract health service delivery areas. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Establishment of contract health service delivery... Services § 136.22 Establishment of contract health service delivery areas. (a) In accordance with the..., contract health service delivery areas are established as follows: (1) The State of Alaska; (2) The...

  15. 77 FR 4821 - Public Health Service Act, Non-competitive Replacement Award (United States)


    ... HUMAN SERVICES Health Resources and Services Administration Public Health Service Act, Non-competitive...: Section 330I(d)(2) of the Public Health Service Act, as amended, 42 U.S.C. 254c-14(d)(2). Catalog of... INFORMATION CONTACT: Monica Cowan, Public Health Analyst, Office for the Advancement of Telehealth, Office...

  16. Health Care Marketing at Keller Army Community Hospital West Point, New York (United States)


    needs; i.e. what services are available or may be made available. The four Ps are commonly refered to as the " marketing mix ". They are integrally tied...Respondents Opinion (II). These four areas addressed the four Ps’ of the marketing mix . Section lIB dealt with the "product" aspect of West Point

  17. African American families' expectations and intentions for mental health services. (United States)

    Thompson, Richard; Dancy, Barbara L; Wiley, Tisha R A; Najdowski, Cynthia J; Perry, Sylvia P; Wallis, Jason; Mekawi, Yara; Knafl, Kathleen A


    A cross-sectional qualitative descriptive design was used to examine the links among expectations about, experiences with, and intentions toward mental health services. Individual face-to-face interviews were conducted with a purposive sample of 32 African American youth/mothers dyads. Content analysis revealed that positive expectations were linked to positive experiences and intentions, that negative expectations were not consistently linked to negative experiences or intentions, nor were ambivalent expectations linked to ambivalent experiences or intentions. Youth were concerned about privacy breeches and mothers about the harmfulness of psychotropic medication. Addressing these concerns may promote African Americans' engagement in mental health services.

  18. Advantages of Information Systems in Health Services

    Directory of Open Access Journals (Sweden)



    Full Text Available Nursing Information System (NIS has been defined as “a part of a health care information system that deals with nursing aspects, particularly the maintenance of the nursing record”. Nursing Uses of Information Systems in order to assess patient acuity and condition, prepare a plan of care or critical pathway, specify interventions, document care, track outcomes and control quality in the given patient care. Patient care processes, Communication, research, education and ward management can be easily delivered using NIS. There is a specific procedure that should be followed when implementing NISs. The electronic databases CINAHL and Medline were used to identify studies for review. Studies were selected from a search that included the terms ‘nursing information systems’, ‘clinical information systems’, ‘hospital information systems’, ‘documentation’, ‘nursing records’, combined with ‘electronic’ and ‘computer’. Journal articles, research papers, and systematic reviews from 1980 to 2007 were included. In Greek Hospitals there have been made many trials and efforts in order to develop electronic nursing documentation with little results. There are many difficulties and some of them are different levels of nursing education, low nurse to patient ratios, not involvement of nurses in the phases of their implementation, resistance in change. Today’s nursing practice in Greece needs to follow others counties paradigm and phase its controversies and problems in order to follow the worldwide changes in delivering nursing care.

  19. The mental health service crisis of neoliberalism -- an antipodean perspective. (United States)

    Carney, Terry


    Major transformations in forms of governance of the liberal state have been wrought over the course of the last century, including the rise of neoliberalism and 'new public management.' Mental health too has witnessed change, with pharmacological treatment displacing residential care, a shift to community-based services, mainstreaming with general health care, and greater reliance on civil society institutions such as the family or markets. This article considers whether mental health law, and its court/tribunal 'gatekeepers' have kept pace with those changes. It argues that the focus of the liberal project needs to shift to measures which will better guarantee access to mental health services, and keep a more watchful eye on both 'hidden' coercion of people on community treatment orders, and passive neglect of human need.

  20. Health service interventions targeting relatives of heart patients

    DEFF Research Database (Denmark)

    Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe


    AIMS: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health...... systematically reviewed to clarify what the health services do for relatives of heart patients and to assess the effects of interventions. We searched Medline, EMBASE, PsycINFO, CINAHL database, CSA and the Cochrane Library from January 2000 to March 2006. RESULTS: Only six scientific articles reported...... on interventions testing health service activities for relatives of heart patients, and one literature review scrutinized earlier studies within the field. All the interventions indicate positive effects on patients' and/or relatives' health and well-being, in accordance with nurses' assessments. Nevertheless...

  1. Price elasticity of expenditure across health care services. (United States)

    Duarte, Fabian


    Policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures. Estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies. Using unique individual-level data compiled from administrative records from the Chilean private health insurance market, I estimate the price elasticity of expenditures across a variety of health care services. I find elasticities that range between zero for the most acute service (appendectomy) and -2.08 for the most elective (psychologist visit). Moreover, the results show that at least one third of the elasticity is explained by the number of visits; the rest is explained by the intensity of each visit. Finally, I find that high-income individuals are five times more price sensitive than low-income individuals and that older individuals are less price-sensitive than young individuals.

  2. Implementing the integration of component services for reproductive health. (United States)

    Mayhew, S H; Lush, L; Cleland, J; Walt, G


    In the wake of the 1994 International Conference on Population and Development in Cairo, considerable activity has occurred both in national policymaking for reproductive health and in research on the implementation of the Cairo Program of Action. This report considers how effectively a key component of the Cairo agenda--integration of the management of sexually transmitted infections, including human immunodeficiency virus, with maternal and child health-family planning services--has been implemented. Quantitative and qualitative data are used to illuminate the difficulties faced by implementers of reproductive health programs in Ghana, Kenya, South Africa, and Zambia. In these countries, clear evidence is found of a critical need to reexamine the continuing focus on family planning services and the nature of the processes by which managers implement reproductive health policies. Implications of findings for policy and program direction are discussed.

  3. [Articulation between child and adolescent mental health services]. (United States)

    Delfini, Patricia Santos de Souza; Reis, Alberto Olavo Advincula


    The objective of this paper was to describe and analyze the articulation between children and adolescent mental health care interventions undertaken by teams working under the Family Health Strategy (FHS) and Psychosocial Care Centers for Children and Adolescents (CAPSI). In order to achieve these objectives, semi-structured interviews were conducted with five CAPSI and 13 FHS managers from five different regions of the city of São Paulo, Brazil. The 18 interviews were transcribed and analyzed froma hermeneutic perspective. It was found that interactions between the FHS and CAPSI occur mainly through referral of cases, matrix support or partnerships in cases concerning CAPSI. Obstacles, such as a lack of human resources, productivity goals and lack of training in mental health of FHS professionals were mentioned. The referral system and passing responsibility for mental health cases to specialized services and the hegemonic biomedical model and the fragmentation of care are common place in these services.

  4. Providing primary health care through integrated microfinance and health services in Latin America. (United States)

    Geissler, Kimberley H; Leatherman, Sheila


    The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic

  5. On residents’ satisfaction with community health services after health care system reform in Shanghai, China, 2011

    Directory of Open Access Journals (Sweden)

    Li Zhijian


    Full Text Available Abstract Background Health care system reform is a major issue in many countries and therefore how to evaluate the effects of changes is incredibly important. This study measured residents’ satisfaction with community health care service in Shanghai, China, and aimed to evaluate the effect of recent health care system reform. Methods Face-to-face interviews were performed with a stratified random sample of 2212 residents of the Shanghai residents using structured questionnaires. In addition, 972 valid responses were retrieved from internet contact. Controlling for sex, age, income and education, the study used logistic regression modeling to analyze factors associated with satisfaction and to explain the factors that affect the residents’ satisfaction. Results Comparing current attitudes with those held at the initial implementation of the reform in this investigation, four dimensions of health care were analyzed: 1 the health insurance system; 2 essential drugs; 3 basic clinical services; and 4 public health services. Satisfaction across all dimensions improved since the reform was initiated, but differences of satisfaction level were found among most dimensions and groups. Residents currently expressed greater satisfaction with clinical service (average score=3.79, with 5 being most satisfied and the public health/preventive services (average score=3.62; but less satisfied with the provision of essential drugs (average score=3.20 and health insurance schemes (average score=3.23. The disadvantaged groups (the elderly, the retired, those with only an elementary education, those with lower incomes had overall poorer satisfaction levels on these four aspects of health care (P Conclusion The respondents showed more satisfaction with the clinical services (average score=3.79 and public health services/interventions (average score=3.79; and less satisfaction with the health insurance system (average score=3.23 and the essential drug system

  6. Public health service administration and academia. A joint venture. (United States)

    Campbell, B F; King, J B


    Joint ventures between service and academia are designed to enhance the quality of client services, enrich faculty teaching experiences and skills, and strengthen communication channels. The joint venture described in this article is an example of how public health nursing services and academia can be united through faculty participation in administration. Included in the discussion are the impetus for the project, the contract negotiations, the positive outcomes and disadvantages of the venture, and questions that should be raised when a similar venture is considered.

  7. Health Services Utilization Patterns Associated with Emergency Department Closure

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders


    , 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours......, during a period of reduced opening hours and after closure, compared with the rest of Viborg County. RESULTS: Emergency service use did not change among Morsø municipality residents compared to other Viborg County residents. Compared to men in other parts of the county, Morsø men did not change their use...

  8. India-EU relations in health services: prospects and challenges

    Directory of Open Access Journals (Sweden)

    Chanda Rupa


    Full Text Available Abstract Background India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Methods Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. Results The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i Telemedicine; (ii Clinical trials and research in India for EU-based pharmaceutical companies; (iii Medical transcriptions and back office support; (iv Medical value travel; and (v Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. Conclusions The paper concludes that although there are several

  9. Cloud based emergency health care information service in India. (United States)

    Karthikeyan, N; Sukanesh, R


    A hospital is a health care organization providing patient treatment by expert physicians, surgeons and equipments. A report from a health care accreditation group says that miscommunication between patients and health care providers is the reason for the gap in providing emergency medical care to people in need. In developing countries, illiteracy is the major key root for deaths resulting from uncertain diseases constituting a serious public health problem. Mentally affected, differently abled and unconscious patients can't communicate about their medical history to the medical practitioners. Also, Medical practitioners can't edit or view DICOM images instantly. Our aim is to provide palm vein pattern recognition based medical record retrieval system, using cloud computing for the above mentioned people. Distributed computing technology is coming in the new forms as Grid computing and Cloud computing. These new forms are assured to bring Information Technology (IT) as a service. In this paper, we have described how these new forms of distributed computing will be helpful for modern health care industries. Cloud Computing is germinating its benefit to industrial sectors especially in medical scenarios. In Cloud Computing, IT-related capabilities and resources are provided as services, via the distributed computing on-demand. This paper is concerned with sprouting software as a service (SaaS) by means of Cloud computing with an aim to bring emergency health care sector in an umbrella with physical secured patient records. In framing the emergency healthcare treatment, the crucial thing considered necessary to decide about patients is their previous health conduct records. Thus a ubiquitous access to appropriate records is essential. Palm vein pattern recognition promises a secured patient record access. Likewise our paper reveals an efficient means to view, edit or transfer the DICOM images instantly which was a challenging task for medical practitioners in the

  10. A Service Design Thinking Approach for Stakeholder-Centred eHealth. (United States)

    Lee, Eunji


    Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

  11. Estimating the Costs of Services Provided by Health House and Health Centers in Shahroud

    Directory of Open Access Journals (Sweden)

    mohammad amiri


    Full Text Available Introduction: Calculating cost is an important management tool for programming, control, supervision and evaluation of health services in order that informed decisions can be done. This study was done to determine the cost of services provided by health centers, and health house in Shahroud in 2009.Methods: In this study, all health centers in urban and rural regions were studied. 70 forms for provided services, public and specific materials used for each service, medicine and equipment, time required for each service and activities, buildings and equipment depreciation costs were used to collect the data. Then the costs of each unit including direct and indirect costs (overhead, as well as the costs of one center and one health care home were calculated through cost analysis software. Results: Findings from data analysis showed that 44.4% of health care providers were male and 55.6% were female. 22.8% of the personnel were working in health house, 26.1% in rural health centers, 9.1% in urban health centers, health centers 24.5% in urban boarding health centers, 2.6% in health care posts and 14.9% were working in Healthcare Department. The highest cost were personnel costs (66.1% followed by central department costs (12.8%. Next were the costs for drug consumption with 11.0% and specific use with 3.8%. The highest cost was also for training healthcare providers (1325209 RLS and lowest cost was for sampling of influenza (3872 RLS. Conclusion: Due to high personnel costs, increasing of productivity will play an important role in reducing labor costs .Also, moderating workforce and the using private sector participation in services and outsourcing costly units can play an important role in optimum utilization of resources.

  12. The adoption of mobile health management services: an empirical study. (United States)

    Hung, Ming-Chien; Jen, Wen-Yuan


    As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal health management services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile Health Management Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile health management technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that "perceived usefulness" and "attitude" significantly affected the behavioral intention of adopting MHMS. Both "perceived ease of use" and "perceived usefulness," significantly affected "attitude," and "perceived ease of use" significantly affected "perceived usefulness" as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal health management will contribute to increases in both the level of general health and the efficient management of healthcare resources.

  13. Use of Health Care Services and Associated Factors among Women.

    Directory of Open Access Journals (Sweden)

    Nader Esmailnasab


    Full Text Available To estimate the prevalence and analyze factors associated with both public and private health services utilization in women population in a western district of Iran.A cross-sectional study with 1200 individuals aged 18-49 years carried out in different districts of Sanandaj City, western Iran, in 2012. The main outcome variable was use of health service in the previous 12 months. The in-dependent variables were age, education level, place of residence, marital and pregnancy status, household wealth, oc-cupation and duration time of employment, and rating of quality of health services.The prevalence of public and private health services utilization were 60.8% [95%CI: 57.8, 63.8] and 53.8% [95%CI: 50.8%, 56.8%], respectively (P=0.001. After controlling other investigated factors using logistic regression; the academic educational level (OR=1.36, 95%CI: 1.03, 1.80; OR=1.76, 95%CI: 1.33, 2.33, residents of urban (OR=1.65, 95%CI: 1.10, 2.47; OR=1.60, 95%CI: 1.10, 2.42, pregnancy status (OR=2.38, 95%CI: 1.60, 3.55; OR=2.36, 95%CI: 1.61, 3.47, and high level of quality of health services (OR=1.61, 95%CI: 1.15, 2.27; OR=1.70, 95%CI: 1.20, 2.40 were found to be predictors of utilization of both public and private health care respectively. There was also statistically relation between high level of household wealth (OR=3.01, 95% CI: 2.00, 4.57 and private health services utilization.Prevalence of health services utilization varied according to the individual and social factors of popula-tion studied. Present study emphasizes the need to develop care models that focus on the characteristics and demands of the subjects.

  14. Online Spatial Database of US Army Public Health Command Region-West Mosquito Surveillance Records: 1947-2009 (United States)


    geocoding errors. Output addresses were checked against input to identify discrepancies, and results that had a low precision level (to street or geocoder / 30 THE ARMY MEDICAL DEPARTMENT JOURNAL combination of internet searches...calculated area. Data were filtered in Excel for unique locations, and these point data were converted to shape files for mapping in DIVA- GIS 5.2

  15. Gamification in Healthcare: Perspectives of Mental Health Service Users and Health Professionals. (United States)

    Hopia, Hanna; Raitio, Katja


    The purpose of this descriptive qualitative study is to explore the perceptions and experiences that mental health service users (n = 10) and healthcare professionals (n = 32) have regarding the use of gamification in mental health care. Data was gathered by interviews. The mental health service users described promoting and retarding factors in the use of gamification, while professionals described the requirements for using gamification and changes occurring in the work culture. Additional research is needed on how game-playing elements could be integrated as a systematic part of mental health practice and how the digital skills of professionals could be effectively developed.

  16. Health Seeking Behavior and Utilization of Health Care Services in Eastern Hilly Region of Nepal

    Directory of Open Access Journals (Sweden)

    Sailesh Bhattarai


    Full Text Available noBackground & Objectives: Preventive, promotive, curative, and rehabilitative health care services depend not only in availability & accessibility of it but also on awareness and attitude of the people and various inter-woven social structure that determines in making choice. The objective of this study was to explore health seeking behavior and utilization of health care services in the rural places in VDCs of Ilam district of Eastern Nepal.Materials & Methods: A cross sectional study was conducted in between period of March 25th 2013 to April 10th 2013 Fikkal and Pashupatinagar VDCs in Ilam district with sample of 300 people. Data was collected using a semi-structured questionnaire.Results: One fifth of the populations were found to be seeking traditional healers’ service and 80 percent among modern treatment system were relying on private treatment facility for treating sickness. People who had lived more than 20 years in that place and who felt modern health services were costly were likely to use service of traditional healers. Similarly people suffering from chronic illness, having health facility more than 30 minutes and using stretcher or walking as means of transportation were using government health centers more compared to private services.Conclusion: Significant people still use traditional healers’ service and the government health facility utilization was low as compared to private. The people living for longer period in that place and having the concept that modern health centers are costly were primary user of traditional healing system. Health facility nearby or people who could afford for automobile travel facilities were using costly private health centers.JCMS Nepal. 2015; 11(2:8-16

  17. How Health Relationship Management Services (HRMS Benefits Corporate Wellness

    Directory of Open Access Journals (Sweden)

    Nik Tehrani


    Full Text Available The typical worker spends about 47 hours a week commuting sitting in cars, trains, buses, or sitting at their desks. These statistics show that maintaining a healthy work and life balance has become progressively important. Workplace wellness and health promotion are of central importance for any organization in today's world. People are becoming highly conscious about their health and seek to ensure that they are provided with best medical services and facilities in case of any health issue. Organizations have switched to proactive strategies for the healthcare of their employees. Billions of dollars are spent on the workforce only after illnesses or injuries have occurred. Over the past several decades, healthcare services have drastically changed, altering the manner in which healthcare was previously managed. Technological advancements in medical systems have revolutionized the healthcare industry, and digital health tracking has been quite successful in monitoring patients’ health. Since patients are continuously monitored, no matter where they are, these systems can indicate patients’ adherence to medical protocols and act as a warning sign for such diseases as heart problems, Alzheimer’s disease, and many others. Health Relationship Management Services (HRMS is a new paradigm which defines comprehensive healthcare for an individual. HRMS is a complete health ecosystem suitable for the workplace, which enables healthcare providers to collect personal health data from various sources, analyze it for positive outcomes, and take action to preserve an employee’s good health to reduce absenteeism or turnover. HRMS can act as a preventative sentinel for corporate well-being as well.

  18. MedlinePlus Connect for Electronic Health Record (EHR) Systems - Web Service (United States)

    U.S. Department of Health & Human Services — A Web service that allows patient portals and electronic health record (EHR) systems to use existing code sets to link to relevant, authoritative health information...

  19. Community health workers : Bridging the gap between health needs of immigrant elderly and health- and welfare services in the Netherlands

    NARCIS (Netherlands)

    Verhagen, I.


    The aim of this thesis is to assess the effectiveness of a Community Health Worker (CHW) intervention programme to improve immigrant elderly’s access to health- and welfare services. Additionally, effects on loneliness, health related quality of life (HRQOL), and self-efficacy were explored. Anal

  20. Health Seeking Behavior and Family Planning Services Accessibility in Indonesia

    Directory of Open Access Journals (Sweden)

    Niniek Lely Pratiwi


    Full Text Available Background: The MDG target to increase maternal health will be achieved when 50% of maternal deaths can be prevented through improvment the coverage of K1, K4, to make sure that midwife stay in the village improve the delivery by health workers in health facilities, increase coverage long-term contraceptive methods participant as well as family and community empowerment in health. Methods: This study is a further analysis of Riskesdas in 2010 to assess how big the accessibility of services in family planning in Indonesia. Results: Women of 3–4 children in rural greater and prevalence (27.1% compared to women who live in urban areas (25.0%. The main reason of not using contraception mostly because they want to have children 27.0% in urban, 28.2% rural whereas, the second reason is the fear of side effects 23.1% in urban, 16.5% rural. There is 10% of respondent did not use contraceptives, because they did not need it. Health seeking behavior of pregnant women with family planning work status has a significant relationship (prevalence ratio 1.073. The jobless mothers has better access to family planning services compared to working mother. Conclusions: Accessibility of family planning services is inadequate, because not all rural ‘Poskesdes’ equipped with infrastructure and family planning devices, a lack of knowledge of family planning in rural areas. Health seeking behavior of family planning services is mostly to the midwives, the scond is to community health centers and than polindes, ‘poskesdes’ as the ranks third.

  1. [The British Health Services System--major changes once again. The White Paper and commercialization of the National Health Service]. (United States)

    Kolflaath, J


    In February 1989 Prime Minister Margaret Thatcher presented her Proposals in a White Paper. These proposals imply essential changes in the National Health Service (NHS) in Great Britain. The changes will result in a more commercial way of managing both the hospitals and the offices of general practitioners. Among other things, they will imply buying and selling health services. Important objectives in the proposals are cost control, quality assurance and a greater choice for patients. During a visit to London this winter, the author studied the main topics of the proposals. This article discusses the content and aims of the White Paper, also with relevance to Norwegian health policy. Some aspects of the British health system today are also considered, with special reference to the development of the NHS during last 10 to 15 years.

  2. A New Approach to Health Services and Pharmacy in Cuba. (United States)

    Sánchez, Alina M


    In December 17, 2014, U.S. President Barack Obama surprised the world by announcing his intention to enter into negotiations aimed at reestablishing diplomatic relations with Cuba. Since then, expectations and interest regarding the health system of that country have increased. This report focuses on the Cuban health and pharmacy systems from a practical and educational standpoint. Pharmaceutical services, strengths, opportunities, and challenges are described. Cuba's new trends toward patient-centered care are analyzed to provide insights for developing pharmaceutical care practice and implementing policies suitable for practice in all health care settings.

  3. Interoperability design of personal health information import service. (United States)

    Tuomainen, Mika; Mykkänen, Juha


    Availability of personal health information for individual use from professional patient records is an important success factor for personal health information management (PHIM) solutions such as personal health records. In this paper we focus on this crucial part of personal wellbeing information management splutions and report the interoperability design of personal information import service. Key requirements as well as design factors for interfaces between PHRs and EPRs are discussed. Open standards, low implementation threshold and the acknowledgement of local market and conventions are emphasized in the design.

  4. Problem Gambling Treatment within the British National Health Service (United States)

    Rigbye, Jane; Griffiths, Mark D.


    According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study…

  5. [Organization of health services and tuberculosis care management]. (United States)

    Barrêto, Anne Jaquelyne Roque; de Sá, Lenilde Duarte; Nogueira, Jordana de Almeida; Palha, Pedro Fredemir; Pinheiro, Patrícia Geórgia de Oliveira Diniz; de Farias, Nilma Maria Porto; Rodrigues, Débora Cezar de Souza; Villa, Tereza Cristina Scatena


    The scope of this study was to analyze the discourse of managers regarding the relationship between the organization of the health services and tuberculosis care management in a city in the metropolitan region of João Pessoa, State of Pernambuco. Using qualitative research in the analytical field of the French line of Discourse Analysis, 16 health workers who worked as members of the management teams took part in the study. The transcribed testimonials were organized using Atlas.ti version 6.0 software. After detailed reading of the empirical material, an attempt was made to identify the paraphrasic, polyssemic and metaphoric processes in the discourses, which enabled identification of the following discourse formation: Organization of the health services and the relation with TB care management: theory and practice. In the discourse of the managers the fragmentation of the actions of control of tuberculosis, the lack of articulation between the services and sectors, the compliance of the specific activities for TB, as well as the lack of strategic planning for management of care of the disease are clearly revealed. In this respect, for the organization of the health services to be effective, it is necessary that tuberculosis be considered a priority and acknowledged as a social problem in the management agenda.

  6. NATO Advanced Research Institute on Health Services Systems

    CERN Document Server

    Werff, Albert; Hirsch, Gary; Barnard, Keith


    The Advanced Research Institute on "Health Services Systems" was held under the auspices of the NATO Special Programme Panel on Systems Science as a part of the NATO Science Committee's continuous effort to promote the advancement of science through international cooperation. A special word is said in this respect supra by Pro­ fessor Checkland, Chairman of the Systems Science Panel. The Advanced Research Institute (ARI) was organized for the purpose of bringing together senior scientists to seek a consensus on the assessment of the present state of knowledge on the specific topic of "health services systems" and to present views and recom­ mendations for future health services research directions, which should be of value to both the scientific community and the people in charge of reorienting health services. The conference was structured so as to permit the assembly of a variety of complementary viewpoints through intensive group discussions to be the basis of this final report. Invitees were selected fr...

  7. Environment and air pollution: health services bequeath to grotesque menace. (United States)

    Qureshi, Muhammad Imran; Rasli, Amran Md; Awan, Usama; Ma, Jian; Ali, Ghulam; Faridullah; Alam, Arif; Sajjad, Faiza; Zaman, Khalid


    The objective of the study is to establish the link between air pollution, fossil fuel energy consumption, industrialization, alternative and nuclear energy, combustible renewable and wastes, urbanization, and resulting impact on health services in Malaysia. The study employed two-stage least square regression technique on the time series data from 1975 to 2012 to possibly minimize the problem of endogeniety in the health services model. The results in general show that air pollution and environmental indicators act as a strong contributor to influence Malaysian health services. Urbanization and nuclear energy consumption both significantly increases the life expectancy in Malaysia, while fertility rate decreases along with the increasing urbanization in a country. Fossil fuel energy consumption and industrialization both have an indirect relationship with the infant mortality rate, whereas, carbon dioxide emissions have a direct relationship with the sanitation facility in a country. The results conclude that balancing the air pollution, environment, and health services needs strong policy vistas on the end of the government officials.

  8. Student-Life Stress in Education and Health Service Majors (United States)

    Zascavage, Victoria; Winterman, Kathleen G.; Buot, Max; Wies, Jennifer R.; Lyzinski, Natalie


    In order to better understand the effects of student-life stress on Education and Health Service majors (n = 195) at a private, religious, Midwestern university in the USA, we assessed student perception of overall stress level and physical stress level using the Student-life Stress Inventory. The targeted sample consisted of students with…

  9. Supply chain management in health services : an overview

    NARCIS (Netherlands)

    de Vries, J.; Huijsman, R.


    Purpose - This paper seeks to concentrate on the question whether any parallels can be found between the industrial sector and health care services with respect to the developments that have taken place in the area of Supply Chain Management. Starting from an analysis of existing literature, it is i

  10. The State of the Psychology Health Service Provider Workforce (United States)

    Michalski, Daniel S.; Kohout, Jessica L.


    Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of…

  11. Offering-level strategy formulation in health service organizations. (United States)

    Pointer, D D


    One of six different strategies must be selected for a health service offering to provide consumers with distinctive value and achieve sustainable competitive advantage in a market or market segment. Decisions must be made regarding objectives sought, market segmentation, market scope, and the customer-value proposition that will be pursued.

  12. Maternal health-seeking behavior: the role of financing and organization of health services in Ghana. (United States)

    Aboagye, Emmanuel; Agyemang, Otuo Serebour


    This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's health system has shaped maternal health-seeking behavior of women in the district. The paper employs a qualitative case study technique to build a complex and holistic picture, and report detailed views of the women in their natural setting. A purposeful sampling technique is applied to select 16 women in the district for this study. Through face-to-face interviews and group discussions with the selected women, comprehensive and in-depth information on health- seeking behavior and health outcomes are elicited for the analysis. The study highlights that characteristics embedded in decentralization and provision of free maternal health care influence health-seeking behavior. Particularly, the use of antenatal care has increased after the delivery exemption policy in Ghana. Interestingly, the study also reveals certain social structures, which influence women's attitude towards their decisions and choices of health facilities.

  13. Army Training. Management Initiatives Needed To Enhance Reservists' Training. Report to the Chairman, Subcommittee on Military Personnel and Compensation, Committee on Armed Services. (United States)

    General Accounting Office, Washington, DC. Div. of National Security and International Affairs.

    A study was made to determine the extent to which Army reservists (the National Guard and the Army Reserve) are training in critical tasks and battlefield survival and to identify the factors affecting this training. Information was gathered by interviewing officials at headquarters offices, analyzing overall Army training information, and…

  14. Why do Chinese Canadians not consult mental health services: health status, language or culture? (United States)

    Chen, Alice W; Kazanjian, Arminée; Wong, Hubert


    Data from the Canadian Community Health Survey Cycle 1.1 showed that Chinese immigrants to Canada and Chinese individuals born in Canada were less likely than other Canadians to have contacted a health professional for mental health reasons in the previous year in the province of British Columbia. The difference persisted among individuals at moderate to high risk for depressive episode. Both immigrant and Canadian-born Chinese showed similar characteristics of mental health service use. The demographic and health factors that significantly affected their likelihood to consult mental health services included Chinese language ability, restriction in daily activities, frequency of medical consultations, and depression score. Notwithstanding lower levels of mental illness in ethnic Chinese communities, culture emerged as a major factor explaining differences in mental health consultation between Chinese and non-Chinese Canadians.

  15. Medical students' attitudes toward abortion and other reproductive health services. (United States)

    Rosenblatt, R A; Robinson, K B; Larson, E H; Dobie, S A


    This paper investigated the attitude toward abortion and other reproductive health services of first- and second-year medical students at the Seattle campus of the University of Washington, a large regional primary care-oriented medical school, in 1996-97. A total of 219 (76.6%) students responded. The majority of the students support the availability of a broad range of reproductive health services including abortion; 58.1% felt that first-trimester abortions should be available to patients under most circumstances. Of the 43.4% of students who anticipated a career in family practice, most expected to provide abortions in their future practices. Moreover, older students and women were more likely to support the provision of abortion services. This study concludes that despite the continuing pressure on abortion providers, most first- and second-year medical students at a fairly state-supported medical school intend to incorporate this procedure into their future practices.

  16. Catalog of Completed Studies, US Army Health Care Studies and Clinical Investigation Activity. (United States)


    Environment Substudy: AD A139001 Effects of Chemical Protective Clothing on the Performance of Basic Medical Tasks (HCSD Report #83-001) 8 DATE TITLE...Contact urticaria to parabens , Arch. Dermatol, 1979, 115:1231-1232. *13 Smith, E. B., Padilla, R. S., McCabe, J. M., Becker, L. E., Benzoyl...Chemical Environment . --3-Report #83-001. Ft. Sam Houston, TX: Health Care Studies and Clinical Investigation Activity, December 1982. 19 Penetar, D. M

  17. Utilization of outpatient mental health services after inpatient alcoholism treatment. (United States)

    Booth, B M; Cook, C A; Blow, F C; Bunn, J Y


    It is generally agreed that use of aftercare services following discharge from alcoholism treatment is optimum for patients to achieve long-term recovery. However, the quantity and duration of utilization of such services in non-experimental settings are generally unknown. Using secondary data sources, we studied 5,635 alcoholics completing formal extended inpatient treatment and 1,860 alcoholics discharged from brief inpatient hospitalizations in Department of Veterans Affairs medical centers. Weekly use of outpatient mental health services (OPMH) prior to hospital admission was equally low for both patient groups (approximately 2-3% of patients) until four weeks prior to admission, at which time OPMH use increased, particularly for the extended treatment group. In the four weeks after discharge, use of OPMH services was substantially higher for patients with extended treatment compared to those with brief hospitalizations (40% vs. 18%), with 22% of patients completing treatment utilizing such services in the first week after discharge. Utilization steadily decreased until only 8% and 4% of both groups, respectively, were using OPMH services at the end of six months after discharge. Study results suggest the need to examine barriers to outpatient mental health utilization after discharge as well as interventions to increase compliance with long-term aftercare.

  18. The regional drug information service: a factor in health care? (United States)

    Leach, F N


    Most regional health authorities throughout the United Kingdom have established drug information units to provide health service staff with a wide range of information about drugs and drug use. The units, which are staffed by drug information pharmacists, provide their service mainly by answering inquiries, although some disseminate information more positively through lectures and bulletins.An analysis of inquiries received by regional information units during 1976 showed that most were submitted by hospital doctors or pharmacists; comparatively few were received from general practitioners. Topics of inquiry included adverse effects of drugs, source of supply and identification, current treatment, dosage, route, precautions, and pharmaceutical problems such as stability or formulation of drug preparations. A more detailed analysis of the inquiries received by the North-western Regional Drug Information Service at Manchester over three years showed that the number of inquiries gradually increased and that more were received from general practitioners after a programme of lectures had been introduced to tell them about the service. The North-western service also received more requests from hospital pharmacists than other units, though many originated from clinicians.The regional drug information units consulted widely with clinical and other specialists in answering questions, but about a quarter of all inquiries were pharmaceutical, relating to stability and incompatibility. A multidisciplinary approach therefore seems necessary to provide a comprehensive and advisory drug information service.

  19. Identifying mental health services in clinical genetic settings. (United States)

    Cappelli, M; Esplen, M J; Wilson, B J; Dorval, M; Bottorff, J L; Ly, M; Carroll, J C; Allanson, J; Humphreys, E; Rayson, D


    The purpose of this study was to examine the mental health needs of individuals at risk for adult onset hereditary disorder (AOHD) from the perspective of their genetic service providers, as it is unknown to what extent psychosocial services are required and being met. A mail-out survey was sent to 281 providers on the membership lists of the Canadian Association of Genetic Counsellors and the Canadian College of Medical Geneticists. The survey assessed psychosocial issues that were most commonly observed by geneticists, genetic counsellors (GCs), and nurses as well as availability and types of psychosocial services offered. Of the 129 respondents, half of genetic service providers reported observing signs of depression and anxiety, while 44% noted patients' concerns regarding relationships with family and friends. In terms of providing counselling to patients, as the level of psychological risk increased, confidence in dealing with these issues decreased. In addition, significantly more GCs reported that further training in psychosocial issues would be most beneficial to them if resources were available. As a feature of patient care, it is recommended that gene-based predictive testing include an integrative model of psychosocial services as well as training for genetic service providers in specific areas of AOHD mental health.

  20. Sexual health: the role of sexual health services among homeless young women living in Toronto, Canada. (United States)

    Oliver, Vanessa; Cheff, Rebecca


    Recent statistics indicate limited condom use, high STI (sexually transmitted infection) rates, and a general lack of knowledge about reproductive and sexual health among homeless youth. This research focuses on the experiences of homeless female and transgendered youth, providing an insider's perspective on shaping sexual health interventions. This qualitative research is based on life history interviews and participant observation with eight homeless young women who reflect the diversity of the homeless population in Toronto, Ontario, Canada. Their particularized sexual experiences and health-seeking behaviors illustrate the range of issues faced by this community, speaking to the efficacy of current health promotion strategies. Too often faced with judgmental health and social service providers who they perceive to undermine their agency and empowerment, these women highlight the challenges they face when seeking sexual and reproductive health services and information. In addition to speaking to the struggles and frustrations they face in regard to their sexual health and the services with which they choose to interact, the women provide suggestions for improved care. From these, the authors include key recommendations for the provision of culturally competent, sex-positive, and nonjudgmental health services with the hope that health practitioners and promoters can learn from these experiences, both positive and negative, when caring for and supporting young women living in exceptional circumstances.

  1. Health sector reform and sexual and reproductive health services in Mongolia. (United States)

    Hill, Peter S; Dodd, Rebecca; Dashdorj, Khurelmaa


    Since its transition to democracy, Mongolia has undergone a series of reforms, both at national level and in the health sector. This paper examines the pace and scope of these reforms, the ways in which they have impacted on sexual and reproductive health services and their implications for the health workforce. Formerly pro-natalist, Mongolia has made significant advances in contraceptive use, women's education and reductions in maternal mortality. However, rising adolescent pregnancy and sexually transmitted infections, and persisting high levels of abortion, remain challenges. The implementation of the National Reproductive Health Programme has targeted skills development, outreach and the provision of resources. Innovative adolescent-friendly health services have engaged urban youth, and the development of family group practices has created incentives to provide primary medical care for marginalised communities, including sexual and reproductive health services. The Health Sector Strategic Masterplan offers a platform for coordinated development in health, but is threatened by a lack of consensus in both government and donor communities, competing health priorities and the politicisation of emerging debates on fertility and abortion. With previous gains in sexual and reproductive health vulnerable to political change, these tensions risk the exacerbation of existing disparities and the development by default of a two-tiered health care system.

  2. Health and education: service providers in partnership to improve mental health

    Directory of Open Access Journals (Sweden)

    Eapen Valsamma


    Full Text Available Abstract Background Children and adolescents from complex or disadvantaged backgrounds and multiple needs often are reluctant to seek help and this is particularly relevant in the context of mental health difficulties. Further, the complexity of the health system can be overwhelming to the family who are likely to be chaotic and less able to seek help. The current project piloted an integrated service delivery model involving a child psychiatry service and the department of education to promote access to mental health assessment and intervention to young people attending special education schools in Sydney, Australia. Findings and conclusion The project allowed improved access to mental health services for a group of young people who would otherwise not have sought help through traditional referral pathways. Our findings support strategies to promote the social milieu of schools as a way of achieving better mental health and learning outcomes.

  3. Does health insurance ensure equitable health outcomes? An analysis of hospital services usage in urban India. (United States)

    Dutta, Mousumi; Husain, Zakir


    In this paper, we examine the relationship between socio-economic status (SES) and the usage of in-patient services, and analyze the impact of introducing health insurance in India - a major developing country with poor health outcomes. In contrast to results of similar works undertaken for developed countries, our results reveal that the positive relation between usage of in-patient services and SES persists even in the presence of health insurance. This implies that health insurance is unable to eliminate the inequities in accessing healthcare services that stem from disparities in SES. In fact, insurance aggravates inequity in the healthcare market. The study is based on unit-level data from the 2005-06 Morbidity and Health Care Survey undertaken by National Sample Survey Organization.

  4. The representation of health care services in Mexican television: potential consequences for health subjectivities

    Directory of Open Access Journals (Sweden)

    Soledad Rojas Rajs


    Full Text Available The objective of this paper is to analyze the representation of health services in Mexican television, considering that television plays an important role in the production and reproduction of the social meanings of health. A descriptive study analyzed the contents of 672 hours of continuous television (media flows broadcast in Mexico in 2011, examining advertising, television shows and newscasts. The analysis of all these messages shows that the representation of private care services predominates. When public care services are mentioned, the communication is mainly regarding the Seguro Popular de Salud [Popular Health Insurance, for those with low incomes], while the social security model of care is underrepresented. We therefore conclude that television favors the two first models of health care. This kind of representation could hold potential consequences for health subjectivities.

  5. The prospects for health services in the United States. (United States)

    Freidson, E


    The enormous variety of diagnoses and prescriptions for dealing with the health care crisis in the United States can be simplified and clarified by reference to four logically distinct models of methods for organizing the production of health services. The assumptions of the free market model, the bureaucratic planning model, the professional model and the cooperative equalitarian model are described, as are the characteristic pathologies connected with the form those models take in reality. The intrinsically expansionist character of the manufacturing, service and consumer segments of the U.S. health system is described and the suggestion made that legislative attempts to contain costs will lead to increased bureaucratization primarily at the expense of the consumer.

  6. Challenges, solutions, and best practices in telemental health service delivery across the pacific rim-a summary. (United States)

    Doarn, Charles R; Shore, Jay; Ferguson, Stewart; Jordan, Patricia J; Saiki, Stanley; Poropatich, Ronald K


    The Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Materiel Command, in conjunction with the American Telemedicine Association's Annual Mid-Year Meeting, conducted a 1-day workshop on how maturing and emerging processes and applications in the field of telemental health (TMH) can be expanded to enhance access to behavioral health services in the Pacific Rim. The purpose of the workshop was to bring together experts in the field of TMH from the military, federal agencies, academia, and regional healthcare organizations serving populations in the Pacific Rim. The workshop reviewed current technologies and systems to better understand their current and potential applications to regional challenges, including the Department of Defense and other federal organizations. The meeting was attended by approximately 100 participants, representing military, government, academia, healthcare centers, and tribal organizations. It was organized into four sessions focusing on the following topic areas: (1) Remote Screening and Assessment; (2) Post-Deployment Adjustment Mental Health Treatment; (3) Suicide Prevention and Management; and (4) Delivery of Training, Education, and Mental Health Work Force Development. The meeting's goal was to discuss challenges, gaps, and collaborative opportunities in this area to enhance existing or create new opportunities for collaborations in the delivery of TMH services to the populations of the Pacific Rim. A set of recommendations for collaboration are presented.

  7. Technologies for HIV prevention and care: challenges for health services. (United States)

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia


    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  8. Franchising of health services in low-income countries. (United States)

    Montagu, Dominic


    Grouping existing providers under a franchised brand, supported by training, advertising and supplies, is a potentially important way of improving access to and assuring quality of some types of clinical medical services. While franchising has great potential to increase service delivery points and method acceptability, a number of challenges are inherent to the delivery model: controlling the quality of services provided by independent practitioners is difficult, positioning branded services to compete on either price or quality requires trade-offs between social goals and provider satisfaction, and understanding the motivations of clients may lead to organizational choices which do not maximize quality or minimize costs. This paper describes the structure and operation of existing franchises and presents a model of social franchise activities that will afford a context for analyzing choices in the design and implementation of health-related social franchises in developing countries.

  9. Regulating India's health services: to what end? What future? (United States)

    Peters, David H; Muraleedharan, V R


    India has a comprehensive legal and regulatory framework and large public health delivery system which are disconnected from the realities of health care delivery and financing for most Indians. In reviewing the current bureaucratic approach to regulation, we find an extensive set of rules and procedures, though we argue it has failed in three critical ways, namely to (1) protect the interests of vulnerable groups; (2) demonstrate how health financing meets the public interests; (3) generate the trust of providers and the public. The paper reviews the state of alternative approaches to regulation of health services in India, using consumer and market based approaches, as well as multi-actor and collaborative approaches. We argue that poor regulation is a symptom of poor governance and that simply creating and enforcing the rules will continue to have limited effects. Rather than advocate for better implementation and expansion of the current bureaucratic approach, where Ministries of Health focus on their roles as inspectorate and provider, we propose that India's future health system is more likely to achieve its goals through greater attention to consumer and other market oriented approaches, and through collaborative mechanisms that enhance accountability. Civil society organizations, the media, and provider organizations can play more active parts in disclosing and using information on the use of health resources and the performance of public and private providers. The overview of the health sector would be more effective, if Indian Ministries of Health were to actively facilitate participation of these key stakeholders and the use of information.

  10. Efficiency of workplace surveys conducted by Finnish occupational health services. (United States)

    Savinainen, Minna; Oksa, Panu


    In Finland, workplace surveys are used to identify and assess health risks and problems caused by work and make suggestions for continuous improvement of the work environment. With the aid of the workplace survey, occupational health services can be tailored to a company. The aims of this study were to determine how occupational health professionals gather data via the workplace survey and the effect survey results have on companies. A total of 259 occupational health nurses and 108 occupational health physicians responded to the questionnaire: 84.2% were women and 15.8% were men. The mean age of the respondents was 48.8 years (range, 26 to 65 years). Usually occupational health nurses and foremen and sometimes occupational health physicians and occupational safety and health representatives initiate the workplace survey. More than 90% of the surveys were followed by action proposals, and about 50% of these were implemented. The proposals implemented most often concerned personal protective equipment and less often leadership. Survey respondents should have both the opportunity and the authority to affect resources, the work environment, work arrangements, and tools. Teamwork among occupational health and safety professionals, management, and employees is vital for cost-effectively solving today's complex problems at workplaces around the globe.

  11. Online anonymous discussion between service users and health professionals to ascertain stakeholder concerns in using e-health services in mental health. (United States)

    Jones, Ray B; Ashurst, Emily J


    Implementation of e-health in mental health services requires that we are aware of stakeholders' concerns. We ascertained the views of mental health professionals and mental health service users through the (1) development of 12 topics based on the research literature, (2) presentation to 31 participants (19 mental health professionals and 12 mental health service users) and discussion in three 1-week programmes, (3) thematic analysis of transcripts, and (4) comparison with the literature to identify areas requiring attention in e-health implementation. This method of engaging mental health service users and mental health professionals was effective. We identified areas that (1) should be the first to implement (e.g. discussion forums, email, and Skype), (2) where further education and engagement are necessary before e-health methods could be used (e.g. unsupported computerised cognitive behavioural therapy, computer-patient interviewing, and patient access to online medical records), and (3) for further research (e.g. the impact of bad online experiences).

  12. Are patient surveys valuable as a service-improvement tool in health services? An overview

    Directory of Open Access Journals (Sweden)

    Patwardhan A


    Full Text Available Anjali Patwardhan,1 Charles H Spencer21Nationwide Children’s Hospital Columbus, 2Ohio State University, Columbus, OH, USAAbstract: Improving the quality of care in international health services was made a high priority in 1977. The World Health Assembly passed a resolution to greatly improve “Health for all” by the year 2000. Since 1977, the use of patient surveys for quality improvement has become a common practice in the health-care industry. The use of surveys reflects the concept that patient satisfaction is closely linked with that of organizational performance, which is in turn closely linked with organizational culture. This article is a review of the role of patient surveys as a quality-improvement tool in health care. The article explores the characteristics, types, merits, and pitfalls of various patient surveys, as well as the impact of their wide-ranging application in dissimilar scenarios to identify gaps in service provision. It is demonstrated that the conducting of patient surveys and using the results to improve the quality of care are two different processes. The value of patient surveys depends on the interplay between these two processes and several other factors that can influence the final outcome. The article also discusses the business aspect of the patient surveys in detail. Finally, the authors make future recommendations on how the patient survey tool can be best used to improve the quality of care in the health-care sector.Keywords: patient surveys, quality improvement, service gaps 

  13. Mobile Health Care over 3G Networks: the MobiHealth Pilot System and Service

    NARCIS (Netherlands)

    Wac, Katarzyna; Bults, Richard; Konstantas, Dimitri; Halteren, van Aart; Jones, Val; Widya, Ing; Herzog, Rainer


    Health care is one of the most prominent areas for the application of wireless technologies. New services and applications are today under research and development targeting different areas of health care, from high risk and chronic patients’ remote monitoring to mobility tools for the medical perso

  14. Role of the police in linking individuals experiencing mental health crises with mental health services

    NARCIS (Netherlands)

    van den Brink, Rob H. S.; Broer, Jan; Tholen, Alfons J.; Winthorst, Wim H.; Visser, Ellen; Wiersma, Durk


    Background: The police are considered frontline professionals in managing individuals experiencing mental health crises. This study examines the extent to which these individuals are disconnected from mental health services, and whether the police response has an influence on re-establishing contact

  15. BrdsNBz: Sexually Experienced Teens More Likely to Use Sexual Health Text Message Service (United States)

    Willoughby, Jessica Fitts


    Text messaging services are becoming an increasingly popular way to provide sexual health information to teens, but little is known about who uses such services. This study assessed whether teens at a greater risk for negative sexual health outcomes use a sexual health text message service. A text message service that connects teens with sexual…

  16. 75 FR 40842 - Public Health Service Act (PHS), Delegation of Authority (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Service Act (PHS), Delegation of... Services under the following section under Title XXVI of the Public Health Service Act, and the Ryan...

  17. Domestic Contingency Operations: A New Role for the United States Army (United States)


    The addition of operations other than war to military lexicology greatly assists to define the role of the Army in support of domestic missions but...transportation, linguists , and health services directly translate to the domestic environment. This critical skills are essential for disaster

  18. Effect of Health Services Quality to Inpatient Satisfaction in Health Centre of Jayapura Regency, Papua

    Directory of Open Access Journals (Sweden)

    Taufik A AWibowo


    Full Text Available To measure the quality of health care using five dimensions of service quality that is direct evidence (Tangibles responsiveness (responsiveness, reliability (realibility, security (assurance, and empathy. The purpose of this study is to determine the effect of the quality of inpatient health care with patient satisfaction in the health center Jayapura district. Survey method with cross sectional analytic study population in this study that all patients hospitalized at the health center during the month of August to September 2016. Sampling was conducted with a total sampling technique with a number of 106 respondents. Sources of primary data obtained from questionnaires and secondary data from six health centers in the county inpatient Jayapura. Analysis of data using multiple linear regression. The results showed that the most dominant variables linked to patient satisfaction compared with other variable is direct evidence (tangibles. The quality of health services at the health center Jayapura district has a significant relationship to the direct evidence (tangibles with patient satisfaction. Jayapura Regency Government through the Department of Health to maintain and continuously improve the quality of health care is the most basic health centers by strengthening institutions, infrastructure, and financing of adequate health centers so as to improve the quality of health centers and satisfaction to the patient.

  19. Using e-health applications to deliver new mental health services. (United States)

    Christensen, Helen; Hickie, Ian B


    Traditional clinic-based service delivery systems remain inaccessible to many Australians with mental health problems. If we are to substantially reduce the burden of mental illness, we need to develop more accessible, empowering and sustainable models of mental health care. E-health technologies have specific efficiencies and advantages in the domains of health promotion, prevention, early intervention and prolonged treatment. It is timely to use the best features of these technologies to start to build a more responsive and efficient mental health care system.

  20. [The sainsbury centre for mental health: forensic mental health services in England and wales]. (United States)

    Rutherford, M; Duggan, S


    The Sainsbury Centre for Mental Health (SCMH) is a charity founded in 1985 by Gatsby Charitable Foundation. The SCMH works to improve the quality of life for people with mental health problems by influencing policy and practice in mental health and related services. Working to improve the quality of mental health care for people in prison is one of SCMH main work theme. This paper describes some epidemiological aspects of mental health situation of prisoners in England and Wales and the available forensic facilities to manage this kind of patients in prison.

  1. Community Health Service in Urban China: Rebuilding Health Care Systems in New Ways

    Institute of Scientific and Technical Information of China (English)

    赵志广; 卢祖洵


    IN THE 1970s, the World Health Organization(WHO) put forward a community-oriented healthservice model based on the experience of Europeancountries such as Britain. At present, this model hasbeen adopted as the key strategy to make health ser-vices accessible, affordable and socially acceptableand is an important component of health servicesystem in many countries.1,2In the early 1950s, China set out to establish athree-level primary health care network in urban andrural areas in order to provide health care...

  2. Predictors of consumer satisfaction in community mental health center services. (United States)

    Sohn, Minji; Barrett, Hope; Talbert, Jeffery


    Kentucky Department for Behavioral Health Developmental and Intellectual Disabilities conducted a survey to evaluate consumers' satisfaction with services delivered at the Community Mental Health Centers (CMHCs) in Kentucky. The survey was administered at outpatient clinics operated by fourteen CMHCs in 2010. The purpose of this study was to identify factors that predict whether clients will respond that they were "generally satisfied" with services received from CMHCs. A logistic regression model was developed using respondents' characteristics and their responses to survey questions. Survey questions were grouped into seven core domains: general satisfaction, access, quality, participation in treatment planning, outcomes, functioning, and social connectedness. In result, responses to domains of access, quality and participation in treatment planning significantly affected clients' perception of general satisfaction. Respondents who positively assessed those domains of services were more likely to answer that they were generally satisfied with services. Based on the analysis in this report, improvement in certain domains of services, especially access, quality and participation in treatment planning could increase the level of positive responses in general satisfaction.

  3. Evidence Translation in a Youth Mental Health Service

    Directory of Open Access Journals (Sweden)

    Alan P. Bailey


    Full Text Available An evidence–practice gap is well established in the mental health field, and knowledge translation is identified as a key strategy to bridge the gap. This study outlines a knowledge translation strategy, which aims to support clinicians in using evidence in their practice within a youth mental health service (headspace. We aim to evaluate the strategy by exploring clinicians’ experiences and preferences. The translation strategy includes the creation and dissemination of evidence translation resources that summarize the best available evidence and practice guidelines relating to the management of young people with mental disorders. Semi-structured interviews were conducted with 14 youth mental health clinicians covering three topics: experiences with evidence translation resources, preferences for evidence presentation, and suggestions regarding future translation efforts. Interviews were recorded, transcribed verbatim, coded, and analyzed using thematic analysis. Themes were both predetermined by interview topic and identified freely from the data. Clinicians described their experiences with the evidence translation resources as informing decision making, providing a knowledge base, and instilling clinical confidence. Clinicians expressed a preference for brief, plain language summaries and for involvement and consultation during the creation and dissemination of resources. Suggestions to improve the dissemination strategy and the development of new areas for evidence resources were identified. The knowledge translation efforts described support clinicians in the provision of mental health services for young people. The preferences and experiences described have valuable implications for services implementing knowledge translation strategies.

  4. Experiences of volunteering: a partnership between service users and a mental health service in the UK. (United States)

    Fegan, Colette; Cook, Sarah


    The aim of the study was to investigate how people with serious mental illness perceived the experience of volunteering for the health care organisation in which they had received a service. The study took a qualitative approach and in phase one, eleven service user volunteers were purposefully sampled and interviewed. In depth interviews were analysed using grounded theory. This paper describes the findings from phase one, and highlights the following themes to represent the volunteering experience: 1) rehearsing for a new direction; 2) treading carefully at first; 3) discovering my new self; and, 4) using my experience and extending relationships. These themes further support a tentative theoretical framework that considers supported volunteering to enhance recovery because it fosters positive risk taking and gives individuals a valued identity that integrates their mental health experience. In phase two, this framework will be tested with service users in more diverse volunteer positions. The findings of my study suggest that mental health services are in a unique position to build partnerships with service users to support their recovery and journeys toward employment by providing opportunities for volunteering.

  5. Survey of health promotion organisational arrangements and levels of service for health promotion. (United States)

    Jones, K E; Brockway, C R; Atkinson, R E


    This study was promoted by the Executive Committee of the Association of Directors of Public Health when faced with the need to examine the organisation of and quantify health promotion arrangements in the Health Districts of England and Wales, resulting from the concerns of many of the members of the Association. These concerns were based on the views that health promotion is a key purchasing function of the District Health Authorities and must be appropriately and effectively structured and adequately resourced if the requirements of The Health of The Nation are to be fulfilled. There are many aspects to health promotion work and the delivery of health promotion services which will need addressing in the new commissioning environment of the NHS. A need was recognised for up-to-date data about health promotion services to inform a necessary debate about future arrangements, since it appeared that organisational change was being driven by influences unconnected with the possibly most appropriate structure of health promotion departments and which relate to a contemporary view of health promotion. Reducing the size and cutting the cost of commissioning authorities was perceived as one of the most important influences. A postal questionnaire survey to all Health District and Regional Health Authorities in England and Wales was conducted covering questions about the present organisational arrangements and levels of service, and soliciting the opinions of those canvassed. A total of 185 District and Regional Health Authorities, effectively reduced to 171 because of mergers, was sent questionnaires, of which 141 were completed and returned, giving a response rate of 82.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Type of Maltreatment as a Predictor of Mental Health Service Use for Children in Foster Care. (United States)

    Garland, Ann F.; And Others


    Evaluation of demographic, behavioral, and mental health service utilization data on 662 children in foster care found that 56% had received mental health services. Children who experienced "active" types of maltreatment (such as sexual abuse) were more likely to receive mental health services even when severity of mental health problems…

  7. 75 FR 22140 - Office of Clinical and Preventive Services; Division of Oral Health; Dental Preventive and... (United States)


    ... HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services; Division of Oral Health.... Well-designed Support Centers will indirectly impact upon patients' oral health by directly addressing...-based oral health promotion/disease prevention (HP/DP) initiatives. Centers will send an...

  8. Marketing home health care medical services: the physician's view. (United States)

    Ryan, E J; Phelps, R A


    The authors surveyed physicians serving the Jackson, Mississippi home health care market. They identified problems and studied physician perceptions regarding services provided by home health care agencies, private duty nursing agencies, and durable medical equipment suppliers. Respondents perceived home health care as providing: (1) increased patient satisfaction, (2) greater patient convenience, (3) earlier discharge, and (4) lowered patient costs. They least liked: (1) lack of control and involvement in the patient caring process, (2) paperwork, (3) quality control potential, and the possibility that patient costs could increase. Two sets of implications for health care marketers are presented that involve both national and regional levels. Overall results indicate that a growing and profitable market segment exists and is being served in an effective and socially responsible manner.

  9. Integrating service user participation in mental health care: what will it take?

    Directory of Open Access Journals (Sweden)

    Sharon Lawn


    Full Text Available Participation in mental health care poses many challenges for mental health service users and service providers. Consideration of these issues for improving the integration of service user participation in mental health care can help to inform integrated care within health care systems, broadly. This paper argues for practicing greater empathy and teaching it, stigma reduction, changing what we measure, valuing the intrinsic aspects of care more, employing more people with lived experience within mental health services, raising the visibility of service users as leaders and our teachers within services and redefining integrated care from the service user perspective.

  10. Health status in the ambulance services: a systematic review

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    Hem Erlend


    Full Text Available Abstract Background Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. This article systematically explores the literature on health problems and work-related and individual health predictors in the ambulance services. Methods We identified the relevant empirical literature by searching several electronic databases including Medline, EMBASE, PsychINFO, CINAHL, and ISI Web of Science. Other relevant sources were identified through reference lists and other relevant studies known by the research group. Results Forty-nine studies are included in this review. Our analysis shows that ambulance workers have a higher standardized mortality rate, higher level of fatal accidents, higher level of accident injuries and a higher standardized early retirement on medical grounds than the general working population and workers in other health occupations. Ambulance workers also seem to have more musculoskeletal problems than the general population. These conclusions are preliminary at present because each is based on a single study. More studies have addressed mental health problems. The prevalence of post-traumatic stress symptom caseness was > 20% in five of seven studies, and similarly high prevalence rates were reported for anxiety and general psychopathology in four of five studies. However, it is unclear whether ambulance personnel suffer from more mental health problems than the general working population. Conclusion Several indicators suggest that workers in the ambulance services experience more health problems than the general working population and workers in other health occupations. Several methodological challenges, such as small sample sizes, non-representative samples, and lack of comparisons with normative data limit the interpretation of many studies. More coordinated research and replication are needed to compare data across studies. We discuss some strategies for

  11. Health care agreements as a tool for coordinating health and social services

    Directory of Open Access Journals (Sweden)

    Andreas Rudkjøbing


    Full Text Available Introduction: In 2007, a substantial reform changed the administrative boundaries of the Danish health care system and introduced health care agreements to be signed between municipal and regional authorities. To assess the health care agreements as a tool for coordinating health and social services, a survey was conducted before (2005–2006 and after the reform (2011.Theory and methods: The study was designed on the basis of a modified version of Alter and Hage's framework for conceptualising coordination. Both surveys addressed all municipal level units (n = 271/98 and a random sample of general practitioners (n = 700/853.Results: The health care agreements were considered more useful for coordinating care than the previous health plans. The power relationship between the regional and municipal authorities in drawing up the agreements was described as more equal. Familiarity with the agreements among general practitioners was higher, as was the perceived influence of the health care agreements on their work.Discussion: Health care agreements with specific content and with regular follow-up and systematic mechanisms for organising feedback between collaborative partners exemplify a useful tool for the coordination of health and social services.Conclusion: There are substantial improvements with the new health agreements in terms of formalising a better coordination of the health care system.

  12. Economic growth and health progress in Italy: 30 years of National Health Service. (United States)

    Vannelli, Alberto; Buongiorno, Massimo; Zanardo, Michele; Basilico, Valerio; Capriata, Giulio; Rossi, Fabrizio; Pruiti, Vincenzo; Battaglia, Luigi


    On December 23 of 1978, during first Italian recession since the end of World War II, Parliament voted for Law 833 that gives birth to the Italian National Public Health Services (SSN) as the new and alternative model of health care system. It was the beginning of the match of Italian health care with the world class level of the public health care. Each crisis requires solidarity and actions. Maintaining levels of health and other social expenditures is critical to protect life and livelihood and to boost productivity. The purpose of the present study is to establish an alternative point of view to demonstrate that Gross Domestic Product, is a function of health care expenditure. The chronology of the events was created by using the laws published on "Gazzetta Ufficiale" (GU). In order to analyze the corporate effectiveness and efficiency, we have divided the SSN into its three main components, namely resources (input), services (output) and performances (outcome). Health services have certainly been pioneers and are still today standard-bearers of a challenge which has borne its fruits. According to the "Organization for Economic Co-operation and Development", SSN ranks second in the world classification of the return on the health care services in 2000. The World Health Organization has published in 2005 the same result: SSN ranks second in the world for ability and quality of the health care in relationship to the resources invested The continuous reforms of health care system introduced stability to the Italian system more than others countries. Success of SSN function rooted in the ability of system to adapt assuring mechanism of positive feed-back correction. In the future SSN, will required new set of reforms, such as redefinition of structures and mechanisms of governance, strategic plans, clinical administrations.

  13. Standardized dataset health services: Part 2--top to bottom. (United States)

    Galemore, Cynthia A; Maughan, Erin D


    It is critical for school nurses to promote and educate others on what they do. Data can help shape the message into understandable language across education and health. While Part 1 of this article discusses NASN's progress on identifying a standardized dataset for school health services, Part 2 focuses on the analysis and sharing of data at the local level. Examples of how to use the data to improve practice and create change are included. Guidance is provided in creating and sharing data as part of an annual report as a final step in advocating for school health services commensurate with student health needs. As the work on an evidence-based uniform dataset continues at the national level, what should be the response at the local level? Do we wait, or do we continue to collect certain data? The purpose of Part 2 of this article is to describe how data being collected locally illustrate health trends, benchmarking, and school nursing outcomes and can be compiled and shared in an annual report.

  14. Integrated mental health services in England: a policy paradox

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    Elizabeth England


    Full Text Available Purpose: The purpose of this paper is to examine the effects of health care policy on the development of integrated mental health services in England. Data sources: Drawing largely from a narrative review of the literature on adult mental health services published between January 1997 and February 2003 undertaken by the authors, we discuss three case studies of integrated care within primary care, secondary care and across the primary/secondary interface for people with serious mental illness. Conclusion: We suggest that while the central thrust of a raft of recent Government policies in England has been towards integration of different parts of the health care system, policy waterfalls and implementation failures, the adoption of ideas before they have been thoroughly tried and tested, a lack of clarity over roles and responsibilities and poor communication have led to an integration rhetoric/reality gap in practice. This has particular implications for people with serious mental health problems. Discussion: We conclude with suggestions for strategies that may facilitate more integrated working.

  15. Does mental health service integration affect compulsory admissions?

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    André I. Wierdsma


    Full Text Available Background: Over recent years, the number of compulsory admissions in many countries has increased, probably as a result of the shift from inpatient to outpatient mental health care. This might be mitigated by formal or collaborative relationships between services. Methods: In a retrospective record linkage study, we compared two neighboring districts, varying in level of service integration. Two periods were combined: 1991–1993 and 2001–2003. We included patients aged 18–60, who had a first emergency compulsory admission (n=830. Their psychiatric history was assessed, and service-use after admission was monitored over a 12-month follow-up. Results: Over a 10-year period, compulsory admission rates increased by 47%. Difference in relative increase between the integrated and non-integrated services was 14%. Patient characteristics showed different profiles in the two districts. Length of stay was >10 days shorter in the integrated district, where the proportion of involuntary readmissions decreased more, and where aftercare was swift and provided to about 10% more patients than in the non-integrated district. Conclusions: Services outcomes showed better results where mental healthcare was more integrated. However, limited effects were found and other factors than integration of services may be more important in preventing compulsory admissions.

  16. OT - Education for the health services of the future

    DEFF Research Database (Denmark)

    Hansen, Bodil Winther; Sørensen, Annette; Hove, Anne


    OT - Education for the health services of the future This presentation offers knowledge about which qualifications the health services and OT practice in general demand from Occupational Therapists. The study was developed in a wider context of the constant reflection within higher education...... by University College Oeresund. To express the level of education to be achieved in terms of competences and learning outcome, the study was inspired by the tuning process of educational structures in Europe, which is part of the Bologna process to integrate higher education area in Europe. The study is based...... on literature studies, quantitative and qualitative methods suitable for uncovering demands of competences – i.e. generic as well as and subject-specific competences. Informants were sampled among OT professional leaders and the members of the board of governors at the Faculty of Occupational Therapy Copenhagen...

  17. Dr. Louis Sullivan: Treating America's Most Critical Health and Human Services Ills. (United States)

    Cox, William E,; Matthews, Frank L.


    Interview with Dr. Louis Sullivan, Secretary of Health and Human Services. Discusses his views on health education, budget, access to health care, minority health, abortion, infant mortality, drugs, the Head Start Program, federal planning effects, and family influences. (JS)

  18. Assessment of oral health promotion services offered as part of maternal and child health services in the Tshwane Health District, Pretoria, South Africa

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    Yolanda Kolisa


    Full Text Available Objectives: The study aimed to assess the oral health promotion services provided as part of the maternal and child health (MCH services in the Tshwane Health District, Pretoria, South Africa.Methods: The research design was a descriptive cross-sectional study using a modified standard questionnaire. The population was drawn from the parents/caregivers (PCGs and the MCH nurses at seven clinics during June 2012 and June 2013 in Pretoria.Results: The nurses’ response rate was 83%; average age of 37 years. The majority of the nurses (65% were females; 60% were professional nurses. Most (63% of the nurses reported that they provided oral health education (OHE services. A shortage of dental education materials (43%, staff time (48%, and staff training (52% were large constraints to nurses providing OHE. The majority of PCGs (n = 382; mean age 31.5 years had a low education level (76%. About 55% of PCGs received information on children’s oral health from the television and 35% at the MCH clinics. PCGs beliefs were worrying as about 38% believed primary dentition is not important and need not be saved.Conclusion: There is evidence of minimal integration of OHE at MCH sites. Parents’ beliefs are still worrying as a significant number do not regard the primary dentition as important. The MCH site remains an important easily accessible area for integration of oral health services with general health in complementing efforts in prevention of early childhood caries.Keywords: Oral health; Promotion integration

  19. Perspectives on Health, Health Needs and Health Care Services among Select Nomad Tribal Populations of Rajasthan, India

    Directory of Open Access Journals (Sweden)

    Bandana Sachdev


    Full Text Available Objective: To study the opinion of select nomad tribal communities of Rajasthan State in India on health, health needs, and health care services. Methods: A cross-sectional study involving 1113 nomadic populations in select districts of Jhunjhunu, Sikar and Churu were undertaken. A perception on regarding various health issues among the study populations were obtained through semi-structured questionnaires. Results: The major insight of nomad tribal populations on health, health need and health care services are lack of infrastructures, inaccessibility to health institutions, ill-treated by government hospitals staff, acceptability and affordability are some of the main problems contributing to their poor health status. Conclusion: The Nomad tribal environment and sense of community with its associated strong social networks are identified as key determinants for common perception in all communities. However, the inaccessibility to health care and reluctance to seek help for health issues remain a significant problem in nomad tribal areas. In considering priorities for health, greater effort and resources are required to increase their awareness and change attitudes towards health issues

  20. Impact of Universal Health Care Coverage on patient demand for health care services in Thailand. (United States)

    Panpiemras, Jirawat; Puttitanun, Thitima; Samphantharak, Krislert; Thampanishvong, Kannika


    Fully implemented in Thailand in 2002, the Universal Health Care Coverage (UC) Program aimed to provide cheap access to health care services, for 30 baht (less than 1 U.S. dollar) per visit, to all uninsured Thais. In this paper, we studied the impact of the UC in Thailand on the demand for health care services using hospital level data. We found that the UC program was successful in increasing outpatient demand for health care, particularly the demand from the elderly and the poor. However, outpatient demand for health care dramatically increased during the first year of the program and faded away quickly in subsequent years. In contrast to outpatient demand, the number of inpatient visits and the number of days for which the inpatients were admitted at hospitals declined after the UC program was launched. In this paper, we offer our explanation of these phenomena, highlight problems associated with the UC program, and provide policy recommendations to improve the program.

  1. Advances in e-health and telemedicine: strategy to bring health service users

    Directory of Open Access Journals (Sweden)

    Wilson Giovanni Jiménez Barbosa


    Full Text Available Background: The e-health and telemedicine have emerged as tools to facilitate access to health services, both populations far from the centres, and those who reside near them is not easily accessible or require constant controls by their professionals health traffickers. Objective: To reflect on the uses, progress and difficulties faced by Information and Communication Technologies (ICT as a strategy to bring health services to users. Methodology: qualitative hermeneutic research; advanced in two phases. The first, theoretical review by finding relevant articles in scientific databases. The second phase, critical analysis of literature found, in order to understand the dynamics generated from the use of ICT in the health sector, its current uses and prospected, and the risk that can generate its implementation for providers and patients. Results: The e-health and telemedicine have advanced in their development process andColombiahas not been outside, but there are still drawbacks of ethical, legal and operational order, which are not static and show great variation over time, becoming challenges are not independent but are associated with the dynamic progress of ICT. Conclusion: e-health and telemedicine are valid strategies to improve access to health services to communities. But require the development of processes to prevent, mitigate and / or exceed the inconveniences that may arise from its use. 

  2. Mental health services commissioning and provision: Lessons from the UK? (United States)

    Ikkos, G; Sugarman, Ph; Bouras, N


    The commissioning and provision of healthcare, including mental health services, must be consistent with ethical principles - which can be summarised as being "fair", irrespective of the method chosen to deliver care. They must also provide value to both patients and society in general. Value may be defined as the ratio of patient health outcomes to the cost of service across the whole care pathway. Particularly in difficult times, it is essential to keep an open mind as to how this might be best achieved. National and regional policies will necessarily vary as they reflect diverse local histories, cultures, needs and preferences. As systems of commissioning and delivering mental health care vary from country to country, there is the opportunity to learn from others. In the future international comparisons may help identify policies and systems that can work across nations and regions. However a persistent problem is the lack of clear evidence over cost and quality delivered by different local or national models. The best informed economists, when asked about the international evidence do not provide clear answers, stating that it depends how you measure cost and quality, the national governance model and the level of resources. The UK has a centrally managed system funded by general taxation, known as the National Health Service (NHS). Since 2010, the UK's new Coalition* government has responded by further reforming the system of purchasing and providing NHS services - aiming to strengthen choice and competition between providers on the basis of quality and outcomes as well as price. Although the present coalition government's intention is to maintain a tax-funded system, free at the point of delivery, introducing market-style purchasing and provider-side reforms to encompass all of these bring new risks, whilst not pursuing reforms of a system in crisis is also seen to carry risks. Competition might bring efficiency, but may weaken cooperation between providers

  3. [The Italian armed forces health service during the Great War]. (United States)

    De Caro, Walter; Marucci, Anna Rita; Sansoni, Julita


    The Great War had a huge impact on Italian society. The organisation of the armed forces health service faced extreme difficulties due to the extensive loss of life of an almost exclusively terrestrial war. In this context, the role of the medical staff and nursing staff was essential, as the example of the volunteer Red Cross nurses testifies. However, this conflict revealed the need to improve the training of the nursing staff, as was the case in Anglo-Saxon countries.

  4. Management system of organizational and economic changes in health services


    Natalya Vasilyevna Krivenko


    In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizationa...

  5. Assessing human health risk in the USDA forest service

    Energy Technology Data Exchange (ETDEWEB)

    Hamel, D.R. [Department of Agriculture-Forest Service, Washington, DC (United States)


    This paper identifies the kinds of risk assessments being done by or for the US Department of Agriculture (USDA) Forest Service. Summaries of data sources currently in use and the pesticide risk assessments completed by the agency or its contractors are discussed. An overview is provided of the agency`s standard operating procedures for the conduct of toxicological, ecological, environmental fate, and human health risk assessments.

  6. Value-added service in health care institutions. (United States)

    Umiker, W


    In today's highly competitive atmosphere, the survival of health care institutions depends largely on the ability to provide value-added services (VAS) at the lowest possible cost. Managers must identify their customers and delineate the needs and expectation of those customers. A strategy for satisfying these needs and expectations is essential. While technical advances and reasonable charges are important, a successful "high-tech," "high touch" approach demands the combination of process reengineering and employee training in customer relations.

  7. Impact of immigration on health and human services: Florida's experience. (United States)

    McNeece, C Aaron; Falconer, Mary Kay; Springer, David


    Florida has been the destination for large numbers of immigrants fleeing political persecution or economic hardships. Cubans and Haitians have been two of the largest immigrant groups arriving and settling in Florida. Both have received national and local attention. This article describes the immigration experience of Haitians and Cubans in Florida. The descriptions emphasize the differences between these two groups in their adjustment to life in south Florida. The article also addresses Florida's reaction to federal policies regarding immigration and highlights Florida's struggle to meet the service needs of these immigrant populations. Fiscal impacts of immigration are quantified in several service categories, including education, social services, health care, and criminal justice. Florida's action based on the documentation of the immigration fiscal impact is explained. Finally, how the state allocated the $18 million in federal funding provided as a response to Florida's documented impact is covered.

  8. Smokes and Obscurants: A Health and Environmental Effects Data Base Assessment. A First-Order, Environmental Screening and Ranking of Army Smokes and Obscurants. Phase 1 (United States)


    Data,Models U.S. Department of the Army. 1982. "Smoke and Obscurants Program. "Keep on Smokin "." Army Research, Development, & Acquisition. 23(3):1-3...the Army. 1982. "Smoke and Obscurants Program. ’Keep on Smokin ’." Army Research, Development, & Acquisition. 23(3):1-3 (S1110). U.S. Dept of the Army

  9. Results and analysis: a pilot study on quality of life of soldiers in the first response army

    Institute of Scientific and Technical Information of China (English)

    TANG Ming-xin; GUO Qiang; YAN Xiao-yan; GUO Peng-fei


    Objective:To explore the fundamental theory, methods and data of the quality of life (QOL) of soldiers and its influence factors in the first response army. Methods :Totally 215 soldiers in the first response army of a military area in China were inquired by using self-regulating questionnaire and WHOQOL-BREF (Chinese Edition). Results:WHOQOL-BREF had good acceptability, reliability and validity in the first response army. QOL of soldiers in the first response army was middling. The influencing factors of QOL of the soldiers in first army includes self-report health, different areas where the army men come from, different arms of services, whether only child in family. And the difference was statistically significant. Conclusion:WHOQOL-BREF is fit for evaluating the quality of life of soldiers in the first response army. There are differences of the quality of life among the soldiers in the first response army. So we should take appropriate measures to improve the soldiers' quality of life.

  10. Report of the Department of the Army Officer Education and Training Review Board (United States)


    technical services, and other senior officers on high level logistical commands and staffs. The Board finds that limited instruction in this area of logistica ...George F. Jones. Comdt US Army Transportation School Col t,. William Lyon, Comdt Col Vernon K..Johnson, Asilt Coridt Walter Reed Army Institute of...Army Security Agency School. 126 DRAFT .(17) U. S. Army Signal School. (18) U. S. Army Southeastern Signal School. (19) U. S. Army Transportation

  11. Estimated expenditures for essential public health services--selected states, fiscal year 1995. (United States)


    Essential public health services are activities that public health departments and other partners undertake to protect and ensure the health of the public. To characterize expenditures for those services and to distinguish within them expenditures for personal health-care services from community-based health services directed toward populations, the Public Health Service (PHS) and the Public Health Foundation surveyed senior health officials in eight states (Arizona, Iowa, Louisiana, New York, Oregon, Rhode Island, Texas and Washington [combined 1995 population: 57.8 million]). This report summarizes the results of that survey, which indicate that spending on community-based health services is a small proportion of spending on essential services and an even smaller proportion of total health-care expenditures.

  12. Perceptions of the mental health impact of intimate partner violence and health service responses in Malawi

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    Lignet Chepuka


    Full Text Available Background and objectives: This study explores the perceptions of a wide range of stakeholders in Malawi towards the mental health impact of intimate partner violence (IPV and the capacity of health services for addressing these. Design: In-depth interviews (IDIs and focus group discussions (FGDs were conducted in three areas of Blantyre district, and in two additional districts. A total of 10 FGDs, 1 small group, and 14 IDIs with health care providers; 18 FGDs and 1 small group with male and female, urban and rural community members; 7 IDIs with female survivors; and 26 key informant interviews and 1 small group with government ministry staff, donors, gender-based violence service providers, religious institutions, and police were conducted. A thematic framework analysis method was applied to emerging themes. Results: The significant mental health impact of IPV was mentioned by all participants and formal care seeking was thought to be impeded by social pressures to resolve conflict, and fear of judgemental attitudes. Providers felt inadequately prepared to handle the psychosocial and mental health consequences of IPV; this was complicated by staff shortages, a lack of clarity on the mandate of the health sector, as well as confusion over the definition and need for ‘counselling’. Referral options to other sectors for mental health support were perceived as limited but the restructuring of the Ministry of Health to cover violence prevention, mental health, and alcohol and drug misuse under a single unit provides an opportunity. Conclusion: Despite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience.

  13. Health care in a changing society: the health services of Israel. (United States)

    Margolis, E


    In the pre-State era, Israeli society displayed an "ascetic" orientation with emphasis on austerity and egalitarianism. The medical profession was influenced by the basic philosophy of the country and coped successfully with the country's health problems, mainly by lowering morbidity and mortality rates. With the emergence of the State of Israel, mass immigration of people with different backgrounds, cultures, and values occurred, and health problems of the disability, dissatisfaction, and discomfort type arose. The existing medical organizations were unable to handle them. The story of three such organizations is detailed in brief: the first medical school in Jerusalem, the greatest supplier of curative services--the workers' sick fund (Kupa Holim), and the Ministry of Health. Their impact on the health services of the country is described. These services are splintered into numerous self-contained authorities and an understanding of the overall needs is lacking. This state of affairs reflects the antagonistic interests of the political powers behind the various health agencies. A concensus within the health field on the nature of the problems and their solution could be reached if the health organizations accepted a broader philosophy of health, comprising its somatic, mental, and social aspects, and if they commit themselves to applying this philosophy in their activities. This may lead to considerable changes in medical education, more attention being focused on the social functions of medicine than on medical technology; health care would become more comprehensive and would cover all aspects of health in its preventive, curative, and rehabilitative stages. Failure to meet the health needs of the changing society will constitute a false reading of the public pulse. Of late, the voices demanding the conquest of social diseases and the attainment of health in its broadest sense are becoming more and more audible.

  14. The health of women in the US fire service

    Directory of Open Access Journals (Sweden)

    Jahnke Sara A


    Full Text Available Abstract Background Despite statements from national fire service organizations, including the International Association of Fire Fighters (IAFF and the International Association of Fire Chiefs (IAFC, promoting a diverse work force related to gender within the fire service, rates of women firefighters remain very low. Thus, research into why this extensive gender disparity continues is a high priority. Recent years have seen a number of large scale studies on firefighter health and health risk behaviors however, none have focused on the health of women firefighters and nearly all have eliminated women from the sample due to small sample size. Data from the present report is drawn from all females in a large, randomly selected cohort of firefighters in an epidemiological study designed to assess health outcomes and health risk behaviors identified as most important to the fire service. Methods Data reported for the present study were collected as baseline data for the Firefighter Injury and Risk Evaluation (FIRE Study, a longitudinal cohort study examining risk factors for injury in both career and volunteer firefighters in the IAFC Missouri Valley Region. Of the departments assessed, only 8 career and 6 volunteer departments had any women firefighters. All the women solicited for participation chose to enroll in the study. The number of women ranged from 1 to 7 in career departments and 1 to 6 in volunteer departments. Results Where possible, comparisons are made between female firefighters and published data on male firefighters as well as comparisons between female firefighters and military members. Compared to male firefighters, females had more favorable body composition among both career and volunteer firefighters. Tobacco use rates were generally higher among females than males and rates among female firefighters were similar to the rates of female military members. While rates of alcohol use were higher than the general population, only

  15. Physical accessibility and utilization of health services in Yemen

    Directory of Open Access Journals (Sweden)

    Clark Allan


    Full Text Available Abstract Background Assessment of physical access to health services is extremely important for planning. Complex methods that incorporate data inputs from road networks and transport systems are used to assess physical access to healthcare in industrialised countries. However, such data inputs hardly exist in many developing countries. Straight-line distances between the service provider and resident population are easily obtained but their relationship with driving distance and travel time is unclear. This study aimed to investigate the relationship between different measures of physical access, including straight-line distances, road distances and travel time and the impact of these measures on the vaccination of children in Yemen. Methods Coordinates of houses and health facilities were determined by GPS machine in Urban and rural areas in Taiz province, Yemen. Road distances were measured by an odometer of a vehicle driven from participants' houses to the nearest health centre. Driving time was measured using a stop-watch. Data on children's vaccination were collected by personal interview and verified by inspecting vaccination cards. Results There was a strong correlation between straight-line distances, driving distances and driving time (straight line distances vs. driving distance r = 0.92, p Conclusion Straight-line distances, driving distances and driving time are strongly linked and associated with vaccination uptake. Straight-line distances can be used to assess physical access to health services where data inputs on road networks and transport are lacking. Impact of physical access is clear in Yemen, highlighting the need for efforts to target vaccination and other preventive healthcare measures to children who live away from health facilities.

  16. The impact of racism on the delivery of health care and mental health services. (United States)

    Hollar, M C


    This article presents research findings useful in formulating a Best Practices Model for the delivery of mental health services to underserved minority populations. Aspects of the role of racism in health care delivery and public health planning are explored. An argument is made for inclusion of the legacy of the slavery experience and the history of racism in America in understanding the current health care crisis in the African-American population. The development of an outline in APA DSM IV for the use of cultural formulations in psychiatric diagnosis is discussed.

  17. Utilisation of oral health services, oral health needs and oral health status in a peri-urban informal settlement. (United States)

    Westaway, M S; Viljoen, E; Rudolph, M J


    Interviews were conducted with 294 black residents (155 females and 138 males) of a peri-urban informal settlement in Gauteng to ascertain utilisation of oral health services, oral health needs and oral health status. Only 37 per cent of the sample had consulted a dentist or medical practitioner, usually for extractions. Teenagers and employed persons were significantly less likely to utilise dentists than the older age groups and unemployed persons. Forty per cent were currently experiencing oral health problems such as a sore mouth, tooth decay and bleeding/painful gums. Two hundred and twelve (73 per cent) interviewees wanted dental treatment or advice. Residents who rated their oral health status as fair or poor appeared to have the greatest need for oral health services. The use of interviews appears to be a cost-effective method of determining oral morbidity.

  18. Medical Tourism and the Libyan National Health Services

    Directory of Open Access Journals (Sweden)

    El Taguri A


    Full Text Available Medical tourism is a term that is used frequently by the media and travel agencies as a catchall phrase to describe a process where people travel to other countries to obtain medical, dental, and/or surgical care [1,2]. Leisure aspects of traveling are usually included on such a medical travel trip [1]. The term is also used to describe a situation where doctors travel to other places to deliver services to endogenous populations [3].Many factors have led to the recent increase in popularity of medical tourism. Among these factors are the absence of a particular service and the high cost of health care in some countries of origin on one side, and the ease and affordability of international travel, and the improvement of technology and standards of care in host countries on the other side. This phenomenon cannot be separated from globalization and tendency for a more liberal world trade. In countries that operate from a public health-care system, it can take a considerable amount of time to get needed medical care. In Britain and Canada, for example, the waiting period for a hip replacement can be a year or more, while in Bangkok or Bangalore, a patient can be in the operating room the morning after getting off a plane [2]. The post-surgery mortality rate in the 15,000 heart operations done every year in Scots Heart Institute and Research Centre in Delhi and Faridabad is only 0.8%, which is less than half of most major hospitals in the United States or Europe [2]. However, the real attraction is price [2]. The cost of surgery in India, Thailand or South Africa can be one-tenth of the price of comparable treatment in the United States or Western Europe [2]. A heart operation as an example costs €32000 in the United States, €16000 in Europe, but less than €3000 in India. A full facelift that would cost $20,000 in the U.S. runs at about $1,250 in South Africa [2]. In addition, clinics in these countries provide single-patient rooms that

  19. [Gerodontology--a challenge also for public health services]. (United States)

    Nitschke, I; Reiber, T


    The dental services of the public health service (OGD) should not confine themselves to dental screening in kindergartens and schools but also turn their attention to the advancement of oral health in the special risk groups of the senior citizens. Although government resources are limited, new capacities could be gained by restructuring. Is it really prudent, in a lifetime perspective, for the OGD to solely focus on the oral health of youths while oral neglect in long-term care carries on unabated? A stronger support by the OGD of gerodontology should be instituted on its boards, publicised in health reports, and implemented in supervisory bodies for quality management of the long-term care facilities. An endorsement of the structures of long-term care insurance and training facilities would be desirable. The OGD could assist the fitter seniors through specific education to participate in dental prevention programmes and motivate physicians to inspect the oral cavity. Furthermore, recommendations regarding the structuring of geriatric dental care by the OGD would be helpful. The OGD is a vital partner to gerodontology. Therefore, further projects should be conducted in cooperation with dental organisations.

  20. [Management committees in health services: an empirical study]. (United States)

    Cecilio, Luiz Carlos de Oliveira


    The aim of the article, based on field data collected from a continuing education program for primary health clinic administrators, was to analyze the functioning of a health service management strategy called "management committees". Different meanings and operational modalities emerged in the committees. Various antimonies appeared in the way the committees operate (autonomy versus heteronomy, reproduction of "instituted" versus "instituting" processes, and communicative versus instrumental reasoning), thus reflecting the level of complexity in this management mechanism. Healthcare provision per se by the clinics only appeared occasionally on the committees' agenda, which mainly focused on administrative issues. The article suggests that further research is needed on the coordinator's involvement in the field of forces constituting the management committee, besides developing pedagogical strategies to support the clinic coordinators and health teams in building the committees. The primary data were submitted to an epistemological discussion anchored in the idea of double hermeneutics, multiple validation of research results, and the relationship between theory and practice.

  1. The contribution of organization theory to nursing health services research. (United States)

    Mick, Stephen S; Mark, Barbara A


    We review nursing and health services research on health care organizations over the period 1950 through 2004 to reveal the contribution of nursing to this field. Notwithstanding this rich tradition and the unique perspective of nursing researchers grounded in patient care production processes, the following gaps in nursing research remain: (1) the lack of theoretical frameworks about organizational factors relating to internal work processes; (2) the need for sophisticated methodologies to guide empirical investigations; (3) the difficulty in understanding how organizations adapt models for patient care delivery in response to market forces; (4) the paucity of attention to the impact of new technologies on the organization of patient care work processes. Given nurses' deep understanding of the inner workings of health care facilities, we hope to see an increasing number of research programs that tackle these deficiencies.

  2. A political history of the Indian Health Service. (United States)

    Bergman, A B; Grossman, D C; Erdrich, A M; Todd, J G; Forquera, R


    One of the few bright spots to emerge from the history of relations between American Indians and the federal government is the remarkable record of the Indian Health Service (IHS). The IHS has raised the health status of Indians to approximate that of most other Americans, a striking achievement in the light of the poverty and stark living conditions experienced by this population. The gains occurred in spite of chronically low funding and can be attributed to the combination of vision, stubbornness, and political savvy of the agency's physician directors and the support of a handful of tribal leaders and powerful allies in the Congress and the White House. Despite the agency's imperfections and the sizeable health problems that still exist among American Indians and Alaskan Natives, the IHS is an example of one federal program that has worked.

  3. Scientific works of research workers of the army health service; Travaux scientifiques des chercheurs du service de sante des armees

    Energy Technology Data Exchange (ETDEWEB)



    Ten articles about the effects of gamma radiation on human or animal cells are studied here. Regulation of cytokines, effect of interleukin 6, expression of the C-fos protein, interest of the study of a biological check up after an accidental irradiation, interaction and transport of cysteamine( radioprotector), approach of a treatment of radioinduced medullary aplasia, expression of TNF alpha and gelatinase B, are the subjects related here. (N.C.).

  4. Scientific works of research workers of the army health service; Travaux scientifiques des chercheurs du service de sante des armees

    Energy Technology Data Exchange (ETDEWEB)



    Ten articles about the effects of gamma radiation or neutron radiation on human or animal cells are studied here. Effects of radiation, recoveries, research on radioprotective substances are examined in these articles. (N.C.).


    Directory of Open Access Journals (Sweden)

    Elka Atanasova


    Full Text Available Background: In all European countries, an important policy objective is the equity of access to health care. The factors that affect access to health care can differ as the demand- and supply-side factors. Moreover, there are many tools to assess the extent of inequity in access to services. One simple tool is the assessing reports of unmet needs for health care. Purpose: The study has two objectives: to examine the evidence of self-reported unmet needs and to analyze the relationship between foregone medical care and both type of residence and socioeconomic status. Materials and Methods: We use data from the European Union Statistics on Income and Living Conditions. The access to health care is measured using the concept of unmet need for medical examination or treatment during the last 12 months. The relationship between foregone medical care and both type of residence and socioeconomic status is examined through the representative survey conducted in 2014. Results: The Eurostat results show that treatment costs are the most common reason for foregone medical care in Bulgaria. We observe a gradual decrease in the share of people who reported having unmet needs due to being too expensive. According to the 2014 survey, significant differences between urban and rural areas as well as among the income groups are identified. The results show the problems in access to health care services mainly in small towns and villages. Conclusion: Although major essential changes were made in the Bulgarian health care system, the equity problems remain an important challenge to policy-makers.

  6. Defense Health Care: Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals (United States)


    identify a military treatment facility and if one is not available then they refer to a facility contracted with the MHS network . 22Military service ...DEFENSE HEALTH CARE Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals...committees June 2016 DEFENSE HEALTH CARE Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals What GAO Found

  7. Exploring the dimensions of access to health services: implications for nursing research and practice. (United States)

    Racher, Frances E; Vollman, Ardene Robinson


    Access to health services is a major concern across North America and abroad, with particular salience for the residents of rural and remote areas and the health professionals committed to providing services to them. Intrinsic to this discussion is clarification of the phenomenon of access to health services, a concept that remains nebulous and obscure to consumers, health care providers, and policymakers alike. Multiple understandings of access to health services impedes progress in the development of policy, the creation of programs, and the transformation of health services. Considerable discussion of theory concerning access to health services is articulated in public or community health literature and that of other disciplines; however, limited attention to this topic is apparent in nursing literature. This report articulates definitions, dimensions, and frameworks of access to health services from available literature and existing theory. Further, key points are identified and discussed for consideration in nursing research on the term access and implications for practice.


    Directory of Open Access Journals (Sweden)

    Budi Hidayat


    Full Text Available Background: Indonesian's health care system is characterized by underutilized of the health-care infrastructure. One of the ways to improve the demand for formal health care is through health insurance. Responding to this potentially effective policy leads the Government of Indonesia to expand health insurance coverage by enacting the National Social Security Act in 2004. In this particular issue, understanding provider choice is therefore a key to address the broader policy question as to how the current low uptake of health care services could be turned in to an optimal utilization. Objective:To estimate a model of provider choice for outpatient care in Indonesia with specific attention being paid to the role of health insurance. Methods: A total of 16485 individuals were obtained from the second wave of the Indonesian Family Life survey. A multinomial logit regression model was applied to a estimate provider choice for outpatient care in three provider alternative (public, private and self-treatment. A policy simulation is reported as to how expanding insurance benefits could change the patterns of provider choice for outpatient health care services. Results: Individuals who are covered by civil servant insurance (Askes are more likely to use public providers, while the beneficiaries of private employees insurance (Jamsostek are more likely to use private ones compared with the uninsured population. The results also reveal that less healthy, unmarried, wealthier and better educated individuals are more likely to choose private providers than public providers. Conclusions: Any efforts to improve access to health care through health insurance will fail if policy-makers do not accommodate peoples' preferences for choosing health care providers. The likely changes in demand from public providers to private ones need to be considered in the current social health insurance reform process, especially in devising premium policies and benefit packages

  9. Demand for and Accessibility to Reproductive Health Service of Urban Floating Population

    Institute of Scientific and Technical Information of China (English)


    The demand for knowledge of productive health and the current status of productive health services provided by relevant governmental institutions were qualitatively and quantitatively studied. The study identified the key factors that influenced the demand for the productive health services and results of the services. It also discussed the effective approaches to control, planning and sustainable development of the reproductive health services for the floating populations.

  10. Developing and Implementing Health and Sustainability Guidelines for Institutional Food Service123


    Kimmons, Joel; Jones, Sonya; McPeak, Holly H.; Bowden, Brian


    Health and sustainability guidelines for institutional food service are directed at improving dietary intake and increasing the ecological benefits of the food system. The development and implementation of institutional food service guidelines, such as the Health and Human Services (HHS) and General Services Administration (GSA) Health and Sustainability Guidelines for Federal Concessions and Vending Operations (HHS/GSA Guidelines), have the potential to improve the health and sustainability ...

  11. Expectations of Health Care Professionals Regarding the Services

    Directory of Open Access Journals (Sweden)

    Somayeh Hanafi


    Full Text Available Background: The provision of accurate and timely drug information to health care professionals is an important mechanism to promote safe and effective drug therapy for patients. World’s Drug and Poison Information Centers (DPICs are mainly affiliated to hospitals, rather rarely with faculties of pharmacy or with faculties of medicine and other related organizations.Methods: Data was collected from a questionnaire which was distributed among 400 health care providers in April 2009. Data were analyzed using SPSS software (version 17.Results: Medical reference books and drug information textbooks (36.7% and expert colleagues (29.7% were the “most commonly” used drug information resources. In addition, 77.8% of respondents “almost never” use DPICs. About 77% of respondents were non- acquainted with these centers’ activities. Five expectations were considered ‘very important’ by respondents: Provide information on IV drugs incompatibilities (74%, Provide drug interaction information (70.1%, Provide new drugs information (56.5%, Education/training of health care professionals regarding rational drug therapy and prevention of medication errors (54.9%, Providing information on dosage forms of drugs available in Iran (53.5%.Conclusion: Being non acquaintance with services of DPIC centers can be considered as the most important reason of not using them. Considering “announcement of availability of drugs in pharmacy” as one of the activities of DPICs, shows that the health care professionals are not acquainted with real services of these centers. It shows an urgent need for culture building activities to introduce them to these centers services.

  12. Medical sociology and health services research: past accomplishments and future policy challenges. (United States)

    Wright, Eric R; Perry, Brea L


    The rising costs and inconsistent quality of health care in the United States have raised significant questions among professionals, policy makers, and the public about the way health services are being delivered. For the past 50 years, medical sociologists have made significant contributions in improving our understanding of the nature and impact of the organizations that constitute our health care system. In this article, we discuss three central findings in the sociology of health services: (1) health services in the U.S. are unequally distributed, contributing to health inequalities across status groups; (2) social institutions reproduce health care inequalities by constraining and enabling the actions of health service organizations, health care providers, and consumers; and (3) the structure and dynamics of health care organizations shape the quality, effectiveness, and outcomes of health services for different groups and communities. We conclude with a discussion of the policy implications of these findings for future health care reform efforts.

  13. [International trade in health services and the medical industrial complex: implications for national health systems]. (United States)

    Santos, Maria Angelica Borges dos; Passos, Sonia Regina Lambert


    Health services have increasingly proven to be an innovative sector, gaining prominence in the medical industrial complex through expansion to public and international markets. International trade can foster economic development and redirect the resources and infrastructure available for healthcare in different countries in favorable or unfavorable directions. Wherever private providers play a significant role in government-funded healthcare, GATS commitments may restrict health policy options in subscribing countries. Systematic information on the impacts of electronic health services, medical tourism, health workers' migration, and foreign direct investment is needed on a case-by-case basis to build evidence for informed decision-making, so as to maximize opportunities and minimize risks of GATS commitments.

  14. Delivering health information services and technologies to urban community health centers: the Chicago AIDS Outreach Project. (United States)

    Martin, E R; McDaniels, C; Crespo, J; Lanier, D


    Health professionals cannot address public health issues effectively unless they have immediate access to current biomedical information. This paper reports on one mode of access, the Chicago AIDS Outreach Project, which was supported by the National Library of Medicine through outreach awards in 1995 and 1996. The three-year project is an effort to link the programs and services of the University of Illinois at Chicago Library of the Health Sciences and the Midwest AIDS Training and Education Center with the clinic services of community-based organizations in Chicago. The project was designed to provide electronic access to AIDS-related information for AIDS patients, the affected community, and their care givers. The project also provided Internet access and training and continued access to library resources. The successful initiative suggests a working model for outreach to health professionals in an urban setting.

  15. 78 FR 1825 - Notice of Establishment of an Animal and Plant Health Inspection Service Stakeholder Registry (United States)


    ... Inspection Service Stakeholder Registry AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... Service stakeholder registry. FOR FURTHER INFORMATION CONTACT: Ms. Hallie Zimmers, Advisor for State and Stakeholder Relations, Legislative and Public Affairs, APHIS, room 1147, 1400 Independence Avenue...

  16. Community control of health services. Dr. Martin Luther King, Jr. Health Center's community management system. (United States)

    Tichy, N M; Taylor, J I


    This article presents the case of Dr. Martin Luther King Jr. Health Center's unique community management system in which neighborhood workers have been developed to assume managerial responsibilities and are directing the Center. The Martin Luther King Center experience is instructive because the Center was able to achieve significant community control by focusing primarily on the internal dimension of control, namely, management, without experiencing destructive conflicts and the deterioration of health services.

  17. [Use of maternal health services in rural Mexico]. (United States)

    Potter, J E


    Because of the spread of western health care into rural Mexican communities through primary health care programs and medical school graduates performing their year of community service, the proportion of rural Mexican women whose deliveries were attended by physicians increased from 17.7% in 1969 to 45.8% in 1981. The primary objective of this work is to identify factors involved in the utilization of the modern medical system for prenatal care and of hospital delivery in transitional rural areas. A secondary objective is to evaluate the impact of modern prenatal care and hospital delivery on perinatal and neonatal mortality. The data came from a 1981 survey by the Mexican Institute of Social Security of a nationally representative sample of 7953 fertile-aged women in 410 communities with fewer than 2500 inhabitants. The survey provided information on both utilization of health services and on medical and biological conditions that might have prompted women to seek modern medical care. This study was limited to 1579 pregnancies which arrived at term in the 13 months preceding the survey. Among dependent variables, the variable for prenatal care was a 1st prenatal visit in the 1st 5 months of pregnancy. 486 women, about 31% of the sample, had such a visit. 69% of the subsample of 1579 women had had some form of prenatal care, of whom 63% had their 1st consultation in the 1st 5 months. 36% of deliveries occurred in hospitals. There were 64 prenatal or neonatal deaths in the 1579 pregnancies, including 38 deaths in the 1st month and 26 stillbirths. The independent variables included 5 factors measuring health facilities available in the community, 3 assessing the commercial center used by the community, and 2 assessing the respondent's housing. The 2 individual factors were birth order and education. 7 factors concerned symptoms of pregnancy and 4 complications during delivery. The multivariate analysis of these factors was carried out by logistic regression. The

  18. TRICARE: the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); specialized treatment services (STS) program--DoD. Notice. (United States)


    This notice is to advise interested parties that Brooke Army Medical Center (BAMC) and Wilford Hall Medical Center (WHMC), hereinafter referred to as Destination San Antonio, have been designated the Regional Specialized Treatment Service facilities (STSFs) for DRGs 1, 3, 4, 49, 104-107, 110-111, 191, 209, 491, 286, and 357. The application for the STSF designation was submitted by the Lead Agency for TRICARE Region 6 and approved by the Assistant Secretary of Defense (Health Affairs). The Lead Agent will oversee that the STSFs maintain the quality and standards required for specialized treatment services. DoD beneficiaries residing within a 200-mile radius of Destination San Antonio facilities falling into the above patient category must be evaluated by Destination San Antonio staff before receiving care for these DRGs under direct military care or TRICARE/CHAMPUS cost sharing. Travel and lodging for the patient and, if stated to be medically necessary by a referring physician, for a nonmedical attendant, will be reimbursed by Destination San Antonio facility in accordance with the provisions of the Joint Federal Travel Regulation. Although evaluation in person is preferred, it is possible to conduct the evaluation telephonically if the patient is unable to travel to a Destination San Antonio facility. If the care for these DRGs cannot be performed at the Destination San Antonio facilities, the TRICARE Managed Care Support Contractor for Region 6 will provide a medical necessity review prior to issuance of an Inpatient Care Authorization or Non-availability Statement.

  19. Investigating the affordability of key health services in South Africa. (United States)

    Cleary, Susan; Birch, Steve; Chimbindi, Natsayi; Silal, Sheetal; McIntyre, Di


    This paper considers the affordability of using public sector health services for three tracer conditions (obstetric care, tuberculosis treatment and antiretroviral treatment for HIV-positive people), based on research undertaken in two urban and two rural sites in South Africa. We understand affordability as the 'degree of fit' between the costs of seeking health care and a household's ability-to-pay. Exit interviews were conducted with over 300 patients for each of the three tracer conditions in each of the four sites (i.e. a total sample of over 3600). Total direct costs for the service used at the time of the interview, as well as other health related costs incurred during the preceding month either for self-care or the use of plural providers were assessed, as were a range of indicators of ability-to-pay. The percentage of households incurring direct costs exceeding 10% of household consumption expenditure and those borrowing money or selling assets as a mechanism for coping with the burden of direct costs were calculated. Logistic regressions were also conducted to identify factors that were significantly associated with these indicators of affordability. There were significant differences in affordability between rural and urban sites; costs were higher, ability-to-pay was lower and there was a greater proportion of households selling assets or borrowing money in rural areas. There were also significant differences across tracers, with a higher percentage of households receiving tuberculosis and antiretroviral treatment borrowing money or selling assets than those using obstetric services. As these conditions require expenses to be incurred on an ongoing basis, the sustainability of such coping strategies is questionable. Policy makers need to explore how to reduce direct costs for users of these key health services in the context of the particular characteristics of different treatment types. Affordability needs to be considered in relation to the dynamic

  20. Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar (United States)

    Low, Sharon; Tun, Kyaw Thura; Mhote, Naw Pue Pue; Htoo, Saw Nay; Maung, Cynthia; Kyaw, Saw Win; Shwe Oo, Saw Eh Kalu; Pocock, Nicola Suyin


    Background Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods A case study method was used to document how existing human resources for health (HRH) reach the vulnerable population in the ethnic health organizations’ (EHOs) and community-based organizations’ (CBHOs) service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion Despite the chronic conflict in Burma/Myanmar, this

  1. Human resources for health: task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar

    Directory of Open Access Journals (Sweden)

    Sharon Low


    Full Text Available Background: Burma/Myanmar was controlled by a military regime for over 50 years. Many basic social and protection services have been neglected, specifically in the ethnic areas. Development in these areas was led by the ethnic non-state actors to ensure care and the availability of health services for the communities living in the border ethnic-controlled areas. Political changes in Burma/Myanmar have been ongoing since the end of 2010. Given the ethnic diversity of Burma/Myanmar, many challenges in ensuring health service coverage among all ethnic groups lie ahead. Methods: A case study method was used to document how existing human resources for health (HRH reach the vulnerable population in the ethnic health organizations’ (EHOs and community-based organizations’ (CBHOs service areas, and their related information on training and services delivered. Mixed methods were used. Survey data on HRH, service provision, and training were collected from clinic-in-charges in 110 clinics in 14 Karen/Kayin townships through a rapid-mapping exercise. We also reviewed 7 organizational and policy documents and conducted 10 interviews and discussions with clinic-in-charges. Findings: Despite the lack of skilled medical professionals, the EHOs and CBHOs have been serving the population along the border through task shifting to less specialized health workers. Clinics and mobile teams work in partnership, focusing on primary care with some aspects of secondary care. The rapid-mapping exercise showed that the aggregate HRH density in Karen/Kayin state is 2.8 per 1,000 population. Every mobile team has 1.8 health workers per 1,000 population, whereas each clinic has between 2.5 and 3.9 health workers per 1,000 population. By reorganizing and training the workforce with a rigorous and up-to-date curriculum, EHOs and CBHOs present a viable solution for improving health service coverage to the underserved population. Conclusion: Despite the chronic conflict in

  2. 77 FR 51543 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting (United States)


    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-second meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times...:15 a.m. Place: Radisson Hotel & Suites Austin Downtown, 111 East Cesar Chavez Street, Austin,...

  3. 76 FR 25696 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting (United States)


    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-seventh meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times.... Place: Park Place Hotel, 300 East State Street, Traverse City, MI 49684. (231) 946-5000. Status:...

  4. 45 CFR 50.5 - Waivers for the delivery of health care service. (United States)


    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Waivers for the delivery of health care service... for the delivery of health care service. In determining whether to request a waiver for an Exchange... the delivery of health care service: (a) The Exchange Visitor must submit a statement that he or...

  5. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers (United States)


    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care by Non-VA Providers... methodology for non-VA providers of home health services and hospice care. The proposed rulemaking would include home health services and hospice care under the VA regulation governing payment for other...

  6. 76 FR 31337 - Public Health Service Act (PHS); Delegation of Authority (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Service Act (PHS); Delegation of Authority Notice is hereby given that pursuant to Section 3306(14) of the Public Health Service Act (PHS),...

  7. Caregiver perceptions about mental health services after child sexual abuse. (United States)

    Fong, Hiu-fai; Bennett, Colleen E; Mondestin, Valerie; Scribano, Philip V; Mollen, Cynthia; Wood, Joanne N


    The objective of this study was to describe caregiver perceptions about mental health services (MHS) after child sexual abuse (CSA) and to explore factors that affected whether their children linked to services. We conducted semi-structured, in-person interviews with 22 non-offending caregivers of suspected CSA victimschild advocacy center in Philadelphia. Purposive sampling was used to recruit caregivers who had (n=12) and had not (n=10) linked their children to MHS. Guided by the Health Belief Model framework, interviews assessed perceptions about: CSA severity, the child's susceptibility for adverse outcomes, the benefits of MHS, and the facilitators and barriers to MHS. Interviews were audio-recorded, transcribed, coded, and analyzed using modified grounded theory. Recruitment ended when thematic saturation was reached. Caregivers expressed strong reactions to CSA and multiple concerns about adverse child outcomes. Most caregivers reported that MHS were generally necessary for children after CSA. Caregivers who had not linked to MHS, however, believed MHS were not necessary for their children, most commonly because they were not exhibiting behavioral symptoms. Caregivers described multiple access barriers to MHS, but caregivers who had not linked reported that they could have overcome these barriers if they believed MHS were necessary for their children. Caregivers who had not linked to services also expressed concerns about MHS being re-traumatizing and stigmatizing. Interventions to increase MHS linkage should focus on improving communication with caregivers about the specific benefits of MHS for their children and proactively addressing caregiver concerns about MHS.

  8. Perceived Relationships among Components of Insurance Service for Users of Complementary Health Insurance Service

    Directory of Open Access Journals (Sweden)

    Urban Sebjan


    Full Text Available This article explores the relationship between the components of the services provided by complementary voluntary health insurance (CVHI, to which users ascribe different levels of importance. Research model that consists of four constructs (importance of quality service, additional coverage, price discounts of CVHI and insurance company reputation and an indicator of the importance of insurance premium of CVHI was tested with structural equation modelling (SEM on the sample of 300 Slovenian users of CVHI. Our findings show that - according to the users - the importance of the component of CVHI service (insurance premium is reflected in the perceived importance of other components of CVHI (additional coverage, quality, price discounts and insurance company reputation.

  9. Meeting the Oral Health Needs of Immigrants: National Public Health Services Vs. Charitable Volunteer Services In Rome, Italy

    Directory of Open Access Journals (Sweden)

    Denise Corridore


    Full Text Available

    Background: oral health is an important aspect of well-being. In Italy immigrants can have different access to health care services, and can opt for the national Health Service (nHS and/ or private non- profit health care organizations. The purpose of this study was to develop an instrument to evaluate oral health in the immigrant population of rome and to investigate the differences between two different types of ser- vices: the First observation unit at the department of oral and Maxillo Facial Sciences, at the "Sapienza" university of rome (a nHS affiliate, and a charitable organization, the caritas dental center (cdc.
    Methods: a multiple-choice questionnaire was administered between the last trimester of 2006 and the first trimester of 2007. a chi square analysis was performed and the level of significance was set at p<0.05. reSulTS: The sample was composed of 250 people, of which 100 were patients of the cdc and 150 were patients of the nHS. The percentage of non-Italians was 80% (n=80 in the cdc sample, and only 16% (n=25 in the nHS sample. In the cdc, definitive resolving therapies, such as tooth extractions, prevailed (60% v’s 47% nHS; p=0.033. In addition, the frequency of consumption of sugary foods and drinks was significantly higher among cdc patients (31% reported to consume these over 9 times a day compared to nHS patients (11% reporting this consumption.
    Discussion: the study shows a substantial under using of the national Health Service for oral health care needs by the immigrant population. The particular composition of the sample, with a high prevalence being of romanian nationality, might reflect specific conditions of this nationality. The results showed that immigrants were satisfied with the health care even though they encountered difficulties in terms of level of communication.

  10. The ethics of health service delivery: a challenge to public health leadership. (United States)

    DeLuca, D M


    The ethical distribution of health care is a central issue now that AIDS has started to be a drain on health care resources. If the worst predictions are true, the next half century will be capitalized by a great stress of the health care delivery system in the Pacific. The critical challenges that face the current leadership are: sustaining commitment to all levels of administration to reduce social and health inequities; making sound decisions on policies, priorities and goals that are based on valid information; strengthen health infrastructure, based on the principle of primary health care, including appropriate distribution of staffing, skills, technology and resources. The goals of the Pacific Health Promotion and Development center must not focus exclusively on AIDs. Hepatitis B control measures, hypertension and diabetes, primary care in remote areas, and rehabilitation initiatives must be kept in place. Humanitarian interests for AIDs patients must be balanced with the pragmatic reality of saving children's hearing, or extending useful lives. The attributes of respect, accountability, leadership, judgement, fairness, integrity and honesty controlled by principles of social justice must be part of the administrative decision making process. The 2 major issues facing public health professional are: (1) the financial considerations involved with increasingly expensive technology, services and research, contrasted against the need to prioritize their use and development; (2) pragmatic and ideological needs must be balanced to maximize preventative and curative services and make them available to those who can benefit from them.

  11. The effectiveness of M-health technologies for improving health and health services: a systematic review protocol

    Directory of Open Access Journals (Sweden)

    Patel Vikram


    Full Text Available Abstract Background The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health around the world. Findings To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1 interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2 interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3 interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders. A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms for the following mobile electronic devices (MEDs and a range of compatible media: mobile phone; personal digital assistant (PDA; handheld computer (e.g. tablet PC; PDA phone (e.g. BlackBerry, Palm Pilot; Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player; handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will

  12. The impact of health system governance and policy processes on health services in Iraqi Kurdistan

    Directory of Open Access Journals (Sweden)

    Khoshnaw Hiro


    Full Text Available Abstract Background Relative to the amount of global attention and media coverage since the first and second Gulf Wars, very little has been published in the health services research literature regarding the state of health services in Iraq, and particularly on the semi-autonomous region of Kurdistan. Building on findings from a field visit, this paper describes the state of health services in Kurdistan, analyzes their underlying governance structures and policy processes, and their overall impact on the quality, accessibility and cost of the health system, while stressing the importance of reinvesting in public health and community-based primary care. Discussion Very little validated, research-based data exists relating to the state of population health and health services in Kurdistan. What little evidence exists, points to a region experiencing an epidemiological polarization, with different segments of the population experiencing rapidly-diverging rates of morbidity and mortality related to different etiological patterns of communicable, non-communicable, acute and chronic illness and disease. Simply put, the rural poor suffer from malnutrition and cholera, while the urban middle and upper classes deal with issues of obesity and Type 2 diabetes. The inequity is exacerbated by a poorly governed, fragmented, unregulated, specialized and heavily privatized system, that not only leads to poor quality of care and catastrophic health expenditures, but also threatens the economic and political stability of the region. There is an urgent need to revisit and clearly define the core values and goals of a future health system, and to develop an inclusive governance and policy framework for change, towards a more equitable and effective primary care-based health system, with attention to broader social determinants of health and salutogenesis. Summary This paper not only frames the situation in Kurdistan in terms of a human rights or special political

  13. Army Contracting: Training and Guidance Needed to Ensure Appropriate Use of the Option to Extend Services Clause (United States)


    value reported in FPDS-NG Computer support Services 12 months 12 months --First extension: 6 months --Second extension: 6 months $14.5 million...extensions are included below: • A sole-source bridge contract to provide computer support services such as hosting, computer operations, application...order. Call for additional information. Connect with GAO on Facebook , Flickr, Twitter, and YouTube. Subscribe to our RSS Feeds or E-mail Updates

  14. School Mental Health Services for the 21st Century: Lessons from the District of Columbia School Mental Health Program (United States)

    Price, Olga Acosta; Lear, Julia Graham


    In January 2007, The Center for Health and Health Care in Schools at the George Washington University School of Public Health and Health Services was commissioned to assess operations of school mental health programs in Washington, D.C. and recommend future directions in practices, policies and systems development. While this guidance is directed…

  15. Are Posttraumatic Stress Symptoms Related to Mental Health Service Use?

    DEFF Research Database (Denmark)

    Madsen, Trine; Andersen, Søren Bo; Karstoft, Karen-Inge


    the Danish registers. RESULTS: The prevalence of PTSD symptoms increased over time, and almost 10% of the sample reported high levels of PTSD symptoms 2.5 years postdeployment. Overall, 37% of the soldiers utilized mental health services; 6% utilized psychiatric services, and 12.4% redeemed a prescription...... of posttraumatic stress disorder (PTSD) in soldiers before and after deployment to Afghanistan. METHODS: Prospectively, 703 Danish soldiers who deployed from January 2009 to August 2009 were followed up with 6 assessments from predeployment to 2.5 years postdeployment in 2012. At assessments, the soldiers...... responded to a comprehensive questionnaire including a measure of PTSD symptoms (the PTSD Checklist-Civilian version). These self-reported data were combined with individual-level records of receiving psychotherapy from the Military Psychological Division at the Danish Defense and psychiatric treatment from...

  16. Planning the Marketing Activity in the Health Care Services

    Directory of Open Access Journals (Sweden)

    Violeta Radulescu


    Full Text Available The integration of marketing in the field of health care, starting with the 50’s, was accompanied by a series of controversies generated by the ethical and moral aspects that this type of services imply, as well as by the difficulty in determining exactly the demand, the unequal access to information of participants, the regulated mechanism for the establishment of prices and of rates and the intervention of the third party payer, the significant role of the state in ensuring the fair access of population to basic services, etc.The formulation of the marketing strategies, in the marketing planning process, starts from the generic strategy chosen by the organization according to its mission and objectives. As it has to adapt to the environment where it acts, to cope with the changes that appear, the organization must benefit from a perspective vision, all its actions must be subordinated to this vision in a whole marketing policy.

  17. Implementation research on community health workers’ provision of maternal and child health services in rural Liberia (United States)

    Luckow, Peter W; Kenny, Avi; White, Emily; Ballard, Madeleine; Dorr, Lorenzo; Erlandson, Kirby; Grant, Benjamin; Johnson, Alice; Lorenzen, Breanna; Mukherjee, Subarna; Ly, E John; McDaniel, Abigail; Nowine, Netus; Sathananthan, Vidiya; Sechler, Gerald A; Kraemer, John D; Siedner, Mark J


    Abstract Objective To assess changes in the use of essential maternal and child health services in Konobo, Liberia, after implementation of an enhanced community health worker (CHW) programme. Methods The Liberian Ministry of Health partnered with Last Mile Health, a nongovernmental organization, to implement a pilot CHW programme with enhanced recruitment, training, supervision and compensation. To assess changes in maternal and child health-care use, we conducted repeated cross-sectional cluster surveys before (2012) and after (2015) programme implementation. Findings Between 2012 and 2015, 54 CHWs, seven peer supervisors and three clinical supervisors were trained to serve a population of 12 127 people in 44 communities. The regression-adjusted percentage of children receiving care from formal care providers increased by 60.1 (95% confidence interval, CI: 51.6 to 68.7) percentage points for diarrhoea, by 30.6 (95% CI: 20.5 to 40.7) for fever and by 51.2 (95% CI: 37.9 to 64.5) for acute respiratory infection. Facility-based delivery increased by 28.2 points (95% CI: 20.3 to 36.1). Facility-based delivery and formal sector care for acute respiratory infection and diarrhoea increased more in agricultural than gold-mining communities. Receipt of one-or-more antenatal care sessions at a health facility and postnatal care within 24 hours of delivery did not change significantly. Conclusion We identified significant increases in uptake of child and maternal health-care services from formal providers during the pilot CHW programme in remote rural Liberia. Clinic-based services, such as postnatal care, and services in specific settings, such as mining areas, require additional interventions to achieve optimal outcomes. PMID:28250511


    Directory of Open Access Journals (Sweden)

    Miglė Eleonora Černikovaitė


    Full Text Available Purpose – Identify medical expectations of tourists choosing Lithuania as medical tourism country and to make comparative analysis with situation in Thailand. Medical tourism is one of the most promising fields of business in the world. International trade in medical services also has huge economic potential and gradually increasing outcome for the global economy (Bookman & Bookman, 2007. Major medical tourism destinations: Thailand, India, Singapore and Malaysia attracted more than 2.5 million medical travellers (United Nations Economic and Social Commission for Asia and the Pacific, 2008. Lithuania is among the major emerging markets in medical tourism that is increasing every year. This study showed that main factors of attracting tourist to Lithuania: fast service and exceptional patient care, the high-tech medical equipment, good prices both for medical and travel services. Comparing to Thailand situation, Lithuania is attractive to the most medical tourist, because of the good quality services with affordable prices and location, while people choosing Thailand – mainly is affected by advertising. The main recommendation for attracting medical tourists to Lithuania is to initiate the advertising campaign to the targeted audiences. Design/methodology/approach – The comparative analysis of scientific literature and empirical comparative quantitative research was executed for acquiring the expectations for medical tourists in Lithuania. Findings – Overview of health and medical tourism situation in Lithuania and other emerging markets. This study showed that main factors of attracting tourist to Lithuania: fast service and exceptional patient care, the high-tech medical equipment, good prices both for medical and travel services and other. Comparative empirical analysis of medical tourist expectations in Lithuania and Thailand. Comparing to Thailand situation, Lithuania is attractive to the most medical tourist, because of the good

  19. Interoperable eHealth Platform for Personalized Smart Services

    DEFF Research Database (Denmark)

    Mihaylov, Mihail Rumenov; Mihovska, Albena Dimitrova; Kyriazakos, Sofoklis


    Independent living is one of the main challenges linked to an increasing ageing population and concerns both patients and healthy elderlies. A lot of research has focused on the area of ambient-assisted living (AAL) technologies towards an intelligent caring home environment able to offer...... personalized context-aware applications to serve the user's needs. This paper proposes the use of advised sensing, context-aware and cloud-based lifestyle reasoning to design an innovative eHealth platform that supports highly personalized smart services to primary users. The architecture of the platform has...

  20. [Disinfectants in health service institutions and frequency of their use]. (United States)

    Kieć-Swierczyńska, M


    On the basis of information obtained from sanitary and epidemiological stations places all over the country and from hospitals of the Lodz region it was found that about 60 types of disinfectants are now under use in Poland. The most frequent ones are: lysoformine, chloramine, aldesan, virkon, hypochloride, septil R, cidex, lysol, denatured alcohol, secuspet, aerodesine 2000, desoform, iodoseptane. Some of them contain well known allergenic factors (glutaraldehyde, benzalkonium, hydroquinone, phenol). Bearing in mind an increasing incidence of occupational skin diseases among health service workers it is postulated to continue studies of allergenic properties of disinfectants.

  1. Conceptualising spirituality for medical research and health service provision

    Directory of Open Access Journals (Sweden)

    Koenig Harold G


    Full Text Available Abstract The need to take account of spirituality in research and health services provision is assuming ever greater importance. However the field has long been hampered by a lack of conceptual clarity about the nature of spirituality itself. We do not agree with the sceptical claim that it is impossible to conceptualise spirituality within a scientific paradigm. Our aims are to 1 provide a brief over-view of critical thinking that might form the basis for a useful definition of spirituality for research and clinical work and 2 demystify the language of spirituality for clinical practice and research.

  2. Non-Psychiatric Services Provided in a Mental Health Unit in a County Jail. (United States)

    Young, Diane S.


    Examines mental health service provision by social workers in a county jail through a retrospective review of 359 mentally ill jail inmates' health and mental health records. Of the non-psychiatric, mental health services provided beyond initial assessment, housing placement evaluations and follow-up sessions were the most frequent. Suggestions…

  3. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access (United States)

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.


    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…


    Spector-Bagdady, Kayte


    The market for direct-to-consumer (DTC) health services continues to grow rapidly with former patients converting to customers for the opportunity to purchase varied diagnostic tests without the involvement of their clinician. For the first time a DTC genetic testing company is advertising health-related reports "that meet [Food and Drug Administration] standards for being clinically and scientifically valid." Ethicists and regulatory agencies alike have recognized the need for a more informed transaction in the DTC context, but how should we classify a commercial transaction for something normally protected by a duty of care? How can we assure informed agreements in an industry with terms and conditions as varied as the services performed? The doctrine of "informed consent" began as an ethical construct building on the promise of beneficence in the clinical relationship and elevating the principle of autonomy--but in the DTC context should we hold providers to legal standards of informed consent and associated medical malpractice liability, or contractual obligations where consumers would seek remedy for breach? This Article analyzes the fine balance that must be struck in an industry where companies are selling services for entertainment or non-medical purposes that possess the capacity to produce serious and disquieting medical information. It begins by reviewing current standards of consent in the clinical setting from both a legal and ethical perspective and then lays forth current standards for DTC consent using two currently controversial case studies: that of keepsake fetal ultrasound and genetic testing. DTC keepsake ultrasound and genetic testing providers attempt to de-medicalize the devices used for these procedures from their intended medical uses to non-medical uses. But while keepsake ultrasound is marketed as "intended for entertainment purposes only," it can provide medical information as an incidental finding. 23andMe currently purports to be the

  5. Evidence-Based Services in a Statewide Public Mental Health System: Do the Services Fit the Problems? (United States)

    Schiffman, Jason; Becker, Kimberly D.; Daleiden, Eric L.


    This study examined the degree to which a literature review of evidence-based services identified services appropriate for the actual problems of youth involved in intensive public mental health services. The diagnostic profiles and specific intervention targets reported by treatment providers were coded to determine whether a relevant empirically…

  6. The Global Health Strategy of the Department of Health and Human Services: building on the lessons of PEPFAR. (United States)

    Daulaire, Nils


    Building on its experience as a principal participant in the President's Emergency Plan for AIDS Relief, the Department of Health and Human Services has embarked on a new era of global initiatives that ultimately will protect the health of Americans. The Global Health Strategy announced by health and human services secretary Kathleen Sebelius in January 2012 recognizes that the health of Americans is intertwined with that of the rest of the world. The initiative features ten objectives that range from enhanced global health surveillance and preventing infectious diseases and health threats to health diplomacy. The Global Health Strategy is designed to make optimal use of the department's many specialty agencies and their considerable technical and programmatic expertise. The strategy moves beyond the President's Emergency Plan for AIDS Relief to redefine Health and Human Services' role outside US borders in addressing the health challenges of the twenty-first century.

  7. A Study to Determine the Feasibility of Establishing a Wellness Center at Martin Army Community Hospital (United States)


    MTF) establish a Wellness/Health Promotion Center to provide the services needed to support the wellness concepto (Department of the Army, 1984). 2...Directive 1010.10 (Health Promotion). 6. It is recommended that a marketing plan be developed for the wellness center. The plan should include articles for...1981). Wellness programs attract new markets for hospitals. Hospitals, 55(22), 115-116, 119. Manring, S.L. (1985). Evaluating corporate wellness and

  8. Why public health services? Experiences from profit-driven health care reforms in Sweden. (United States)

    Dahlgren, Göran


    Market-oriented health care reforms have been implemented in the tax-financed Swedish health care system from 1990 to 2013. The first phase of these reforms was the introduction of new public management systems, where public health centers and public hospitals were to act as private firms in an internal health care market. A second phase saw an increase of tax-financed private for-profit providers. A third phase can now be envisaged with increased private financing of essential health services. The main evidence-based effects of these markets and profit-driven reforms can be summarized as follows: efficiency is typically reduced but rarely increased; profit and tax evasion are a drain on resources for health care; geographical and social inequities are widened while the number of tax-financed providers increases; patients with major multi-health problems are often given lower priority than patients with minor health problems; opportunities to control the quality of care are reduced; tax-financed private for-profit providers facilitate increased private financing; and market forces and commercial interests undermine the power of democratic institutions. Policy options to promote further development of a nonprofit health care system are highlighted.

  9. Improving health services for African migrants in China: A health diplomacy perspective. (United States)

    McLaughlin, Megan M; Lee, Margaret C; Hall, Brian J; Bulterys, Marc; Ling, Li; Tucker, Joseph D


    Global health has become an increasingly prominent component of foreign policy in the last decade. The term health diplomacy has been used to describe this growing interface between foreign policy and global health, and it encompasses both the concept of using health to further foreign policy objectives as well as the idea that diplomatic tools can be helpful for attaining public health goals. The Chinese presence in Africa has grown in the last 15 years, generating increased interest in Sino-African relations. While much has been written in recent years about the Chinese presence in Africa, the growing numbers of Africans in China have attracted considerably less attention. Many are small-scale traders and might be expected to face many of the health challenges common among foreign migrants, but their health needs have been largely unrecognised. In this paper, we consider how a health diplomacy approach could be applied to African migrants in China, and the potential advantages and limitations of this strategy. We identify areas of overlap between public health, trade and foreign policy goals that can be emphasised to generate support for improved services for African migrants in China and to engage partners from a diversity of sectors.

  10. Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia. (United States)

    Kruger, Estie; Perera, Irosha; Tennant, Marc


    Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.

  11. PAHO'S Strategy for Universal Access to Health and Universal Health Coverage: implications for health services and hospitals in LAC. (United States)

    Holder, Reynaldo; Fabrega, Ricardo


    Moving towards Universal Access to Health and Universal Health Coverage (UAH/UHC) is an imperative task on the health agenda for the Americas. The Directing Council of the Pan American Health Organization (PAHO) recently approved resolution CD53.R14, titled Strategy for Universal Access to Health and Universal Health Coverage. From the perspective of the Region of the Americas, UAH/UHC "imply that all people and communities have access, without any kind of discrimination, to comprehensive, appropriate and timely, quality health services determined at the national level according to needs, as well as access to safe, affordable, effective, quality medicines, while ensuring that the use of these services does not expose users to financial hardship, especially groups in conditions of vulnerability". PAHO's strategic approach to UAH/UHC sets out four specific lines of action toward effective universal health systems. The first strategic line proposes: a) implementation of integrated health services delivery networks (IHDSNs) based on primary health care as the key strategy for reorganizing, redefining and improving healthcare services in general and the role of hospitals in particular; and b) increasing the response capacity of the first level of care. An important debate initiated in 2011 among hospital and healthcare managers in the region tried to redefine the role of hospitals in the context of IHSDNs and the emerging UAH/UHC movement. The debates resulted in agreements around three main propositions: 1) IHSDNs cannot be envisioned without hospitals; 2) The status-quo and current hospital organizational culture makes IHSDNs inviable; and 3) Without IHSDNs, hospitals will not be sustainable. This process, that predates the approval of PAHO's UAH/UHC resolution, now becomes more relevant with the recognition that UAH/UHC cannot be attained without a profound change in healthcare service and particularly in hospitals. In this context, a set of challenges both for

  12. Army Robotics (United States)


    Army Robotics 07 October 2009 Dr. Grant Gerhart, Senior Research Scientist Bernard Theisen, Joint Center for Robotics DISTRIBUTION STATEMENT A... Robots 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Grant Gerhart; Bernard Theisen 5d. PROJECT NUMBER 5e. TASK...CBRNE • IED Defeat Systems • Disarm / Disrupt • Reconnaissance • Investigation • Explosive Sniffer • Common Robotic Kit • EOD • Convoy • Log

  13. Do Online Mental Health Services Improve Help-Seeking for Young People? A Systematic Review


    Kauer, Sylvia Deidre; Mangan, Cheryl; Sanci, Lena


    Background Young people regularly use online services to seek help and look for information about mental health problems. Yet little is known about the effects that online services have on mental health and whether these services facilitate help-seeking in young people. Objective This systematic review investigates the effectiveness of online services in facilitating mental health help-seeking in young people. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyse...

  14. [Comparative analysis of occupational health services practice of international companies of oil and gas industry and ILO Convention "Occupational Health Services"]. (United States)

    Gevorkian, É V; Spiridonov, V L; Shatokhin, A S; Ékgardt, E V; Avdokhin, A V; Iakovlev, A P


    A comparative analysis of current work practices of occupational health services of international companies of Russian oil & gas industry and provisions of ILO Convention 161 and Recommendation 171 "Occupational Health Services" has been carried out. Proposals for improvement and harmonization of labor legislation related to this problem have been formulated.

  15. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    Directory of Open Access Journals (Sweden)

    Zaina Mchome

    Full Text Available Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning. The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

  16. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania. (United States)

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela


    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people's access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers' mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people's efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed.

  17. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program? (United States)


    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply...

  18. 德国联邦国防军心理卫勤工作%Mental Health Service in German Federal Armed Forces

    Institute of Scientific and Technical Information of China (English)

    冯杰; 李晨; 刘柳; 郭树森; 张建杰


    德国联邦国防军历来重视军事作业过程的心理因素,以及军事人员心理问题和心理疾病的预防.德军心理卫勤工作严格依照该国相关法律法规,确立心理卫生人员的执业范围及资质,建立健全相应管理制度和督导体系,其研究工作科学、系统,尤其重视实战应用.这些做法为我军心理卫勤工作发展、人员教育培训及管理体系健全等方面提供有益借鉴和参考.%The psychological factors of military operations usually are focused by The German Federal Armed Forces, as well as the prevention of psychological problems and mental illness in military personnel. The mental health - care work is in strict accordance with the Germany laws and regulations in army. The practice scope and qualification in mental health staff are limited by German Psychological Association, including the management system and supervision system. The focus of psychological service in army is to promote the practical fighting capacity. The measures of German are the useful references of Chinese peoples Liberation Army in the logistic support of mental health, the education & training of psychological specialist, and the perfection of management - supervision system.

  19. Incorporating Electronic Business Initiatives in Health Services and Health Tourism: A Case Study of Malaysia

    Directory of Open Access Journals (Sweden)

    Mohammad Talh


    Full Text Available Telecommunications, information communication technology, miniaturization, computers and Internet went through shorter product life styles and achieved widespread diffusion and reformed the nature of business operation and enhanced competitive business environment instantly. This technological advancement has resulted in evolution and innovation of many products, services and business processes. The Internet has resulted in the emergence of virtual markets with four primary distinctive characteristics, which are real time, shared, open and global. The greatest feature of the Internet is the absence of intermediaries; the manufacturers are able to sell their product relatively easier to buyers via Internet. E-business today is no longer technological issue, but is also a business issue. Incorporating E-business initiatives in health services aims to go beyond the traditional modes of healthcare delivery and instead, provide greater access to better and higher quality healthcare. It is achieved by grabbing opportunities of enhanced multimedia and information technologies and developing new technological solutions. In addition, E-business initiative is incorporated in enhancing health tourism sector through cost cutting strategies and improving quality of patients' care. Thus, this paper attempts to discuss the current states of health services and health tourism and how the emergence of E-business initiative can be capitalized to further boost the industry in Malaysia.

  20. Measuring functional service quality using SERVQUAL in a high-dependence health service relationship. (United States)

    Clark, W Randy; Clark, Leigh Anne


    Although there is a growing concern about health care quality, little research has focused on how to measure quality in long-term care settings. In this article, we make the following observations: (1) most users of the SERVQUAL instrument reassess customers' expectations each time they measure quality perceptions; (2) long-term care relationships are likely to be ongoing, dependent relationships; (3) because of this dependence, customers in the long-term care setting are likely to reduce their expectations when faced with poor service quality; (4) by using this "settled" expectations level, service providers may make biased conclusions of quality improvements. We recommend various methods for overcoming or minimizing this "settling" effect and propose modifications to the SERVQUAL gap 5 measure to assess quality in a long-term care setting.

  1. Service Users' Perceptions of an Outreach Wellbeing Service: A Social Enterprise for Promoting Mental Health. (United States)

    Hartley, Sandra Elaine


    Inadequate provision and limited access to mental healthcare has been highlighted with the need to offer more contemporary ways to provide clinically effective interventions. This study aimed to present an insight into service users' perceptions of an outreach Wellbeing Service (WBS), providing psychological therapy in social settings. Descriptive and thematic analysis was undertaken of 50 returned surveys. Comparison of initial and final mental health measures demonstrated a significant improvement in all outcomes with 96% of participants reporting being helped by attending. Participants were assisted to rebuild social connections in a safe and supportive environment and were facilitated to become more self-determining as their resourcefulness to self-manage was cultivated. Situated within different settings within the community, the WBS offers a workable example of a novel approach to supporting and promoting citizens to become more resilient and lead a more fulfilling and independent life in the community.

  2. Service - Tradition - Change: A History of the Fort Worth District, U.S. Army Corps of Engineers 1975-1999 (United States)


    provided 59 opportunities for hunters, anglers, birdwatchers , hikers, and picnickers. 30 Canyon Lake, located between Austin and San Antonio...for hikers and birdwatchers . The FWD constructed this area in 1995, in partnership with Ducks Unlimited and the Soil Conservation Service. It quickly...political and economic trends since 1980, such as a greater reliance on the market place, a smaller role for the federal government, and the end of

  3. Developing a Service Platform Definition to Promote Evidence-Based Planning and Funding of the Mental Health Service System

    Directory of Open Access Journals (Sweden)

    Yong Yi Lee


    Full Text Available Ensuring that a mental health system provides ‘value for money’ requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions to aggregations of services that are meaningful for policy makers. The ‘service platform’ is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature. The aim of this study was to develop a service platform definition that is consistent with how policy makers conceptualize the major elements of the mental health service system and to test the validity and utility of this definition through consultation with mental health policy makers. We derived a provisional definition informed by existing literature and consultation with experienced mental health researchers. Using a modified Delphi method, we obtained feedback from nine Australian policy makers. Respondents provided written answers to a questionnaire eliciting their views on the acceptability, comprehensibility and usefulness of a service platform definition which was subject to qualitative analysis. Overall, respondents understood the definition and found it both acceptable and useful, subject to certain conditions. They also provided suggestions for its improvement. Our findings suggest that the service platform concept could be a useful way of aggregating mental health services as a means for presenting priority setting evidence to policy makers in mental health. However, further development and testing of the concept is required.

  4. Developing a service platform definition to promote evidence-based planning and funding of the mental health service system. (United States)

    Lee, Yong Yi; Meurk, Carla S; Harris, Meredith G; Diminic, Sandra; Scheurer, Roman W; Whiteford, Harvey A


    Ensuring that a mental health system provides 'value for money' requires policy makers to allocate resources to the most cost-effective interventions. Organizing cost-effective interventions into a service delivery framework will require a concept that can guide the mapping of evidence regarding disorder-level interventions to aggregations of services that are meaningful for policy makers. The 'service platform' is an emerging concept that could be used to this end, however no explicit definition currently exists in the literature. The aim of this study was to develop a service platform definition that is consistent with how policy makers conceptualize the major elements of the mental health service system and to test the validity and utility of this definition through consultation with mental health policy makers. We derived a provisional definition informed by existing literature and consultation with experienced mental health researchers. Using a modified Delphi method, we obtained feedback from nine Australian policy makers. Respondents provided written answers to a questionnaire eliciting their views on the acceptability, comprehensibility and usefulness of a service platform definition which was subject to qualitative analysis. Overall, respondents understood the definition and found it both acceptable and useful, subject to certain conditions. They also provided suggestions for its improvement. Our findings suggest that the service platform concept could be a useful way of aggregating mental health services as a means for presenting priority setting evidence to policy makers in mental health. However, further development and testing of the concept is required.

  5. Competition in the UK National Health Service: mission impossible? (United States)

    Maynard, A


    Despite the dominant ideology of the 1980s being libertarian, pragmatism triumphed and, despite several attempts to privatise the UK National Health Service, the Thatcherite reforms maintained public finance and sought to create competition in the supply of health care. Even this partial reform was radical and has led to major changes in structure and process. However, the Government has refused to evaluate both the cost and the outcome of the reforms. Furthermore, with minimal definition of how the 'internal market' was to work, the Government has regulated the competitive processes in an ad hoc manner, often responding to obvious but unforeseen problems (e.g. local monopoly power). Competition is costly to create, requiring large investments in managerial personnel and information technology, and difficult to sustain because of the propensity of capitalists, through self interest, to destroy capitalism. Problems such as quality, equity and the closure of excess capacity were well defined prior to the NHS reforms and have not yet been resolved following the reforms. Whether adversarial rather than collaborative relationships are more efficient in the health care sector is unknown. Indeed there remains little evidence to sustain the claims of political rhetoric that competition 'works' i.e. increases efficiency, enhances equity and contains costs. Despite this reformers seek to create competition and complete mission impossible.

  6. Smoke and Obscurants; a Health and Environmental Effects Data Base Assessment. A First-Order, Environmental Screening and Ranking of Army Smokes and Obscurants (United States)


    Kodels S1110 U.S. Department of the Army. 1982. "Smoke and Obscurants Program. "Keep on Smokin "." Army Research, Development, &Acquisition. 23(3):1-3...1983, Vol. 24, issue 4, p.26 (S1108) U.S.Depat-et of the Army. 1982. "Smoke and Obscurants Program. ’Keep on, Smokin ’." Ari~W Research, Development...Department of the Army. 1982. "Smoke and Obscurants Program. ’Keep on Smokin ’" Army Research, Developmeut, & Auiion 23):-3 (S1110). 112 ooper A.E., and

  7. The Mobile Reference Service: a case study of an onsite reference service program at the School of Public Health. (United States)

    Tao, Donghua; McCarthy, Patrick G; Krieger, Mary M; Webb, Annie B


    The School of Public Health at Saint Louis University is located at a greater distance from the library than other programs on the main medical center campus. Physical distance diminishes the ease of access to direct reference services for public health users. To bridge the gap, the library developed the Mobile Reference Service to deliver on-site information assistance with regular office hours each week. Between September 2006 and April 2007, a total of 57 in-depth reference transactions took place over 25 weeks, averaging 2 transactions per week in a 2-hour period. Overall reference transactions from public health users went up 28%, while liaison contacts with public health users doubled compared to the same period the year before. The Mobile Reference Service program has improved library support for research and scholarship, cultivated and strengthened liaison relationships, and enhanced marketing and delivery of library resources and services to the Saint Louis University School of Public Health.

  8. Index to Army Times 1991 (United States)



  9. A panel priority rating exercise for the British Forces Germany Health Services Market test. (United States)

    Jefferson, T O; Demicheli, V


    We report on the application to the BFG Health Services Market Testing (MT) study of the response to a users' questionnaire and panel discussions to determine in which priority and how services should be provided. The questionnaire served to inform lay and health care panel members on users' views on the relative importance of future health services and the way they will be provided. Based on the questionnaire results and data contained in the BAOR Report of Public Health for 1992/93 the panel assigned the highest priorities to emergency services, followed by routine General Practitioner services and essential hospital services. The lowest ranking were non-essential hospital services, health care for children with special needs and provision of designated transport. There was a high consistency in views between the lay and health care members of the panel.

  10. Effectiveness of a Social Marketing Campaign Promoting Use of a Sexual Health Text Service by Teens. (United States)

    Willoughby, Jessica Fitts


    Sexual health text message services are becoming an increasingly popular way to provide adolescents with accurate sexual health information, but promotion of such services is often limited. This study uses three quantitative methods (service use data, a text message-based questionnaire, and an in-school online survey) to assess the effectiveness of an in-school social marketing campaign promoting a sexual health text message service that connects teens directly with a health educator. The 3-month campaign was associated with increased service use, but use was still relatively low. Follow-up qualitative work that included focus groups and interviews found a number of barriers to use. Teens indicated they did not have sexual health questions, did not think of the service, or were unsure how to use it. Teens also brought up additional barriers such as concern over parents seeing the messages. Implications for text message service providers and health educators are discussed.

  11. "Remnants of feudalism"? Women's health and their utilization of health services in rural China. (United States)

    Anson, O; Haanappel, F W


    Almost five decades ago, the Chinese Communist Party wished to abolish all "remnants of feudalism," including the patriarchal social order. Just one year after the revolution, the Marriage Law endorsed women's rights within the family, but no operative measures were taken to enforce it. Some of the economic reforms since independence even strengthened patrilocality and, possibly, patriarchal values. The purpose of this study was to explore the degree to which patrilocality served to maintain the traditional patriarchal stratification among women in the household by exploring women's health patterns and utilization of health services. Data were collected from 3859 women residing in rural Hebei, and variation in health and help seeking of six categories of relation to household head--mothers, wives, daughters, daughters-in-law, family heads, and other relatives--were explored. Utilization of health services is not dependent on women's position in the household, but primarily on per-capita income. Health patterns seem to indicate that mothers of the head of the household still have a considerable power to define their roles and share of household work. Women head of family, most of whom are married, appear to be under strain, which could be a result of their culturally "deviant" position. We conclude that old patriarchal values are intertwined with values of equality in current rural China.

  12. [European integration and health policies: repercussions of the internal European Market on access to health services]. (United States)

    Guimarães, Luisa; Giovanella, Lígia


    This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions.

  13. 38 CFR 17.242 - Coordination of programs with Department of Health and Human Services. (United States)


    ... specialized medical resources or medical information services shall be coordinated to a maximum extent... jurisdiction of the Department of Health and Human Services. Grants for Exchange of Information ... with Department of Health and Human Services. 17.242 Section 17.242 Pensions, Bonuses, and...

  14. 29 CFR 36.440 - Health and insurance benefits and services. (United States)


    ... Education Programs or Activities Prohibited § 36.440 Health and insurance benefits and services. Subject to § 36.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or... 29 Labor 1 2010-07-01 2010-07-01 true Health and insurance benefits and services. 36.440...

  15. 10 CFR 1042.440 - Health and insurance benefits and services. (United States)


    ... in Education Programs or Activities Prohibited § 1042.440 Health and insurance benefits and services. Subject to § 1042.235(d), in providing a medical, hospital, accident, or life insurance benefit, service... 10 Energy 4 2010-01-01 2010-01-01 false Health and insurance benefits and services....

  16. 45 CFR 86.39 - Health and insurance benefits and services. (United States)


    ... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 86.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service... 45 Public Welfare 1 2010-10-01 2010-10-01 false Health and insurance benefits and services....

  17. 45 CFR 2555.440 - Health and insurance benefits and services. (United States)


    ... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services....

  18. 7 CFR 15a.39 - Health and insurance benefits and services. (United States)


    ... Programs and Activities Prohibited § 15a.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a... 7 Agriculture 1 2010-01-01 2010-01-01 false Health and insurance benefits and services....

  19. 34 CFR 106.39 - Health and insurance benefits and services. (United States)


    ... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not... 34 Education 1 2010-07-01 2010-07-01 false Health and insurance benefits and services....

  20. 32 CFR 196.440 - Health and insurance benefits and services. (United States)


    ... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its... 32 National Defense 2 2010-07-01 2010-07-01 false Health and insurance benefits and services....

  1. 45 CFR 618.440 - Health and insurance benefits and services. (United States)


    ....440 Health and insurance benefits and services. Subject to § 618.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services....

  2. Factors associated with the utilization and costs of health and social services in frail elderly patients

    Directory of Open Access Journals (Sweden)

    Kehusmaa Sari


    Full Text Available Abstract Background Universal access is one of the major aims in public health and social care. Services should be provided on the basis of individual needs. However, municipal autonomy and the fragmentation of services may jeopardize universal access and lead to variation between municipalities in the delivery of services. This paper aims to identify patient-level characteristics and municipality-level service patterns that may have an influence on the use and costs of health and social services of frail elderly patients. Methods Hierarchical analysis was applied to estimate the effects of patient and municipality-level variables on services utilization. Results The variation in the use of health care services was entirely due to patient-related variables, whereas in the social services, 9% of the variation was explained by the municipality-level and 91% by the patient-level characteristics. Health-related quality of life explained a major part of variation in the costs of health care services. Those who had reported improvement in their health status during the preceding year were more frequent users of social care services. Low informal support, poor functional status and poor instrumental activities of daily living, living at a residential home, and living alone were associated with higher social services expenditure. Conclusions The results of this study showed municipality-level variation in the utilization of social services, whereas health care services provided for frail elderly people seem to be highly equitable across municipalities. Another important finding was that the utilization of social and health services were connected. Those who reported improvement in their health status during the preceding year were more frequently also using social services. This result suggests that if municipalities continue to limit the provision of support services only for those who are in the highest need, this saving in the social sector may, in

  3. Health care expenditure, laboratory services and IVD market. (United States)

    Veronesi, E; Mambretti, C; Gazzaniga, P


    What has been written until now should not be misinterpreted: without doubt there is wastage in the Italian health care expenditure which must be rationalized. Moreover, the public deficit-now over two million billion lira-will probably prevent any reinvestment in health care of resources liberated through the above-mentioned rationalization process. In the near future, the attention of the authorities should be focused on how to reduce public spending, which probably also includes spending on health care. The message which needed to be passed on here does not refuse to recognize the possibility of rationalizing health care expenditure in Italy nor does it reject the need for this course of action. Instead it tries to give the following warning: in the light of the above circumstances-or the fact that even now the authorities cannot admit to spending "much" in the absolute sense, especially with regard to technology, or the fundamental role of IVDs in health care processes, or the difficulties in which the companies of the sector have been placed-it is possible to state that any blind, or worse still, ill-equipped, intervention in this field would have the undoubted effect of damaging the health care sector, or even place many companies on their knees, without receiving the expected benefits on the balance sheet. Benefits in the form of efficiency and saving can only be obtained from an effective reorganisation of the health structures, in line with the reforms provided for by legislative decree n. 502/92 (and subsequent modifications)--which, due to aspects too numerous to mention, is still a dead letter--and by taking steps towards valuing the laboratory services. As already stated, to talk of inefficiency in general terms means talking of unproductive expenditure: this occurs when utilizing factors whose cost is "too high" and/or productivity is "too low". It is with this distinction in mind that intervention must come; assessing factors not individually but

  4. [Qualitative research in health services research - discussion paper, Part 1: What is the idea?]. (United States)

    Meyer, T; Karbach, U; Holmberg, C; Güthlin, C; Patzelt, C; Stamer, M


    In this first part of a 3-part discussion paper the working group "Qualitative Methods" in the German Network of Health Services Research (DNVF) identifies the potentials and opportunities qualitative research methods provide for health services research. Many research questions relevant for health services research require the use of qualitative methods. However, the potential of and need for qualitative research in health services research has not yet received sufficient attention from funding bodies. We discuss the applicability and importance of qualitative research for the field of health services research. We then move on to describe the key characteristics of qualitative research that need to be taken into account in health services research. We discuss characteristics such as open-ended (qualitative) data, interpretation of meanings, the search for contradictions, closeness to everyday life, openness towards change or modification of the research question and processes in the context of health services research. To ensure a high-quality approach in qualitative methods for the health services research, sufficient competency in methods and appropriate settings that account for the peculiarities of qualitative methods need to be developed. These include an appropriate time frame and sufficient and qualified personnel to conduct qualitative research. Qualitative research is not a research paradigm in itself rather it comprises of many different and diverging approaches. The goal of this paper is to show the diversity of qualitative research methods, its importance for health services research, and to open up the discussion on strategies for integrating qualitative methods into health services research.

  5. Coordination in networks for improved mental health service

    Directory of Open Access Journals (Sweden)

    Johan Hansson


    Full Text Available Background: Well-organised clinical cooperation between health and social services has been difficult to achieve in Sweden as in other countries.Purpose: This paper presents an empirical study of a mental health coordination network in one area in Stockholm. The aim was to describe the development and nature of coordination within a mental health and social care consortium and to assess the impact on care processes and client outcomes.Method: Data was gathered through interviews with coordina­tors from three rehabilitation units. The interviews focused on coordination activities aimed at supporting the clients’ needs and investigated how the coordinators acted according to the consortium's holistic approach. Data on The Camberwell Assess­ment of Need (CAN-S showing clients’ satisfaction was used to assess on set of outcomes. Findings: The findings revealed different coordination activities and factors both helping and hindering the network coordination activities. One factor helping was the history of local and personal informal cooperation and shared responsibilities evident. Unclear roles and routines hindered cooperationPractical value: The contribution is an empirical example and a model for organisations establishing structures for network coordination. One lesson for current policy about integrated health care is to adapt and implement ”pair coordinators” where full structural integration is not possible. Another lesson, based on the idea of patient quality by coordinated care, is specific to adapt the work of the local psychiatric addictive team – an independent special team in the psychiatric outpatient care serving psychotic clients with complex addictive problems.

  6. Coordination in networks for improved mental health service

    Directory of Open Access Journals (Sweden)

    Johan Hansson


    Full Text Available Background: Well-organised clinical cooperation between health and social services has been difficult to achieve in Sweden as in other countries. Purpose: This paper presents an empirical study of a mental health coordination network in one area in Stockholm. The aim was to describe the development and nature of coordination within a mental health and social care consortium and to assess the impact on care processes and client outcomes. Method: Data was gathered through interviews with coordina­tors from three rehabilitation units. The interviews focused on coordination activities aimed at supporting the clients’ needs and investigated how the coordinators acted according to the consortium's holistic approach. Data on The Camberwell Assess­ment of Need (CAN-S showing clients’ satisfaction was used to assess on set of outcomes. Findings: The findings revealed different coordination activities and factors both helping and hindering the network coordination activities. One factor helping was the history of local and personal informal cooperation and shared responsibilities evident. Unclear roles and routines hindered cooperation Practical value: The contribution is an empirical example and a model for organisations establishing structures for network coordination. One lesson for current policy about integrated health care is to adapt and implement ”pair coordinators” where full structural integration is not possible. Another lesson, based on the idea of patient quality by coordinated care, is specific to adapt the work of the local psychiatric addictive team – an independent special team in the psychiatric outpatient care serving psychotic clients with complex addictive problems.

  7. Ethical priority setting for universal health coverage: challenges in deciding upon fair distribution of health services. (United States)

    Norheim, Ole F


    Priority setting is inevitable on the path towards universal health coverage. All countries experience a gap between their population's health needs and what is economically feasible for governments to provide. Can priority setting ever be fair and ethically acceptable? Fairness requires that unmet health needs be addressed, but in a fair order. Three criteria for priority setting are widely accepted among ethicists: cost-effectiveness, priority to the worse-off, and financial risk protection. Thus, a fair health system will expand coverage for cost-effective services and give extra priority to those benefiting the worse-off, whilst at the same time providing high financial risk protection. It is considered unacceptable to treat people differently according to their gender, race, ethnicity, religion, sexual orientation, social status, or place of residence. Inequalities in health outcomes associated with such personal characteristics are therefore unfair and should be minimized. This commentary also discusses a third group of contested criteria, including rare diseases, small health benefits, age, and personal responsibility for health, subsequently rejecting them. In conclusion, countries need to agree on criteria and establish transparent and fair priority setting processes.

  8. Contextual influences on reproductive health service use in Uttar Pradesh, India. (United States)

    Stephenson, Rob; Tsui, Amy Ong


    This study examines the determinants of the use of four types of reproductive health-care services in Uttar Pradesh, India: contraceptive services, antenatal care, delivery in a medical institution, and services dealing with reproductive tract and sexually transmitted infections. The analysis uses a multilevel modeling strategy to assess the presence of household- and community-level variation in service use. The influence of community-level characteristics and reproductive health-care service attributes on service use is examined. The results highlight strong community-level influences on service use, although the type of community effect varies by service type. The role of some individual and household factors in determining a person's use of services is mediated by the characteristics of the community in which the individual lives. The results demonstrate the need to look beyond individual factors when examining health-care-seeking behavior, and illustrate that there is no singular "community" effect on service use.

  9. Person-Organization Fit and Its Effect on Retention of Army Officers with Less Than Eight Years of Active Duty Service (United States)


    workload, personal time, and job enjoyment are critically important factors to the employee in determining satisfaction . Each of these are intrinsic...organization (i.e., the U.S. Army). As stated above, career satisfaction impacts retention and is therefore important to the Army. The 6 current talent...lead to decreased satisfaction and increased turnover. To assess P-O fit, prospective employees are evaluated against the organizational values

  10. The integration of a telemental health service into rural primary medical care. (United States)

    Davis, G L; Boulger, J G; Hovland, J C; Hoven, N T


    Mental health care shortages in rural areas have resulted in the majority of services being offered through primary medical care settings. The authors argue that a paradigm shift must occur so that those in need of mental health care have reasonable, timely access to these services. Changes proposed include integrating mental health services into primary medical care settings, moving away from the traditional view of mental health care services (one therapist, one hour, and one client), and increasing the consultative role of psychologists and other mental health care providers in primary medical care. Characteristics of mental health providers that facilitate effective integration into primary medical care are presented. The results of a needs assessment survey and an example of a telemental health project are described. This project involved brief consultations with patients and their physicians from a shared care model using a broadband internet telecommunications link between a rural clinic and mental health service providers in an urban area.

  11. Effectiveness of service linkages in primary mental health care: a narrative review part 1


    Parker Sharon; Holdsworth Louise; Perkins David; Fuller Jeffrey D; Kelly Brian; Roberts Russell; Martinez Lee; Fragar Lyn


    Abstract Background With the move to community care and increased involvement of generalist health care providers in mental health, the need for health service partnerships has been emphasised in mental health policy. Within existing health system structures the active strategies that facilitate effective partnership linkages are not clear. The objective of this study was to examine the evidence from peer reviewed literature regarding the effectiveness of service linkages in primary mental he...

  12. Guidelines for clinical supervision in health service psychology. (United States)


    This document outlines guidelines for supervision of students in health service psychology education and training programs. The goal was to capture optimal performance expectations for psychologists who supervise. It is based on the premises that supervisors (a) strive to achieve competence in the provision of supervision and (b) employ a competency-based, meta-theoretical approach to the supervision process. The Guidelines on Supervision were developed as a resource to inform education and training regarding the implementation of competency-based supervision. The Guidelines on Supervision build on the robust literatures on competency-based education and clinical supervision. They are organized around seven domains: supervisor competence; diversity; relationships; professionalism; assessment/evaluation/feedback; problems of professional competence, and ethical, legal, and regulatory considerations. The Guidelines on Supervision represent the collective effort of a task force convened by the American Psychological Association (APA) Board of Educational Affairs (BEA).

  13. Mixed methods, mixed methodology health services research in practice. (United States)

    Johnstone, P Lynne


    Mixed methods, mixed methodology research is a little documented but increasingly accepted approach employed to investigate organizational phenomena. The author presents a synthesis of literature that informed the decision to adopt a mixed methods, mixed methodology, dominantly naturalistic study approach to health services research in which she explored the process and organizational consequences of new artifact adoption in surgery. She describes the way whereby a collective case study involving five Australian hospitals yielded quantitative and qualitative data that were analyzed using inductive and/or deductive reasoning. She goes beyond the theoretical rational for employing a mixed methods, mixed methodology approach to present a summative conceptual model of the research process and describe the structural aspects of the dissertation in which the research was reported that should benefit researchers contemplating the value of such an approach.

  14. Implementing business continuity effectively within the UK National Health Service. (United States)

    Roberts, Patrick; Molyneux, Helen


    Whereas major incident planning is very well established within National Health Service (NHS) organisations in the UK, business continuity management (BCM) planning, in many cases, is a relatively new activity; however, a combination of factors including the emergence of H1N1 influenza, has led to growing interest in the subject. This paper draws on both the personal experience of the authors and published research in relevant fields to make a number of specific recommendations about the effective implementation of BCM within NHS organisations. These include the need to define the BCM project properly; conduct a thorough business impact analysis considering 'back office' as well as clinical activities; define suitable command and control arrangements with clear delegated authority; and support plan development with appropriate training.

  15. Migrant labour, racism and the British National Health Service. (United States)

    Kyriakides, Christopher; Virdee, Satnam


    This study explores the dynamics of racism, specifically its generation and reproduction as an ideology, and its role in affecting the reception and occupational location of migrant medical labour in Britain. It is argued that the treatment of 'overseas doctors' in Britain draws on a complex interplay between racism and nationalism underpinned by the historical construction of 'welfarism' as a moral legitimator of 'Britishness'. Through an exploration of internal and external immigration controls introduced with the aim of regulating migrant labour, we demonstrate how British social policy and elite discourses of 'race' combine to construct moral prescriptions of threat such that migrants and British-born 'non-whites' entering the British medical profession are forced to negotiate 'saviour/pariah' ascriptions indicative of discriminatory but contradictory processes specific to the operation of the British National Health Service as a normative institution.

  16. Liberalizing the health care market: the new government's ambition for the English National Health Service. (United States)

    Lewis, Richard Q; Thorlby, Ruth


    England's National Health Service (NHS) faces the prospect of a radical overhaul by the current coalition government, with the aim of improving the quality and efficiency of health services. The government has identified the increased use of competition between providers as a primary lever to achieve its goals and is creating a competitive market comprising state, private, and not-for-profit providers. This market will be overseen by an independent economic regulator with powers to intervene and shape local markets for health services. While the use of market incentives is not wholly novel, if implemented, these new reforms imply a rapid expansion of the scope and scale of competitive market forces within the NHS. This article examines the government's current proposals for increased use of competition and considers its potential impact in the light of the available evidence. It argues that despite some research evidence pointing to the potentially beneficial effects of competition on quality and efficiency, there are also risks of adverse outcomes. Consequently, there is significant uncertainty as to whether this policy will deliver the desired objectives.


    Directory of Open Access Journals (Sweden)

    Bodog Simona-Aurelia


    Full Text Available The online environment has opened new opportunities for consumers of health services, both in terms of the need for information on identified health problem and the possibilities of solving them and choosing the desired health service, resulting in a significant impact on decision of the consumer of health services. The consumers of health services use the internet to get information on identified health problems both before consulting a health service or its buying decision, because of their desire to be informed when acquiring health service, and its subsequent purchase to verify the correctness of service received. In this context, the health care provider cannot create and promote his own desires and beliefs if he wants to be the top choice of the consumers of health services. This paper aims to analyze the impact of the online environment on the decisions of the consumer of health services. The study was conducted on a sample of 223 patients admitted to two public hospitals in Oradea. The patients were given a questionnaire with 20 items, which mainly focused on: information sources, accessing sites with medical content, the moment of accessing the site, verification of information and information from the online influence on their behavior. From the analysis it appears that the information sought by patients online are general, fewer patients frequently access sites of medical institutions, health care facilities or health blogs and forums. The decisions of the Consumers of health care services are influenced to a lesser extent by the information from the online environment, the decisive role in terms of making a decision represent the information received from the doctor. Finally, for the consumer of health care services is difficult to choose because, to some extent even if the needs are becoming increasingly difficult to satisfy a substrate remains related to the personality and mentality of each, of the personal factors regarding

  18. Emergency Contraception Education for Health and Human Service Professionals: An Evaluation of Knowledge and Attitudes (United States)

    Colarossi, Lisa; Billowitz, Marissa; Breitbart, Vicki


    Objective: To assess the knowledge and attitudes of health care providers, health educators, and social service providers before and after a training session on emergency contraceptive pills. Design: A survey study using pre-post training measurements. Setting: Two hundred and twenty-three medical, social service, and health education providers in…

  19. 9 CFR 113.6 - Animal and Plant Health Inspection Service testing. (United States)


    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Animal and Plant Health Inspection Service testing. 113.6 Section 113.6 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION... STANDARD REQUIREMENTS Applicability § 113.6 Animal and Plant Health Inspection Service testing....

  20. The Rural-Urban Divide: Health Services Utilization among Older Mexicans in Mexico (United States)

    Salinas, Jennifer J.; Al Snih, Soham; Markides, Kyriakos; Ray, Laura A.; Angel, Ronald J.


    Context: Mexico. Purpose: Using the health care service utilization model as a framework, this paper will analyze the differences in health care service use among older Mexicans living in urban and rural areas in Mexico. Methods: The Mexican Health and Aging Survey (MHAS) data were used to test the applicability of Andersen's "model of health…