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Sample records for health service national

  1. The Danish National Health Service Register

    DEFF Research Database (Denmark)

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

    2011-01-01

    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...

  2. Who Killed the English National Health Service?

    Directory of Open Access Journals (Sweden)

    Martin Powell

    2015-05-01

    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.

  3. 78 FR 9705 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Science.gov (United States)

    2013-02-11

    ... 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...

  4. 77 FR 11557 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Science.gov (United States)

    2012-02-27

    ... 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)...

  5. National Mental Health Services Survey (N-MHSS), 2010

    Data.gov (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...

  6. National Mental Health Services Survey (N-MHSS-2010)

    Data.gov (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...

  7. National Guard Families After Combat: Mental Health, Use of Mental Health Services, and Perceived Treatment Barriers

    National Research Council Canada - National Science Library

    Gorman, Lisa A; Blow, Adrian J; Ames, Barbara D; Reed, Philip L

    2011-01-01

    .... The purpose of this cross-sectional study was to assess mental health symptoms, utilization of mental health services, and perceived barriers to service use among National Guard members and their significant others...

  8. Problem Gambling Treatment within the British National Health Service

    Science.gov (United States)

    Rigbye, Jane; Griffiths, Mark D.

    2011-01-01

    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…

  9. Lean implementation in primary care health visiting services in National Health Service UK.

    Science.gov (United States)

    Grove, A L; Meredith, J O; Macintyre, M; Angelis, J; Neailey, K

    2010-10-01

    This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.

  10. Integrating children's health services: evaluation of a national demonstration project.

    Science.gov (United States)

    Hughes, D C; Brindis, C; Halfon, N; Newacheck, P W

    1997-12-01

    Increasingly, the public and private sectors are turning to "service integration" efforts to reduce, if not eliminate, barriers to needed care created by categorical programs. In 1991, the Robert Wood Johnson Foundation established a new national demonstration project, called the Child Health Initiative, intended to test the feasibility of developing mechanisms at the community level to coordinate the delivery of health services and to pay for those services through a flexible pool of previously categorical funds. This article presents the findings of an independent evaluation of the Child Health Initiative. The evaluation utilized a combination of qualitative methods to assess and describe the experiences of the communities as they developed and implemented integrated health services. It used a repeated measures design involving two site visits and interim telephone interviews, as well as review of documents. Overall, the demonstration project achieved mixed success. Both care coordination and the production of community health report cards were found to be achievable within the relatively short life of the foundation grant. However, many sites experienced significant delays in the production of report cards and implementing care coordination plans because the sites largely did not benefit from the successful models already in existence. Little clear progress was made in implementing the decategorization component of the project. Sites experienced difficulties due to lack of previous experience with this new undertaking, the inability to secure active cooperation from local, state, and federal agencies, the relatively short duration of the project, and other factors. A number of lessons were learned from this project that may be useful in future decategorization experiments, including (1) a clear understanding of the concept and its applications among all parties is essential, (2) high-level political commitments to the effort are needed between all levels of

  11. 42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF... Corps Personnel § 23.13 What nondiscrimination requirements apply to National Health Service Corps sites...

  12. 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

    2003-01-01

    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

  13. Medical Tourism and the Libyan National Health Services

    Directory of Open Access Journals (Sweden)

    El Taguri A

    2007-01-01

    recognized location of choice for quality healthcare and an integrated centre of excellence for clinical and wellness services, medical education and research [2]. An international medical travel conference (IMTC was held in December 2006 and some web sites such as ArabMedicare.com were established to accompany the needs of this growing market.In spite of the aforementioned rewards, medical tourism is not without risks [3]. Medical tourism can do harm to national health services of the host as well as the country of origin. Besides cultural and language issues, there are risks inherent in traveling as accidents, exposure to different infectious diseases, risks from traveling soon after surgery, impossibility of treating chronic disease after a single consultation, the non familiarity of how a certain specialty applies to other communities, the on-off consultations, the limited possibility for follow up, the absence of record of the consultation [3], and most importantly fraud and abuse.The total amount of money spent by Libyans on both forms of medical tourism is difficult to estimate. It ranges between $100-200 millions per year for treatment abroad, but the accurate figures are not available. The form of medical tourism where doctors rather than patients travel, gained a momentum with the increased role of private practice in health service delivery. There is a real threat from the growing market of medical tourism in the region on the public health oriented national health system in Libya. The two neighboring countries that are mostly visited by Libyans have a lower performance of National Health Service in comparison to Libyan National Health services with an objective assessment as revealed by infant mortality rate, life expectancy at birth, maternal mortality ratio and proportion of low birth weight [7]. Giving the non-popularity of tourism among the Libyan population, traveling in itself is an important event in one’s life. We should not deny that in many cases

  14. Migrant labour, racism and the British National Health Service.

    Science.gov (United States)

    Kyriakides, Christopher; Virdee, Satnam

    2003-11-01

    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.

  15. 77 FR 51543 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting

    Science.gov (United States)

    2012-08-24

    ... 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,...

  16. Implementing business continuity effectively within the UK National Health Service.

    Science.gov (United States)

    Roberts, Patrick; Molyneux, Helen

    2010-11-01

    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.

  17. Rather unspectacular: design choices in National Health Service glasses

    Directory of Open Access Journals (Sweden)

    Dr Joanne Gooding

    2017-04-01

    Full Text Available This article considers the design and production of spectacles in Britain following the introduction of standardised frame styles under the National Health Service. NHS spectacles were provided as a functional, durable medical appliance to be delivered cost-effectively and there was no explicit concern for fashion or the patient experience. The actions of the government and professional bodies greatly affected the trade in eyewear and thus restricted opportunities for innovative design and consumer choice. Within the range of state regulation frames there was no active concern for ‘design’ in terms of appearance and it was only through the purchase of private frames that significant choice and variety in eyewear could be attained. The scope for the public to select a more fashionable frame whilst receiving an element of state aid was through the purchase of NHS hybrid private frames.

  18. Importance of antimicrobial stewardship to the English National Health Service

    Directory of Open Access Journals (Sweden)

    Dixon J

    2014-05-01

    Full Text Available Jill Dixon, Christopher JA Duncan Department of Infectious Diseases and Tropical Medicine, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK Abstract: Antimicrobials are an extremely valuable resource across the spectrum of modern medicine. Their development has been associated with dramatic reductions in communicable disease mortality and has facilitated technological advances in cancer therapy, transplantation, and surgery. However, this resource is threatened by the dwindling supply of new antimicrobials and the global increase in antimicrobial resistance. There is an urgent need for antimicrobial stewardship (AMS to protect our remaining antimicrobials for future generations. AMS emphasizes sensible, appropriate antimicrobial management for the benefit of the individual and society as a whole. Within the English National Health Service (NHS, a series of recent policy initiatives have focused on all aspects of AMS, including best practice guidelines for antimicrobial prescribing, enhanced surveillance mechanisms for monitoring antimicrobial use across primary and secondary care, and new prescribing competencies for doctors in training. Here we provide a concise summary to clarify the current position and importance of AMS within the NHS and review the evidence base for AMS recommendations. The evidence supports the impact of AMS strategies on modifying prescribing practice in hospitals, with beneficial effects on both antimicrobial resistance and the incidence of Clostridium difficile, and no evidence of increased sepsis-related mortality. There is also a promising role for novel diagnostic technologies in AMS, both in enhancing microbiological diagnosis and improving the specificity of sepsis diagnosis. More work is needed to establish an evidence base for interventions to improve public and patient education regarding the role of antibiotics in common clinical syndromes, such as respiratory tract infection. Future

  19. Competition in the UK National Health Service: mission impossible?

    Science.gov (United States)

    Maynard, A

    1993-03-01

    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.

  20. National Health Expenditure Data

    Data.gov (United States)

    U.S. Department of Health & Human ServicesNational Health Expenditure Accounts are comprised of the following, National Health Expenditures - Historical and Projected, Age Estimates, State Health...

  1. Outsourcing in the Italian National Health Service: findings from a national survey.

    Science.gov (United States)

    Macinati, Manuela S

    2008-01-01

    Over the last decade, outsourcing has become one of the major issues in health care. Two major concerns are related to public health care outsourcing practice. The first one involves the suitability of the outsourcing strategy in the public sector, principally with reference to the outsourcing of essential clinical services. The second one relates to the actual benefits of the outsourcing practice in health care, in terms of cost reduction and increasing efficiency. This paper aims to contribute to the debate and literature on outsourcing through a national survey carried out in the Italian National Health Service. In order to achieve the research objective, a questionnaire was developed and, after a pilot test, it was mailed to all Italian public providers. The total response rate was around 42%. Results showed that outsourcing is a widespread phenomenon within health care, especially in the ancillary services area. Moreover, results showed many criticalities of the outsourcing practice in the Italian health-care sector. On the one hand, criticalities concerned the reasons for outsourcing, the characteristics of the outsourced services and the management of the relationship with the vendor. With reference to essential clinical service, outsourcing, as currently managed by health-care providers, may potentially weaken their ability to reach its own objectives. On the other hand, criticalities related to respondent-perceived benefits. Despite the overall positive outsourcing experience expressed in the survey, the results on perceived benefits showed that the effects of outsourcing did not always align to managers' expectations, especially in the cost containment and efficiency area.

  2. National pathways for suicide prevention and health services research.

    Science.gov (United States)

    Ahmedani, Brian K; Vannoy, Steven

    2014-09-01

    In 2012, the National Action Alliance for Suicide Prevention's Research Prioritization Task Force (RPTF) released a series of Aspirational Goals (AGs) to decrease suicide deaths and attempts. The RPTF asked experts to summarize what was known about particular AGs and to propose research pathways that would help reach them. This manuscript describes what is known about the benefits of access to health care (AG8) and continuity of care (AG9) for individuals at risk for suicide. Research pathways are proposed to address limitations in current knowledge, particularly in U.S. healthcare-based research. Using a three-step process, the expert panel reviewed available literature from electronic databases. For two AGs, the experts summarized the current state of knowledge, determined breakthroughs needed to advance the field, and developed a series of research pathways to achieve prevention goals. Several components of healthcare provision have been found to be associated with reduced suicide ideation, and in some cases they mitigated suicide deaths. Randomized trials are needed to provide more definitive evidence. Breakthroughs that support more comprehensive patient data collection (e.g., real-time surveillance, death record linkage, and patient registries) would facilitate the steps needed to establish research infrastructure so that various interventions could be tested efficiently within various systems of care. Short-term research should examine strategies within the current healthcare systems, and long-term research should investigate models that redesign the health system to prioritize suicide prevention. Evidence exists to support optimism regarding future suicide prevention, but knowledge is limited. Future research is needed on U.S. healthcare services and system enhancements to determine which of these approaches can provide empirical evidence for reducing suicide. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights

  3. The Italian National Health Service expenditure on workplace prevention and safety (2006-2013): a national-level analysis.

    Science.gov (United States)

    Signorelli, C; Riccò, M; Odone, A

    2016-01-01

    The World Health Organization (WHO) stated that countries' health policies should give high priority to primary prevention of occupational health hazards. Scant data are available on health expenditure on workplace prevention and safety services and on its impact on occupational health outcomes in Italy and in other European countries. objective of the present study was to systematically retrieve, analyse and critically appraise the available national-level data on public health expenditure on workplace prevention and safety services as well as to correlate them with occupational health outcomes. National-level data on total public health expenditure on prevention services, its share spent on workplace prevention and safety services as well as on number of workers receiving appropriate health surveillance were derived from the national public health expenditure monitoring system over a 8-year study period (2006-2013). An analytic approach was adopted to explore the association between health expenditure and occupational health services supply. The Italian National Health Service spends almost € 5 billion per year on preventive care, of which 13.3% are spent on workplace prevention and safety programmes (€ 645 million, € 10.6 per capita). There is wide heterogeneity between Italian regions. Our findings are useful for health systems and policies analysis, national and international comparisons as well as for health policy makers to plan, implement and monitor occupational health prevention programmes.

  4. Importance of antimicrobial stewardship to the English National Health Service.

    Science.gov (United States)

    Dixon, Jill; Duncan, Christopher Ja

    2014-01-01

    Antimicrobials are an extremely valuable resource across the spectrum of modern medicine. Their development has been associated with dramatic reductions in communicable disease mortality and has facilitated technological advances in cancer therapy, transplantation, and surgery. However, this resource is threatened by the dwindling supply of new antimicrobials and the global increase in antimicrobial resistance. There is an urgent need for antimicrobial stewardship (AMS) to protect our remaining antimicrobials for future generations. AMS emphasizes sensible, appropriate antimicrobial management for the benefit of the individual and society as a whole. Within the English National Health Service (NHS), a series of recent policy initiatives have focused on all aspects of AMS, including best practice guidelines for antimicrobial prescribing, enhanced surveillance mechanisms for monitoring antimicrobial use across primary and secondary care, and new prescribing competencies for doctors in training. Here we provide a concise summary to clarify the current position and importance of AMS within the NHS and review the evidence base for AMS recommendations. The evidence supports the impact of AMS strategies on modifying prescribing practice in hospitals, with beneficial effects on both antimicrobial resistance and the incidence of Clostridium difficile, and no evidence of increased sepsis-related mortality. There is also a promising role for novel diagnostic technologies in AMS, both in enhancing microbiological diagnosis and improving the specificity of sepsis diagnosis. More work is needed to establish an evidence base for interventions to improve public and patient education regarding the role of antibiotics in common clinical syndromes, such as respiratory tract infection. Future priorities include establishing novel approaches to antimicrobial management (eg, duration of therapy, combination regimens) to protect against resistance and working with the pharmaceutical

  5. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Science.gov (United States)

    2010-10-01

    ... 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...

  6. Why some countries have national health insurance, others have national health services, and the U.S. has neither.

    Science.gov (United States)

    Navarro, V

    1989-01-01

    This article presents a discussion of why some capitalist developed countries have national health insurance schemes, others have national health services, and the U.S. has neither. The first section provides a critical analysis of some of the major answers given to these questions by authors belonging to the schools of thought defined as 'public choice', 'power group pluralism' and 'post-industrial convergence'. The second section puts forward an alternative explanation rooted in an historical analysis of the correlation of class forces in each country. The different forms of funding and organization of health services, structured according to the corporate model or to the liberal-welfare market capitalism model, have appeared historically in societies with different correlations of class forces. In all these societies the major social force behind the establishment of a national health program has been the labor movement (and its political instruments--the socialist parties) in its pursuit of the welfare state. In the final section the developments in the health sector after World War II are explained. It is postulated that the growth of public expenditures in the health sector and the growth of universalism and coverage of health benefits that have occurred during this period are related to the strength of the labor movement in these countries.

  7. The provision of dental implants in the National Health Service Hospital dental services--a national questionnaire.

    Science.gov (United States)

    Butterworth, C J; Baxter, A M; Shaw, M J; Bradnock, G

    2001-01-27

    To assess the activity of consultants in restorative dentistry in the United Kingdom in the provision of osseointegrated dental implants within the National Health Service Hospital service and to evaluate their attitudes concerning the relevant medical and oral factors considered in patient selection for implant treatment. Anonymous postal questionnaire in the United Kingdom. Consultants in restorative dentistry. Out of the sample of 145, 109 consultants (75%) completed the questionnaire in 1999. 54 of the 109 consultants (49.5%) are involved in the provision of osseointegrated implant treatment, treating an average of 29 cases/year (range 2-150). However, over one third of the respondents treated 10 or less cases/year. 89% worked with oral surgeons as an implant team. 68% used Branemark (Nobel Biocare) implants as their main system. The majority of consultants felt that smoking, psychoses and previous irradiation were the most important medical factors that contra-indicated implant retained restorations whilst untreated periodontitis, poor oral hygiene and uncontrolled caries were the most important oral contra-indications. Many centres were experiencing significant problems with the funding of implant treatment with one centre receiving no funding. The implications for patient care and specialist training are discussed. There is a marked variation in the number of patients treated with endosseous dental implants within the United Kingdom National Health Service hospitals. Many consultants treat 10 or fewer patients each year. In the main, there is agreement about the factors that contra-indicate implant treatment; these are in line with national guidelines.

  8. Economic growth and health progress in Italy: 30 years of National Health Service.

    Science.gov (United States)

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

    2012-01-01

    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.

  9. [The British Health Services System--major changes once again. The White Paper and commercialization of the National Health Service].

    Science.gov (United States)

    Kolflaath, J

    1989-08-20

    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.

  10. 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

    2012-03-01

    Full Text Available

    Abstract:
    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.

  11. Organisation of Prostate Cancer Services in the English National Health Service.

    Science.gov (United States)

    Aggarwal, A; Nossiter, J; Cathcart, P; van der Meulen, J; Rashbass, J; Clarke, N; Payne, H

    2016-08-01

    The National Prostate Cancer Audit (NPCA) started in April 2013 with the aim of assessing the process of care and its outcomes in men diagnosed with prostate cancer in England and Wales. One of the key aims of the audit was to assess the configuration and availability of specialist prostate cancer services in England. In 2014, the NPCA undertook an organisational survey of all 143 acute National Health Service (NHS) Trusts and 48 specialist multidisciplinary team (MDT) hubs cross England. Questionnaires established the availability and location of core diagnostic, treatment and patient-centred support services for the management of non-metastatic prostate cancer in addition to specific diagnostic and treatment procedures that reflect the continuing evolution of prostate cancer management, such as high-intensity focused ultrasound (HIFU) and stereotactic body radiotherapy. The survey received a 100% response rate. The results showed considerable geographical variation with respect to the availability of core treatment modalities, the size of the target population and catchment areas served by specialist MDT hubs, as well as in the uptake of additional procedures and services. Specifically there are gaps in the availability of core radiotherapy procedures; high dose rate and low dose rate brachytherapy are available in 44% and 75% of specialist MDTs, respectively. By comparison, there seems to be a relative 'over-penetration' of surgical innovation, with 67% of specialist MDTs providing robotic-assisted laparoscopic prostatectomy and 21% HIFU. There is also evidence of increased centralisation of core surgical procedures and regional inequity in the availability of surgical innovation across England. The organisational survey of the NPCA has provided a comprehensive assessment of the structure and function of specialist MDTs in England and the availability of prostate cancer procedures and services. As part of the prospective audit, the NPCA will assess the effect of

  12. National Policy on Health Care Hearing: an evaluative study from covering services and diagnostic procedures

    OpenAIRE

    2014-01-01

    PURPOSE: To evaluate the National Policy on Hearing Health Care (PNASA) based on the coverage of specialized services and diagnostic procedures in hearing health care in Brazil. METHODS: This is an evaluation study focused on the coverage of specialized services that offer moderate- and high-complexity diagnostic procedures by region and in Brazil as a whole. We analyzed the data for the period of 2004-2011 collected from the Unified Health System's Informatics Department database (DATASUS), ...

  13. Liberalizing the health care market: the new government's ambition for the English National Health Service.

    Science.gov (United States)

    Lewis, Richard Q; Thorlby, Ruth

    2011-01-01

    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.

  14. RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes.

    Science.gov (United States)

    Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel

    2017-08-01

    To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P hospital mortality rates were higher at larger hospitals, but no significant differences were found when mortality was risk adjusted. There was an association between nurse workload with mortality rate for selected conditions (r: 0.25; P = 0.009). Safety committee and multidisciplinary ward rounds were also associated with outcomes. We have not found any association between complexity and intra-hospital mortality. There is an association between some management indicators with intra-hospital mortality and the length of stay. Better disease-specific outcomes adjustments and a larger number of IMUs in the sample may provide more insights about the association between management of IMUs with healthcare outcomes.

  15. PATIENTS’ SATISFACTION WITH HEALTH SERVICES AT THE NATIONAL INSTITUTE OF PUBLIC HEALTH OF KOSOVA

    Science.gov (United States)

    Ramadani, Naser; Zhjeqi, Valbona; Berisha, Merita; Hoxha, Rina; Gashi, Sanije; Begolli, Ilir; Salihu, Drita; Muçaj, Sefedin

    2016-01-01

    Aim: Purpose of the research is to assess patient satisfaction with the quality of health services provided in National Institute of Public Health of Kosova. Methods: Study was observational and cross-sectional. Interviews were conducted with 625 clients of IPH. Inclusion criteria for enrollment in the study were patients above 18 years old, with verbally informed consent. Results: In our study, access to IPH, efficacy, patient-provider interpersonal communication, and explanations regarding procedures, readiness to answer to patients need and physical settings and appearance are valued satisfactorily whereas cleanliness was rated with minimal grades. Evaluated 12 quality components, were scored with average mark 3.6. Conclusions: SWOT analysis, and fishbone diagram should be used on regular bases and a new position for a manager for administrative issues, is opened, complaints box and list of rights and responsibilities of patients were dislocated in a more visible place, and internal staff turnover, is introduced. PMID:27482155

  16. Estimating Health Services Requirements

    Science.gov (United States)

    Alexander, H. M.

    1985-01-01

    In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.

  17. 42 CFR 23.8 - What operational requirements apply to an entity to which National Health Service Corps personnel...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What operational requirements apply to an entity to which National Health Service Corps personnel are assigned? 23.8 Section 23.8 Public Health PUBLIC... Assignment of National Health Service Corps Personnel § 23.8 What operational requirements apply to an entity...

  18. Text4baby: Development and Implementation of a National Text Messaging Health Information Service

    Science.gov (United States)

    Whittaker, Robyn; Meehan, Judy; Jordan, Elizabeth; Stange, Paul; Cash, Amanda; Meyer, Paul; Baitty, Julie; Johnson, Pamela; Ratzan, Scott; Rhee, Kyu

    2012-01-01

    Text4baby is the first free national health text messaging service in the United States that aims to provide timely information to pregnant women and new mothers to help them improve their health and the health of their babies. Here we describe the development of the text messages and the large public–private partnership that led to the national launch of the service in 2010. Promotion at the local, state, and national levels produced rapid uptake across the United States. More than 320 000 people enrolled with text4baby between February 2010 and March 2012. Further evaluations of the effectiveness of the service are ongoing; however, important lessons can be learned from its development and uptake. PMID:23078509

  19. PTSD Trajectory, Co-morbidity, and Utilization of Mental Health Services among National Guard Soldiers

    Science.gov (United States)

    2014-09-01

    focus not only on documenting the prevalence and correlates of PTSD and other mental illness and health service utilization among these forces, but...experiences as determinants of mental health in this group. We focus not only on documenting the prevalence and correlates of PTSD and other mental illness ...prevalence of sexual violence and mental health symptoms among National Guard and Reserve soldiers, this research found that lifetime sexual violence

  20. Financing reforms of public health services in China: lessons for other nations.

    Science.gov (United States)

    Liu, Xingzhu; Mills, Anne

    2002-06-01

    Financing reforms of China's public health services are characterised by a reduction in government budgetary support and the introduction of charges. These reforms have changed the financing structure of public health institutions. Before the financing reforms, in 1980, government budgetary support covered the full costs of public health institutions, while after the reforms by the middle of the 1990s, the government's contribution to the institutions' revenue had fallen to 30-50%, barely covering the salaries of health workers, and the share of revenue generated from charges had increased to 50-70%. These market-oriented financing reforms improved the productivity of public health institutions, but several unintended consequences became evident. The economic incentives that were built into the financing system led to over-provision of unnecessary services, and under-provision of socially desirable services. User fees reduced the take-up of preventive services with positive externalities. The lack of government funds resulted in under-provision of services with public goods' characteristics. The Chinese experience has generated important lessons for other nations. Firstly, a decline in the role of government in financing public health services is likely to result in decreased overall efficiency of the health sector. Secondly, levying charges for public health services can reduce demand for these services and increase the risk of disease transmission. Thirdly, market-oriented financing reforms of public health services should not be considered as a policy option. Once this step is made, the unintended consequences may outweigh the intended ones. Chinese experience strongly suggests that the government should take a very active role in financing public health services.

  1. Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil.

    Science.gov (United States)

    Malta, Deborah Carvalho; Bernal, Regina Tomie Ivata; Lima, Margareth Guimarães; Araújo, Silvânia Suely Caribé de; Silva, Marta Maria Alves da; Freitas, Maria Imaculada de Fátima; Barros, Marilisa Berti de Azevedo

    2017-06-01

    To assess whether sex, education level, and health insurance affect the use of health services among the adult Brazilian population with chronic noncommunicable diseases (NCD). Data from a cross-sectional survey were analyzed, the National Health Survey (PNS). Frequency of use of services in the population that referred at least one NCD were compared with the frequency from a population that did not report NCD, according to sex, education level, health insurance, and NCD number (1, 2, 3, 4, or more). The prevalence and prevalence ratios were calculated crude and adjusted for sex, age, region, and 95% confidence intervals. The presence of a noncommunicable disease was associated with increase in hospitalizations in the last 12 months, in 1.7 times (95%CI 1.53-1.9). Failing to perform usual activities in the last two weeks for health reasons was 3.1 times higher in NCD carriers (95%CI 2.78-3.46); while the prevalence of medical consultation in the last 12 months was 1.26 times higher (95%CI 1.24-1.28). NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level. NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level. Analisar se sexo, escolaridade e posse de plano de saúde influenciam a utilização de serviços de saúde entre a população adulta brasileira portadora de doenças crônicas não transmissíveis (DCNT). Foram analisados dados de inquérito transversal, a Pesquisa Nacional de Saúde (PNS). Foram comparadas as frequências de uso de serviços na população que referiu pelo menos uma DCNT, com aquelas que não relatam DCNT, segundo sexo, escolaridade, posse de plano de saúde e número de DCNT (1, 2, 3, 4 ou mais). Foram calculadas as prevalências e razões de prevalência (RP) brutas e ajustadas por sexo, idade e região e respectivos intervalos de

  2. Medical Tourism and the Libyan National Health Services

    OpenAIRE

    El Taguri, Adel

    2007-01-01

    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 ...

  3. Potential challenges facing distributed leadership in health care: evidence from the UK National Health Service.

    Science.gov (United States)

    Martin, Graeme; Beech, Nic; MacIntosh, Robert; Bushfield, Stacey

    2015-01-01

    The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non-clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co-located health-care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse.

  4. Efficiency in the National Health Service: lessons from abroad.

    Science.gov (United States)

    Drummond, M; Maynard, A

    1988-01-01

    Although the NHS gives relatively good value for money when compared to other countries' health care systems, there are managerial initiatives from abroad that could potentially increase NHS efficiency. However, there is currently very little systematic evaluation of the impact of managerial interventions in terms of their benefits and costs. This paper considers four areas of current policy interest (evaluation of new medical technologies, quality assurance, primary health care and the public/private mix), reviews experience abroad and outlines how promising initiatives could be evaluated in the NHS setting. It is argued that if lessons are to be learned about the efficient management of the NHS from abroad or not, there needs to be more systematic evaluation of managerial interventions along the lines commonly proposed for clinical interventions.

  5. Partnering in research: a national research trial exemplifying effective collaboration with American Indian Nations and the Indian Health Service.

    Science.gov (United States)

    Chadwick, Jennifer Q; Copeland, Kenneth C; Daniel, Mary R; Erb-Alvarez, Julie A; Felton, Beverly A; Khan, Sohail I; Saunkeah, Bobby R; Wharton, David F; Payan, Marisa L

    2014-12-15

    Despite the fact that numerous major public health problems have plagued American Indian communities for generations, American Indian participation in health research traditionally has been sporadic in many parts of the United States. In 2002, the University of Oklahoma Health Sciences Center (Oklahoma City, Oklahoma) and 5 Oklahoma American Indian research review boards (Oklahoma City Area Indian Health Service, Absentee Shawnee Tribe, Cherokee Nation, Chickasaw Nation, and Choctaw Nation) agreed to participate collectively in a national research trial, the Treatment Options for Type 2 Diabetes in Adolescence and Youth (TODAY) Study. During that process, numerous lessons were learned and processes developed that strengthened the partnerships and facilitated the research. Formal Memoranda of Agreement addressed issues related to community collaboration, venue, tribal authority, preferential hiring of American Indians, and indemnification. The agreements aided in uniting sovereign nations, the Indian Health Service, academics, and public health officials to conduct responsible and ethical research. For more than 10 years, this unique partnership has functioned effectively in recruiting and retaining American Indian participants, respecting cultural differences, and maintaining tribal autonomy through prereview of all study publications and local institutional review board review of all processes. The lessons learned may be of value to investigators conducting future research with American Indian communities. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Change of government: one more big bang health care reform in England's National Health Service.

    Science.gov (United States)

    Hunter, David J

    2011-01-01

    Once again the National Health Service (NHS) in England is undergoing major reform, following the election of a new coalition government keen to reduce the role of the state and cut back on big government. The NHS has been undergoing continuous reform since the 1980s. Yet, despite the significant transaction costs incurred, there is no evidence that the claimed benefits have been achieved. Many of the same problems endure. The reforms follow the direction of change laid down by the last Conservative government in the early 1990s, which the recent Labour government did not overturn despite a commitment to do so. Indeed, under Labour, the NHS was subjected to further market-style changes that have paved the way for the latest round of reform. The article considers the appeal of big bang reform, questions its purpose and value, and critically appraises the nature and extent of the proposed changes in this latest round of reform. It warns that the NHS in its current form may not survive the changes, as they open the way to privatization and a weakening of its public service ethos.

  7. Implementing a national Scottish digital health & wellbeing service at scale: a qualitative sudy of stakeholders' views

    OpenAIRE

    Agbakoba, Ruth; McGee-Lennon, Marilyn; Bouamrane, Matt-Mouley; Watson, Nicholas; Mair, Frances

    2015-01-01

    Digital technologies are being used as part of international efforts to revolutionize healthcare in order to meet increasing demands such as the rising burden of chronic disease and ageing populations. In Scotland there is a government push towards a national service (Living It Up) as a single point of reference where citizens can access information, products and services to support their health and wellbeing. The aim of the study is to examine implementation issues including the challenges o...

  8. Health economic burden that wounds impose on the National Health Service in the UK.

    Science.gov (United States)

    Guest, Julian F; Ayoub, Nadia; McIlwraith, Tracey; Uchegbu, Ijeoma; Gerrish, Alyson; Weidlich, Diana; Vowden, Kathryn; Vowden, Peter

    2015-12-07

    To estimate the prevalence of wounds managed by the UK's National Health Service (NHS) in 2012/2013 and the annual levels of healthcare resource use attributable to their management and corresponding costs. This was a retrospective cohort analysis of the records of patients in The Health Improvement Network (THIN) Database. Records of 1000 adult patients who had a wound in 2012/2013 (cases) were randomly selected and matched with 1000 patients with no history of a wound (controls). Patients' characteristics, wound-related health outcomes and all healthcare resource use were quantified and the total NHS cost of patient management was estimated at 2013/2014 prices. Patients' mean age was 69.0 years and 45% were male. 76% of patients presented with a new wound in the study year and 61% of wounds healed during the study year. Nutritional deficiency (OR 0.53; p<0.001) and diabetes (OR 0.65; p<0.001) were independent risk factors for non-healing. There were an estimated 2.2 million wounds managed by the NHS in 2012/2013. Annual levels of resource use attributable to managing these wounds and associated comorbidities included 18.6 million practice nurse visits, 10.9 million community nurse visits, 7.7 million GP visits and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds and associated comorbidities was £5.3 billion. This was reduced to between £5.1 and £4.5 billion after adjusting for comorbidities. Real world evidence highlights wound management is predominantly a nurse-led discipline. Approximately 30% of wounds lacked a differential diagnosis, indicative of practical difficulties experienced by non-specialist clinicians. Wounds impose a substantial health economic burden on the UK's NHS, comparable to that of managing obesity (£5.0 billion). Clinical and economic benefits could accrue from improved systems of care and an increased awareness of the impact that wounds impose on patients and the NHS. Published by the BMJ Publishing

  9. From consumerism to partnership? Britain's National Health Service at the turn of the century.

    Science.gov (United States)

    Calnan, M; Gabe, J

    2001-01-01

    It has been argued that "consumerism" has been one of the main influences on health policy in many countries over the last decade or so. This article focuses on the role of consumerism in U.K. health policy during this period through the introduction of changes in National Health Service provision such as introduction of the quasi-market, creation of the new managerialism, and new organizational structures set up under the recent Labour government. It considers the consequences of these changes for the users of health care and for citizenship rights, in particular the extent to which the changes have empowered these users and citizens.

  10. Information sharing between the National Health Service and criminal justice system in the United Kingdom.

    Science.gov (United States)

    Lennox, Charlotte; Mason, Julie; McDonnell, Sharon; Shaw, Jenny; Senior, Jane

    2012-09-01

    Offenders with mental health problems often have complex and interrelated needs which separately challenge the criminal justice system (CJS) and National Health Service (NHS) in the United Kingdom (U.K.). Consequently, interagency collaboration and timely information sharing are essential. This study focused on the sharing of information about people with mental health problems in contact with the CJS. Questionnaires were distributed to a range of health and criminal justice personnel. The results showed that there was a mismatch between what service user information criminal justice agencies felt they needed and what was routinely received. Prison Service staff received more information (between 15% and 37%) from health agencies than the police (between 6% and 22%). Health professionals received most of the information they needed from criminal justice agencies (between 55% and 85%). Sharing service user information was impeded by incompatible computer systems and restrictions due to data protection/confidentiality requirements. In the U.K., recent governmental publications have highlighted the importance of information sharing; however there remains a clear mismatch between what health related information about service users criminal justice agencies need, and what is actually received. Better guidance is required to encourage and empower people to share.

  11. Health economic burden that different wound types impose on the UK's National Health Service.

    Science.gov (United States)

    Guest, Julian F; Ayoub, Nadia; McIlwraith, Tracey; Uchegbu, Ijeoma; Gerrish, Alyson; Weidlich, Diana; Vowden, Kathryn; Vowden, Peter

    2017-04-01

    The aim of this study was to estimate the patterns of care and annual levels of health care resource use attributable to the management of different wound types by the UK's National Health Service (NHS) in 2012/2013 and the annual costs incurred by the NHS in managing them. This was a retrospective cohort analysis of the records of 2000 patients in The Health Improvement Network (THIN) Database. Patients' characteristics, wound-related health outcomes and all health care resource use were quantified, and the total NHS cost of patient management was estimated at 2013/2014 prices. The NHS managed an estimated 2·2 million patients with a wound during 2012/2013. Patients were predominantly managed in the community by general practitioners (GPs) and nurses. The annual NHS cost varied between £1·94 billion for managing 731 000 leg ulcers and £89·6 million for managing 87 000 burns, and associated comorbidities. Sixty-one percent of all wounds were shown to heal in an average year. Resource use associated with managing the unhealed wounds was substantially greater than that of managing the healed wounds (e.g. 20% more practice nurse visits, 104% more community nurse visits). Consequently, the annual cost of managing wounds that healed in the study period was estimated to be £2·1 billion compared with £3·2 billion for the 39% of wounds that did not heal within the study year. Within the study period, the cost per healed wound ranged from £698 to £3998 per patient and that of an unhealed wound ranged from £1719 to £5976 per patient. Hence, the patient care cost of an unhealed wound was a mean 135% more than that of a healed wound. Real-world evidence highlights the substantial burden that wounds impose on the NHS in an average year. Clinical and economic benefits to both patients and the NHS could accrue from strategies that focus on (a) wound prevention, (b) accurate diagnosis and (c) improving wound-healing rates. © 2016 Medicalhelplines.com Inc and John

  12. National implementation of a mental health service model: A survey of Crisis Resolution Teams in England.

    Science.gov (United States)

    Lloyd-Evans, Brynmor; Paterson, Bethan; Onyett, Steve; Brown, Ellie; Istead, Hannah; Gray, Richard; Henderson, Claire; Johnson, Sonia

    2017-01-11

    In response to pressures on mental health inpatient beds and a perceived 'crisis in acute care', Crisis Resolution Teams (CRTs), acute home treatment services, were implemented nationally in England following the NHS Plan in the year 2000: an unprecedentedly prescriptive policy mandate for three new types of functional community mental health team. We examined the effects of this mandate on implementation of the CRT service model. Two hundred and eighteen CRTs were mapped in England, including services in all 65 mental health administrative regions. Eighty-eight percent (n = 192) of CRT managers in England participated in an online survey. CRT service organization and delivery was highly variable. Nurses were the only professional group employed in all CRT staff teams. Almost no teams adhered fully to government implementation guidance. CRT managers identified several aspects of CRT service delivery as desirable but not routinely provided. A national policy mandate and government guidance and standards have proved insufficient to ensure CRT implementation as planned. Development and testing of resources to support implementation and monitoring of a complex mental health intervention is required.

  13. National Health Interview Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States...

  14. Private finance of services covered by the National Health Insurance package of benefits in Israel.

    Science.gov (United States)

    Engelchin-Nissan, Esti; Shmueli, Amir

    2015-01-01

    Private health expenditure in systems of national health insurance has raised concern in many countries. The concern is mainly about the accessibility of care to the poor and the sick, and inequality in use and in health. The concern thus refers specifically to the care financed privately rather than to private health expenditure as defined in the national health accounts. To estimate the share of private finance in total use of services covered by the national package of benefits. and to relate the private finance of use to the income and health of the users. The Central Bureau of Statistics linked the 2009 Health Survey and the 2010 Incomes Survey. Twenty-four thousand five hundred ninety-five individuals in 7175 households were included in the data. Lacking data on the share of private finance in total cost of care delivered, we calculated instead the share of uses having any private finance-beyond copayments-in total uses, in primary, secondary, paramedical and total care. The probability of any private finance in each type of care is then related, using random effect logistic regression, to income and health state. Fifteen percent of all uses of care covered by the national package of benefits had any private finance. This rate ranges from 10 % in primary care, 16 % in secondary care and 31 % in paramedical care. Twelve percent of all uses of physicians' services had any private finance, ranging from 10 % in family physicians to 20 % in pulmonologists, psychiatrists, neurologists and urologists. Controlling for health state, richer individuals are more likely to have any private finance in all types of care. Controlling for income, sick individuals (1+ chronic conditions) are 30 % in total care and 60 % in primary care more likely to have any private finance compared to healthy individuals (with no chronic conditions). The national accounts' "private health spending" (39 % of total spending in 2010) is not of much use regarding equity of and

  15. [International trade in health services and the medical industrial complex: implications for national health systems].

    Science.gov (United States)

    Santos, Maria Angelica Borges dos; Passos, Sonia Regina Lambert

    2010-08-01

    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.

  16. "Liberalizing" the English National Health Service: background and risks to healthcare entitlement.

    Science.gov (United States)

    Filippon, Jonathan; Giovanella, Ligia; Konder, Mariana; Pollock, Allyson M

    2016-08-29

    The recent reform of the English National Health Service (NHS) through the Health and Social Care Act of 2012 introduced important changes in the organization, management, and provision of public health services in England. This study aims to analyze the NHS reforms in the historical context of predominance of neoliberal theories since 1980 and to discuss the "liberalization" of the NHS. The study identifies and analyzes three phases: (i) gradual ideological and theoretical substitution (1979-1990) - transition from professional and health logic to management and commercial logic; (ii) bureaucracy and incipient market (1991-2004) - structuring of the bureaucracy focused on administration of the internal market and expansion of pro-market measures; and (iii) opening to the market, fragmentation, and discontinuity of services (2005-2012) - weakening of the territorial health model and consolidation of health as an open market for public and private providers. This gradual but constant liberalization has closed services and restricted access, jeopardizing the system's comprehensiveness, equity, and universal healthcare entitlement in the NHS.

  17. The effect of the National Health Insurance Scheme (NHIS) on health service delivery in mission facilities in Ghana: a retrospective study

    OpenAIRE

    Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses

    2016-01-01

    Background In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities i...

  18. Oral health need and access to dental services: evidence from the National Survey of Children's Health, 2007.

    Science.gov (United States)

    Bell, Janice F; Huebner, Colleen E; Reed, Sarah C

    2012-04-01

    This study examines associations between parents' report of their children's oral health and receipt of a dental visit for preventive care. We conducted a cross-sectional analysis of oral health status and receipt of a preventive dental visit among US children and youth, ages 1-17 years, using data from the 2007 National Survey of Children's Health (n = 86,764). Survey-weighted logistic regression was used to estimate associations between perceived oral health status and receipt of a preventive dental health visit in the prior 12 months. Overall, 78 % of children and youth received at least one preventive dental health visit in the prior year. Among the youngest children, lower oral health status was associated with higher odds of receiving a preventive dental visit; among older children, lower oral health status was associated with lower odds of receiving a dental visit for preventive care. Use of preventive dental health care is below national target goals. Younger children in worse oral health are more likely, and older youth less likely, to receive preventive dental care. Public health efforts to educate parents to seek early and ongoing preventive oral health care, rather than services in response to problems, may yield oral health benefits later in childhood and over the life course.

  19. Internal customer management and service gaps within the National Health Service.

    Science.gov (United States)

    Chaston, I

    1994-08-01

    One implication of being required to respond to the Patients' Charter without access to more resources, is that managers in the U.K. health care sector will have to ensure integration of multiple functions across their units in order to achieve the objective of creating a quality conscious workforce. This situation will probably demand adoption of an internal marketing philosophy within the NHS; thereby ensuring implementation of TQM and/or Customer Care schemes in which departments work together to create effective internal customer chains. To determine the degree to which the NHS have effectively adopted an internal customer orientation, a survey was undertaken using a modified version of the Parasuraman SERVQUAL model. The majority of respondents indicated the existence of Type 1, 2, 3 and 4 Gaps in the internal customer management process within their unit. Major influencers of these service gaps include departments placing internal efficiency ahead of internal customer needs elsewhere in the organization, limited effort to gain further understanding of internal customer needs and an inadequate level formal quality standards for managing internal customer relations. Respondents consider their departments are able and willing to enhance the quality of provision if the issue was given higher priority by senior management. Identified obstacles to increased future emphasis behind an internal customer philosophy include insufficient resources to service internal customer needs, lack of trust between departments and limited confidence about abilities to manage the process. Unless senior managers in the NHS can be persuaded to allocate the resources needed to create effective internal customer chains, then concern must exist about the capability of operating units to fulfil the health care standards specified in the Patients Charter.

  20. Equity in paying for health care services under a national insurance system.

    Science.gov (United States)

    Boaz, R F

    1975-01-01

    The debate over the future of the health care delivery system evolves around the policy issue of what constitutes a fair distribution of the medical services which are considered essential to prolonging life, curing disease, and relieving pain. A case can be made that a socially equitable distribution implies that consumption of medical services is independent of the consumer's income and payment for them unrelated to utilization. The present paper examines to what extent the provisions for financing a national health insurance system are likely to advance or hinder the fair distribution of health care services. Almost all bills specify a mix of direct (cost-shared) and indirect (prepaid) financing. When cost-sharing is based on the quantity of services or on the level of medical expenditure, it helps divert medical care and health insurance benefits to high-income persons at the expense of their low-or moderate-income counterparts. When indirect payments or premium levels are determined by insurance risks rather than by income, they may be too high for persons with moderate means, and are likely to exclude such persons from the national insurance program. When health insurance is tied to salaried employment, it discriminates against the unemployed and the self-employed. To rectify such inequities, some NHI proposals specify separate insurance plans for the disadvantaged. Such programs, which require income-testing to determine eligibility, are likely to be plagued by administrative complications currently engulfing other means-tested social welfare programs. The present paper makes some recommendations for the purpose of avoiding these difficulties and fostering equity in health care.

  1. [Factors related to the use of pediatric emergency services: results from the Spanish National Health Survey].

    Science.gov (United States)

    Expósito-Ruiz, Manuela; Sánchez-López, Juan; Ruiz-Bailén, Manuel; Rodríguez-Del Águila, María Del Mar

    2017-01-01

    To determine the frequency of use of Spanish pediatric emergency services, and to describe user profiles and geographic variations. Descriptive study based on data from the Spanish National Health Survey. We calculated descriptive statistics and analyzed crude and adjusted odds ratios (ORs). Thirty-five percent of the 5495 respondents had come to an emergency department in the past year, and 88.1% of them had used the services of a Spanish national health service hospital. Factors associated with higher use of emergency services were male sex of the patient, (OR, 1.202; 95% CI, 1.047-1.381), a higher educational level of parents (OR, 1.255; 95% CI, 0.983-1.603), and younger age of the child (OR, 0.909; 95% CI, 0.894-0.924). Emergency department use varied widely from one Spanish community to another. There was a positive correlation between use and the presence of a foreign-born population (ρ=0.495, P=.031). The rate of emergency department use is high in Spain. Variability between geographic areas is considerable, and some variation is explained by population characteristics.

  2. Back to the market: yet more reform of the National Health Service.

    Science.gov (United States)

    Lewis, Richard; Gillam, Stephen

    2003-01-01

    Yet more reform of the National Health Service in England has been announced by the Department of Health. In opposition, the Labour Party criticized the creation of an "internal market" for health care by the Conservative government, but five years into the Blair administration, market incentives are to be reinvigorated and the private sector is to be embraced in ways not seen hitherto. New guidance signals the introduction of competitive contracting using cost-per-case currencies, more choice for patients in where they will receive hospital treatment, and the freeing of NHS care providers from the direct political control of ministers. It is intended that the monopolistic features of the NHS in England should give way to greater pluralism, in particular through contracts with privately owned health care organizations. However, there is little evidence to suggest that these policies will be effective, and a number of practical problems may obstruct implementation.

  3. Determinants of mental health service use in the national mental health survey of the elderly in Singapore

    Directory of Open Access Journals (Sweden)

    Kua Ee

    2009-01-01

    Full Text Available Abstract Background Despite high prevalence of mental health problems, only a minority of elderly people seek treatment. Although need-for-care factors are primary determinants of mental health service use, personal predisposing or enabling factors including health beliefs are important but are not well studied. Method In the National Mental Health Survey of Elderly in Singapore, 2003, 1092 older adults aged 60 and above were interviewed for diagnosis of mental disorders (using Geriatric Mental State and treatment, and their health beliefs about the curability of mental illness, embarrassment and stigma, easiness discussing mental problems, effectiveness and safety of treatment and trust in professionals. Results The prevalence of mental disorders was 13%, but only a third of mentally ill respondents had sought treatment. Increased likelihood of seeking treatment was significantly associated with the presence of a mental disorder (OR = 5.27, disability from mental illness (OR = 79.9, and poor or fair self-rated mental health (OR = 2.63, female gender (OR = 2.25, and formal education (OR = 2.40. The likelihood of treatment seeking was lower in those reporting financial limitations for medical care (OR = 0.38, but also higher household income (OR = 0.31. Negative beliefs showed no meaningful associations, but the positive belief that 'to a great extent mental illness can be cured' was associated with increased mental health service use (OR = 6.89. The availability of family caregiver showed a negative association (OR = 0.20. Conclusion The determinants of mental health service use in the elderly included primary need factors, and female gender and socioeconomic factors. There was little evidence of influences by negative health beliefs, but a positive health belief that 'mental illness can be cured' is a strongly positive determinant The influence of family members and care-givers on senior's use of mental health service should be further explored.

  4. A comparative study of internal customer management practices within service sector firms and the National Health Service.

    Science.gov (United States)

    Chaston, I

    1994-02-01

    In responding to the UK government's market forces model, some National Health Service (NHS) managers have introduced private sector concepts such as 'customer care' and 'total quality management' (TQM). Private sector firms find that success of these techniques is dependent upon creating an internal marketing orientation across the entire organization. To determine how internal marketing is being applied, a comparative survey of UK service sector firms and NHS units was undertaken using a modified version of Parasuraman's SERVQUAL model. All respondents indicated existence of type 1, 2, 3 and 4 gaps in the internal customer management process within their organizations. Major influencers of service gaps include departments placing internal efficiency ahead of internal customers and insufficient understanding of internal customer requirements. The survey indicated that, in certain areas of managing service quality, the NHS is performing better than its private sector counterparts. Nevertheless, opportunity for enhancing service quality in the NHS is possible through improving the flow of information between departments, stronger orientation towards meeting customer needs, upgrading provision systems and changing intradepartmental culture. The constraint facing the NHS manager is the limited availability of resources. One solution is to allocate resources in relation to service priorities. A directional planning matrix is presented as a tool for developing an optimum internal customer management strategy within an NHS unit.

  5. Lessons from London: the British are reforming their national health service.

    Science.gov (United States)

    Vall-Spinosa, A

    1991-12-01

    In an effort to keep abreast of the changing needs of a more affluent society and to ensure better value for money, the British are reforming their National Health Service. They are promoting competition and entrepreneurship, and directing funding to follow a patient rather than flowing directly to institutions. British physicians are resisting these changes. The United States, in the middle of a health care crisis of its own, can learn a great deal from Britain, especially in the area of controlling expenditures. The low cost of the National Health Service can be attributed to four major factors: (1) It is general practitioner driven and no patient accesses a specialist or hospital directly. (2) Hospitals, which employ all the specialists and supply most of the technology, operate on very tight, cash-limited budgets. (3) Administrative costs are very low. (4) The expense of malpractice is not (yet) a major concern. Changes occurring in both countries foretell a future wherein our health care systems may look very much alike.

  6. Willingness to pay to sustain and expand National Health Insurance services in Taiwan

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    Lai Mei-Shu

    2008-12-01

    Full Text Available Abstract Background The purpose of the present study was to investigate people's willingness to pay to sustain the current National Health Insurance (NHI program in Taiwan and to extend that program to cover long-term care services. Methods A survey was administered to 1800 inpatients and 1800 outpatients, selected from health care facilities across all accreditation levels that were operating under the supervision of six different regional branches of Taiwan's Bureau of National Health Insurance (BNHI. We used a contingent valuation method with closed-ended questions to elicit participants' willingness to pay for continued national heath insurance and additional institutional long-term care services. We divided participants into six subgroups and asked individuals in these groups referendum-like yes-no questions about whether they were willing to pay one of six price bids: New Taiwan Dollar (NT$ 50, NT$100, NT$200, NT$300, NT$400, or NT$500. Logistic regression was used to analyze willingness to pay. Results We found maximum willingness to pay for continued coverage by the NHI program and additional institutional long-term care services to be NT$66 and NT$137 dollars per month, respectively. Conclusion We found that people were willing to pay more for their insurance coverage. With regard to methodology, we also found that using a contingent valuation method to elicit peoples' willingness to pay for health policy issues is valid. The results of the present referendum-like study can serve as a reference for future policy decision making.

  7. The UK National Health Service's 'innovation agenda': lessons on commercialisation and trust.

    Science.gov (United States)

    Sterckx, Sigrid; Cockbain, Julian

    2014-01-01

    The UK National Health Service (the 'NHS'), encouraged by the 2011 report Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, and empowered by the Health and Social Care Act 2012, is in the process of adopting a new agenda for stimulating innovation in healthcare. For this, the bodies, body materials, and confidential health information of NHS patients may be co-opted. We explain why this brings the NHS into a moral conflict with its basic goal of providing a universal healthcare service. Putting NHS databases at the disposal of industry, without addressing ethical concerns regarding the privacy, autonomy, and moral integrity of patients and without requiring a 'kick-back' to enhance the service that the NHS provides, is inappropriate. As this article shows, with reference to the commercial arena of direct-to-consumer genetic testing, it is crucial that patient and public trust in the NHS is not eroded. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Holding up the oral health safety net: the role of National Health Service Corps alumni dentists in North Carolina.

    Science.gov (United States)

    Bhatavadekar, Neel B; Rozier, R Gary; Konrad, Thomas R

    2011-06-01

      Access to oral health care among low income populations is a growing problem. The National Health Service Corps (NHSC) might increase the supply of dentists motivated to provide services for this population.   To determine if North Carolina dentists who began a service obligation with the NHSC in 1990-1999 continued to provide care for underserved populations and if they differ from non-NHSC alumni primary care dentists who started practice in the state during that same period.   All 19 NHSC alumni and 50 comparison dentists were surveyed by mail. NHSC alumni also responded to selected items in a telephone follow-up interview. The two groups were compared using difference of means tests and multivariate contingency tables.   National Health Service Corps alumni were more likely to be African-American (38%vs. 10%), work in safety net practices (84%vs. 23%), and see more publicly insured patients (60%vs. 19%) than comparison dentists. Yet their job satisfaction was comparable to non-NHSC alumni dentists. Analyses suggested that current practice in safety net settings is affected by dentists' race, altruistic motivations and previous NHSC participation. CONCLUSION AND POLICY IMPLICATION:  Targeted recruitment of African-American dentists and others wanting to work in underserved communities could amplify the effectiveness of the financial incentive of NHSC loan repayment and induce dentists to remain in 'safety net' settings. © 2011 FDI World Dental Federation.

  9. National Database for Autism Research (NDAR): Big Data Opportunities for Health Services Research and Health Technology Assessment.

    Science.gov (United States)

    Payakachat, Nalin; Tilford, J Mick; Ungar, Wendy J

    2016-02-01

    The National Database for Autism Research (NDAR) is a US National Institutes of Health (NIH)-funded research data repository created by integrating heterogeneous datasets through data sharing agreements between autism researchers and the NIH. To date, NDAR is considered the largest neuroscience and genomic data repository for autism research. In addition to biomedical data, NDAR contains a large collection of clinical and behavioral assessments and health outcomes from novel interventions. Importantly, NDAR has a global unique patient identifier that can be linked to aggregated individual-level data for hypothesis generation and testing, and for replicating research findings. As such, NDAR promotes collaboration and maximizes public investment in the original data collection. As screening and diagnostic technologies as well as interventions for children with autism are expensive, health services research (HSR) and health technology assessment (HTA) are needed to generate more evidence to facilitate implementation when warranted. This article describes NDAR and explains its value to health services researchers and decision scientists interested in autism and other mental health conditions. We provide a description of the scope and structure of NDAR and illustrate how data are likely to grow over time and become available for HSR and HTA.

  10. A discussion: the future role of homeopathy in the National Health Service (NHS).

    Science.gov (United States)

    Ng, Daniel Yu-Hin

    2011-07-01

    Homeopathy has been provided by the National Health Service in the UK for over 60 years, funded largely by taxpayer's money. However, in recent years, its provision has come under much criticism questioning its true value. Taking a neutral stance, arguments both for and against the provision of homeopathy on the NHS is presented. It includes issues such as the evidence and safety profile of homeopathy, but also takes into account costs and benefits of homeopathy in a wider perspective. Overall, the provision of homeopathy is justified as long as there is a need within the population, occupying a complementary role alongside conventional medicine.

  11. Career histories and managerial performance of health care chief executive officers: an empirical study in the Italian National Health Service.

    Science.gov (United States)

    Mascia, Daniele; Piconi, Ilaria

    2013-01-01

    Organizational studies widely acknowledge the importance of the relationship between CEO's career histories and managerial performance. Although the health care management literature largely explores the role of CEOs, whether and how top managers' career histories affect their own performance remains still unknown in this industry. The aim of this study was to investigate the career histories of health care CEOs and to explore their impact on managerial performance. Primary data were collected from a sample of 124 CEOs leading health care organizations in the Italian National Health Service in 2008. Biographic data were accessed to gather information about relevant CEOs' demographics and their career histories. The relevance of CEOs' prior experience was considered, taking into account the prominence of health care organizations in which they passed through in their career histories. Regression analyses were employed to assess the impact of CEOs' career histories on their managerial performance. Top managers already appointed as CEOs were more likely to achieve higher levels of performance. Careers with long tenure within the National Health Service appear to increase managerial performance. Those CEOs who accumulated prior experience in a large number of health care structures and who spent time working at the most prominent hospitals were also more likely to achieve higher levels of managerial performance. In health care, a CEO's career history does impact his or her managerial performance. Specifically, patterns of career that imply higher mobility across health care organizations are important. Although interorganizational mobility is significant for CEO performance, the same does not hold for mobility across industries. These findings contribute to the current debate about the need for management renovation within health care organizations.

  12. Teaching-Service integration within the National Professional Health Education Reorientation Program.

    Science.gov (United States)

    Vendruscolo, Carine; Prado, Marta Lenise do; Kleba, Maria Elisabeth

    2016-09-01

    This integrative literature review aimed at identifying the characteristics and describing how teaching-service integration is expressed in studies on Pró-Saúde (Charitable institution for social and hospital assistance) published in Brazil in the period 2007-2012. For the search, the term National Professional Health Education Reorientation Program was entered in the following databases: Virtual Health Library (BVS), Google Scholar and the Bank of Theses of the Coordination for the Improvement of Higher Education Personnel (CAPES). Forty-one publications were selected with the following inclusion criteria: scientific papers; theses and dissertations; studies in English, Portuguese or Spanish. The critical review of studies was performed through a comprehensive reading of the texts. Outcomes are presented in two categories: Dialogue and partnership as tools for teaching-service integration and Movements of change in teaching-service through Pró-Saúde. Studies have shown that changes in professional education and practice are possible and necessary, especially when supported by strategies that encourage active participation of subjects and confirm teaching-service integration as opportunity for dialogue, promoted by this inducing policy.

  13. [Analysis of the technical efficiency of hospitals in the Spanish National Health Service].

    Science.gov (United States)

    Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

    To analyse the technical efficiency and productivity of general hospitals in the Spanish National Health Service (NHS) (2010-2012) and identify explanatory hospital and regional variables. 230 NHS hospitals were analysed by data envelopment analysis for overall, technical and scale efficiency, and Malmquist index. The robustness of the analysis is contrasted with alternative input-output models. A fixed effects multilevel cross-sectional linear model was used to analyse the explanatory efficiency variables. The average rate of overall technical efficiency (OTE) was 0.736 in 2012; there was considerable variability by region. Malmquist index (2010-2012) is 1.013. A 23% variability in OTE is attributable to the region in question. Statistically significant exogenous variables (residents per 100 physicians, aging index, average annual income per household, essential public service expenditure and public health expenditure per capita) explain 42% of the OTE variability between hospitals and 64% between regions. The number of residents showed a statistically significant relationship. As regards regions, there is a statistically significant direct linear association between OTE and annual income per capita and essential public service expenditure, and an indirect association with the aging index and annual public health expenditure per capita. The significant room for improvement in the efficiency of hospitals is conditioned by region-specific characteristics, specifically aging, wealth and the public expenditure policies of each one. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network.

    Science.gov (United States)

    Wright, Adam; Sittig, Dean F

    2008-12-01

    In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

  15. The costs of nursing turnover: evidence from the British National Health Service.

    Science.gov (United States)

    Gray, A M; Phillips, V L; Normand, C

    1996-11-01

    This article reports empirical evidence on the costs of nursing and other staff turnover in the National Health Service. It begins by considering the possible costs and benefits associated with turnover. It then examines current turnover rates in the NHS and existing estimates of the direct administrative costs and the short-term productivity losses associated with turnover. Using these estimates, it compares the cost-effectiveness of a policy which uses across-the-board pay increases to reduce turnover with one which targets pay rises to certain groups only. Next, possible indirect costs of turnover are evaluated using data collected from a large cross-section of providers and other sources. No relationship is found between turnover rates and crude measures of patient service or staff morale measures. The paper concludes with a brief discussion of the main findings and some suggestions for future research.

  16. The perceived impact of the National Health Service on personalised nutrition service delivery among the UK public.

    Science.gov (United States)

    Fallaize, Rosalind; Macready, Anna L; Butler, Laurie T; Ellis, Judi A; Berezowska, Aleksandra; Fischer, Arnout R H; Walsh, Marianne C; Gallagher, Caroline; Stewart-Knox, Barbara J; Kuznesof, Sharon; Frewer, Lynn J; Gibney, Mike J; Lovegrove, Julie A

    2015-04-28

    Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the 'framework approach' described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

  17. Challenges of commissioning and contracting for integrated care in the National Health Service (NHS) in England.

    Science.gov (United States)

    Addicott, Rachael

    2016-01-01

    For many years there has been a separation between purchasing and provision of services in the English National Health Service (NHS). Many studies report that this commissioning function has been weak: purchasers have had little impact or power in negotiations with large acute providers, and have had limited strategic control over the delivery of care. Nevertheless, commissioning has become increasingly embedded in the NHS structure since the arrival of Clinical Commissioning Groups (CCGs) in 2012. Recently, some of these CCGs have focused on how they can contract and commission in different ways to stimulate greater collaboration across providers. This paper examines experiences of commissioning and contracting for integrated care in the English NHS, based on a series of national-level interviews and case studies of five health economies that are implementing novel contracting models. The cases illustrated here demonstrate early experiments to drive innovation through contracting in the NHS that have largely relied on the vision of individual teams or leaders, in combination with external legal, procurement and actuarial support. It is unlikely that this approach will be sustainable or replicable across the country or internationally, despite the best intentions of commissioners. Designing and operating novel contractual approaches will require considerable determination, alongside advanced skills in procurement, contract management and commissioning. The cost of developing new contractual approaches is high, and as the process is difficult and resource-intensive, it is likely that dedicated teams or programs will be required to drive significant improvement.

  18. Utility of the Health of the Nation Outcome Scales (HoNOS) in Predicting Mental Health Service Costs for Patients with Common Mental Health Problems: Historical Cohort Study

    OpenAIRE

    Twomey, Conal; Prina, A. Matthew; Baldwin, David S.; Das-Munshi, Jayati; Kingdon, David; Koeser, Leonardo; Prince, Martin J.; Stewart, Robert; Tulloch, Alex D.; Cieza, Alarcos

    2016-01-01

    Background Few countries have made much progress in implementing transparent and efficient systems for the allocation of mental health care resources. In England there are ongoing efforts by the National Health Service (NHS) to develop mental health ‘payment by results’ (PbR). The system depends on the ability of patient ‘clusters’ derived from the Health of the Nation Outcome Scales (HoNOS) to predict costs. We therefore investigated the associations of individual HoNOS items and the Total H...

  19. The Norwegian national project for ethics support in community health and care services.

    Science.gov (United States)

    Magelssen, Morten; Gjerberg, Elisabeth; Pedersen, Reidar; Førde, Reidun; Lillemoen, Lillian

    2016-11-08

    Internationally, clinical ethics support has yet to be implemented systematically in community health and care services. A large-scale Norwegian project (2007-2015) attempted to increase ethical competence in community services through facilitating the implementation of ethics support activities in 241 Norwegian municipalities. The article describes the ethics project and the ethics activities that ensued. The article first gives an account of the Norwegian ethics project. Then the results of two online questionnaires are reported, characterizing the scope, activities and organization of the ethics activities in the Norwegian municipalities and the ethical topics addressed. One hundred and thirty-seven municipal contact persons answered the first survey (55 % response rate), whereas 217 ethics facilitators from 48 municipalities responded to the second (33 % response rate). The Norwegian ethics project is vast in scope, yet has focused on some institutions and professions (e.g., nursing homes, home-based care; nurses, nurses' aides, unskilled workers) whilst seldom reaching others (e.g., child and adolescent health care; physicians). Patients and next of kin were very seldom involved. Through the ethics project employees discussed many important ethical challenges, in particular related to patient autonomy, competence to consent, and cooperation with next of kin. The "ethics reflection group" was the most common venue for ethics deliberation. The Norwegian project is the first of its kind and scope, and other countries may learn from the Norwegian experiences. Professionals have discussed central ethical dilemmas, the handling of which arguably makes a difference for patients/users and service quality. The study indicates that large (national) scale implementation of CES structures for the municipal health and care services is complex, yet feasible.

  20. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    Directory of Open Access Journals (Sweden)

    Sekandi Juliet

    2011-03-01

    Full Text Available Abstract Background Mulago National Referral Hospital (MNRH, Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23 and focus group discussions (n=7 were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies, staff inadequacies (knowledge, motivation, and professionalism, overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism

  1. Data Analytic Process of a Nationwide Population-Based Study Using National Health Information Database Established by National Health Insurance Service

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    Yong-ho Lee

    2016-02-01

    Full Text Available In 2014, the National Health Insurance Service (NHIS signed a memorandum of understanding with the Korean Diabetes Association to provide limited open access to its databases for investigating the past and current status of diabetes and its management. NHIS databases include the entire Korean population; therefore, it can be used as a population-based nationwide study for various diseases, including diabetes and its complications. This report presents how we established the analytic system of nation-wide population-based studies using the NHIS database as follows: the selection of database study population and its distribution and operational definition of diabetes and patients of currently ongoing collaboration projects.

  2. Data Analytic Process of a Nationwide Population-Based Study Using National Health Information Database Established by National Health Insurance Service.

    Science.gov (United States)

    Lee, Yong Ho; Han, Kyungdo; Ko, Seung Hyun; Ko, Kyung Soo; Lee, Ki Up

    2016-02-01

    In 2014, the National Health Insurance Service (NHIS) signed a memorandum of understanding with the Korean Diabetes Association to provide limited open access to its databases for investigating the past and current status of diabetes and its management. NHIS databases include the entire Korean population; therefore, it can be used as a population-based nationwide study for various diseases, including diabetes and its complications. This report presents how we established the analytic system of nation-wide population-based studies using the NHIS database as follows: the selection of database study population and its distribution and operational definition of diabetes and patients of currently ongoing collaboration projects.

  3. UNDERSTANDING HOW HEALTHY WORKPLACES ARE CREATED: IMPLICATIONS FOR DEVELOPING A NATIONAL HEALTH SERVICE HEALTHY WORKPLACE PROGRAM.

    Science.gov (United States)

    Wyatt, Katrina M; Brand, Sarah; Ashby-Pepper, Julie; Abraham, Jane; Fleming, Lora E

    2015-01-01

    The workplace is an important setting for promoting health and well-being. We sought to understand how successful workplace health and well-being programs were developed and implemented to inform the development of a program for a National Health Service (NHS) hospital. Case studies of successful healthy workplace programs with 34 semi-structured employee interviews informed 12 interviews with NHS staff. Interviews were thematically analyzed using Nvivo. Themes were fed back to participants for further clarification and validation. Healthy workplace programs were characterized by senior management endorsement; collective sense of ownership; presence of visible "quick wins"; and a sense that participation was easy and fun, not mandated. Programs evolved organically, allowing trust to be built and activities to be developed with employees. Interviews with NHS staff suggested a lack of belief in the possibility of change in their workplace due to time and workload pressures, and a sense of an "us and them" relationship with management, as well as environmental barriers. A consistent pattern of how the conditions for a healthy workplace can be created, which map onto the results from the NHS ward staff, suggest that without creating an enabling environment for health-promoting behaviors, workplace programs will have poor uptake and retention.

  4. Health information technology and sociotechnical systems: a progress report on recent developments within the UK National Health Service (NHS).

    Science.gov (United States)

    Waterson, Patrick

    2014-03-01

    This paper summarises some of the research that Ken Eason and colleagues at Loughborough University have carried out in the last few years on the introduction of Health Information Technologies (HIT) within the UK National Health Service (NHS). In particular, the paper focuses on three examples which illustrate aspects of the introduction of HIT within the NHS and the role played by the UK National Programme for Information Technology (NPfIT). The studies focus on stages of planning and preparation, implementation and use, adaptation and evolution of HIT (e.g., electronic patient records, virtual wards) within primary, secondary and community care settings. Our findings point to a number of common themes which characterise the use of these systems. These include tensions between national and local strategies for implementing HIT and poor fit between healthcare work systems and the design of HIT. The findings are discussed in the light of other large-scale, national attempts to introduce similar technologies, as well as drawing out a set of wider lessons learnt from the NPfIT programme based on Ken Eason's earlier work and other research on the implementation of large-scale HIT.

  5. A Clinical Study on The Effect of Oriental Treatment For Obesity in National Health Services

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    Shin Min-seop

    2006-02-01

    Full Text Available Objectives : This study was to investigate the effect of Nationl Health Services for obesity patients by oriental medical treatment. Methods : We analyzed 46 obesity patient joined to Oriental Treatment for Obesity in Sunchang Medical Center with BCA(bocy component analysis, after we had treated them with our obesity program. We analyzed changes of BCA during before and after treatment, and analyzed items in BCA are weight(kg, amount of muscle(kg, amount of body fat(kg, body fat rate(% and BMI(body mass index. Results : 1. Weight, amount of muscle, amount of body fat, body fat rate and BMI were decreased in after treatment, but they didn't have statistical significance. 2. This studies suggest oriental treatment for obesity may be an effective overweigh group(BMI 25~30, because it had statistical significance(p<0.05. 3. It appears that oriental treatment for obesity have an effect in National Health Services

  6. Implementing a National Scottish Digital Health & Wellbeing Service at Scale: A Qualitative Study of Stakeholders' Views.

    Science.gov (United States)

    Agbakoba, Ruth; McGee-Lennon, Marilyn; Bouamrane, Matt-Mouley; Watson, Nicholas; Mair, Frances

    2015-01-01

    Digital technologies are being used as part of international efforts to revolutionize healthcare in order to meet increasing demands such as the rising burden of chronic disease and ageing populations. In Scotland there is a government push towards a national service (Living It Up) as a single point of reference where citizens can access information, products and services to support their health and wellbeing. The aim of the study is to examine implementation issues including the challenges or facilitators which can help to sustain this intervention. We gathered data in three ways: a) participant observation to gain an understanding of LiU (N=16); b) in-depth interviews (N=21) with stakeholders involved in the process; and c) analysis of documentary evidence about the progress of the implementation (N=45). Barriers included the need to "work at risk" due to delays in financing, inadequate infrastructure and skill-set deficiencies, whilst facilitators included trusted relationships, champions and a push towards normalisation. The findings suggest that a Scottish ehealth service is achievable but identifies key considerations for future large scale initiatives.

  7. Are we nearly there yet? A study of the English National Health Service as professional bureaucracies.

    Science.gov (United States)

    Dickinson, Helen; Snelling, Iain; Ham, Chris; Spurgeon, Peter C

    2017-06-19

    Purpose The purpose of this paper is to explore issues of medical engagement in the management and leadership of health services in the English National Health Service (NHS). The literature suggests that this is an important component of high performing health systems, although the NHS has traditionally struggled to engage doctors and has been characterised as a professional bureaucracy. This study explored the ways in which health care organisations structure and operate medical leadership processes to assess the degree to which professional bureaucracies still exist in the English NHS. Design/methodology/approach Drawing on the qualitative component of a research into medical leadership in nine case study sites, this paper reports on findings from over 150 interviews with doctors, general managers and nurses. In doing so, the authors focus specifically on the operation of medical leadership in nine different NHS hospitals. Findings Concerted attention has been focussed on medical leadership and this has led to significant changes to organisational structures and the recruitment and training processes of doctors for leadership roles. There is a cadre of doctors that are substantially more engaged in the leadership of their organisations than previous research has found. Yet, this engagement has tended to only involve a small section of the overall medical workforce in practice, raising questions about the nature of medical engagement more broadly. Originality/value There are only a limited number of studies that have sought to explore issues of medical leadership on this scale in the English context. This represents the first significant study of this kind in over a decade.

  8. Internationally recruited neonatal nurses' experiences in the National Health Service in London.

    Science.gov (United States)

    Alexis, Obrey; Shillingford, Adeline

    2015-08-01

    The aim of this study was to explore internationally recruited neonatal nurses' (IRNNs) perceptions of their experiences of working in the National Health Service (NHS) in London. This was an exploratory study. A purposive sample of 13 nurses (all females) from two teaching hospitals in London participated in this study. Semi-structured face-to-face interviews were used to capture IRNNs views of working in the NHS in London. Five themes emerged, namely: motivation to migrate, lack of preparation for neonatal nurses, environmental conditions impacting on care delivery, neonatal nurses deskilling, and role restrictions as well as professional development. The findings of this study provide first-hand insights from the subjective perspectives of IRNN experiences. IRNNs experienced some challenges to their working lives; however, good preparation is important when recruiting them to work in the NHS. © 2014 Wiley Publishing Asia Pty Ltd.

  9. Child psychoanalytic psychotherapy in the UK National Health Service: an historical analysis

    OpenAIRE

    Rous, Elizabeth; Clark, Andrew

    2009-01-01

    Abstract This review developed from a discussion with the late Professor Richard Harrington about interventions in Child and Adolescent Mental Health services (CAMHS) that lacked an evidence base. Our aim is to investigate the literature for signs that child psychoanalysis is a declining paradigm within the Child and Adolescent Mental Health Services (CAMHS) in the United Kingd...

  10. Sharing the British National Health Service around the world: a self-interested perspective.

    Science.gov (United States)

    Chalkidou, Kalipso; Vega, Jeanette

    2013-10-25

    As the UK reiterates its commitment to protecting and growing its development aid budget amidst an adverse economic environment for the UK and Europe, we discuss the potential to use the country's National Health Service (NHS) model as a vehicle for promoting the country's economic as well as global health diplomacy and development priorities, through a coordinated cross-government plan of action. With the country's Prime Minister serving as a co-chair of the UN post-2015 development agenda panel,a this is a unique opportunity for the UK to put forward its health system architecture as a highly applicable and well-tested model for providing access to efficient and cost-effective care, with minimal financial hardship. Arguably, such a model tailored to the needs of specific countries could consequently lead to commercial opportunities for UK plc. in areas such as consulting, training, education and healthcare products. Finally, this approach would be consistent with the current thinking on the evolving role of UK aid, especially in the case of emerging powers such as India, where the focus has shifted from aid to investment in technical assistance and cooperation as a means of boosting bilateral business and trade.

  11. The psychological contract: is the UK National Health Service a model employer?

    Science.gov (United States)

    Fielden, Sandra; Whiting, Fiona

    2007-05-01

    The UK National Health Service (NHS) is facing recruitment challenges that mean it will need to become an 'employer of choice' if it is to continue to attract high-quality employees. This paper reports the findings from a study focusing on allied health professional staff (n = 67), aimed at establishing the expectations of the NHS inherent in their current psychological contract and to consider whether the government's drive to make the NHS a model employer meets those expectations. The findings show that the most important aspects of the psychological contract were relational and based on the investment made in the employment relationship by both parties. The employment relationship was one of high involvement but also one where transactional contract items, such as pay, were still of some importance. Although the degree of employee satisfaction with the relational content of the psychological contract was relatively positive, there was, nevertheless, a mismatch between levels of importance placed on such aspects of the contract and levels of satisfaction, with employees increasingly placing greater emphasis on those items the NHS is having the greatest difficulty providing. Despite this apparent disparity between employee expectation and the fulfilment of those expectations, the overall health of the psychological contract was still high.

  12. Making sense of effective partnerships among senior leaders in the National Health Service.

    Science.gov (United States)

    Mitra, Mahima; Hoff, Timothy; Brankin, Paul; Dopson, Sue

    2017-05-22

    Changing health care systems depend on strong organizational leadership that realizes the collaborative potential of both physician and nonphysician leaders. The aim of this study was to seek insight into the everyday health care leader experience by examining 24 physician and nonphysician leaders working in the U.K. National Health Service. We explored (a) how they make sense of and act with respect to specific collaborative tensions in their interactions and (b) which aspects of their everyday leadership contexts heighten the probability for producing and resolving such tensions. We conducted 24 in-depth interviews with physician and nonphysician leaders in job titles including Chief Operating Officer, Managing Director, Medical Director, and Clinical Director. Ideas from the social psychological perspectives of sensemaking, organizational role theory, and organizational citizenship behavior helped frame the study. We identified four areas of ongoing tension between senior leaders. Each of these was linked to a set of underlying drivers, with the strongest support for drivers with interpersonal roots. Effective strategies for resolving tensions involved significant effort by leaders at improving the interpersonal dynamics associated with everyday interaction and forging relational connections through enhanced trust within the leadership team. This study outlines the organizational and individual characteristics that lend to effective collaboration among senior health care leadership and the types of collaborative tensions likely to be experienced by senior health care leaders. Organizations should provide greater role clarity for senior leadership roles, promote "soft" interpersonal competencies within them, and better assess potential leaders for success in senior roles. Organizational support in the form of facilitation, time, and spaces to learn together can provide a better context for collaborative decision-making.

  13. The medium-term sustainability of organisational innovations in the national health service

    Directory of Open Access Journals (Sweden)

    Finn Rachael

    2011-03-01

    Full Text Available Abstract Background There is a growing recognition of the importance of introducing new ways of working into the UK's National Health Service (NHS and other health systems, in order to ensure that patient care is provided as effectively and efficiently as possible. Researchers have examined the challenges of introducing new ways of working--'organisational innovations'--into complex organisations such as the NHS, and this has given rise to a much better understanding of how this takes place--and why seemingly good ideas do not always result in changes in practice. However, there has been less research on the medium- and longer-term outcomes for organisational innovations and on the question of how new ways of working, introduced by frontline clinicians and managers, are sustained and become established in day-to-day practice. Clearly, this question of sustainability is crucial if the gains in patient care that derive from organisational innovations are to be maintained, rather than lost to what the NHS Institute has called the 'improvement-evaporation effect'. Methods The study will involve research in four case-study sites around England, each of which was successful in sustaining its new model of service provision beyond an initial period of pilot funding for new genetics services provided by the Department of Health. Building on findings relating to the introduction and sustainability of these services already gained from an earlier study, the research will use qualitative methods--in-depth interviews, observation of key meetings, and analysis of relevant documents--to understand the longer-term challenges involved in each case and how these were surmounted. The research will provide lessons for those seeking to sustain their own organisational innovations in wide-ranging clinical areas and for those designing the systems and organisations that make up the NHS, to make them more receptive contexts for the sustainment of innovation. Discussion

  14. Student and Nonstudent National Guard Service Members/Veterans and Their Use of Services for Mental Health Symptoms

    Science.gov (United States)

    Bonar, Erin E.; Bohnert, Kipling M.; Walters, Heather M.; Ganoczy, Dara; Valenstein, Marcia

    2015-01-01

    Objective: To compare mental health symptoms and service utilization among returning student and nonstudent service members/veterans (SM/Vs). Participants: SM/Vs (N = 1,439) were predominately white (83%) men (92%), half were over age 30 (48%), and 24% were students. Methods: SM/Vs completed surveys 6 months post deployment (October 2011-July…

  15. The snakes and ladders of National Health Service management in England.

    Science.gov (United States)

    Powell, Martin

    2014-01-01

    This article explores managerial careers in the National Health Service (NHS) through the lens of talent management, particularly focusing on how managers view barriers (snakes) and facilitators (ladders) to career progression. There is a significant literature on enablers and barriers to career progression, but much of this focuses on specific groups such as black and minority ethnic and female workers, and there is relatively little material on the general workforce of the NHS. The research design is a mixed method quantitative (questionnaire) and qualitative (interview and focus group) approach consisting of a quasi-probability element that focuses on a maximum variety sample and a purposive element that seeks policy views at central and strategic health authority level, and examines talent management in high-performing NHS organisations. Ladders are identified as follows: volunteering, secondment, networking, mentoring, academic qualifications, development, good role models/managers and appraisal/personal development plan. Snakes are identified as managing expectations; identity and cognitive diversity; location; sector; NHS toxic and favouritism culture; poor talent spotting; credentialism; exclusive approach to talent; and sustainability. It concludes that while previous conceptual and empirical work is fairly clear on any ladders, it is less clear on snakes. Copyright © 2013 John Wiley & Sons, Ltd.

  16. Student and Nonstudent National Guard Service Members/Veterans and Their Use of Services for Mental Health Symptoms.

    Science.gov (United States)

    Bonar, Erin E; Bohnert, Kipling M; Walters, Heather M; Ganoczy, Dara; Valenstein, Marcia

    2015-01-01

    To compare mental health symptoms and service utilization among returning student and nonstudent service members/veterans (SM/Vs). SM/Vs (N = 1,439) were predominately white (83%) men (92%), half were over age 30 (48%), and 24% were students. SM/Vs completed surveys 6 months post deployment (October 2011-July 2013). Students and nonstudent SM/Vs did not differ in positive screens for depression, anxiety, hazardous drinking, or posttraumatic stress disorder. Students (n = 81) and nonstudents (n = 265) with mental health symptoms had low levels of mental health service use (eg, Department of Veterans Affairs [VA], civilian, or military facilities), at 47% and 57%. respectively. Fewer students used VA mental health services. Common barriers to treatment seeking included not wanting treatment on military records and embarrassment. Like other returning SM/Vs, student SM/Vs have unmet mental health needs. The discrepancy between potential need and treatment seeking suggests that colleges might be helpful in further facilitating mental health service use for student SM/Vs.

  17. Ethnic differences in women's use of mental health services: do social networks play a role? Findings from a national survey.

    Science.gov (United States)

    Kapadia, Dharmi; Nazroo, James; Tranmer, Mark

    2016-11-28

    The reasons for ethnic differences in women's mental health service use in England remain unclear. The aims of this study were to ascertain: ethnic differences in women's usage of mental health services, if social networks are independently associated with service use, and if the association between women's social networks and service use varies between ethnic groups. Logistic regression modelling of nationally representative data from the Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC) survey conducted in England. The analytic sample (2260 women, aged 16-74 years) was drawn from the representative subsample of 2340 women in EMPIRIC for whom data on mental health services, and social networks were available. Pakistani and Bangladeshi women were less likely than White women to have used mental health services (Pakistani OR = 0.23, CI = 0.08-0.65, p = .005; Bangladeshi OR = 0.25, CI = 0.07-0.86, p = .027). Frequent contact with relatives reduced mental health service use (OR = 0.45, CI = 0.23-0.89, p = .023). An increase in perceived inadequate support in women's close networks was associated with increased odds of using mental health services (OR = 1.91, CI = 1.11-3.27, p = .019). The influence of social networks on mental health service use did not differ between ethnic groups. The differential treatment of women from Pakistani and Bangladeshi ethnic groups in primary care settings could be a possible reason for the observed differences in mental health service use.

  18. Understanding the working relationships between National Health Service clinicians and finance staff.

    Science.gov (United States)

    Minogue, Virginia; McCaffry, Rebecca

    2017-03-13

    Purpose The Department of Health and the National Health Service (NHS) Future Focused Finance (FFF) programme promotes effective engagement between clinical and finance staff. Surveys undertaken by the Department of Health between 2013 and 2015 found few NHS Trusts reported high levels of engagement. The purpose of this paper is to gain a better understanding of current working relationships between NHS clinical and finance professionals and how they might be supported to become more effective. Design/methodology/approach Ipsos MORI were commissioned by the NHS FFF programme to undertake an online survey of NHS clinical and finance staff between June and August 2015. Findings The majority of clinicians had a member of a finance team linked to their speciality or directorate. Clinical and finance professionals have a positive view of joint working preferring face-to-face contact. Clinician's confidence in their understanding of finance was generally good and finance staff felt they had a good understanding of clinical issues. Effective working relationships were facilitated by face-to-face contact, a professional relationship, and the availability of clear, well presented finance and activity data. Research limitations/implications Data protection issues limited the accessibility of the survey team to NHS staff resulting in a relatively low-response rate. Other forms of communication, including social media, were utilised to increase access to the survey. Originality/value The FFF programme is a unique programme aimed at making the NHS finance profession fit for the future. The close partnering work stream brings together the finance and clinical perspective to share knowledge, evidence, training, and to develop good practice and engagement.

  19. Affordability as a discursive accomplishment in a changing National Health Service.

    Science.gov (United States)

    Russell, Jill; Greenhalgh, Trisha

    2012-12-01

    Health systems worldwide face the challenges of rationing. The English National Health Service (NHS) was founded on three core principles: universality, comprehensiveness, and free at the point of delivery. Yet patients are increasingly hearing that some treatments are unaffordable on the NHS. We considered affordability as a social accomplishment and sought to explore how those charged with allocating NHS resources achieved this in practice. We undertook a linguistic ethnography to examine the work practices of resource allocation committees in three Primary Care Trusts (PCTs) in England between 2005 and 2012, specifically deliberations over 'individual funding requests' (IFRs)--requests by patients and their doctors for the PCT to support a treatment not routinely funded. We collected and analysed a diverse dataset comprising policy documents, legal judgements, audio recordings, ethnographic field notes and emails from PCT committee meetings, interviews and a focus group with committee members. We found that the fundamental values of universality and comprehensiveness strongly influenced the culture of these NHS organisations, and that in this context, accomplishing affordability was not easy. Four discursive practices served to confer legitimacy on affordability as a guiding value of NHS health care: (1) categorising certain treatments as only eligible for NHS funding if patients could prove 'exceptional' circumstances; (2) representing resource allocation decisions as being not (primarily) about money; (3) indexical labelling of affordability as an ethical principle, and (4) recontextualising legal judgements supporting refusal of NHS treatment on affordability grounds as 'rational'. The overall effect of these discursive practices was that denying treatment to patients became reasonable and rational for an organisation even while it continued to espouse traditional NHS values. We conclude that deliberations about the funding of treatments at the margins of NHS

  20. 78 FR 64228 - National Institutes of Health

    Science.gov (United States)

    2013-10-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special...

  1. 75 FR 6044 - National Institutes of Health

    Science.gov (United States)

    2010-02-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the National Institute of Environmental Health Sciences,...

  2. School Health Services

    Centers for Disease Control (CDC) Podcasts

    2017-09-13

    School health services reduce absenteeism and improve academic achievement according to research. If you have school-aged children, you’ll want to listen to this podcast to learn more about healthy school environments and the link between health and academic achievement.  Created: 9/13/2017 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 9/13/2017.

  3. Slow Poisoning? Interests, Emotions, and the Strength of the English NHS: Comment on "Who Killed the English National Health Service?".

    Science.gov (United States)

    Greer, Scott L

    2015-10-01

    Martin Powell makes the point that the death of the National Health Service (NHS) is constantly asserted without criteria. This article suggests that the NHS is many things, which makes criteria unstable. The alignment of interests in the structure of the NHS enables both overheated rhetoric and political strength, and that pluralization of provision might actually undermine that alignment over time.

  4. Parent Concern and Enrollment in Intervention Services for Young Children with Developmental Delays: 2007 National Survey of Children's Health

    Science.gov (United States)

    Marshall, Jennifer; Kirby, Russell S.; Gorski, Peter A.

    2016-01-01

    This study sought to address underenrollment and late entry to early intervention by identifying factors associated with parental concern and services for developmental delays. The authors analyzed responses from 27,566 parents of children from birth to age 5 from the 2007 National Survey of Children's Health to quantify and to identify factors…

  5. Why Do Speech and Language Therapists Stay in, Leave and (Sometimes) Return to the National Health Service (NHS)?

    Science.gov (United States)

    Loan-Clarke, John; Arnold, John; Coombs, Crispin; Bosley, Sara; Martin, Caroline

    2009-01-01

    Background: Research into recruitment, retention and return of speech and language therapists in the National Health Service (NHS) is relatively limited, particularly in respect of understanding the factors that drive employment choice decisions. Aims: To identify what factors influence speech and language therapists working in the NHS to stay,…

  6. Relationship Between Health Service Use and Health Information Technology Use Among Older Adults: Analysis of the US National Health Interview Survey

    Science.gov (United States)

    2011-01-01

    Background Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults’ use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. Objective This study examined the relationship between US older adults’ use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. Methods The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. Results The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were

  7. Stress and burnout in colorectal and vascular surgical consultants working in the UK National Health Service.

    Science.gov (United States)

    Sharma, A; Sharp, D M; Walker, L G; Monson, J R T

    2008-06-01

    It has been suggested that dealing with cancer is associated with increased stress and burnout in health-care professionals. The aim of this study is to examine the prevalence of psychiatric morbidity and burnout in surgeons working in the National Health Service (NHS), and the putative relationship between psychiatric morbidity, burnout and the amount of cancer-related work. All consultant colorectal and vascular surgeons identified from their professional societies were sent a booklet consisting of questions about cancer-related and specialty-specific work load, job satisfaction and socio-demographics. It also included the General Health Questionnaire (GHQ-12), the Maslach Burnout Inventory (MBI) and the Coping Questionnaire. Logistic regression analysis was used to identify independent predictors of psychiatric morbidity (GHQ), burnout (MBI) and retirement intentions. Five hundred and one questionnaire booklets were completed and returned (response rate 58.7%). The mean age of respondents was 47 years (range 31-65). The majority of the surgeons were male (460, 92%). One hundred and sixty-three (33%) surgeons scored in the positive range of the GHQ, and 154 (32%) had high burnout on at least one subscale of the MBI. Three hundred and eighty-three (77%) surgeons stated that they intended to retire before the statutory retirement age. Level of work satisfaction and perceived adequacy of training in communication and management skills were significantly negatively correlated with GHQ and MBI scores. Surgeons who planned to take early retirement or wished to retire as soon as they could afford to were more likely to have psychiatric morbidity and/or burnout. Surgeons who were married or cohabiting were less likely to have psychiatric morbidity, and younger surgeons were more likely to have higher levels of depersonalization (DP). Work satisfaction was negatively correlated with psychiatric morbidity and all three burnout scales. Colorectal surgeons had a greater

  8. Can the National Health Service Cancer Plan timeline be applied to colorectal hepatic metastases?

    LENUS (Irish Health Repository)

    Jones, Claire

    2012-02-01

    INTRODUCTION: The National Health Service (NHS) Cancer Plan guidelines recommend a maximum 2-week wait from referral to first appointment, and 2 months from referral to treatment for primary cancers. However, there are currently no guidelines available for metastatic disease. In the UK, nearly half of all colorectal cancer patients develop hepatic metastases. Timely, surgical resection offers the potential for cure. The aim of this study was to audit current practice for colorectal liver metastases in a regional hepatobiliary unit, and compare this to the NHS Cancer Plan standards for primary disease. PATIENTS AND METHODS: A retrospective review of the unit\\'s database was performed for all hepatic metastases referrals from January 2006 to December 2008. The dates of referral, first appointment, investigations and initiation of treatment, along with patient\\'s age and sex, were recorded on Microsoft Excel and analysed. Time was expressed as mean +\\/- SD in days. RESULTS: A total of 102 patients with hepatic metastases were identified. Five were excluded due to incomplete data. The average time from referral to first appointment was 10.6 +\\/- 9.4 days and the average time from referral to treatment was 38.5 +\\/- 28.6 days. Seventy-five (72.7%) had surgical intervention, of whom 37 also had chemotherapy. CONCLUSIONS: The data compare favourably to the NHS Cancer Plan guidelines for primary malignancy, demonstrating that a regional hepatobiliary unit is capable of delivering a service for colorectal liver metastases that adheres to the NHS Cancer Plan. Therefore, the NHS Cancer Plan can be applied to this cohort.

  9. Markets and targets in the English National Health Service: is there a role for behavioral economics?

    Science.gov (United States)

    Oliver, Adam

    2012-08-01

    Over the past twenty years, the emphasis of reform attempts to improve efficiency within the English National Health Service (NHS) has oscillated between markets and targets. Both strategies are informed by standard economic theory but thus far have achieved varying degrees of success. Behavioral economics is currently in vogue and offers an alternative (or, in some cases, a complement) to standard economic theory on what motivates human behavior. There are many aspects to behavioral economics, but space constraints allow just three to be considered here: identity, loss aversion, and hyperbolic discounting. An attempt is made in this article to speculate on the extent to which these three concepts can explain the success or otherwise of the NHS market and target policies of the last two decades, and some suggestions are offered as to how policies might be usefully designed in the future. Arguably the key points are that people are more likely to be motivated if they identify with the ethos of the policy; the threat of losses will often provoke more of a response than the promise of gains; and the "immediate moment" matters enormously to individuals, so policies that require human action should be designed to make that moment as enjoyable (or as pain free) as possible.

  10. XML-based clinical data standardisation in the National Health Service Scotland

    Directory of Open Access Journals (Sweden)

    Raluca Bunduchi

    2006-12-01

    Full Text Available The objective of this paper is to clarify the role that socio-economic factors played in shaping the development of XML-based clinical data standards in the National Health Service in Scotland from 2000 to 2004. The paper discusses the NHS Scotland approach to clinical data standardisation, emphasising the actors involved, their choices during the standard development process and the factors that have shaped these choices. The case suggests that the NHS Scotland approach to clinical data standardisation is shaped by strong political pressures for fast development of an integrated electronic patient care system, economic pressures for high efficiency and cost reductions, and organisational requirements for strong clinical support. Such economic, political and organisational pressures explain the informal approach to standard development, the emphasis on fast system development and strong clinical involvement. At the same time, market factors explain the low commitment of the IT vendors, which might have otherwise put significant pressure onNHSScotland to pursue a more formalised standardisation approach within an internationally recognised standard-setting body.

  11. School mental health services: signpost for out-of-school service utilization in adolescents with mental disorders? A nationally representative United States cohort.

    Directory of Open Access Journals (Sweden)

    Marion Tegethoff

    Full Text Available BACKGROUND: School mental health services are important contact points for children and adolescents with mental disorders, but their ability to provide comprehensive treatment is limited. The main objective was to estimate in mentally disordered adolescents of a nationally representative United States cohort the role of school mental health services as guide to mental health care in different out-of-school service sectors. METHODS: Analyses are based on weighted data (N = 6483 from the United States National Comorbidity Survey Replication Adolescent Supplement (participants' age: 13-18 years. Lifetime DSM-IV mental disorders were assessed using the fully structured WHO CIDI interview, complemented by parent report. Adolescents and parents provided information on mental health service use across multiple sectors, based on the Service Assessment for Children and Adolescents. RESULTS: School mental health service use predicted subsequent out-of-school service utilization for mental disorders i in the medical specialty sector, in adolescents with affective (hazard ratio (HR = 3.01, confidence interval (CI = 1.77-5.12, anxiety (HR = 3.87, CI = 1.97-7.64, behavior (HR = 2.49, CI = 1.62-3.82, substance use (HR = 4.12, CI = 1.87-9.04, and eating (HR = 10.72, CI = 2.31-49.70 disorders, and any mental disorder (HR = 2.97, CI = 1.94-4.54, and ii in other service sectors, in adolescents with anxiety (HR = 3.15, CI = 2.17-4.56, behavior (HR = 1.99, CI = 1.29-3.06, and substance use (HR = 2.48, CI = 1.57-3.94 disorders, and any mental disorder (HR = 2.33, CI = 1.54-3.53, but iii not in the mental health specialty sector. CONCLUSIONS: Our findings indicate that in the United States, school mental health services may serve as guide to out-of-school service utilization for mental disorders especially in the medical specialty sector across various mental disorders, thereby

  12. Measuring Outcomes in Mental Health Services for Older People: An Evaluation of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+)

    Science.gov (United States)

    Gee, Susan B.; Croucher, Matthew J.; Beveridge, John

    2010-01-01

    The Health of the Nation Outcome Scales (HoNOS) family of measures is routinely used in mental health services in the New Zealand, Australia, and the United Kingdom. However, the psychometric properties of the HoNOS65+ for elderly people have not been extensively evaluated. The aim of the present study was to examine the validity, reliability, and…

  13. An evaluation of staff engagement programmes in four National Health Service Acute Trusts.

    Science.gov (United States)

    Hewison, Alistair; Gale, Nicola; Yeats, Rowena; Shapiro, Jonathan

    2013-01-01

    The purpose of this paper is to report the findings from an evaluation project conducted to investigate the impact of two staff engagement programmes introduced to four National Health Service (NHS) hospital Trusts in England. It seeks to examine this development in the context of current policy initiatives aimed at increasing the level of staff involvement in decision-making, and the related literature. A mixed-methods approach incorporating document analysis, interviews, a survey and appreciative inquiry, informed by the principles of impact evaluation design, was used. The main finding to emerge was that leadership was crucial if widespread staff engagement was to be achieved. Indeed, in some of the trusts the staff engagement programmes were seen as mechanisms for developing leadership capability. The programmes had greater impact when they were "championed" by the Chief Executive. Effective communication throughout the organisations was reported to be a prerequisite for staff engagement. Problems were identified at the level of middle management where the lack of confidence in engaging with staff was a barrier to implementation. The nature of the particular organisational context is crucial to the success of efforts to increase levels of staff engagement. The measures that were found to work in the trusts would need to be adapted and applied to best meet the needs of other organisations. Many health care organisations in England will need to harness the efforts of their workforce if they are to meet the significant challenges of dealing with financial restraint and increasing patient demand. This paper provides some insights on how this can be done.

  14. Findings from a survey on GIS use in the UK National Health Service: organisational challenges and opportunities.

    Science.gov (United States)

    Higgs, Gary; Smith, Darren P; Gould, Myles I

    2005-04-01

    The use of geographical information systems (GIS) in a variety of application areas points to an increasing interest in the spatial aspects of health policies. Despite the fact that most public sector organisations in the United Kingdom (UK) have access to such software tools, there has not been a comprehensive review of take-up within the health sector. In this paper, we report on a recently completed mixed-method research project that has examined the current levels of GIS use in the UK National Health Service, and focus our discussion on health authorities (HAs). Couched within the context of previous studies that have been concerned with outlining the types of factors influencing IT implementation in the health sector, we illuminate the importance of behavioural, cultural and organisational factors on the diffusion of GIS in the UK National Health Service. It is noted that very few organisations had a GIS strategy and we contend that if GIS is to play a wider role in addressing issues surrounding 'joined-up' government, more advice and guidance is needed on policies promoting the exchange of geographical data between agencies concerned with tackling health issues. We conclude by drawing attention to the perceived lack of national guidance on GIS matters, more generally, within the UK health sector.

  15. Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003

    Directory of Open Access Journals (Sweden)

    Collins Charles D

    2007-03-01

    Full Text Available Abstract Background In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme (GIS and Labour Insurance Scheme (LIS to the new Urban Employee Basic Health Insurance Scheme (BHIS. Methods This paper uses data from the National Health Services Surveys of 1998 and 2003 to examine the impact of the reform on population coverage. Particular attention is paid to coverage in terms of gender, age, employment status, and income levels. Following a description of the data between the two years, the paper will discuss the relationship between the insurance reform and the growing inequities in population coverage. Results An examination of the data reveals a number of key points: a The overall coverage of the newly established scheme has decreased from 1998 to 2003. b The proportion of the urban population without any type of health insurance arrangement remained almost the same between 1998 and 2003 in spite of the aim of the 1997 reform to increase the population coverage. c Higher levels of participation in mainstream insurance schemes (i.e. GIS-LIS and BHIS were identified among older age groups, males and high income groups. In some cases, the inequities in the system are increasing. d There has been an increase in coverage of the urban population by non-mainstream health insurance schemes, including non-commercial and commercial ones. The paper discusses three important issues in relation to urban insurance coverage: institutional diversity in the forms of insurance, labour force policy and the non-mainstream forms of commercial and non-commercial forms of insurance. Conclusion The paper concludes that the huge economic development and expansion has not resulted in a reduced disparity in

  16. Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003.

    Science.gov (United States)

    Xu, Ling; Wang, Yan; Collins, Charles D; Tang, Shenglan

    2007-03-03

    In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme (GIS) and Labour Insurance Scheme (LIS) to the new Urban Employee Basic Health Insurance Scheme (BHIS). This paper uses data from the National Health Services Surveys of 1998 and 2003 to examine the impact of the reform on population coverage. Particular attention is paid to coverage in terms of gender, age, employment status, and income levels. Following a description of the data between the two years, the paper will discuss the relationship between the insurance reform and the growing inequities in population coverage. An examination of the data reveals a number of key points: a) The overall coverage of the newly established scheme has decreased from 1998 to 2003. b) The proportion of the urban population without any type of health insurance arrangement remained almost the same between 1998 and 2003 in spite of the aim of the 1997 reform to increase the population coverage. c) Higher levels of participation in mainstream insurance schemes (i.e. GIS-LIS and BHIS) were identified among older age groups, males and high income groups. In some cases, the inequities in the system are increasing. d) There has been an increase in coverage of the urban population by non-mainstream health insurance schemes, including non-commercial and commercial ones. The paper discusses three important issues in relation to urban insurance coverage: institutional diversity in the forms of insurance, labour force policy and the non-mainstream forms of commercial and non-commercial forms of insurance. The paper concludes that the huge economic development and expansion has not resulted in a reduced disparity in health insurance coverage, and that limited cross

  17. National Head Start Association Position Paper: A Look at Head Start's Health Services and Their Value to Our Nation's Poorest Children.

    Science.gov (United States)

    Smith, Angela; Greene, Sarah; Allen, Ben; Ryan, Joel; Kane, Elizabeth; Shillady, Amy; Hansen, Jacquelyn

    Since its inception, Head Start has used a varied and comprehensive approach to meet the needs of children in poverty. This position paper of the National Head Start Association asserts that the programs current federal-to-local guidance and funding structure under the Department of Health and Human Services is effective and argues that valuable…

  18. Health outcomes and family services in kinship care: analysis of a national sample of children in the child welfare system.

    Science.gov (United States)

    Sakai, Christina; Lin, Hua; Flores, Glenn

    2011-02-01

    To comprehensively assess family services, health, and health care outcomes for US children in kinship care vs foster care. A 3-year prospective cohort study. National Survey of Child and Adolescent Well-Being. The sample consisted of 1308 US children entering out-of-home care following reported maltreatment. Kinship care vs foster care. Baseline caregivers' support services and the children's behavioral, mental health, and health service use outcomes 3 years after placement. Kinship caregivers were more likely than foster caregivers to have a low socioeconomic status but reported significantly fewer support services (caregiver subsidies, parent training, peer support, and respite care). Kinship care was associated with a lower risk ratio (RR) of continuing behavioral problems (RR = 0.59; 95% confidence interval [CI], 0.41-0.80), low social skills (RR = 0.61; 95% CI, 0.40-0.87), mental health therapy use (RR = 0.45; 95% CI, 0.27-0.73), and psychotropic medication use (RR = 0.46; 95% CI, 0.24-0.82) but higher risk of substance use (RR = 1.88; 95% CI, 0.92-3.20) and pregnancy (RR = 4.78; 95% CI, 1.07-17.11). Kinship caregivers received fewer support services than foster caregivers. Children in kinship care fared better with behavioral and social skills problems, mental health therapy use, and psychotropic medication use. Adolescents in kinship care may be at higher risk for substance use and pregnancy.

  19. National Health Interview Survey (NHIS) - National Cardiovascular Disease Surveillance Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2001 to 2014. The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are...

  20. National Health Interview Survey (NHIS) - National Cardiovascular Disease Surveillance Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2001 forward. The National Health Interview Survey (NHIS) has monitored the health of the nation since 1957. NHIS data on a broad range of health topics are...

  1. Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff

    Directory of Open Access Journals (Sweden)

    Collins Luke

    2011-07-01

    Full Text Available Abstract Background In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. Methods We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. Results The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%. Respondents considered the NHS tinnitus referral process to be generally effective (67%, but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%, nor was the opportunity to access specialist counselling provided by clinical psychology (35%. To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. Conclusions Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved

  2. Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff.

    Science.gov (United States)

    Gander, Phillip E; Hoare, Derek J; Collins, Luke; Smith, Sandra; Hall, Deborah A

    2011-07-06

    In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS) Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%). Respondents considered the NHS tinnitus referral process to be generally effective (67%), but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%), nor was the opportunity to access specialist counselling provided by clinical psychology (35%). To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved access to psychological services through audiologist training, and

  3. Pulmonary embolism following ankle fractures treated without an operation - an analysis using National Health Service data.

    Science.gov (United States)

    Jameson, Simon S; Rankin, Kenneth S; Desira, Nicola L; James, Philip; Muller, Scott D; Reed, Mike R; Rangan, Amar

    2014-08-01

    The majority of ankle fractures are stable and can be treated without an operation, most commonly with cast immobilisation. Based on concerns regarding the risk of a venous thromboembolic event (VTE) while immobilised, there is currently debate as to whether these patients should receive VTE prophylaxis for the duration of treatment. Rates of pulmonary embolism (PE) in this patient group are unknown. This retrospective cohort study was designed to identify patients treated without an operation for ankle fracture and determine the occurrence of PE and inpatient mortality within 90 days of injury using the English National Health Service administrative databases. Logistic regression models were used to assess the influence of age, gender and Charlson co-morbidity score on these outcomes. We identified 14777 adult patients over a 54-month period (April 2007-September 2011) that met our linkage and inclusion criteria (isolated, unilateral closed ankle fracture that did not require hospitalisation). Mean age was 46.4 years (range 18-99) and the majority had a Charlson 0 score (97.7%). There were 32 (0.22%) PEs within 90 days of the fracture (including in one patient who subsequently died). After adjustment, Charlson score of ≥1 was associated with a greater risk of PE (Odds ratio = 11.97, p < 0.001) compared to Charlson 0. Risk for these patients was 2.08%. In total, fifteen patients (0.11%) died in hospital within 90 days. Pulmonary embolism is rare following ankle fractures treated without an operation. Patients with multiple co-morbidities are at a higher risk. Based on this evidence, an ankle fracture treated without an operation does not appear to be an indication for routine VTE prophylaxis.

  4. 78 FR 52538 - Office of Direct Service and Contracting Tribes; National Indian Health Outreach and Education...

    Science.gov (United States)

    2013-08-23

    ...) and Hardship Waiver requirements) and eligibility determinations, and maximizing revenue opportunities... reform regarding Medicaid expansion revenue opportunities and individual health insurance coverage and... Internal Revenue Service that may take an additional 2-5 weeks to become active). Completing and submitting...

  5. Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

    Directory of Open Access Journals (Sweden)

    Ramona Fernanda Ceriotti Toassi

    2013-06-01

    Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

  6. 75 FR 71134 - National Institutes of Health

    Science.gov (United States)

    2010-11-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Closed Meeting..., Cancer Control, National Institutes of Health, HHS) Dated: November 16, 2010. Jennifer S....

  7. The Danish National Health Service Register (NHSR) as a Source for Research on Primary Care

    DEFF Research Database (Denmark)

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

    the following is registered: 1. The citizen: The unique personal identification number and the allocation to a general practice. The number make it possible to register the age and sex of the citizen, follow the individual contacts with health care over time and merge with other registers. 2. The provider......: Identification number of the practice, referral to specialist and fees. 3. The service: Consultations, telephone consultations, home visits, e-mail consultations and preventive consultations. Also laboratory and additional services like anti-conception counselling are registered. The clinical information...... is small or absent. The possibilities for linking to other registers containing health and social information or with ad hoc collected data make NHSR an interesting research tool. Validity and coverage: All citizens registers with the personal identification number when contacting the health care system...

  8. Financing the package of services during the first decade of the national health insurance law in Israel: trends and issues.

    Science.gov (United States)

    Shmueli, Amir; Achdut, Leah; Sabag-Endeweld, Miri

    2008-09-01

    In 1995, a National Health Insurance Law (NHIL) was enacted in Israel. It specified a mandatory package of services to be provided by the four competing private non-profit sickness funds, and secured the financing of that provision. This review discusses the main issues associated with financing of--and the sickness funds' expenditure on--the package of services and analyzes the trends during the first decade of the implementation of the NHIL. The main findings indicate that between 1995 and 2005 the "real value" of the budget of the package of services has eroded by more than a third, most of it being due to the under-updating with regard to technological advances. The steep rise in the co-payment paid by users of health services and in voluntary supplementary health insurance ownership which is offered by the sickness funds partially financed that erosion. The growth of private spending on health, including on voluntary supplementary insurance, took place in all population groups and in the lowest income-quintile in particular. Indices of the progressivity of the financing of the package of services indicate that the burden of financing has been slightly regressive. In spite of the increase in the share of the regressive private expenditure between 1997 and 2003, overall, the finance became less regressive due to the health tax becoming less regressive. In conclusion, the introduction of the Israeli NHIL was a promising social achievement, but, during its first decade and facing tight national budgets and receiving lower national priority, subsequent regulation eroded the real value of its benefits, and its principles of solidarity and equity in finance. After 10 years of experience, the system might need refreshment and policy amendments that will correspond to its original aspirations.

  9. A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

    Directory of Open Access Journals (Sweden)

    Kenicer David

    2012-09-01

    Full Text Available Abstract Background NICE recommends computerised cognitive behavioural therapy (cCBT for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS. Methods A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT. Results Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult. Conclusions Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks.

  10. Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care.

    Science.gov (United States)

    Fotaki, Marianna

    2014-11-01

    Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care.

  11. Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003

    OpenAIRE

    Xu, L.; Wang, Yan; Collins, C. D.; Tang, Shenglan

    2007-01-01

    Abstract Background In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme (GIS) and Labour Insurance Scheme (LIS) to the new Urban Employee Basic Health Insurance Scheme (BHIS). Methods This paper uses data from the National...

  12. Use of national data base for strategic management of municipal oral health services for Danish children and adolescents

    DEFF Research Database (Denmark)

    Hansen, I.; Foldspang, Anders; Poulsen, S.

    2001-01-01

    Abstract –Objective: To evaluate the use of a national register for strategic management of dental health services for 0–17-year-old Danish children and to identify determinants for their use of the system as a strategic tool in management of the services. Methods: During the period December 1997......) the population and the socio-economic, cultural and political environment of the municipality; and 2) dental morbidity was collected as antecedent data from various official sources. Results: Seventy-seven percent of municipalities with public clinics and 68% of municipalities without public clinics used SCOR...... decreased from 1995 to 1996. Otherwise no associations between dental health and use of the system could be demonstrated. Conclusions: SCOR is widely used as a strategic planning instrument concerning the Danish dental services for children and adolescents. The predictors associated with its use are partly...

  13. The fiction of health Services

    Science.gov (United States)

    2012-01-01

    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 with us until today. The confusing substitution of Health Services with Medical Services began toward 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 with its model being adopted by many countries with resulting distortion of the true meaning of Health Services. The consequences of this fiction have been ominous. It is necessary to call things by their names and not deceive society. To correct the serious imbalance between Medical Services and Health Services, Hygeia and Asclepius must become a brother and sisterhood. PMID:24893062

  14. New Zealand's health system: national policy goals and decentralized service planning and delivery.

    Science.gov (United States)

    Gauld, Robin

    2007-01-01

    To inaugurate the fifth year of its publication, The American Heart Hospital Journal (AHHJ) focused its Winter 2007 issue on health care systems from around the world, with 8 articles contributed by national leaders in their respective countries. Due to the interest and wide range of expertise in the international cardiac community, we will continue to publish Special Reports throughout 2007 on this topic. We invite members of the international community to share with readers of the AHHJ, their insights on the strengths and weaknesses of their respective health care and cardiac care systems, as well as their ideas and aspirations for future change.

  15. Social class inequalities in the utilization of health care and preventive services in Spain, a country with a national health system.

    Science.gov (United States)

    Garrido-Cumbrera, Marco; Borrell, Carme; Palència, Laia; Espelt, Albert; Rodríguez-Sanz, Maica; Pasarín, M Isabel; Kunst, Anton

    2010-01-01

    In Spain, despite the existence of a National Health System (NHS), the utilization of some curative health services is related to social class. This study assesses (1) whether these inequalities are also observed for preventive health services and (2) the role of additional private health insurance for people of advantaged social classes. Using data from the Spanish National Health Survey of 2006, the authors analyze the relationships between social class and use of health services by means of Poisson regression models with robust variance, controlling for self-assessed health. Similar analyses were performed for waiting times for visits to a general practitioner (GP) and specialist. After controlling for self-perceived health, men and women from social classes IV-V had a higher probability of visiting the GP than other social classes, but a lower probability of visiting a specialist or dentist. No large class differences were observed in frequency of hospitalization or emergency services use, or in breast cancer screening or influenza vaccination; cervical cancer screening frequency was lower among women from social classes IV-V. The inequalities in specialist visits, dentist visits, and cervical cancer screening were larger among people with only NHS insurance than those with double health insurance. Social class differences in waiting times were observed for specialist visits, but not for GP visits. Men and women from social classes IV-V had longer waits for a specialist; this was most marked among people with only NHS insurance. Clearly, within the NHS, social class inequalities are still evident for some curative and preventive services. Further research is needed to identify the factors driving these inequalities and to tackle these factors from within the NHS. Priority areas include specialist services, dental care, and cervical cancer screening.

  16. Obstacles to "race equality" in the English National Health Service: Insights from the healthcare commissioning arena.

    Science.gov (United States)

    Salway, Sarah; Mir, Ghazala; Turner, Daniel; Ellison, George T H; Carter, Lynne; Gerrish, Kate

    2016-03-01

    Inequitable healthcare access, experiences and outcomes across ethnic groups are of concern across many countries. Progress on this agenda appears limited in England given the apparently strong legal and policy framework. This disjuncture raises questions about how central government policy is translated into local services. Healthcare commissioning organisations are a potentially powerful influence on services, but have rarely been examined from an equity perspective. We undertook a mixed method exploration of English Primary Care Trust (PCT) commissioning in 2010-12, to identify barriers and enablers to commissioning that addresses ethnic healthcare inequities, employing:- in-depth interviews with 19 national Key Informants; documentation of 10 good practice examples; detailed case studies of three PCTs (70+ interviews; extensive observational work and documentary analysis); three national stakeholder workshops. We found limited and patchy attention to ethnic diversity and inequity within English healthcare commissioning. Marginalization of this agenda, along with ambivalence, a lack of clarity and limited confidence, perpetuated a reinforcing inter-play between individual managers, their organisational setting and the wider policy context. Despite the apparent contrary indications, ethnic equity was a peripheral concern within national healthcare policy; poorly aligned with other more dominant agendas. Locally, consideration of ethnicity was often treated as a matter of legal compliance rather than integral to understanding and meeting healthcare needs. Many managers and teams did not consider tackling ethnic healthcare inequities to be part-and-parcel of their job, lacked confidence and skills to do so, and questioned the legitimacy of such work. Our findings indicate the need to enhance the skills, confidence and competence of individual managers and commissioning teams and to improve organizational structures and processes that support attention to ethnic

  17. Managing a sustainable, low carbon supply chain in the English National Health Service: The views of senior managers.

    Science.gov (United States)

    Grose, Jane; Richardson, Janet

    2013-04-18

    Objectives:In an effort to reduce costs and respond to climate change, health care providers (Trusts) in England have started to change how they purchase goods and services. Many factors, both internal and external, affect the supply chain. Our aim was to identify those factors, so as to maintain future supply and business continuity in health and social care.Methods:Qualitative interviews with 20 senior managers from private and public sector health service providers and social care providers in south west England. Interviews were recorded, transcribed and thematically analysed.Results:There were four areas of concern: contradictions with government legislation which caused confusion about how best to deliver sustainable solutions; procurement was unclear and created multiple approaches to purchasing bulk items at low cost; internal organizational systems needed to be reconsidered to embed sustainability; and embedding sustainability requires a review of organizational systems. There are examples of sustainability solutions throughout the National Health Service (NHS) but the response continues to be patchy. More research is needed into why some Trusts and some staff do not recognize the benefits of a core approach or find the systems unable to respond.Conclusions:The NHS is one of the major purchasers of goods and services in England and is therefore in an excellent position to encourage sustainable resource management, manufacturing, use and disposal.

  18. Medical examination of Israeli 17-year-olds before military service as a national resource for health information.

    Science.gov (United States)

    Kark, J D; Kedem, R; Revach, M

    1986-01-01

    At age 17 years Israelis undergo medical examination for the purpose of health classification for military service. The potential use of this extensive data collection system for epidemiologic studies is illustrated for selected conditions. Trends in diagnosed disorders over a 25-year period are exemplified in the changing prevalence of tuberculosis, bronchial asthma, diabetes, epilepsy and heart defects. Within birth cohorts, cross-sectional analyses of height, body mass, blood pressure and disorders--such as bronchial asthma, allergic rhinitis, diabetes, psychiatric diagnoses and such genetic conditions as familial Mediterranean fever--point to clear ethnic differences. Educational level is strongly associated with measures of health status. Potential uses of this resource include: detecting groups in need of preventive, curative and rehabilitative care, assessing changing needs and priorities of health care, evaluation of intervention programs and health services provided in childhood, a wide spectrum of etiologic studies including assessment of health effects of social change, follow-up studies including the natural history of disorders, and developing data systems such as national registries of rare or important conditions. Issues relating to data reliability and validity, changing disease classification and nonexamination of groups exempted from military service limit interpretation of findings and restrict uses of this resource. Emphasis on standardization of data collection and diagnostic criteria, quality assurance and improved data management will be necessary.

  19. Health service deficits and school-aged children with asthma: a population-based study using data from the 2007-2008 National Survey of Child Health.

    Science.gov (United States)

    Lutfiyya, M Nawal; McCullough, Joel Emery; Lipsky, Martin S

    2012-01-01

    Asthma is one of the most common and costly illnesses of childhood. This study addresses health services deficits experienced by school-aged children with asthma. Analyzing data from the 2007-2008 National Survey of Child Health, this cross-sectional study used household income, race/ethnicity, and geographic residency as the primary independent variables and health service deficits as the dependent variable. Multivariate analysis yielded that other/multiracial (odds ratio [OR], 1.234; 95% confidence interval [CI], 1.226-1.242) and Hispanic (OR, 2.207; 95% CI, 1.226-1.242) school-aged children with asthma had greater odds of having health services deficits as did both urban (OR, 1.106; 95% CI, 1.099-1.113) and rural (OR, 1.133; 95% CI, 1.124-1.142) school-aged children with asthma. Children with either moderate (OR, 1.195; 95% CI, 1.184-1.207) or mild (OR, 1.445; 95% CI, 1.431-1.459) asthma had greater odds of having a health services deficit than those with severe asthma. Low-income school-aged children with asthma had greater odds of having a health services deficit than high-income children (OR, 1.031; 95% CI, 1.026-1.036). At lesser odds of having a health service deficit were those who were African American, of middle-range income, male, or who were school-aged children with asthma in good to excellent health. Both African American and other/multiracial school-aged children were at greater risk of having asthma than either Caucasian or Hispanic children. Three vulnerable subgroups of school-aged children with asthma-rural, Hispanic, and those of low income were the most likely to have health service deficits.

  20. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

    Directory of Open Access Journals (Sweden)

    Aggarwal R

    2015-11-01

    Full Text Available Reena Aggarwal,1,2 Tim Swanwick2 1Women's Health, Whittington Health, London, UK; 2Health Education England, North Central and East London, London, UK Abstract: Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline. Keywords: National Health Service, junior doctors, quality improvement, management, health care

  1. Ditching the single-payer system in the national health service: how the English Department of Health is learning the wrong lessons from the United States.

    Science.gov (United States)

    Reynolds, Lucy; Gerada, Clare; McKee, Martin

    2012-01-01

    Reforms to the British National Health Service introduce major changes to how health care will be delivered. The core elements include the creation of new purchaser organizations, Clinical Commissioning Groups, which unlike their predecessors will be able to recruit and reject general practices and their patients without geographical restriction. The Clinical Commissioning Groups are to transition from statutory bodies to freestanding organizations, with most of their functions privatized and an increasingly privatized system of provision, In this paper, we explore the likely consequences of these proposals, drawing in particular on the experience of managed care organizations in the United States, whose approach has influenced the English proposals extensively. We argue that the wrong lessons are being learned and the English reforms are likely to fundamentally undermine the principles on which the British National Health Service was founded.

  2. National Occupational Health Service policies and programs for workers in small-scale industries in China.

    Science.gov (United States)

    Zhi, S; Sheng, W; Levine, S P

    2000-01-01

    Over the 14 years since economic reform began, and the restructuring of the economy to encourage international trade, a large number of township enterprises have been developed and put into operation in the Peoples Republic of China. From 1978 to 1991, the number of enterprises has increased 11.5 times; the number of employees has increased 2.4 times; the fixed assets have increased 13.7 times; and the value of the total output has increased 22.5 times. In this article, a report is given on a sample survey in 30 counties in 1990, which showed that 82.69% of rural industrial enterprises had at least one type of occupational hazard in their work environments. Workers engaged in at least one type of hazardous working environment accounted for 33.91% of the blue-collar workers. Physical examinations were performed for seven types of occupational diseases: silicosis, coal worker's pneumoconiosis, asbestosis, chronic lead poisoning, benzene analogs poisoning, chronic chromium poisoning, and noise-induced hearing loss. The total detectable rate of the seven types of occupational diseases was 4.4% among those workers. In addition, 11% had illnesses suspected of being (though not proven to be) caused by occupational exposures. Most township enterprises do not provide basic occupational health services. The coverage of five routine occupational health service activities provided for township enterprises were very limited, from 1.4 to 36%.

  3. 78 FR 55751 - National Institutes of Health

    Science.gov (United States)

    2013-09-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute; Notice of Meeting Pursuant to... Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard, Rockville, MD 20852....

  4. [The national health status].

    Science.gov (United States)

    Afek, Arnon

    2010-04-01

    During the Golden Age of Medicine (20th Century), scientific and technological breakthroughs enabled physicians to treat diseases that were previously incurable. The idealist, romantic approach of medical practice believed in the right of every human being to receive the best treatment possible, regardless of cost. However, the rise in health care expenditure at the end of the last century made this approach impossible to follow. The growing health expenses are due to the increased percentage of chronically sick patients and elderly population, costs of novel technologies and public expectations. Israel spends 7.9% of its GDP on health, a figure which has not changed in the last fifteen years, while other western countries spend a considerably higher and increasing percentage of their GDP on health. Public resources must be allocated in order to maintain the health of the population and to decrease inequities. A data-based demonstration of the population health status and health care system is therefore mandated. in this issue of the Harefuah, three articles are presented which try to show different aspects of the measurement of Israeli heath status. The data accumulated is used to improve the health status of the Israeli people. The Israel Medical Association (IMA) has assumed responsibility for the creation of an objective index for the measurement and evaluation of the public state of health and the healthcare system. The goal of the IMA National Health Index is to promote discussions regarding medicine and health in Israel, and to serve as a tool to be used by relevant policy makers. Prof. Israeli et al discuss the merits of the National Health Index as well as delineate the difficulties regarding the methodology and choice of parameters. They suggest methods for its improvement. Dr Cohen and his colleagues of Clalit Health Services present the Quality Health indicator program in the community. In effect over the past fifteen years, this program is based on

  5. The Complexities of 'Consumerism': Choice, Collectivism and Participation within Britain's National Health Service, c.1961-c.1979.

    Science.gov (United States)

    O'Hara, Glen

    2013-05-01

    This article explores the overlapping and conflicting points of contact between 'consumerism', collectivism and participation in Britain's National Health Service during a period of relatively well-funded expansion during the economic 'golden age' of the 1960s and 1970s. Despite recent neo-liberal attempts to define 'consumerism' around the wishes and choices of the individual, and to conceptualise areas such as individual hospital referrals as particularly 'consumerist', this article demonstrates that collective provision, the protection of disadvantaged groups and the concept of 'participatory' citizen involvement were all alternative meanings of the concept during this period, co-existing uneasily with the competitive concepts that have become more familiar since the late 1980s. This insight is then utilised to show how health care debates today might become better informed, ignoring extreme claims for all three concepts and focusing instead on a theoretically informed but ultimately empirical grasp of constant flux in any health care system.

  6. The Slow, Lingering Death of the English NHS: Comment on "Who Killed the English National Health Service?".

    Science.gov (United States)

    Hunter, David J

    2016-01-01

    The death of the English National Health Service (NHS) may be slow in coming but that does not mean that it is not the Conservative-led UK government's desired end state. The government is displaying tactical cunning in achieving its long-term purpose to remould the British state. Powell seeks greater clarity amidst the confusion but the lack of clarity is a principal weapon in the government's assault on the public realm, including the NHS. Moreover, there is ample supporting evidence to caution against Powell's tendency to complacency concerning the ultimate fate of the NHS.

  7. Towards evidence-based, GIS-driven national spatial health information infrastructure and surveillance services in the United Kingdom.

    Science.gov (United States)

    Boulos, Maged N Kamel

    2004-01-28

    The term "Geographic Information Systems" (GIS) has been added to MeSH in 2003, a step reflecting the importance and growing use of GIS in health and healthcare research and practices. GIS have much more to offer than the obvious digital cartography (map) functions. From a community health perspective, GIS could potentially act as powerful evidence-based practice tools for early problem detection and solving. When properly used, GIS can: inform and educate (professionals and the public); empower decision-making at all levels; help in planning and tweaking clinically and cost-effective actions, in predicting outcomes before making any financial commitments and ascribing priorities in a climate of finite resources; change practices; and continually monitor and analyse changes, as well as sentinel events. Yet despite all these potentials for GIS, they remain under-utilised in the UK National Health Service (NHS). This paper has the following objectives: (1) to illustrate with practical, real-world scenarios and examples from the literature the different GIS methods and uses to improve community health and healthcare practices, e.g., for improving hospital bed availability, in community health and bioterrorism surveillance services, and in the latest SARS outbreak; (2) to discuss challenges and problems currently hindering the wide-scale adoption of GIS across the NHS; and (3) to identify the most important requirements and ingredients for addressing these challenges, and realising GIS potential within the NHS, guided by related initiatives worldwide. The ultimate goal is to illuminate the road towards implementing a comprehensive national, multi-agency spatio-temporal health information infrastructure functioning proactively in real time. The concepts and principles presented in this paper can be also applied in other countries, and on regional (e.g., European Union) and global levels.

  8. Towards evidence-based, GIS-driven national spatial health information infrastructure and surveillance services in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Boulos Maged

    2004-01-01

    Full Text Available Abstract The term "Geographic Information Systems" (GIS has been added to MeSH in 2003, a step reflecting the importance and growing use of GIS in health and healthcare research and practices. GIS have much more to offer than the obvious digital cartography (map functions. From a community health perspective, GIS could potentially act as powerful evidence-based practice tools for early problem detection and solving. When properly used, GIS can: inform and educate (professionals and the public; empower decision-making at all levels; help in planning and tweaking clinically and cost-effective actions, in predicting outcomes before making any financial commitments and ascribing priorities in a climate of finite resources; change practices; and continually monitor and analyse changes, as well as sentinel events. Yet despite all these potentials for GIS, they remain under-utilised in the UK National Health Service (NHS. This paper has the following objectives: (1 to illustrate with practical, real-world scenarios and examples from the literature the different GIS methods and uses to improve community health and healthcare practices, e.g., for improving hospital bed availability, in community health and bioterrorism surveillance services, and in the latest SARS outbreak; (2 to discuss challenges and problems currently hindering the wide-scale adoption of GIS across the NHS; and (3 to identify the most important requirements and ingredients for addressing these challenges, and realising GIS potential within the NHS, guided by related initiatives worldwide. The ultimate goal is to illuminate the road towards implementing a comprehensive national, multi-agency spatio-temporal health information infrastructure functioning proactively in real time. The concepts and principles presented in this paper can be also applied in other countries, and on regional (e.g., European Union and global levels.

  9. Lights and shades in the managerialization of the Italian National Health Service.

    Science.gov (United States)

    Lega, Federico

    2008-11-01

    After fifteen years from the first of a series of reforms that introduced managerial paradigms and techniques into the Italian National Health System (INHS), it is possible to provide a critical assessment of the outcomes of such changes. The aim of this paper is to assess how these reforms have changed the INHS, to what extent they concurred to improve the system, where they failed and which issues are still in agenda. To do so we run through the recent history of the INHS and propose an interpretative framework to understand the grounds for its light and shade results. The basis for the analysis is triple. The study draws from researches, literature review, action-researches and field investigations conducted over the last 10 years in the INHS.

  10. Innovation and the English National Health Service: a qualitative study of the independent sector treatment centre programme.

    Science.gov (United States)

    Turner, Simon; Allen, Pauline; Bartlett, Will; Pérotin, Virginie

    2011-08-01

    Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Experience with suspecting child maltreatment in the Norwegian public dental health services, a national survey.

    Science.gov (United States)

    Brattabø, Ingfrid Vaksdal; Iversen, Anette Christine; Åstrøm, Anne Nordrehaug; Bjørknes, Ragnhild

    2016-11-01

    Detecting and responding to child-maltreatment is a serious challenge and public health concern. In Norway, public dental health personnel (PDHP) have a mandatory obligation to report to child welfare services (CWS) if they suspect child-maltreatment. This study aimed to assess PDHP's frequency of reporting and failing to report to CWS and whether the frequencies varied according to personal, organizational and external characteristics. An electronic questionnaire was sent to 1542 public dental hygienists and dentists in Norway, 1200 of who responded (77.8%). The majority 60.0%, reported having sent reports of concern to CWS throughout their career, 32.6% had suspected child-maltreatment but failed to report it in their career and 42.5% had sent reports during the three-year period from 2012 to 2014. The reporting frequency to CWS was influenced by PDHP's personal, organizational and external characteristics, while failure to report was influenced by personal characteristics. Compared to international studies, PDHP in Norway sends reports of concern and fails to report to CWS at relatively high rates. PDHP's likelihood of reporting was influenced by age, working experience, number of patients treated, size of the municipality and geographical region, while failure to report to CWS was influenced by working experience.

  12. Quality, bias and service user experience in healthcare: 10 years of mental health guidelines at the UK National Collaborating Centre for Mental Health.

    Science.gov (United States)

    Kendall, Tim; Glover, Naomi; Taylor, Clare; Pilling, Stephen

    2011-08-01

    The guideline programme developed by the National Collaborating Centre for Mental Health (NCCMH) for the National Institute for Health and Clinical Excellence (NICE) is probably the most comprehensive and methodologically advanced mental health guideline programme in the world, covering most adults and children with mental health problems and addressing a broad range of pharmacological and psychological/psychosocial interventions. As the success of the NICE programme gains momentum, its influence in the National Health Service (NHS) grows. If guidelines contain systematic bias the effects will be widespread. Over the last 10 years the NCCMH has recognized imperfections and patterns of bias in the way that evidence is generated and included in guidelines, including psychological/psychosocial interventions and drug treatments. The pharmaceutical industry remains a major source of bias through selective reporting and publishing, and represents a threat to ensuring the evidence underpinning guidelines and clinical decision-making is as complete and reliable as possible. The inclusion of service users into guideline development at the NCCMH has developed in parallel to the identification and understanding of evidential bias, and is now becoming an important focus for high-quality guidelines which are becoming increasingly person-centred. For mental health this is as radical as the integration of psychological/psychosocial treatments into what has, for many years, been a largely medical domain. The future role of service users in monitoring their own experience of care and ensuring that trusts are accountable to them is now a real possibility and is likely to have an impact upon the traditional power relations in mental health and the stigma usually associated with psychiatric problems.

  13. The changing National Health Service: market-based reform and morality: Comment on "Morality and Markets in the NHS".

    Science.gov (United States)

    Frith, Lucy

    2015-04-01

    This commentary explores some of the issues raised by Gilbert et al. short communication, Morality and Markets in the NHS. The increasing role of market mechanisms and the changing types of healthcare providers together with the use of choice and competition to drive improvements in quality in the National Health Service (NHS), all have important ethical implications. In order for the NHS to continue providing the level of service quality that out performs many high-income countries, despite spending much less on healthcare, we need a re-think of creeping marketization and privatisation and a consolidation of the NHS as a publically owned resource run for the benefit of patients and the public, not commercial interests.

  14. Health Services Use and HIV Prevalence Among Migrant and National Female Sex Workers in Portugal: Are We Providing the Services Needed?

    Science.gov (United States)

    Dias, Sónia; Gama, Ana; Pingarilho, Marta; Simões, Daniel; Mendão, Luís

    2017-08-01

    This cross-sectional bio-behavioral survey conducted with 853 female sex workers (FSW) aimed to examine differences in use of HIV health services, testing and prevalence among migrant and national FSW. A quarter of undocumented FSW had never used National Health Service (NHS) and 15 % never tested for HIV, significantly more than nationals (p VIH, test y prevalencia entre TS migrantes y nacionales. Un cuarto de las TS indocumentadas nunca utilizaron el Servicio Nacional de Salud (SNS) y el 15 % nunca fueron testadas respecto al VIH, porcentajes significativamente superiores a las observadas para las nacionales (p VIH fue auto reportada por 11.9 % de las nacionales, 1.8 % de las migrantes documentadas y 0.8 % de las indocumentadas (p VIH fue reactivo para un 13.6 % de las indocumentadas, 8.0 % de las nacionales y 2.3 % de las documentadas. Una proporción mayor de migrantes desconocía su serostatus positivo en comparación con las nacionales. El test del VIH fue menos frecuente entre las indocumentadas, quien nunca utilizó el SNS y quien no sabía dónde recurrir si sospechaba estar infectada por el VIH. Promover un diagnóstico precoz en conexión con los cuidados en TS migrantes debe ser respaldado mientras se desarrollan servicios de salud mejor adaptados a sus necesidades.

  15. Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status

    Directory of Open Access Journals (Sweden)

    Meyer Sarah

    2011-09-01

    Full Text Available Abstract Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR Health Information System (HIS. Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5 was higher than in Africa on average (1.8. Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1. The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient

  16. University psychiatry in Italy: organisation and integration of university clinics and the National Health Service

    Directory of Open Access Journals (Sweden)

    Pier Maria Furlan

    2013-09-01

    Full Text Available INTRODUCTION: In the Italian psychiatric system, community-based care has become increasingly important and widespread since the national reform of 1978. This report aims to provide an overview of the involvement of university medical schools in this process, considering their responsibility for teaching and training specialist practitioners and professionals. METHODS: The study was carried out between early 2010 and February 2011. An 18-items, self-administered, questionnaire was designed to investigate the number of faculty members that are responsible both for running a clinical ward and for providing community-based healthcare. RESULTS: Nine out of 53 faculty members (17% manage a Mental Health Department, 9 (17% manage a University Department, and 2 (3.8% manage both types of department. Less than half of the teachers have full responsibility (hospital and community; however the percentage reaches 73.2% if we include the hospital wards open to the community emergencies. The remaining 26.8% have no responsibility for community psychiatry. Moreover there were undoubtedly still too many universities with specialisation schools that are without an appropriate network of facilities enabling them to offer complex psychiatric training. DISCUSSION: As expected, there were several types of healthcare management that were not uniformly distributed throughout Italy and there were also marked differences between mental health care provision in the North, Centre, and South of Italy. The university involvement in clinical responsibility was great, but at the management level there was a lack of equality in terms of clinical care, which risks being reflected also on the institutional functions of teaching and research.

  17. National occupational health service policies and programs for workers in small scale industries in China

    Energy Technology Data Exchange (ETDEWEB)

    Su Zhi; Wang Sheng; Levine, S.P.

    2000-07-01

    Over the 14 years since economic reform began, and the restructuring of the economy to encourage international trade, a large number of township enterprises have been developed and put into operation in the Peoples Republic of China. In this paper, a report is given on a sample survey in 30 counties in 1990, which showed that 82.69% of rural industrial enterprises had at least one type of occupational hazard in their work environments. Workers engaged in at least one type of hazardous working environment accounted for 33.91% of the blue-collar workers. Physical examinations were performed for seven types of occupational diseases: silicosis, coal worker's pneumoconiosis, asbestosis, chronic lead poisoning, benzene analogs poisoning, chronic chromium poisoning, and noise-induced hearing loss. The total detectable rate of the seven types of occupational diseases was 4.4% among those workers. In addition, 11% had illnesses suspected of being caused by occupational exposures. Most township enterprises do not provide basic occupational health services.

  18. 78 FR 58539 - National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and...

    Science.gov (United States)

    2013-09-24

    ... community health assets and needs 13. Partner with the community 14. Create conflict and grievance... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... Health and Health Care AGENCY: Office of Minority Health, Office of the Secretary, Department of...

  19. Using the World Health Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings

    Directory of Open Access Journals (Sweden)

    Cabral de Mello Meena

    2011-09-01

    Full Text Available Abstract Background Most adolescents live in resource-constrained countries and their mental health has been less well recognised than other aspects of their health. The World Health Organization's 4-S Framework provides a structure for national initiatives to improve adolescent health through: gathering and using strategic information; developing evidence-informed policies; scaling up provision and use of health services; and strengthening linkages with other government sectors. The aim of this paper is to discuss how the findings of a recent systematic review of mental health problems in adolescents in resource-constrained settings might be applied using the 4-S Framework. Method Analysis of the implications of the findings of a systematic search of the English-language literature for national strategies, policies, services and cross-sectoral linkages to improve the mental health of adolescents in resource-constrained settings. Results Data are available for only 33/112 [29%] resource-constrained countries, but in all where data are available, non-psychotic mental health problems in adolescents are identifiable, prevalent and associated with reduced quality of life, impaired participation and compromised development. In the absence of evidence about effective interventions in these settings expert opinion is that a broad public policy response which addresses direct strategies for prevention, early intervention and treatment; health service and health workforce requirements; social inclusion of marginalised groups of adolescents; and specific education is required. Specific endorsed strategies include public education, parent education, training for teachers and primary healthcare workers, psycho-educational curricula, identification through periodic screening of the most vulnerable and referral for care, and the availability of counsellors or other identified trained staff members in schools from whom adolescents can seek assistance for

  20. Behavioral Health and Service Use Among Civilian Wives of Service Members and Veterans: Evidence from the National Survey of Drug Use and Health

    Science.gov (United States)

    2015-01-01

    Diagnostic and Statistical Manual of Mental Disorders, Version IV ( APA , 2000). The following four behavioral health service use outcomes were examined...Statistical Manual of Mental Disorders, revised 4th ed., Washington, D.C., 2000. APA —See American Psychiatric Association. Brown, Ryan Andrew, Grant N...ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for

  1. Health Information National Trends Survey (HINTS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Health Information National Trends Survey (HINTS) is a biennial, cross-sectional survey of a nationally-representative sample of American adults that is used to...

  2. National Weather Service, Emergency Medical Services, Scripps Institution of Oceanography/UCSD and California EPA Collaboration on Heat Health Impact and Public Notification for San Diego County

    Science.gov (United States)

    Tardy, A. O.; Corcus, I.; Guirguis, K.

    2015-12-01

    The National Weather Service (NWS) has issued official heat alerts in the form of either a heat advisory or excessive heat warning product to the public and core partners for many years. This information has traditionally been developed through the use of triggers for heat indices which combine humidity and temperature. The criteria typically used numeric thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality or population acclimation. In 2013, the Scripps Institution of Oceanography, University of California, San Diego in collaboration with the Office of Environmental Health Hazard Assessment, of the California Environmental Protection Agency and the NWS completed a study of heat health impact in California, while the NWS San Diego office began modifying their criteria towards departure from climatological normal with much less dependence on humidity or heat index. The NWS changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system which documents heat health impacts. Results from the UCSD study were finalized and published in 2014; they supported the need for significant modification of the traditional criteria. In order to better understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch, which is charged by the County's Public Health Officer to monitor heat-related illness and injury daily from June through September. The data were combined with UCSD research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, practices and procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services. The end result of the

  3. Trade in health services.

    Science.gov (United States)

    Chanda, Rupa

    2002-01-01

    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.

  4. The paradox of non-evidence based, publicly funded complementary alternative medicine in the English National Health Service: An explanation.

    Science.gov (United States)

    Sheppard, Maria K

    2015-10-01

    Despite the unproven effectiveness of many practices that are under the umbrella term 'complementary alternative medicine' (CAM), there is provision of CAM within the English National Health Service (NHS). Moreover, although the National Institute for Health and Care Excellence was established to promote scientifically validated medicine in the NHS, the paradox of publicly funded, non-evidence based CAM can be explained as linked with government policy of patient choice and specifically patient treatment choice. Patient choice is useful in the political and policy discourse as it is open to different interpretations and can be justified by policy-makers who rely on the traditional NHS values of equity and universality. Treatment choice finds expression in the policy of personalised healthcare linked with patient responsibilisation which finds resonance in the emphasis CAM places on self-care and self-management. More importantly, however, policy-makers also use patient choice and treatment choice as a policy initiative with the objective of encouraging destabilisation of the entrenched healthcare institutions and practices considered resistant to change. This political strategy of system reform has the unintended, paradoxical consequence of allowing for the emergence of non-evidence based, publicly funded CAM in the NHS. The political and policy discourse of patient choice thus trumps evidence based medicine, with patients that demand access to CAM becoming the unwitting beneficiaries.

  5. The effects of Constitutional Amendment 29 on the regional allocation of public funds for the National Health Service in Brazil.

    Science.gov (United States)

    Piola, Sérgio Francisco; de França, José Rivaldo Mello; Nunes, André

    2016-02-01

    This article analyzes the effects of Constitutional Amendment 29 in financing the Brazilian National Health Service, SUS, between 2000 and 2010. The aim was to analyze how the resources that were allocated by the three spheres of government were used on a general basis and in specific regions. Analysis was also conducted on the possible repercussions of the Amendment in the allocation of finances for SUS. The results showed: an important increase in the designated resources that were used by the three spheres of government during the aforementioned period. There was an increase in real terms of 112% in consolidated spending and an 89% increase in spending per capita by the three spheres. There was also more participation from the States, the Federal District and the Municipalities in financing the system. However, in spite of the increase in the use of financial resources, regional inequalities, in relation to spending per capita, remained practically unchanged.

  6. Has equity in government subsidy on healthcare improved in China? Evidence from the China's National Health Services Survey.

    Science.gov (United States)

    Si, Lei; Chen, Mingsheng; Palmer, Andrew J

    2017-01-10

    Monitoring the equity of government healthcare subsidies (GHS) is critical for evaluating the performance of health policy decisions. China's low-income population encounters barriers in accessing benefits from GHS. This paper focuses on the distribution of China's healthcare subsidies among different socio-economic populations and the factors that affect their equitable distribution. It examines the characteristics of equitable access to benefits in a province of northeastern China, comparing the equity performance between urban and rural areas. Benefit incidence analysis was applied to GHS data from two rounds of China's National Health Services Survey (2003 and 2008, N = 27,239) in Heilongjiang province, reflecting the information in 2002 and 2007 respectively. Concentration index (CI) was used to evaluate the absolute equity of GHSs in outpatient and inpatient healthcare services. A negative CI indicates disproportionate concentration of GHSs among the poor, while a positive CI indicates the GHS is pro-rich, a CI of zero indicates perfect equity. In addition, Kakwani index (KI) was used to evaluate the progressivity of GHSs. A positive KI denotes the GHS is regressive, while a negative value denotes the GHS is progressive. CIs for inpatient care in urban and rural residents were 0.2036 and 0.4497 respectively in 2002, and those in 2007 were 0.4433 and 0.5375. Likewise, CIs for outpatient care are positive in both regions in 2002 and 2007, indicating that both inpatient and outpatient GHSs were pro-rich in both survey periods irrespective of region. In addition, KIs for inpatient services were -0.3769 (urban) and 0.0576 (rural) in 2002 and those in 2007 were 0.0280 and 0.1868. KIs for outpatient service were -0.4278 (urban) and -0.1257 (rural) in 2002, those in 2007 were -0.2572 and -0.1501, indicating that equity was improved in GHS in outpatient care in both regions but not in inpatient services. The benefit distribution of government healthcare subsidies

  7. A national quitline service and its promotion in the mass media: modelling the health gain, health equity and cost-utility.

    Science.gov (United States)

    Nghiem, Nhung; Cleghorn, Christine L; Leung, William; Nair, Nisha; Deen, Frederieke S van der; Blakely, Tony; Wilson, Nick

    2017-07-24

    Mass media campaigns and quitlines are both important distinct components of tobacco control programmes around the world. But when used as an integrated package, the effectiveness and cost-effectiveness are not well described. We therefore aimed to estimate the health gain, health equity impacts and cost-utility of the package of a national quitline service and its promotion in the mass media. We adapted an established Markov and multistate life-table macro-simulation model. The population was all New Zealand adults in 2011. Effect sizes and intervention costs were based on past New Zealand quitline data. Health system costs were from a national data set linking individual health events to costs. The 1-year operation of the existing intervention package of mass media promotion and quitline service was found to be net cost saving to the health sector for all age groups, sexes and ethnic groups (saving $NZ84 million; 95%uncertainty interval 60-115 million in the base-case model). It also produced greater per capita health gains for Māori (indigenous) than non-Māori (2.2 vs 0.73 quality-adjusted life-years (QALYs) per 1000 population, respectively). The net cost saving of the intervention was maintained in all sensitivity and scenario analyses for example at a discount rate of 6% and when the intervention effect size was quartered (given the possibility of residual confounding in our estimates of smoking cessation). Running the intervention for 20 years would generate an estimated 54 000 QALYs and $NZ1.10 billion (US$0.74 billion) in cost savings. The package of a quitline service and its promotion in the mass media appears to be an effective means to generate health gain, address health inequalities and save health system costs. Nevertheless, the role of this intervention needs to be compared with other tobacco control and health sector interventions, some of which may be even more cost saving. © Article author(s) (or their employer(s) unless otherwise

  8. Service delivery and pharmacotherapy for alcohol use disorder in the era of health reform: Data from a national sample of treatment organizations

    Science.gov (United States)

    Knudsen, Hannah K.; Roman, Paul M.

    2015-01-01

    Background Although there is a growing literature examining organizational characteristics and medication adoption, little is known about service delivery differences between specialty treatment organizations that have and have not adopted pharmacotherapy for alcohol use disorder (AUD). This study compares adopters and non-adopters across a range of treatment services, including levels of care, availability of tailored services for specific populations, treatment philosophy and counseling orientations, and adoption of comprehensive wraparound services. Methods In-person interviews were conducted with program leaders from a national sample of 372 organizations that deliver AUD treatment services in the US. Results About 23.6% of organizations had adopted at least one AUD medication. Organizations offering pharmacotherapy were similar to non-adopters across many measures of levels of care, tailored services, treatment philosophy, and social services. The primary area of difference between the two groups was for services related to health problems other than AUD. Pharmacotherapy adopters were more likely to offer primary medical care, medications for smoking cessation, and services to address co-occurring psychiatric conditions. Conclusions Service delivery differences were modest between adopters and non-adopters of AUD pharmacotherapy, with the exception of health-related services. However, the greater adoption of health-related services by organizations offering AUD pharmacotherapy represents greater medicalization of treatment, which may mean these programs are more strongly positioned to respond to opportunities for integration under health reform. PMID:25893539

  9. What did the public think of health services reform in Bangladesh? Three national community-based surveys 1999–2003

    Directory of Open Access Journals (Sweden)

    Hossain Md Zakir

    2007-02-01

    Full Text Available Abstract Background Supported by development partners, the Government of Bangladesh carried out a comprehensive reform of health services in Bangladesh between 1998 and 2003, intended to make services more responsive to public needs: the Health and Population Sector Programme (HPSP. They commissioned a series of surveys of the public, as part of evaluation of the HPSP. This article uses the survey findings to examine the changes in public opinions, use and experience of health services in the period of the HPSP. Methods We carried out three household surveys (1999, 2000 and 2003 of a stratified random sample of 217 rural sites and 30 urban sites. Each site comprised 100–120 contiguous households. Each survey included interviews with 25,000 household respondents and managers of health facilities serving the sites, and gender-stratified focus groups in each site. We measured: household ratings of government health services; reported use of services in the preceding month; unmet need for health care; user reports of waiting times, payments, explanations of condition, availability of prescribed medicines, and satisfaction with service providers. Results Public rating of government health services as "good" fell from 37% to 10% and the proportion using government treatment services fell from 13% to 10%. Unmet need increased from 3% to 9% of households. The proportion of visits to government facilities fell from 17% to 13%, while the proportion to unqualified practitioners rose from 52% to 60%. Satisfaction with service providers' behaviour dropped from 66% to 56%. Users were more satisfied when waiting time was shorter, prescribed medicines were available, and they received explanations of their condition. Conclusion Services have retracted despite increased investment and the public now prefer unqualified practitioners over government services. Public opinion of government health services has deteriorated and the reforms have not specifically

  10. "Worse than being married": the exodus of British doctors from the National Health Service to Canada, c. 1955-75.

    Science.gov (United States)

    Wright, David; Mullally, Sasha; Cordukes, Mary Colleen

    2010-10-01

    Despite a sizeable literature on the evolution of health insurance in Britain and Canada, there is virtually no research on the transnational migration of physicians between these countries in the immediate postwar period. This article hopes to address this neglected subject. Three inter-related topics will be examined. First, the paper will summarize the debate over physician emigration from the National Health Service (NHS) in postwar Britain. It will demonstrate how British social scientists and politicians began to come to grips with a major demographic exodus of British-trained doctors in the late 1950s and early 1960s. Second, it will analyze the changing health human resource situation in 1960s Canada, which focused, for practical and cultural reasons, on General Medical Council of Britain licensed practitioners. Third, through oral interviews of British-trained physicians who settled in Canada during the 1960s, it will examine the professional and personal reasons why physicians left Britain for Canada. It reveals that, among a myriad of personal issues that motivated a physician to leave the NHS, the inflexibility and hierarchical nature of British medicine loomed very large. The paper will conclude by reflecting on the contemporary significance of this fascinating historical phenomenon.

  11. 'Partners in clime': sustainable development and climate change--what can the National Health Service do?

    Science.gov (United States)

    Cosford, P

    2009-01-01

    Climate change is arguably the biggest threat to health in the medium and long term. Necessary responses to this threat include adaptation, i.e. preparing to respond to the consequences of climate change, of which there are many in respect of health; and mitigation, i.e. reducing the activities that lead to climate change and, in particular, reducing the levels of greenhouse gas emissions, the most significant of which is carbon.

  12. The fiction of health services

    Directory of Open Access Journals (Sweden)

    Oscar Echeverry

    2012-06-01

    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.

  13. National Health and Nutrition Examination Survey (NHANES)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1999-2000 forward. The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of...

  14. Examples of applied public health through the work of the Epidemic Intelligence Service officers at CDC's National Center for Environmental Health: 2006-2015.

    Science.gov (United States)

    Carroll, Yulia I; Rashid, Fauzia A; Falk, Henry; Howley, Meredith M

    2017-01-01

    The Epidemic Intelligence Service officers (EISOs) at the National Center for Environmental Health (NCEH)/Agency for Toxic Substances and Disease Registry (ATSDR) respond to public health outbreaks, assist public health surveillance, and recommend public health actions. We summarize the breadth of work done by EISOs assigned to NCEH/ATSDR during 2006-2015. We used the Web of Science, Scopus, and PubMed databases to identify articles authored by the EISOs, number and types of epidemiologic assistance field investigations (Epi-Aids), and interviewed NCEH/ATSDR programs with EISO assignees. The largest number of NCEH/ATSDR EISO publications (n = 61) and Epi-Aids (n = 110) related to toxic chemicals (23 and 37, respectively), followed by natural disasters and those caused by humans (19 and 25, respectively), extreme temperature-related illness (9), and chronic diseases (8). The investigations raised awareness, identified risk factors and public health needs, and introduced better prevention and protection measures for human health. Through field investigations and other technical assistance, NCEH/ATSDR provided leadership and staff scientists to assist in the field, as well as knowledge transfer to local, state, territorial, and international health departments.

  15. Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia

    Directory of Open Access Journals (Sweden)

    Ensor Tim

    2012-08-01

    Full Text Available Abstract Background Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. Methods A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. Findings Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population

  16. Budgeting based on need: a model to determine sub-national allocation of resources for health services in Indonesia.

    Science.gov (United States)

    Ensor, Tim; Firdaus, Hafidz; Dunlop, David; Manu, Alex; Mukti, Ali Ghufron; Ayu Puspandari, Diah; von Roenne, Franz; Indradjaya, Stephanus; Suseno, Untung; Vaughan, Patrick

    2012-08-29

    Allocating national resources to regions based on need is a key policy issue in most health systems. Many systems utilise proxy measures of need as the basis for allocation formulae. Increasingly these are underpinned by complex statistical methods to separate need from supplier induced utilisation. Assessment of need is then used to allocate existing global budgets to geographic areas. Many low and middle income countries are beginning to use formula methods for funding however these attempts are often hampered by a lack of information on utilisation, relative needs and whether the budgets allocated bear any relationship to cost. An alternative is to develop bottom-up estimates of the cost of providing for local need. This method is viable where public funding is focused on a relatively small number of targeted services. We describe a bottom-up approach to developing a formula for the allocation of resources. The method is illustrated in the context of the state minimum service package mandated to be provided by the Indonesian public health system. A standardised costing methodology was developed that is sensitive to the main expected drivers of local cost variation including demographic structure, epidemiology and location. Essential package costing is often undertaken at a country level. It is less usual to utilise the methods across different parts of a country in a way that takes account of variation in population needs and location. Costing was based on best clinical practice in Indonesia and province specific data on distribution and costs of facilities. The resulting model was used to estimate essential package costs in a representative district in each province of the country. Substantial differences in the costs of providing basic services ranging from USD 15 in urban Yogyakarta to USD 48 in sparsely populated North Maluku. These costs are driven largely by the structure of the population, particularly numbers of births, infants and children and also key

  17. 76 FR 25696 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting

    Science.gov (United States)

    2011-05-05

    ...-Snell at the Office of Rural Health Policy (ORHP) via Telephone at (301) 443-0835 or by e-mail at ddemasse-snell@hrsa.gov . The committee meeting agenda will be posted on ORHP's Web site http://www...

  18. Legitimate Peripheral Participation by Sandwich Year Interns in the National Health Service

    Science.gov (United States)

    Davies, Helen Maria; Sandiford, Peter John

    2014-01-01

    Student internships are widely seen as a valuable part of education provision and there is a growing body of research into internship programmes from student, employer and educator perspectives. This paper explores the experiences of a group of information technology interns employed in a small organisation involved in health care business…

  19. Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients’ evaluations of the effectiveness of treatments

    Science.gov (United States)

    Aazh, Hashir; Moore, Brian C. J.; Lammaing, Karen; Cropley, Mark

    2016-01-01

    Abstract Objective: To assess patients’ judgements of the effectiveness of the tinnitus and hyperacusis therapies offered in a specialist UK National Health Service audiology department. Design: Cross-sectional service evaluation questionnaire survey. Patients were asked to rank the effectiveness of the treatment they received on a scale from 1 to 5 (1 = no effect, 5 = very effective). Study sample: The questionnaire was sent to all patients who received treatment between January and March 2014 (n = 200) and 92 questionnaires were returned. Results : The mean score was greatest for counselling (Mean = 4.7, SD = 0.6), followed by education (Mean = 4.5, SD = 0.8), cognitive behavioural therapy - CBT (Mean = 4.4, SD = 0.7), and hearing tests (Mean = 4.4, SD = 0.9). Only 6% of responders rated counselling as 3 or below. In contrast, bedside sound generators, hearing aids, and wideband noise generators were rated as 3 or below by 25%, 36%, and 47% of participants, respectively. Conclusion: The most effective components of the tinnitus and hyperacusis therapy interventions were judged by the patients to be counselling, education, and CBT. PMID:27195947

  20. Psychosis, Socioeconomic Disadvantage and Health Service Use in South Australia: Findings from the Second Australian National Survey of Psychosis

    Directory of Open Access Journals (Sweden)

    Shaun eSweeney

    2015-11-01

    Full Text Available The association between mental illness and poor physical health and socioeconomic outcomes has been well established. In the twenty-first century, the challenge of how mental illnesses such as psychosis are managed in the provision of public health services remains complex. Developing effective clinical mental health support and interventions for individuals requires a coordinated and robust mental health system supported by social as well as health policy that places a priority on addressing socioeconomic disadvantage in mental health cohorts. This paper thus examines the complex relationship between socioeconomic disadvantage, family/social supports, physical health and health service utilisation in a community sample of 402 participants diagnosed with psychosis. The paper utilises quantitative data collected from the 2010 Survey of High Impact Psychosis research project conducted in a socioeconomically disadvantaged region of Adelaide, South Australia. Participants (42% female provided information about socio-economic status, education, employment, physical health, contact with family and friends, and health service utilisation. The paper highlights that socio-economic disadvantage is related to increased self-reported use of emergency departments, decreased use of general practitioners for mental health reasons, higher body mass index, less family contact and less social support. In particular, the paper explores the multifaceted relationship between socioeconomic disadvantage and poor health confronting individuals with psychosis, highlighting the complex link between socioeconomic disadvantage and poor health. It emphasizes that mental health service usage for those with higher levels of socioeconomic disadvantage differs from those experiencing lower levels of socioeconomic disadvantage. The paper also stresses that the development of health policy and practice that seeks to redress the socioeconomic and health inequalities created by

  1. Pharmacoepidemiological data from drug dispensing charities as a measure of health patterns in a population not assisted by the Italian National Health Service

    Directory of Open Access Journals (Sweden)

    Silvia Bini

    2016-08-01

    Full Text Available We analysed drug dispensation by charitable organisations in a year time. Drugs were grouped according to the Anatomic Therapeutic Chemical classification and the amount dispensed was calculated with the system of the Daily Defined Dose (DDD and expressed as DDD/1000 subjects/day. A number of 87,550 subjects were studied (13,308 Italians; 74,242 Immigrants. Though we noticed a great sesonal variability, the drugs most frequently dispensed were those for the respiratory, cardiovascular and gastrointestinal system and antibiotics, which is different from the rest of the Italian population and the immigrant population assisted by our National Health Service (NHS. We also found that chronic diseases are increasing in these subjects. We conclude that the subjects not receiving NHS assitance have, at least in part, different health patterns and requirements. This should be considered when planning tailored interventions.

  2. Power in the National Health Service: a case study of a unit considering NHS Trust status.

    Science.gov (United States)

    Peck, E

    1991-07-01

    There are a number of theoretical frameworks which aim to provide a language for understanding and discussing the nature of power and influence in organisational decision making. One of the most recent and comprehensive frameworks is that developed by Mintzberg. Following a resumé of the most pertinent sections of Mintzberg's framework, this paper uses it to investigate the power relationships in an NHS Mental Health Unit (MHU) considering NHS Trust status. This investigation reveals some important conclusions about the nature of power in the NHS but also explores some of the limitations of the framework as a descriptive and predictive tool.

  3. Social insurance for health service.

    Science.gov (United States)

    Roemer, M I

    1997-06-01

    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.

  4. 76 FR 44597 - National Institutes of Health

    Science.gov (United States)

    2011-07-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed...; 93.839, Blood Diseases and Resources Research, National Institutes of Health, HHS) Dated: July...

  5. 76 FR 71047 - National Institutes of Health

    Science.gov (United States)

    2011-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism; Notice... EPRB, NIAAA, National Institutes of Health, 5365 Fishers Lane, Room 2085, Rockville, MD 20852,...

  6. Learning from Somaliland? Transferability of learning from volunteering to national health service practice in the UK.

    Science.gov (United States)

    Tillson, Esther; van Wees, Sibylle Herzig; McGowan, Charlotte; Franklin, Hannah; Jones, Helena; Bogue, Patrick; Aliabadi, Shirin; Baraitser, Paula

    2016-03-22

    Capacity building partnerships between healthcare institutions have the potential to benefit both partners particularly in staff development. Previous research suggests that volunteering can contribute to professional development but there is little evidence on how learning is acquired, the barriers and facilitators to learning in this context or the process of translation of learning to the home environment. Volunteers from a healthcare partnership between the UK and Somaliland reported learning in communication, interdisciplinary working, teaching, management, leadership and service development. This learning came from observing familiar practices in unfamiliar environments; alternative solutions to familiar problems; learning about Somali culture; opportunities to assume higher levels of responsibility and new professional relationships. There was variability in the extent of translation to NHS practice. Time and support available for reflection and mentoring were important facilitators of this process. The professional development outcomes documented in this study came directly from the experience of volunteering. Experiential learning theory suggests that this requires a complex process of critical reflection and new knowledge generation, testing and translation for use in new contexts. This process benefits from identification of learning as an important element of volunteering and support for reflection and the translation translation of learning to UK contexts. We suggest that missed opportunities for volunteer learning will remain until the volunteering process is overtly framed as part of continuing professional development.

  7. Predicted savings to the UK National Health Service from switching to generic antiretrovirals, 2014–2018

    Directory of Open Access Journals (Sweden)

    Andrew Hill

    2014-11-01

    Full Text Available Introduction: In other disease areas, generic drugs are normally used after patent expiry. Patents on zidovudine, lamivudine, nevirapine and efavirenz have already expired. Patents will expire for abacavir in late 2014, lopinavir/r in 2016, and tenofovir, darunavir and atazanavir in 2017. However, patents on single-tablet regimens do not expire until after 2026. Methods: The number of people taking each antiretroviral in the UK was estimated from 23,655 individuals in the UK CHIC cohort (2012 database. Costs of patented drugs were taken from the British National Formulary database, assuming a 30% discount. Costs of generic antiretrovirals were estimated using an 80% discount from patented prices, or actual costs where available. Two options were analysed: 1 – all patients use single-tablet regimens and patented versions of drugs; prices remain stable over time; 2 – all people switch from patented to generic drugs when available, after patent expiry (dates shown above. Results: There were an estimated 67,000 people taking antiretrovirals in the UK in 2014, estimated to rise by 8% per year until 2018 (in line with previous rises. The most widely used antiretrovirals in the CHIC cohort were tenofovir (TDF (75%, emtricitabine (FTC (69%, efavirenz (EFV (39%, lamivudine (3TC (23%, abacavir (ABC (18%, darunavir (DRV (21% and atazanavir (ATV (16%. The predicted annual UK cost of generic ABC/3TC/EFV (three generic tablets once daily was £1018 per person-year. Costs of patented single-tablet regimens ranged from £5000 to £7500 per person-year. Assuming continued use of patented antiretrovirals in the UK, the predicted total national costs of antiretroviral treatment were predicted to rise from £425 million in 2014 to £459 m in 2015, £495 m in 2016, £536 m in 2017 and £578 m in 2018. With a 100% switch to generics, total predicted costs were £337 m in 2014, £364 m in 2015, £382 m in 2016, £144 m in 2017 and £169 m in 2018. The total

  8. Acamprosate in the treatment of alcoholism: a budget impact analysis for the National Health Service in Italy

    Directory of Open Access Journals (Sweden)

    Colombo GL

    2012-07-01

    Full Text Available Giorgio L Colombo,1,2 Sergio Di Matteo,2 Giacomo Bruno21Department of Drug Sciences, School of Pharmacy, University of Pavia, Pavia, Italy; 2S.A.V.E. – Studi Analisi Valutazioni Economiche, Milan, ItalyObjective: Alcohol dependence is a common condition associated with high direct and indirect health care costs. The purpose of this analysis was to estimate the economic consequences of acamprosate used as adjuvant therapy in the treatment of alcoholism, defining a budget impact analysis (BIA from the point of view of the Italian National Health Service (NHS.Methods: We developed a model of disease evolution related to alcoholism using data from the PRAMA study. The hypothetical population included in the decision model was obtained from data from the Ministry of Health. We compared the following treatment strategies: no treatment, standard care (psychotherapy, sodium oxybate (sodium salt-4-hydroxybutyric acid, and acamprosate. The time horizon of the model was 10 years. The costs were evaluated from the NHS perspective.Results: We simulated the path for 69,348 patients treated at the outpatient clinics of the Addiction Services (SerT, and 38,911 patients discharged from hospital. Patients in the acamprosate group had lower alcohol-related events, with a reduction of the total cost. The BIA shows that the increase in the use of acamprosate was associated with a progressive decrease of total costs, calculated as the sum of the diagnosis-related groups (DRG, rehabilitation, and drug costs. The increasing use of acamprosate instead of standard care and sodium oxybate would generate cost savings up to over €6 million over 10 years of simulation.Conclusion: The estimates in the model are based on hypothetical situations; the assumptions of the model as well as their specific impact on treatment effect estimations and clinical implications should be validated in real life. Public health care authorities would benefit from mathematical models

  9. National Health Care Survey

    Science.gov (United States)

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  10. Indian Health Service: Find Health Care

    Science.gov (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 ...

  11. Who Are the Young People Choosing Web-based Mental Health Support? Findings From the Implementation of Australia's National Web-based Youth Mental Health Service, eheadspace

    Science.gov (United States)

    Rickwood, Debra; Webb, Marianne; Telford, Nic

    2016-01-01

    Background The adolescent and early adult years are periods of peak prevalence and incidence for most mental disorders. Despite the rapid expansion of Web-based mental health care, and increasing evidence of its effectiveness, there is little research investigating the characteristics of young people who access Web-based mental health care. headspace, Australia’s national youth mental health foundation, is ideally placed to explore differences between young people who seek Web-based mental health care and in-person mental health care as it offers both service modes for young people, and collects corresponding data from each service type. Objective The objective of this study was to provide a comprehensive profile of young people seeking Web-based mental health care through eheadspace (the headspace Web-based counseling platform), and to compare this with the profile of those accessing help in-person through a headspace center. Methods Demographic and clinical presentation data were collected from all eheadspace clients aged 12 to 25 years (the headspace target age range) who received their first counseling session between November 1, 2014 and April 30, 2015 via online chat or email (n=3414). These Web-based clients were compared with all headspace clients aged 12 to 25 who received their first center-based counseling service between October 1, 2014 and March 31, 2015 (n=20,015). Results More eheadspace than headspace center clients were female (78.1% compared with 59.1%), and they tended to be older. A higher percentage of eheadspace clients presented with high or very high levels of psychological distress (86.6% compared with 73.2%), but they were at an earlier stage of illness on other indicators of clinical presentation compared with center clients. Conclusions The findings of this study suggest that eheadspace is reaching a unique client group who may not otherwise seek help or who might wait longer before seeking help if in-person mental health support was

  12. Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volumes I-II.

    Science.gov (United States)

    von Kuster, Thomas, Jr.

    Results from the first federally sponsored study of the chiropractic health care profession are presented, and a broad range of facts and issues of concern to policy-makers, the profession, and the public are described. The two-year project included three national surveys of: service providers (doctors of chiropractic in practice more than two…

  13. Innovation within a national health care system.

    Science.gov (United States)

    Young, Antony

    2017-05-01

    Tony is a practicing frontline National Health Service surgeon and director of medical innovation at Anglia Ruskin University and has founded 4 medical-technology start-ups. He has also cofounded the £500 million Anglia Ruskin MedTech Campus, which will become one of the world's largest health innovation spaces. In 2014, he was appointed as national clinical director for innovation at National Health Service England and in February 2016 became the first national clinical lead for innovation. In this role, he provides clinical leadership and support in delivering improved health outcomes in England, drives the uptake of proven innovations across the National Health Service, promotes economic growth through innovation, and helps make the National Health Service the go-to place on the planet for medical innovation. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Do social networks push families toward or away from youth mental health services?: A national study of families in child welfare.

    Science.gov (United States)

    Martinez, Jonathan I; Lau, Anna S

    2011-09-01

    Social support networks may encourage or dissuade help-seeking for youth behavior problems in ways that contribute to racial/ethnic disparities in mental health services. We examined how parental social network characteristics were related to the use of mental health services in a diverse sample of families in contact with Child Welfare. Data from 1519 families of White (n=812), African American (n=418), and Latino (n=289) origin were drawn from the National Survey of Child and Adolescent Well-Being. Data were collected prospectively after the initiation of a Child Welfare investigation for alleged maltreatment. Results revealed that parental perceptions of support were negatively associated with service use across racial/ethnic groups, and this association was explained by better subsequent mental health status enjoyed by children of parents with stronger social support. Moderator analyses suggested that larger social networks were associated with a decreased use of services among Whites and more highly educated families.

  15. [Marketing in health service].

    Science.gov (United States)

    Ameri, Cinzia; Fiorini, Fulvio

    2014-01-01

    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. Nationwide cervical cancer screening in Korea: data from the National Health Insurance Service Cancer Screening Program and National Cancer Screening Program, 2009-2014.

    Science.gov (United States)

    Shim, Seung Hyuk; Kim, Hyeongsu; Sohn, In Sook; Hwang, Han Sung; Kwon, Han Sung; Lee, Sun Joo; Lee, Ji Young; Kim, Soo Nyung; Lee, Kunsei; Chang, Sounghoon

    2017-09-01

    The rates of participation in the Korean nationwide cervical cancer screening program and the rates of abnormal test results were determined. The database of the National Health Insurance Service (NHIS) was used during the study period (2009-2014). The participation rate increased from 41.10% in 2009 to 51.52% in 2014 (annual percentage change, 4.126%; 95% confidence interval [CI]=2.253-6.034). During the study period, women ≥70 years of age had the lowest rate of participation (range, 21.7%-31.9%) and those 30-39 years of age the second-lowest (27.7%-44.9%). The participation rates of National Health Insurance beneficiaries (range, 48.6%-52.5%) were higher than those of Medical Aid Program (MAP) recipients (29.6%-33.2%). The rates of abnormal results were 0.65% in 2009 and 0.52% in 2014, with a decreasing tendency in all age groups except the youngest (30-39 years). Every year the abnormal result rates tended to decrease with age, from the age groups of 30-39 years to 60-69 years but increased in women ≥70 years of age. The ratio of patients with atypical squamous cells of undetermined significance compared with those with squamous intraepithelial lesions increased from 2.71 in 2009 to 4.91 in 2014. Differences related to age and occurring over time were found in the rates of participation and abnormal results. Further efforts are needed to encourage participation in cervical cancer screening, especially for MAP recipients, elderly women and women 30-39 years of age. Quality control measures for cervical cancer screening programs should be enforced consistently.

  17. 76 FR 13197 - National Institute of Environmental Health Sciences Strategic Planning

    Science.gov (United States)

    2011-03-10

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences... Sciences (NIEHS), Department of Health and Human Services (HHS). ACTION: Request for comments and.... Linda S. Birnbaum, Director, National Institute of Environmental Health Sciences and National...

  18. Budget impact analysis of antiretroviral less drug regimen simplification in HIV-positive patients on the Italian National Health Service

    Directory of Open Access Journals (Sweden)

    Restelli U

    2014-09-01

    Full Text Available Umberto Restelli,1,2 Massimo Andreoni,3 Andrea Antinori,4 Marzia Bonfanti,2 Giovanni Di Perri,5 Massimo Galli,6 Adriano Lazzarin,7 Giuliano Rizzardini,8,9 Davide Croce1,2 1Department of Community Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Centro di Ricerca in Economia e Management in Sanità e nel Sociale (CREMS, Università Carlo Cattaneo – LIUC, Castellanza (VA, Italy; 3Clinical Infectious Diseases, Tor Vergata University (PTV, Rome, Italy; 4Clinical Department, National Institute for Infectious Diseases "L. Spallanzani," Rome, Italy; 5Department of Medical Sciences, Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy; 6Third Division of Infectious Diseases, "Luigi Sacco" Hospital, Milan, Italy; 7Department of Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy; 8First and Second Divisions of Infectious Diseases, "Luigi Sacco" Hospital, Milan, Italy; 9School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Background: Deintensification and less drug regimen (LDR antiretroviral therapy (ART strategies have proved to be effective in terms of maintaining viral suppression in human immunodeficiency virus (HIV-positive patients, increasing tolerability, and reducing toxicity of antiretroviral drugs administered to patients. However, the economic impact of these strategies have not been widely investigated. The aim of the study is to evaluate the economic impact that ART LDR could have on the Italian National Health Service (INHS budget. Methods: A budget impact model was structured to assess the potential savings for the INHS by the use of ART LDR for HIV-positive patients with a 3 year perspective. Data concerning ART cost, patient distribution within different ARTs, and probabilities for patients to change ART on a yearly basis were collected within four Italian infectious diseases departments, providing

  19. NHRIC (National Health Related Items Code)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Related Items Code (NHRIC) is a system for identification and numbering of marketed device packages that is compatible with other numbering...

  20. NHRIC (National Health Related Items Code)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Related Items Code (NHRIC) is a system for identification and numbering of marketed device packages that is compatible with other numbering...

  1. 76 FR 50234 - National Institute of Environmental Health Sciences Notice of Meetings

    Science.gov (United States)

    2011-08-12

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences Notice... and Training (DERT), Nat. Inst. of Environmental Health Sciences, National Institutes of Health, 615... and Training (DERT), Nat. Inst. of Environmental Health Sciences, National Institutes of Health,...

  2. 75 FR 65365 - National Institute of Environmental Health Sciences;

    Science.gov (United States)

    2010-10-22

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: Environmental Health Sciences Review Committee; Research Career... applications. Place: Nat. Inst. of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W...

  3. Management accounting use and financial performance in public health-care organisations: evidence from the Italian National Health Service.

    Science.gov (United States)

    Macinati, Manuela S; Anessi-Pessina, E

    2014-07-01

    Reforms of the public health-care sector have emphasised the role of management accounting (MA). However, there is little systematic evidence on its use and benefits. To fill this gap, we propose a contingency-based model which addresses three related issues, that is, whether: (i) MA use is influenced by contextual variables and MA design; (ii) top-management satisfaction with MA mediates the relationship between MA design and MA use; and (iii) financial performance is influenced by MA use. A questionnaire was mailed out to all Italian public health-care organisations. Structural equation modelling was performed to validate the research hypotheses. The response rate was 49%. Our findings suggest that: (i) cost-containment strategies encourage more sophisticated MA designs; (ii) MA use is directly and indirectly influenced by contingency, organisational, and behavioural variables; (iii) a weakly significant positive relationship exists between MA use and financial performance. These findings are relevant from the viewpoint of both top managers and policymakers. The former must make sure that MA is not only technically advanced, but also properly understood and appreciated by users. The latter need to be aware that MA may improve performance in ways and along dimensions that may not fully translate into better financial results.

  4. Generational status and family cohesion effects on the receipt of mental health services among Asian Americans: findings from the National Latino and Asian American Study.

    Science.gov (United States)

    Ta, Van M; Holck, Peter; Gee, Gilbert C

    2010-01-01

    We investigated the relative strengths of generational status and family cohesion effects on current use of mental health services (past 12 months) among Asian Americans. We conducted a secondary data analysis with data from the National Latino and Asian American Study, 2002 to 2003, restricted to Asian American respondents (n=2087). The study's outcome was current use (past 12 months) of any mental health services. Respondents included Chinese, Filipino, Vietnamese, and other Asian Americans. Multivariate analyses suggest no significant interaction exists between second- versus first-generation Asian Americans and family cohesion. The impact of generational status on mental health service use was significant for third- or later-generation Asian Americans (versus first-generation Asian Americans) and varied with family cohesion score. Family cohesion and generational status both affect the likelihood of Asian Americans to seek mental health services. Our findings also highlight the need for primary care and other providers to consistently screen for mental health status particularly among first-generation Asian Americans. Mental health service programs should target recent immigrants and individuals lacking a strong family support system.

  5. Community Involvement - Health / Service

    OpenAIRE

    2004-01-01

    Elizabeth Andress: Partnerships Produce a National Center for Home Food Preservation. Diana Friedman: National 4-H Healthy Lifestyles Grant. H. Wallace Goddard: Big Surprises on the Road to Happiness. Nancy Kershaw: Connecting the 4-H Clothing Project and Community. Jane A. Landis: NEAFCS Living Well Public Service Campaign. Rhea Lanting: The Healthy Diabetes Plate. Phyllis B. Lewis: Product Look-Alikes. Anna Martin: Raising Diabetes Awareness in Latino Communities. Earl Mcalexander: Youth Fi...

  6. Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals

    Science.gov (United States)

    Griffiths, Peter; Sloane, Douglas M; Rafferty, Anne Marie; Ball, Jane E; Aiken, Linda H

    2015-01-01

    Objectives To examine whether patient satisfaction with nursing care in National Health Service (NHS) hospitals in England is associated with the proportion of non-UK educated nurses providing care. Design Cross-sectional analysis using data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. Logistic regression models with corrections for clustering were used to determine whether the proportions of non-UK educated nurses were significantly related to patient satisfaction before and after taking account of other hospital, nursing and patient characteristics. Setting 31 English NHS trusts. Participants 12 506 patients 16 years of age and older with at least one overnight stay that completed a satisfaction survey; 2962 bedside care nurses who completed a nurse survey; and 31 NHS trusts. Main outcome measure Patient satisfaction. Results The percentage of non-UK educated nurses providing bedside hospital care, which ranged from 1% to 52% of nurses, was significantly associated with patient satisfaction. After controlling for potential confounding factors, each 10-point increase in the percentage of non-UK educated nurses diminished the odds of patients reporting good or excellent care by 12% (OR=0.88), and decreased the odds of patients agreeing that they always had confidence and trust in nurses by 13% (OR=0.87). Other indicators of patient satisfaction also revealed lower satisfaction in hospitals with higher percentages of non-UK educated nurses. Conclusions Use of non-UK educated nurses in English NHS hospitals is associated with lower patient satisfaction. Importing nurses from abroad to substitute for domestically educated nurses may negatively impact quality of care. PMID:26634400

  7. Bacterial screening of platelet components by National Health Service Blood and Transplant, an effective risk reduction measure.

    Science.gov (United States)

    McDonald, Carl; Allen, Jennifer; Brailsford, Susan; Roy, Anjana; Ball, Joanne; Moule, Richard; Vasconcelos, Mariza; Morrison, Rachael; Pitt, Tyrone

    2017-05-01

    Bacterial contamination of blood components remains a major cause of sepsis in transfusion medicine. Between 2006 and 2010 in the 5 years before the introduction of bacterial screening of platelet (PLT) components by National Health Service Blood and Transplant (NHSBT), seven cases of PLT component-associated transmission of bacterial infection were recorded for 10 patients, three of which were fatal. Sampling of individual PLT components was undertaken at 36 to 48 hours after donation and tested in the BacT/ALERT system with 8 mL inoculated into each of aerobic and anaerobic culture bottles. Bottles were incubated until the end of the 7-day shelf life and initial reactive bottles were examined for contamination. Bacterial screened time-expired PLTs were tested as in the screen method. From February 2011 to September 2015, a total of 1,239,029 PLT components were screened. Initial-reactive, confirmed-positive, and false-positive rates were 0.37, 0.03, and 0.19%, respectively. False-negative cultures, all with Staphylococcus aureus, occurred on four occasions; three were visually detected before transfusion and one confirmed transmission resulted in patient morbidity. The NHSBT screening protocol effectively reduced the number of clinically adverse transfusion transmissions by 90% in this reporting period, compared to a similar time period before implementation. Delayed testing of 4515 time-expired PLT units after screening revealed no positives. The implementation of bacterial screening of PLT components with the NHSBT BacT/ALERT protocol was an effective risk reduction measure and increased the safety of the blood supply. © 2017 AABB.

  8. Integrating ecosystem services into national Forest Service policy and operations

    Science.gov (United States)

    Robert Deal; Lisa Fong; Erin Phelps; Emily Weidner; Jonas Epstein; Tommie Herbert; Mary Snieckus; Nikola Smith; Tania Ellersick; Greg Arthaud

    2017-01-01

    The ecosystem services concept describes the many benefits people receive from nature. It highlights the importance of managing public and private lands sustainably to ensure these benefits continue into the future, and it closely aligns with the U.S. Forest Service (USFS) mission to “sustain the health, diversity, and productivity of the Nation’s forests and...

  9. National Health Service Principles as Experienced by Vulnerable London Migrants in “Austerity Britain”: A Qualitative Study of Rights, Entitlements, and Civil-Society Advocacy

    Directory of Open Access Journals (Sweden)

    Elham Rafighi

    2016-10-01

    Full Text Available Background: Recent British National Health Service (NHS reforms, in response to austerity and alleged ‘health tourism,’ could impose additional barriers to healthcare access for non-European Economic Area (EEA migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. Methods: A qualitative study design was selected. Data were collected through document review and 22 indepth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles. Results: The experiences of those ‘vulnerable migrants’ (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over ‘health tourism,’ and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP responsibilities and migrant entitlements. Conclusion: Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers. Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health.

  10. 75 FR 42758 - National Institutes of Health

    Science.gov (United States)

    2010-07-22

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Cancer Institute; Notice of Meeting Pursuant to... Institutes of Health, 9000 Rockville Pike, Building 31, C Wing, 6th Floor, Conference Room 10, Bethesda,...

  11. 78 FR 42967 - National Institutes of Health

    Science.gov (United States)

    2013-07-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Heart, Lung, and Blood Institute; Notice of Closed... Institutes of Health, HHS) Dated: July 12, 2013. Michelle Trout, Program Analyst, Office of Federal...

  12. Making normative structures visible: the British National Health Service and the hospice movement as signifiers of compassion and hope

    NARCIS (Netherlands)

    Brown, P.; Flores, R.

    2011-01-01

    Compassion and hope are vital to individual and societal flourishing, not least through the solidarity and change that they facilitate. This article considers the importance of these two social phenomena for welfare institutions, and in particular for the hospice movement and the National Health Ser

  13. Making normative structures visible: the British National Health Service and the hospice movement as signifiers of compassion and hope

    NARCIS (Netherlands)

    Brown, P.; Flores, R.

    2011-01-01

    Compassion and hope are vital to individual and societal flourishing, not least through the solidarity and change that they facilitate. This article considers the importance of these two social phenomena for welfare institutions, and in particular for the hospice movement and the National Health

  14. Utilization of health care services for childhood morbidity and associated factors in India: a national cross-sectional household survey.

    Directory of Open Access Journals (Sweden)

    Chandrashekhar T Sreeramareddy

    Full Text Available BACKGROUND: Information about utilization of health services and associated factors are useful for improving service delivery to achieve universal health coverage. METHODS: Data on a sample of ever-married women from India Demographic and Health survey 2005-06 was used. Mothers of children aged 0-59 months were asked about child's illnesses and type of health facilities where treatment was given during 15 days prior to the survey date. Type of health facilities were grouped as informal provider, public provider and private provider. Factors associated with utilization of health services for diarrhea and fever/cough was assessed according to Andersen's health behavior model. Multinomial logistic regression analyses were done considering sampling weights for complex sampling design. RESULTS: A total of 48,679 of ever-married women reported that 9.1% 14.8% and 17.67% of their children had diarrhea, fever and cough respectively. Nearly one-third of the children with diarrhea and fever/cough did not receive any treatment. Two-thirds of children who received treatment were from private health care providers (HCPs. Among predisposing factors, children aged 1-2 years and those born at health facility (public/private were more likely to be taken to any type of HCP during illness. Among enabling factors, as compared to poorer household, wealthier households were 2.5 times more likely to choose private HCPs for any illness. Children in rural areas were likely to be taken to any type of HCP for diarrhea but rural children were less likely to utilize private HCP for fever/cough. 'Need' factors i.e. children having severe symptoms were 2-3 times more likely to be taken to any type of HCP. CONCLUSION: Private HCPs were preferred for treatment of childhood illnesses. Involvement of private HCPs may be considered while planning child health programs. Health insurance scheme for childhood illnesses may to protect economically weaker sections from out

  15. National Center for Health Statistics

    Science.gov (United States)

    ... Submit Search The CDC National Center for Health Statistics Note: Javascript is disabled or is not supported ... Survey of Family Growth Vital Records National Vital Statistics System National Death Index Provider Surveys National Health ...

  16. Professionalising counter fraud specialists (fraud investigators) in the UK public sector: a focus upon Department for Work and Pensions, National Health Service and the Local Authority

    OpenAIRE

    Frimpong, KO

    2013-01-01

    This thesis seeks to examine and explore the professionalisation initiatives of the UK public sector counter fraud specialists (fraud investigators), with a focus upon the Department for Work and Pensions (DWP), National Health Service (NHS) and Local Authority (LA). The conceptual framework used to underpin the study was functionalist / “traits” theory of a profession and professionalisation. The main research question for the thesis concerns the issue of whether counter fraud specialism is ...

  17. 75 FR 31745 - Notice of Request for Approval of an Information Collection; National Veterinary Services...

    Science.gov (United States)

    2010-06-04

    ...; National Veterinary Services Laboratories Request Forms AGENCY: Animal and Plant Health Inspection Service... intention to request approval of an information collection associated with the National Veterinary Services... FURTHER INFORMATION CONTACT: For information on request forms associated with the National...

  18. Outcomes, costs and stakeholders' perspectives associated with the incorporation of community pharmacy services into the National Health Insurance System in Thailand: a systematic review.

    Science.gov (United States)

    Asayut, Narong; Sookaneknun, Phayom; Chaiyasong, Surasak; Saramunee, Kritsanee

    2017-08-09

    Identify costs, outcomes and stakeholders' perspectives associated with incorporation of community pharmacy services into the Thai National Health Insurance System and their values to all stakeholders. Using a combination of search terms, a comprehensive literature search was performed using the Thai Journal Citation Index Centre, Health System Research Institute database, PubMed and references from recent reviews. Identified studies were published between January 2000 and December 2014. The review included publications in English and Thai on primary research undertaken in community pharmacies associated with the National Health Insurance System. Two independent authors performed study selection, data extraction and quality assessment. The literature search yielded 251 titles, with 18 satisfying the inclusion criteria. Clinical outcomes of community pharmacy services included control and reduction in blood pressure and blood sugar, improved adherence to medications, an increase in acceptance of interventions, and an increase in healthy behaviours. Thirty-three percentage of those at risk of diabetes and hypertension achieved normal blood sugar and blood pressure levels after being followed for 2-6 months by a community pharmacist. The cost of collaborative screening by community pharmacies and primary care units was US$ 4.5. Diabetes management costs were US$ 5.1-30.7. Community pharmacists reported high satisfaction rates. Stakeholders' perspectives revealed support for the community pharmacists' roles and the inclusion of community pharmacies as partners with the National Health Insurance System. Community pharmacy services improved outcomes for diabetic and hypertensive patients. This review supports the feasibility of incorporating community pharmacies into the Thai National Health System. © 2017 Royal Pharmaceutical Society.

  19. CDC National Environmental Public Health Tracking Network (Tracking Network)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Environmental Public Health Tracking Network is a system of integrated health, exposure, and hazard information and data from a variety of national,...

  20. Conceptions of health service robots

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    2015-01-01

    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...

  1. 76 FR 79201 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2011-12-21

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... Research and Training, Nat. Inst. of Environmental Health Sciences, National Institutes of Health, 615... the Environmental Health Sciences; 93.113, Biological Response to Environmental Health Hazards;...

  2. Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England.

    Science.gov (United States)

    Ovseiko, Pavel V; O'Sullivan, Catherine; Powell, Susan C; Davies, Stephen M; Buchan, Alastair M

    2014-11-08

    Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N = 17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the

  3. The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study

    Directory of Open Access Journals (Sweden)

    Aarons Gregory A

    2012-06-01

    Full Text Available Abstract Background Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States. Methods In-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS at the individual clinician level as a function of the Organizational Social Context (OSC measure at the organizational level, controlling for other organization and clinician characteristics. Results We found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice. Conclusions The findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes.

  4. Do service innovations influence the adoption of electronic health records in long-term care organizations? Results from the U.S. National Survey of Residential Care Facilities.

    Science.gov (United States)

    Bhuyan, Soumitra S; Zhu, He; Chandak, Aastha; Kim, Jungyoon; Stimpson, Jim P

    2014-12-01

    Healthcare organizations including residential care facilities (RCFs) are diversifying their services to meet market demands. Service innovations have been linked to the changes in the way that healthcare organizations organize their work. The objective of this study is to explore the relationship between organizational service innovations and Electronic Health Record (EHR) adoption in the RCFs. We used the data from the 2010 National Survey of Residential Care Facilities conducted by the Centers for Disease Control and Prevention. The outcome was whether an RCF adopted EHR or not, and the predictors were the organizational service innovations including provision of skilled nursing care and medication review. We also added facility characteristics as control variables. Weighted multivariate logistic regressions were used to estimate the relationship between service innovation factors and EHR adoption in the RCFs. In 2010, about 17.4% of the RCFs were estimated to use EHR. Multivariate analysis showed that RCFs employing service innovations were more likely to adopt EHR. The residential care facilities that provide skilled nursing services to their residents are more likely (OR: 1.42; 95% CI: 1.09-1.87) to adopt EHR. Similarly, RCFs with a provision of medication review were also more likely to adopt EHR (OR: 1.40; 95% CI: 1.00-1.95). Among the control variables, facility size, chain affiliation, ownership type, and Medicaid certification were significantly associated with EHR adoption. Our findings suggest that service innovations may drive EHR adoption in the RCFs in the United States. This can be viewed as a strategic attempt by RCFs to engage in a new business arrangement with hospitals and other health care organizations, where quality of care and interoperability of patients' records might play a vital role under the current healthcare reform. Future research could examine the relationship between service innovations and use of different EHR functionality in

  5. Use of national data base for strategic management of municipal oral health services for Danish children and adolescents

    DEFF Research Database (Denmark)

    Hansen, I.; Foldspang, Anders; Poulsen, S.

    2001-01-01

    ) the population and the socio-economic, cultural and political environment of the municipality; and 2) dental morbidity was collected as antecedent data from various official sources. Results: Seventy-seven percent of municipalities with public clinics and 68% of municipalities without public clinics used SCOR......-tables for planning purposes and preventive intervention. Forty percent reported data for all age groups to the SCOR-system and 36% used non-obligatory special codes in order to monitor more specific questions. Use of SCOR data was positively associated with the dental health services being organized in public...

  6. Integrating mental health services: the Finnish experience

    Directory of Open Access Journals (Sweden)

    Ville Lehtinen

    2001-06-01

    Full Text Available The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981–97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986–96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994–98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998–2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000–2003, in

  7. An overview of the National Health Insurance and its possible impact on eye healthcare services in South Africa

    Directory of Open Access Journals (Sweden)

    H. Lawrence Sithole

    2015-03-01

    Full Text Available The National Health Insurance (NHI is an important development that underpins democracy in South Africa. It aims to redress the inequities of public healthcare delivery by implementing transformational policies towards establishing inclusive public healthcare coverage for the entire population of South Africa, with more emphasis on health promotion. The implementation of this initiative has created some hope amongst primary eye healthcare professionals, such as optometrists, that their profession may finally be given the recognition it deserves. Although the government is contemplating introducing a new directorate for eye healthcare and forming an advisory committee on eye healthcare reporting to the Minister of Health, the extent to which eye healthcare will be incorporated into the NHI is currently not clear. It is believed that the white paper on the NHI will shed some light on these issues. Unfortunately, current indications are that the initiative has serious challenges to overcome such as poor infrastructure, budgetary constraints and lack of interest from other healthcare professionals. Furthermore, corruption issues may also need to be addressed if the NHI is to be implemented successfully. Nevertheless, the NHI remains a positive proposition for universal health coverage for the people of South Africa, and there is hope that primary eye care providers, such as optometrists and other eye care professionals, will also play a greater role in the NHI than they currently do in the public healthcare system.

  8. 77 FR 6569 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2012-02-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences, Special Emphasis... Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences...

  9. 78 FR 32672 - National Institute of Environmental Health Sciences (NIEHS); Notice of Meeting

    Science.gov (United States)

    2013-05-31

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences (NIEHS... that the National Institute of Environmental Health Sciences (NIEHS) Division of Extramural Research... Division. Organizing Institute: National Institute of Environmental Health Sciences. Dates and Times: June...

  10. 76 FR 59147 - National Institute of Environmental Health Sciences Notice of Meetings

    Science.gov (United States)

    2011-09-23

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences Notice..., Director, Division of Extramural Research and Training, National Institute of Environmental Health Sciences..., Director, Division of Extramural Research and Training, National Institute of Environmental Health...

  11. 78 FR 59944 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-09-30

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, National Institute of Environmental Health...

  12. 78 FR 64221 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2013-10-28

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. ] Name of Committee: National Institute of Environmental Health Sciences Special Emphasis...: To review and evaluate grant applications. Place: National Institute of Environmental Health...

  13. 77 FR 16844 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2012-03-22

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... . Name of Committee: National Institute of Environmental Health Sciences Special Emphasis Panel;...

  14. 77 FR 60448 - National Institute of Environmental Health Sciences Notice of Meeting

    Science.gov (United States)

    2012-10-03

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences Notice... and projects conducted by the National Institute of Environmental Health Sciences, including...:50 a.m. Agenda: Scientific Presentations Place: National Institute of Environmental Health...

  15. US Forest Service National Forest System Trails

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the world wide web that depicts National Forest Service trails that have been approved for publication. This service is used internally and...

  16. US Forest Service National Wilderness Areas

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the www depicting parcels of Forest Service land congressionally designated as wilderness such as National Wilderness Areas. This map service...

  17. Facilitating Sustainable Waste Management Behaviors Within the Health Sector: A Case Study of the National Health Service (NHS in Southwest England, UK

    Directory of Open Access Journals (Sweden)

    Janet Richardson

    2012-04-01

    Full Text Available Waste costs the National Health Service (NHS £71.2 million in 2007/2008; recycling all papers, newspapers and cardboard produced by the NHS in England and Wales could save up to 42,000 tonnes of CO2. As the largest employer in the UK, the NHS is in a prime position to both lead the way towards a sustainable future, but also act as a test bed for organizational change and provide evidence of what works at an individual level to change attitudes and behavior. However these require changes in mindset, including values, attitudes, norms and behaviors which are required along with clear definitions of the problems faced in terms of economics, society and culture. Initial investigations of the literature indicate that behavior change theory may provide a feasible means of achieving constructive changes in clinical waste management; such approaches require further investigation. This paper describes a feasibility study designed to examine issues that might affect the introduction of a behavior change strategy and improve waste management in a healthcare setting. Guided by the evidence gained from our systematic review, 20 interviews were carried out with senior managers, clinicians and support staff involved in the management of healthcare waste from a broad range of agencies in South West England. Interviews were audio-recorded and transcribed for analysis. Thematic content analysis was conducted in order to identify key issues and actions. Data extraction, coding and analysis were cross checked independently by the four members of the research team. Initial findings suggest tensions, between Government and local policies, between packaging and storage space at ward level and, and between the operational requirements of infection control and maintaining appropriate and ethical patient care. These tensions increase pressures on staff already trying to maintain high quality care in a resource restricted and changing environment.

  18. 76 FR 16798 - National Institutes of Health

    Science.gov (United States)

    2011-03-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Center for Scientific Review; Notice of Closed Meeting... Institutes of Health, 6701 Rockledge Drive, Bethesda, MD 20892 (Telephone Conference Call). Contact...

  19. 78 FR 24760 - National Institutes of Health

    Science.gov (United States)

    2013-04-26

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Prospective Grant of Start-Up Exclusive License: The... Institutes of Health, HHS. ACTION: Notice. SUMMARY: This is notice, in accordance with 35 U.S.C....

  20. 14 April 2014 - UK University College London Hospitals and National Health Service Foundation Trust Chairman R. Murley in the ATLAS cavern with CERN Head of Medical Applications S. Myers and Collaboration Spokesperson D. Charlton.

    CERN Multimedia

    Gadmer, Jean-Claude

    2014-01-01

    Mr Richard Murley Chairman Sir Robert Naylor Chief Executive University College London Hospitals (UCLH) – National Health Service (NHS) Foundation Trust United Kingdom of Great Britain and Northern Ireland

  1. [The case for a new French public health law at the service of a fairer and more effective national health policy].

    Science.gov (United States)

    Cambon, Linda; Alla, François; Lombrail, Pierre

    2012-01-01

    The next public health law in France will need to address a number of issues. A?series of recent reports have highlighted both sharp disparities in health status ? with high rates of premature death and increasing social inequalities in health ? and the need to organize public health. The incoherence of public health policies, the lack of inter-ministerial coordination (a prerequisite for the reduction of health inequalities) and the lack of structure and evaluation in the area of prevention are major weaknesses that the new public health law will need to address. Beyond the inevitable core measures, the new law will also need to promote deep structural reforms, including a unified national policy refocused on key priorities and incorporating non-health sectors, the development of a more effective and coherent prevention policy and, finally, a focus on the issue of inequalities requiring clearly defined integrated measures, not only as a stated principle but as an outcome to be achieved by all health policies. The next public health law will need to be a vehicle for an inevitable and long overdue structuring of public health policy.

  2. Framing in policy processes: a case study from hospital planning in the National Health Service in England.

    Science.gov (United States)

    Jones, Lorelei; Exworthy, Mark

    2015-01-01

    This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and framed decisions to close hospitals or hospital departments as based on the evidence and necessary to ensure safety. We interpreted this framing as a rhetorical strategy for implementing organisational change in the context of community resistance to service closure and a concomitant policy emphasising the importance of public and patient involvement in planning. Although the persuasive power of the framing was limited, a more insidious form of power was identified in the way the framing disguised the political nature of the issue by defining it as a clinical problem. We conclude by discussing how the clinical rationale constrains public participation in decisions about the delivery and organisation of healthcare and restricts the extent to which alternative courses of action can be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Prevalence and Factors Associated with the Use of Eye Care Services in South Korea: Korea National Health and Nutrition Examination Survey 2010–2012

    Science.gov (United States)

    Park, Yong Seok; Heo, Hwan; Ye, Byeong Jin; Suh, Young-Woo; Kim, Seung-Hyun; Park, Shin Hae; Lim, Key Hwan; Lee, Sung Jin; Park, Song Hee

    2017-01-01

    Purpose To estimate the factors and prevalence of eye care service utilization in the South Korean population. Methods This cross-sectional, population-based study included data from 22,550 Koreans aged ≥5 years who participated in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. For people aged 5 to 11 years (young children), information was based on self-reports of contact with eye care service in the past year; for people aged ≥12 years (older population), the information was based on the self-reported lifetime contact with eye care service. Univariate and multivariate logistic regression analyses of the complex sample survey data were performed. Results The prevalence of eye care service use in young children during the past year was 61.1% (95% confidence interval, 58.1%–64.1%), while that in the older population during their lifetime was 73.5%. Subjects aged 7 to 11 years were more likely to have had an eye examination in the past year than subjects aged 5 to 6 years (odds ratio, 3.83; 95% confidence interval, 2.37–6.19). Multivariate logistic regression analysis indicated that higher monthly household income, being a National Health Insurance holder, and having private health insurance were related to more frequent use of eye care services in young children. For the older population and women, those living in an urban area and those with a best-corrected visual acuity less than 20 / 40 in the worse-seeing eye were more likely to have had an eye examination during their lifetime. Low education level was associated with low lifetime use of eye care services in the older population. Conclusions There are sociodemographic disparities with use of eye care services in South Korea. This population-based study provides information that is useful for determining different intervention programs based on sociodemographic disparities to promote eye care service utilization in South Korea. PMID:28243025

  4. 76 FR 77239 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2011-12-12

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... Institute of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W. Alexander Drive... Research and Training, Nat. Inst. of Environmental Health Sciences, National Institutes of Health,...

  5. 75 FR 55805 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2010-09-14

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... Director, Division of Extramural Research and Training, National Institute of Environmental Health Sciences... Health Sciences; 93.113, Biological Response to Environmental Health Hazards; 93.114,...

  6. Individual health services

    Directory of Open Access Journals (Sweden)

    Schnell-Inderst, Petra

    2011-01-01

    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

  7. Health workforce planning and service expansion during an economic crisis: A case study of the national breast screening programme in Ireland.

    Science.gov (United States)

    McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C

    2015-12-01

    This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency.

  8. Understanding repeated non-attendance in health services: a pilot analysis of administrative data and full study protocol for a national retrospective cohort

    Science.gov (United States)

    Williamson, Andrea E; Ellis, David A; Wilson, Philip; McQueenie, Ross; McConnachie, Alex

    2017-01-01

    Introduction Understanding the causes of low engagement in healthcare is a pre-requisite for improving health services’ contribution to tackling health inequalities. Low engagement includes missing healthcare appointments. Serially (having a pattern of) missing general practice (GP) appointments may provide a risk marker for vulnerability and poorer health outcomes. Methods and analysis A proof of concept pilot using GP appointment data and a focus group with GPs informed the development of missed appointment categories: patients can be classified based on the number of appointments missed each year. The full study, using a retrospective cohort design, will link routine health service and education data to determine the relationship between GP appointment attendance, health outcomes, healthcare usage, preventive health activity and social circumstances taking a life course approach and using data from the whole journey in the National Health Service (NHS) healthcare. 172 practices will be recruited (∼900 000 patients) across Scotland. The statistical analysis will focus on 2 key areas: factors that predict patients who serially miss appointments, and serial missed appointments as a predictor of future patient outcomes. Regression models will help understand how missed appointment patterns are associated with patient and practice characteristics. We shall identify key factors associated with serial missed appointments and potential interactions that might predict them. Ethics and dissemination The results of the project will inform debates concerning how best to reduce non-attendance and increase patient engagement within healthcare systems. Significant non-academic beneficiaries include governments, policymakers and medical practitioners. Results will be disseminated via a combination of academic outputs (papers, conferences), social media and through collaborative public health/policy fora. PMID:28196951

  9. US Forest Service Original Proclaimed National Forests and National Grasslands

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the www depicting the boundaries encompassing the National Forest System (NFS) lands within the original proclaimed National Forests, along with...

  10. National Survey on Drug Use and Health (NSDUH), 2009

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  11. National Survey on Drug Use and Health (NSDUH), 2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  12. National Survey on Drug Use and Health (NSDUH), 2011

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  13. National Survey on Drug Use and Health (NSDUH), 2012

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  14. National Survey on Drug Use and Health (NSDUH), 2003

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  15. National Survey on Drug Use and Health (NSDUH), 2005

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  16. National Survey on Drug Use and Health (NSDUH), 2004

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  17. National Survey on Drug Use and Health (NSDUH), 2006

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  18. National Survey on Drug Use and Health (NSDUH), 2008

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  19. National Survey on Drug Use and Health (NSDUH-2008)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  20. National Survey on Drug Use and Health (NSDUH-2012)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  1. National Survey on Drug Use and Health (NSDUH-2014)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  2. National Survey on Drug Use and Health (NSDUH-2009)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  3. National Survey on Drug Use and Health (NSDUH-2013)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  4. National Survey on Drug Use and Health (NSDUH-2004)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...

  5. National Survey on Drug Use and Health (NSDUH-2006)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  6. National Survey on Drug Use and Health (NSDUH-2003)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...

  7. National Survey on Drug Use and Health (NSDUH-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  8. National Survey on Drug Use and Health (NSDUH-2010)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  9. National Survey on Drug Use and Health (NSDUH-2007)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  10. National Survey on Drug Use and Health (NSDUH), 2002

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  11. National Survey on Drug Use and Health (NSDUH-2005)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  12. National Survey on Drug Use and Health (NSDUH-2002)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) measures the prevalence and correlates of drug...

  13. National Survey on Drug Use and Health (NSDUH-2015)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates...

  14. National eHealth strategy toolkit

    CERN Document Server

    2012-01-01

    Worldwide the application of information and communication technologies to support national health-care services is rapidly expanding and increasingly important. This is especially so at a time when all health systems face stringent economic challenges and greater demands to provide more and better care especially to those most in need. The National eHealth Strategy Toolkit is an expert practical guide that provides governments their ministries and stakeholders with a solid foundation and method for the development and implementation of a national eHealth vision action plan and monitoring fram

  15. Cross-national reliability of clinician-rated outcome measures in child and adolescent mental health services

    DEFF Research Database (Denmark)

    Hanssen-Bauer, Ketil; Gowers, Simon; Aalen, Odd O

    2007-01-01

    Assessment Scale (CGAS) and the Global Assessment of Psychosocial Disability (GAPD). Thirty clinicians from 5 nations independently rated 20 written vignettes. The national groups afterwards established national consensus ratings. There were no cross-national differences in independent scores, but there were...

  16. US Forest Service National Forest System Roads

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the www depicting existing National Forest System Roads (NFSR) that are under the jurisdiction of the U.S. Forest Service. Each feature represents a...

  17. Marriage, Cohabitation, and Men's Use of Preventive Health Care Services

    Science.gov (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 ...

  18. Barriers to the successful implementation of school health services ...

    African Journals Online (AJOL)

    The data-collection method of choice for this study was focus group ... Barriers related to governance, for example lack of national policy guidelines for school ... Keywords: school health services; health-promoting schools; health care policy; ...

  19. Towards a model of Strategic Roster Planning and Control: an empirical study of nurse rostering practices in the UK National Health Service.

    Science.gov (United States)

    Silvestro, Rhian; Silvestro, Claudio

    2008-05-01

    Despite the criticality of nurse rostering practices, there is a surprising lack of attention paid to this managerial activity both in practice and in the health-service management literature. This paper reports the results of an inductive, empirical study of rostering practices in the UK National Health Service with a view to developing a shared understanding of roster planning processes and of what constitutes rostering effectiveness. A survey of rostering practices in 50 wards, followed by five in-depth, longitudinal case studies, revealed the complexity of rostering activities, and identified the main design parameters, which were used to specify rostering systems and to prepare periodic rosters. Rostering activities were perceived to directly impact upon service delivery, resource utilization and nurse retention. A number of poor rostering practices were identified, which could lead to dysfunctional behaviour. This analysis points to a clear managerial imperative to improve local competencies in roster planning and control, recognizing their strategic significance in contributing to hospital effectiveness. A 'Strategic Roster Planning and Control (SRPC)' model is proposed, which may provide a framework for evaluating rostering effectiveness, and a platform for the sharing of best practice, in order to stimulate organizational learning and achieve nationwide improvements in hospital performance.

  20. Suicide among veterans in 16 states, 2005 to 2008: comparisons between utilizers and nonutilizers of Veterans Health Administration (VHA) services based on data from the National Death Index, the National Violent Death Reporting System, and VHA administrative records.

    Science.gov (United States)

    Katz, Ira R; McCarthy, John F; Ignacio, Rosalinda V; Kemp, Janet

    2012-03-01

    We sought to compare suicide rates among veterans utilizing Veterans Health Administration (VHA) services versus those who did not. Suicide rates from 2005 to 2008 were estimated for veterans in the 16 states that fully participated in the National Violent Death Reporting System (NVDRS), using data from the National Death Index, NVDRS, and VHA records. Between 2005 and 2008, veteran suicide rates differed by age and VHA utilization status. Among men aged 30 years and older, suicide rates were consistently higher among VHA utilizers. However, among men younger than 30 years, rates declined significantly among VHA utilizers while increasing among nonutilizers. Over these years, an increasing proportion of male veterans younger than 30 years received VHA services, and these individuals had a rising prevalence of diagnosed mental health conditions. The higher rates of suicide for utilizers of VHA among veteran men aged 30 and older were consistent with previous reports about which veterans utilize VHA services. The increasing rates of mental health conditions in utilizers younger than 30 years suggested that the decreasing relative rates in this group were related to the care provided, rather than to selective enrollment of those at lower risk for suicide.

  1. Accessibility of adolescent health services

    Directory of Open Access Journals (Sweden)

    S Richter

    2000-09-01

    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.

  2. 75 FR 32191 - National Health and Nutrition Examination Survey (NHANES) DNA Samples: Guidelines for Proposals...

    Science.gov (United States)

    2010-06-07

    ... HUMAN SERVICES Centers for Disease Control and Prevention National Health and Nutrition Examination...: The National Health and Nutrition Examination Survey (NHANES) is a program of periodic surveys... Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease...

  3. 76 FR 27653 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2011-05-12

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Review Branch, Division of Extramural Research and Training, Nat. Institute Environmental Health Sciences...

  4. 77 FR 12602 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2012-03-01

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... and evaluate grant applications. Place: Nat. Inst. of Environmental Health Sciences, Building 101...

  5. 76 FR 52672 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2011-08-23

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Agenda: To review and evaluate contract proposals. Place: Nat. Inst. of Environmental Health Sciences...

  6. 75 FR 65364 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-10-22

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Agenda: To review and evaluate grant applications. Place: Nat. Inst. of Environmental Health Sciences...

  7. 77 FR 40076 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2012-07-06

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, Nat. Institute of Environmental Health Sciences, P...

  8. 76 FR 26311 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2011-05-06

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Manpower Development in the Environmental Health Sciences; 93.113, Biological Response to Environmental...

  9. 75 FR 27562 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2010-05-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis..., Scientific Review Officer, Nat. Institute of Environmental Health Sciences, Office of Program Operations...

  10. 77 FR 22793 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2012-04-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, Nat. Institute of Environmental Health Sciences, P...

  11. 76 FR 5184 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2011-01-28

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Agenda: To review and evaluate grant applications. Place: Nat. Inst. of Environmental Health Sciences...

  12. 78 FR 59042 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2013-09-25

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES, including... Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W. Alexander Drive, Research...

  13. 77 FR 9673 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2012-02-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the National Institute of Environmental Health Sciences, including... Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W. Alexander Drive, Research...

  14. 77 FR 5261 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2012-02-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis..., Nat. Institute of Environmental Health Sciences, Office of Program Operations, Scientific...

  15. 76 FR 57065 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2011-09-15

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the National Institute of Environmental Health Sciences, including.... Place: Nat. Inst. of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T....

  16. 78 FR 26643 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2013-05-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES, including... Biomarker-Based Epidemiology Group. Place: Nat. Inst. of Environmental Health Sciences, Building...

  17. 75 FR 57280 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2010-09-20

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES, including... Toxicology. Place: Nat. Inst. of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T....

  18. 78 FR 18997 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2013-03-28

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the National Institute of Environmental Health Sciences, including..., Neuropharmacology and Human Metabolism Groups. Place: Nat. Inst. of Environmental Health Sciences, Building...

  19. 75 FR 35076 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2010-06-21

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, Nat. Institute of Environmental Health Sciences,...

  20. 75 FR 7487 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-02-19

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Inst. of Environmental Health Sciences, Office of Program Operations, Scientific Review Branch,...

  1. 77 FR 61613 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2012-10-10

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Branch, Division of Extramural Research and Training, Nat. Institute Environmental Health Sciences, P....

  2. 76 FR 19378 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2011-04-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis...: To review and evaluate grant applications. Place: Nat. Inst. of Environmental Health...

  3. 78 FR 42968 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-07-18

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... review and evaluate grant applications. Place: Nat. Inst. of Environmental Health Sciences, Building...

  4. 77 FR 26300 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2012-05-03

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... and projects conducted by the National Institute of Environmental Health Sciences, including.... Inst. of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W. Alexander...

  5. 77 FR 33472 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2012-06-06

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Administrator, Nat. Institute of Environmental Health Sciences, Office of Program Operations, Scientific...

  6. 75 FR 44273 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-07-28

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Agenda: To review and evaluate grant applications. Place: Nat. Inst. of Environmental Health...

  7. 78 FR 7794 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-02-04

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Sciences; 93.113, Biological Response to Environmental Health Hazards; 93.114, Applied...

  8. 78 FR 26793 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2013-05-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... review and evaluate grant applications. Place: Nat. Inst. of Environmental Health Sciences,...

  9. National Health and Nutrition Examination Survey (NHANES), 2009-2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in...

  10. 77 FR 4332 - Recruitment of Sites for Assignment of National Health Service Corps Loan Repayors (FY 2012)

    Science.gov (United States)

    2012-01-27

    ... medicine physicians who practice obstetrics on a regular basis, providers of geriatric services, pediatric... nurse midwives (CNMs), family medicine physicians who practice obstetrics on a regular basis,...

  11. Characteristics of children and adolescents in the Dutch national in- and outpatient mental health service for deaf and hard of hearing youth over a period of 15 years.

    Science.gov (United States)

    van Gent, Tiejo; Goedhart, Arnold W; Treffers, Philip D A

    2012-01-01

    In this study socio-demographic, deafness-related and diagnostic characteristics of hearing impaired children and adolescents referred to a national mental health service for deaf and hard of hearing children and adolescents were examined. Socio-demographic and diagnostic characteristics were compared to corresponding characteristics of hearing referred peers with identified mental health problems. The difference in characteristics between them and hearing referred peers with identified mental health problems was analyzed. A total of 389 deaf and hard of hearing and 3361 hearing children and adolescents was extracted from a database, all first referrals of patients of a center for child and adolescent psychiatry over a 15-year period. With deaf and hard of hearing patients we found higher rates of environmental stress, as indicated by conditions such as more one parent families (38.6% versus 25.8%), and more parents with a low educational level (44.2% versus 31.1%). Moreover, deaf and hard of hearing patients were older at their first referral (10.8 versus 9.4 years) and had higher rates of pervasive developmental disorders (23.7% versus 12.3%) and mental retardation (20.3% versus 3.9%). Within the target group of deaf and hard of hearing patients, most patients were deaf (68.9%; 22.3% was severely hard of hearing), relatively few (13.7%) had a non-syndromal hereditary hearing impairment, and more (21.3%) had a disabling physical health condition, especially those with a pervasive developmental disorder (42.6%). These findings illustrate both the complexity of the problems of deaf and hard of hearing children and adolescents referred to specialist mental health services, and the need for preventive interventions aimed at early recognition.

  12. Motivation and values of hospital consultants in south-east England who work in the national health service and do private practice.

    Science.gov (United States)

    Humphrey, Charlotte; Russell, Jill

    2004-09-01

    In the UK, a small private health care sector has always existed alongside the national health service (NHS). The conventional assumption is that doctors who work as salaried employees of the NHS are guided in their clinical practice by professional values which encourage them to put their patients' interests first. A common suspicion is that doctors undertaking fee-for-service practice in the private sector are motivated by self-interest, with commitment to their patients compromised by consideration for their purse. The great majority of hospital consultants are salaried employees of the NHS, but most also undertake some private practice. This paper uses findings from an interview study of 60 surgeons and physicians engaged in dual practice of this kind to investigate their reasons for working in this way and look at how they reconcile their personal, professional and public sector values and responsibilities with the temptations of the market. The existence of the private sector and their own engagement in it was regarded by almost all respondents as a net benefit, not only to themselves and their private patients, but also to the NHS, so long as they handled it properly. The interviews revealed a complex range of beliefs and assumptions through which these doctors justify their activities and a variety of informal principles for dealing with such conflicts of interest as they acknowledge. Neither their values nor their actions can be adequately explained using generic concepts of professional self-interest or public service values without consideration of what such concepts represented in the specific social, economic, professional and policy context of health care in south-east England at the time of the study. Copyright 2003 Elseiver Ltd.

  13. [Terrorism, public health and health services].

    Science.gov (United States)

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

    2009-01-01

    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.

  14. Health care's service fanatics.

    Science.gov (United States)

    Merlino, James I; Raman, Ananth

    2013-05-01

    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.

  15. The politics of evaluating Aboriginal Health Services.

    Science.gov (United States)

    Moodie, R

    1989-01-01

    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.

  16. Indian Health Service: Community Health

    Science.gov (United States)

    ... provide for community health. A variety of programs, disciplines, strategies and interventions work together to pursue the ... Office of Finance and Accounting - 10E54 Office of Human Resources - 11E53A Office of Information Technology - 07E57B Office of ...

  17. Plus ça change, plus c'est la meme chose: to the internal market and back in the British National Health Service?

    Science.gov (United States)

    Allen, Pauline

    2002-01-01

    Continuities and changes in policy concerning the organisational structure of the British National Health Service are evident throughout the last decade. This paper presents lessons learned from the internal market experience and discusses the extent to which New Labour policies have taken these into account. The role of decentralised contracts and central government direction in each system is explored. The internal market was less decentralised than expected, and direction from central government continued to be a key element. In the post internal market system, less faith has been placed in the capacity of contracts to improve quality of care, and centralised direction to set and enforce standards has increased. But simultaneously the mechanism of contracting has been retained and it is likely to be extended in increased dealings with the private sector. Efforts are also being made to curtail the high degree of centralisation in the early post internal market years.

  18. High volume acupuncture clinic (HVAC) for chronic knee pain--audit of a possible model for delivery of acupuncture in the National Health Service.

    Science.gov (United States)

    Berkovitz, Saul; Cummings, Mike; Perrin, Chris; Ito, Rieko

    2008-03-01

    Recent research has established the efficacy, effectiveness and cost effectiveness of acupuncture for some forms of chronic musculoskeletal pain. However, there are practical problems with delivery which currently prevent its large scale implementation in the National Health Service. We have developed a delivery model at our hospital, a 'high volume' acupuncture clinic (HVAC) in which patients are treated in a group setting for single conditions using standardised or semi-standardised electroacupuncture protocols by practitioners with basic training. We discuss our experiences using this model for chronic knee pain and present an outcome audit for the first 77 patients, demonstrating satisfactory initial (eight week) clinical results. Longer term (one year) data are currently being collected and the model should next be tested in primary care to confirm its feasibility.

  19. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2017-08-17

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  20. [Mortality aftermyocardial infarction: when the health local organization network has a role in interpreting themarkers of theNational Agency for RegionalHealth Services].

    Science.gov (United States)

    Virgili, Gianni; Barchielli, Alessandro; Balzi, Daniela; Matarrese, Daniela; Paci, Eugenio; Gusinu, Roberto; Zuppiroli, Alfredo; Gensini, Gian Franco

    2013-01-01

    The Italian National Outcome Programme has assessed the performance of Italian hospitals regarding several clinical performance indicators, including 30-daymortality after admission for acute myocardial infarction. Risk adjustment was obtained using demographic and comorbidity data based on the hospital discharge databases in the index admission, as well as in those of the previous two years. Noticeably, the ICD-9-CM 410.7* classification coding for NSTEMI (Non-ST elevation myocardial infarction)myocardial infarction, i.e. the less severe form, was not used, due to known variability in its use. We found that hospital-specific adjusted relative risk of death versus the national mean, as computed by the programme, is negatively associated with the proportion of NSTEMI infarctions at each Tuscan and Florentine hospital, coherently with the hypothesis of a selection by the emergency network, which addresses STEMI (ST elevation myocardial infarction) patients to hospitals offering haemodynamic laboratory with reperfusive services. Individual level clinical data of 3,200 patients in the AMI-Florence study in the period April 2008-March 2010 found that ICD-9-CM410.7* is underused. The analysis based on hospital discharge diagnoses (410.7* vs. other 410* codes) cannot explain differences in mortality among Florentine hospitals, as opposed to the use of a classification of myocardial infarction type (STEMI vs. NSTEMI) based on clinical data collected in AMI-Florence.

  1. Do Social Networks Push Families toward or Away from Youth Mental Health Services?: A National Study of Families in Child Welfare

    Science.gov (United States)

    Martinez, Jonathan I.; Lau, Anna S.

    2011-01-01

    Social support networks may encourage or dissuade help-seeking for youth behavior problems in ways that contribute to racial/ethnic disparities in mental health services. The authors examined how parental social network characteristics were related to the use of mental health services in a diverse sample of families in contact with Child Welfare.…

  2. National Center for Farmworker Health

    Science.gov (United States)

    ... located in Buda, Texas dedicated to improving the health status of farmworker families by providing information services, training and technical assistance, and a variety of products to community and migrant health centers nationwide, as well as ...

  3. National Center for Health Statistics

    Science.gov (United States)

    ... United States National Health Statistics Reports National Vital Statistics Reports News and Events NCHS Pressroom Inside NCHS Blog Events and Announcements Growth Charts Where to Write for Vital Records NCHS For You General Pubilc ...

  4. 76 FR 43988 - National Technical Information Service Advisory Board

    Science.gov (United States)

    2011-07-22

    ... National Technical Information Service National Technical Information Service Advisory Board AGENCY: National Technical Information Service, Commerce. ACTION: Notice of open meeting. SUMMARY: This notice announces the next meeting of the National Technical Information Service Advisory Board (the Advisory...

  5. 78 FR 61337 - National Technical Information Service Advisory Board

    Science.gov (United States)

    2013-10-03

    ... National Technical Information Service National Technical Information Service Advisory Board AGENCY: National Technical Information Service, Commerce. ACTION: Notice of open meeting SUMMARY: This notice announces the next meeting of the National Technical Information Service Advisory Board (the Advisory...

  6. 78 FR 16255 - National Technical Information Service Advisory Board

    Science.gov (United States)

    2013-03-14

    ... National Technical Information Service National Technical Information Service Advisory Board AGENCY: National Technical Information Service, Commerce. ACTION: Notice of Open Meeting. SUMMARY: This notice announces the next meeting of the National Technical Information Service Advisory Board (the Advisory...

  7. 77 FR 57559 - National Technical Information Service Advisory Board

    Science.gov (United States)

    2012-09-18

    ... National Technical Information Service National Technical Information Service Advisory Board AGENCY: National Technical Information Service, Commerce. ACTION: Notice of open meeting. SUMMARY: This notice announces the next meeting of the National Technical Information Service Advisory Board (the Advisory...

  8. Indicators of mental health services evaluation process

    Directory of Open Access Journals (Sweden)

    Ana Caroline Gonçalves Cavalcante

    2014-03-01

    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.

  9. Collaboration between Government and Non-Governmental Organizations (NGOs in Delivering Curative Health Services in North Darfur State, Sudan- a National Report.

    Directory of Open Access Journals (Sweden)

    Abdallah I A Yagub

    2014-05-01

    Full Text Available North Darfur State has been affected by conflict since 2003 and the government has not been able to provide adequate curative health services to the people. The government has come to rely on Non-Governmental Organizations (NGOs to provide curative health services. This study was conducted to examine the existing collaboration between government and NGOs in curative health service delivery in North Darfur State, and to identify the challenges that affect their collaboration.Documentary data were collected from government offices and medical organizations. Primary data were obtained through interviews with government and NGOs representatives. The interviews were conducted with (1 expatriates working for international NGOs (N=15 and (2, health professionals and administrators working in the health sector (N= 45.The collaboration between the government and NGOs has been very weak because of security issues and lack of trust. The NGOs collaborate by providing human and financial resources, material and equipment, and communication facilities. The NGOs supply 70% of curative health services, and contribute 52.9% of the health budget in North Darfur State. The NGOs have employed 1 390 health personnel, established 44 health centres and manage and support 83 health facilities across the State.The NGOs have played a positive role in collaborating with the government in North Darfur State in delivering curative health services, while government's role has been negative. The problem that faces the government in future is how health facilities will be run should a peaceful settlement be reached and NGOs leave the region.

  10. US Forest Service National Grassland Units

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the www depicting National Grassland units designated by the Secretary of Agriculture and permanently held by the Department of Agriculture under...

  11. National Weather Service County Warning Area Boundaries

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains polygons corresponding to the County Warning Areas (CWAs) of each Weather Forecast Office (WFO) in the National Weather Service (NWS).

  12. 77 FR 59942 - Notice of Listing of Members of the National Institutes of Health's Senior Executive Service 2012...

    Science.gov (United States)

    2012-10-01

    ... Performance Review Board, contact the Office of Human Resources, Workforce Relations Division, National... ensure consistency, stability, and objectivity in performance appraisals and requires that notice of the... will serve on the NIH Performance Review Board, which oversees the evaluation of performance...

  13. 78 FR 52779 - Notice of Listing of Members of the National Institutes of Health's Senior Executive Service 2013...

    Science.gov (United States)

    2013-08-26

    ... Performance Review Board, contact the Office of Human Resources, Workforce Relations Division, National... consistency, stability, and objectivity in performance appraisals and requires that notice of the appointment... will serve on the NIH Performance Review Board, which oversees the evaluation of performance...

  14. Communication in the Service of American Health...A Bicentennial Report from the National Library of Medicine.

    Science.gov (United States)

    National Library of Medicine (DHEW), Bethesda, MD.

    Programs of the National Library of Medicine over almost a century and a half are described, ranging from a history of American medical literature and the development of medical indexing to modern technological developments. Activities covered include the development of the Toxicology Information Program and the online data base TOXLINE; the…

  15. 75 FR 44967 - National Institute for Occupational Safety and Health

    Science.gov (United States)

    2010-07-30

    ...: 2010-18767] DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institute for Occupational Safety and... Institute for Occupational Safety and Health (NIOSH), Department of Health and Human Services (HHS). ACTION... Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, MS C-46, Cincinnati, OH...

  16. Evaluation of off-service rotations at National Guard Health Affairs: Results from a perception survey of off-service residents

    Directory of Open Access Journals (Sweden)

    Mustafa M Alquraini

    2013-01-01

    Full Text Available Context: "Off-service" clinical rotations are part of the necessary requirements for many residency training programs. Because these rotations are off-service, little attention is given to their structure and quality of training. This often leads to suboptimal educational experience for the residents on these rotations. Aims: The aim of this study was to assess medical residents′ perceptions, opinions, and levels of satisfaction with their "off-service" rotations at a major residency training site in Saudi Arabia. It was also to evaluate the reliability and validity of a questionnaire used for quality assurance in these rotations. Improved reliability and validity of this questionnaire may help to improve the educational experience of residents in their "off-service" rotations. Materials and Methods: A close-ended questionnaire was developed, Pilot tested and distributed to 110 off-service residents in training programs of different specializations at King Fahad Naitonal Guard Hospital and King Abdulziz Medical City, Riyadh, Saudi Arabia, between September 2011 and December 2011. Results: A total of 80 out of 110 residents completed and returned the questionnaire. Only 33% of these residents had a clear set of goals and educational learning objectives before the beginning of their off-service rotations to direct their training. Surgical specializations had low satisfaction mean scores of 57.2 (11.9 compared to emergency medicine, which had 70.7 (16.2, P value (0.03. The reliability of the questionnaire was Cronbach′s alpha 0.57. The factor analysis yielded a 4-factor solution (educational environment, educational balance, educational goals and objectives, and learning ability; thus, accounting for 51% variance in the data. Conclusion: Our data suggest that there were significant weaknesses in the curriculum for off-service clinical rotations in KAMC and that residents were not completely satisfied with their training.

  17. Evaluation of Primary Health Care service participation in the National Tuberculosis Control Program in Qalyubia Governorate, Egypt

    Directory of Open Access Journals (Sweden)

    Dina S. Elsayed

    2015-10-01

    Conclusion: In Qalyubia Governorate, PHC physicians lack proper knowledge about TB and their units lack proper equipments (Lab and CXR. The PHC system needs to be empowered by the health care authorities through training and equipments for better performance in NTP.

  18. Building National Infrastructures for Patient-Centred Digital Services

    DEFF Research Database (Denmark)

    Thorseng, Anne; Jensen, Tina Blegind

    2015-01-01

    Patient-centred digital services are increasingly gaining impact in the healthcare sector. The premise is that patients will be better equipped for taking care of their own health through instant access to relevant information and by enhanced electronic communication with healthcare providers. One...... infrastructure theory, we highlight the enabling and constraining dynamics when designing and building a national infrastructure for patient-centred digital services. Furthermore, we discuss how such infrastructures can accommodate further development of services. The findings show that the Danish national e-health...... initiative to provide such services to patients is the Danish national e-health portal, sundhed.dk, which is at the forefront of governmental initiatives and which serves as a unified hub between the various participants in the healthcare sector. Studying the evolution of sundhed.dk in light of information...

  19. Indian Health Service

    Science.gov (United States)

    ... a Recruiter Newsroom Announcements Congressional Testimony Contact Us Director's Speeches Fact Sheets IHS Blog Press Releases Reports to Congress Tribal Leader Letters Urban Leader Letters October is National Dental ...

  20. Barriers to healthy eating by National Health Service (NHS hospital doctors in the hospital setting: results of a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Wilson Sue

    2008-08-01

    Full Text Available Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction with the hospital canteen, lifestyle and dietary habits, gender, age, height, weight, job details, and affect. Results: 70% of doctors reported using their hospital canteen each week, with 2 visits per week on average. Canteen opening times, lack of selection and lack of breaks were the most commonly perceived barriers to healthy eating. Availability of healthy options caused the most dissatisfaction. Only 12% felt the NHS was supportive of healthy eating. 74% did not feel their canteen advocated healthy eating. Canteen use is associated with younger age (r = -0.254, p Conclusion Interventions to encourage regular meal breaks, eating breakfast and drinking more water each day need developing. Improved canteen accessibility and availability of healthy options at evenings and weekends may be beneficial.

  1. 75 FR 76986 - Office of the National Coordinator for Health Information Technology; Health Information...

    Science.gov (United States)

    2010-12-10

    ... HUMAN SERVICES Office of the National Coordinator for Health Information Technology; Health Information Technology; Request for Information Regarding the President's Council of Advisors on Science and Technology (PCAST) Report Entitled ``Realizing the Full Potential of Health Information Technology To...

  2. Medical and Health Services Managers

    Science.gov (United States)

    ... Contact & Help Economic Releases Latest Releases » Major Economic Indicators » Schedules for news Releases » By Month By News ... business-related courses with courses in medical terminology, hospital organization, ... often includes courses in health services management, accounting ...

  3. Development of a Korean Fracture Risk Score (KFRS for Predicting Osteoporotic Fracture Risk: Analysis of Data from the Korean National Health Insurance Service.

    Directory of Open Access Journals (Sweden)

    Ha Young Kim

    Full Text Available Asian-specific prediction models for estimating individual risk of osteoporotic fractures are rare. We developed a Korean fracture risk prediction model using clinical risk factors and assessed validity of the final model.A total of 718,306 Korean men and women aged 50-90 years were followed for 7 years in a national system-based cohort study. In total, 50% of the subjects were assigned randomly to the development dataset and 50% were assigned to the validation dataset. Clinical risk factors for osteoporotic fracture were assessed at the biennial health check. Data on osteoporotic fractures during the follow-up period were identified by ICD-10 codes and the nationwide database of the National Health Insurance Service (NHIS.During the follow-up period, 19,840 osteoporotic fractures were reported (4,889 in men and 14,951 in women in the development dataset. The assessment tool called the Korean Fracture Risk Score (KFRS is comprised of a set of nine variables, including age, body mass index, recent fragility fracture, current smoking, high alcohol intake, lack of regular exercise, recent use of oral glucocorticoid, rheumatoid arthritis, and other causes of secondary osteoporosis. The KFRS predicted osteoporotic fractures over the 7 years. This score was validated using an independent dataset. A close relationship with overall fracture rate was observed when we compared the mean predicted scores after applying the KFRS with the observed risks after 7 years within each 10th of predicted risk.We developed a Korean specific prediction model for osteoporotic fractures. The KFRS was able to predict risk of fracture in the primary population without bone mineral density testing and is therefore suitable for use in both clinical setting and self-assessment. The website is available at http://www.nhis.or.kr.

  4. Using the National Provider Identifier for Health Care...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The establishment in recent years of a National Provider Identifier (NPI) offers a new method for counting and categorizing physicians and other health care...

  5. Public and private maternal health service capacity and patient flows in Southern Tanzania: using a geographic information system to link hospital and national census data.

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M E; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health programming. Inclusive partnerships could increase

  6. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Directory of Open Access Journals (Sweden)

    Patrik Tabatabai

    2014-01-01

    Full Text Available Background: Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective: To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design: A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6 in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds, provider-fees for obstetric services and patient turnover (antenatal care, births. Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results: The contribution of faith-based organizations (FBOs to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions: We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising

  7. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M. E.; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Background Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health

  8. What would a socialist health service look like?

    Science.gov (United States)

    Brecher, B

    1997-09-01

    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.

  9. National Rural Health Association

    Science.gov (United States)

    ... History of Rural Health Globalization Urban Bias Dependency Theory Political Economy History of Rural Health IV: '60s ... Data Grassroots Action Center Policy Documents Legislative and Regulatory Agenda Medicaid News Response to 2013 OIG CAH ...

  10. Human Rights and Health Services

    DEFF Research Database (Denmark)

    Skitsou, Alexandra; Bekos, Christos; Charalambous, George

    2016-01-01

    , 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...

  11. Health Services Procurement Policy

    OpenAIRE

    Department of Health

    2000-01-01

    The Healthcare Materials Management Board (HMMB) was established following the report to the Materials Management Advisory Group on procurement and materials management in the health sector Download the Report here

  12. Mobile Health (mHealth) Services and Online Health Educators.

    Science.gov (United States)

    Anshari, Muhammad; Almunawar, Mohammad Nabil

    2016-01-01

    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.

  13. 77 FR 61771 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2012-10-11

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: Environmental Health Sciences Review Committee. Date: November 15... Institute of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W. Alexander...

  14. 77 FR 21788 - National Institute of Environmental Health Sciences Notice of Meeting

    Science.gov (United States)

    2012-04-11

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences Notice...., Director, Division of Extramural Research and Training, Nat. Inst. of Environmental Health Sciences... Manpower Development in the Environmental Health Sciences; 93.113, Biological Response to...

  15. Estimating the budget impact of new technologies added to the National List of Health Services in Israel: stakeholders' incentives for adopting a financial risk-sharing mechanism.

    Science.gov (United States)

    Hammerman, Ariel; Greenberg, Dan

    2009-01-01

    The Israeli National List of Health Services (NLHS) is updated annually according to a government allocated budget. The estimated annual cost of each new technology added to this list is based on budget-impact estimations provided by the HMOs and the manufacturers. The HMOs argue that once a new technology is reimbursed, extensive marketing efforts by industry expands demand and renders the allocated budget insufficient. Industry claims that HMOs, in order to secure a sufficient budget, tend to over-estimate the number of target patients. We provide a framework for a financial risk-sharing mechanism between HMOs and the industry, which may be able to balance these incentives and result in more accurate early budget-impact estimates. To explore the current stakeholders' incentives and behaviors under the existing process of updating the NLHS, and to examine the possible incentives for adopting a financial risk-sharing mechanism on early budget-impact estimations. According to the financial risk-sharing mechanism, HMOs will be partially compensated by the industry if actual use of a technology is substantially higher than what was projected. HMOs will partially refund the government for a budget that was not fully used. To maintain profits, we assume that the industry will present a more realistic budget-impact analysis. HMOs will be less apprehensive of technology promotion, as they would be compensated in case of budget under-estimation. In case of over-estimation of technology use, the budget re-allocated will be used to enlarge the NLHS which is in the best interest of the health technology industry. Our proposed risk-sharing mechanism is expected to counter balance incentives and disincentives that currently exist in adopting new health technologies in the Israeli healthcare system.

  16. Health: looking after the Nation's health

    CSIR Research Space (South Africa)

    Abbott, GR

    2008-11-01

    Full Text Available Health infrastructure is essential to the successful delivery of health services. With a normal planned lifespan of over 50 years, such capital investment endures for extended periods and major changes in the estate take a long time to achieve...

  17. Inequities in Chinese Health Services

    Directory of Open Access Journals (Sweden)

    Heather Mullins-Owens

    2015-03-01

    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.

  18. Forest health monitoring: national status, trends, and analysis 2016

    Science.gov (United States)

    Kevin M. Potter; Barbara L. Conkling

    2017-01-01

    The annual national report of the Forest Health Monitoring (FHM) Program of the Forest Service, U.S. Department of Agriculture, presents forest health status and trends from a national or multi-State regional perspective using a variety of sources, introducesnew techniques for analyzing forest health data, and summarizes results of recently completed...

  19. Service quality and clinical outcomes: an example from mental health rehabilitation services in England.

    Science.gov (United States)

    Killaspy, Helen; Marston, Louise; Omar, Rumana Z; Green, Nicholas; Harrison, Isobel; Lean, Melanie; Holloway, Frank; Craig, Tom; Leavey, Gerard; King, Michael

    2013-01-01

    Current health policy assumes better quality services lead to better outcomes. To investigate the relationship between quality of mental health rehabilitation services in England, local deprivation, service user characteristics and clinical outcomes. Standardised tools were used to assess the quality of mental health rehabilitation units and service users' autonomy, quality of life, experiences of care and ratings of the therapeutic milieu. Multiple level modelling investigated relationships between service quality, service user characteristics and outcomes. A total of 52/60 (87%) National Health Service trusts participated, comprising 133 units and 739 service users. All aspects of service quality were positively associated with service users' autonomy, experiences of care and therapeutic milieu, but there was no association with quality of life. Quality of care is linked to better clinical outcomes in people with complex and longer-term mental health problems. Thus, investing in quality is likely to show real clinical gains.

  20. Mental Health Disorders, Suicide Risk, and Treatment seeking among Formerly Deployed National Guardand Reserve Service Member seen in Non VA Facilities

    Science.gov (United States)

    2016-10-01

    service use, alcohol misuse, suicidal thoughts, and stressful life events were more common among National Guard and Reserve veterans, compared to...to reach our originally planned sample size. Action to be taken:  We have reached out to leaders of student veteran...organizations at over 30 colleges and universities in the central and northeastern PA areas to help with recruitment of the National/Guard Reserve cohort

  1. Auditoria no Sistema Único de Saúde: o papel do auditor no serviço odontológico Auditing in the Brazilian National Health System: the auditor's role in oral health services

    Directory of Open Access Journals (Sweden)

    Carlos Ayach

    2013-03-01

    Full Text Available A auditoria, na saúde, verifica os processos e resultados da prestação de serviços, pressupondo o desenvolvimento de um modelo de atenção adequado, de acordo com as legislações vigentes. Nesta pesquisa, objetivou-se analisar as atividades da auditoria no Sistema Único de Saúde no serviço de saúde bucal, buscando demonstrar as ações e a sua inserção nas três esferas de governo. Foram realizadas análise documental e levantamentos bibliográficos sobre os sistemas de auditoria e o papel do auditor no serviço odontológico desde 1969. Os resultados mostraram que foram encontrados seis artigos sobre auditoria odontológica no SUS e que a atuação do auditor odontológico é abrangente no gerenciamento do sistema, consistindo no controle, na avaliação, na supervisão e na orientação, bem como na garantia da participação social e acesso aos serviços. Na saúde bucal o auditor analisa, monitora e fiscaliza o planejamento das estratégias e os procedimentos efetuados; realiza o cadastramento dos profissionais, das unidades de saúde e a programação física orçamentária; viabiliza os dados para o sistema de informação e o pagamento dos serviços prestados; examina o cumprimento das pactuações, dando um enfoque educativo e não mais policialesco à resolubilidade dos problemas. Conclui-se que existem poucos estudos sobre auditoria odontológica no SUS e que o sistema de auditoria é um instrumento administrativo confiável e essencial para os gestores no desenvolvimento das ações de saúde.Auditing in health verifies processes and results in the provision of services, assuming the development of an adequate care model in accordance with the current legislation. In this research, the goal was to analyze the auditing activities within the Brazilian National Health System, in the oral health service, aiming to demonstrate the actions and their inclusion in the three governmental spheres. Documental analyses were undertaken

  2. Avoidable costs of physical treatments for chronic back, neck and shoulder pain within the Spanish National Health Service: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Serrano-Aguilar Pedro

    2011-12-01

    Full Text Available Abstract Background Back, neck and shoulder pain are the most common causes of occupational disability. They reduce health-related quality of life and have a significant economic impact. Many different forms of physical treatment are routinely used. The objective of this study was to estimate the cost of physical treatments which, despite the absence of evidence supporting their effectiveness, were used between 2004 and 2007 for chronic and non-specific neck pain (NP, back pain (BP and shoulder pain (SP, within the Spanish National Health Service in the Canary Islands (SNHSCI. Methods Chronic patients referred from the SNHSCI to private physical therapy centres for NP, BP or SP, between 2004 and 2007, were identified. The cost of providing physical therapies to these patients was estimated. Systematic reviews (SRs and clinical practice guidelines (CPGs for NP, BP and SP available in the same period were searched for and rated according to the Oxman and AGREE criteria, respectively. Those rated positively for ≥70% of the criteria, were used to categorise physical therapies as Effective; Ineffective; Inconclusive; and Insufficiently Assessed. The main outcome was the cost of physical therapies included in each of these categories. Results 8,308 chronic cases of NP, 4,693 of BP and 5,035 of SP, were included in this study. Among prescribed treatments, 39.88% were considered Effective (physical exercise and manual therapy with mobilization; 23.06% Ineffective; 13.38% Inconclusive, and 23.66% Insufficiently Assessed. The total cost of treatments was € 5,107,720. Effective therapies accounted for € 2,069,932. Conclusions Sixty percent of the resources allocated by the SNHSCI to fund physical treatment for NP, BP and SP in private practices are spent on forms of treatment proven to be ineffective, or for which there is no evidence of effectiveness.

  3. Patients’ attitudes and perceptions of two health-related quality-of-life questionnaires used to collect patient-reported outcome measures in the English National Health Service: A qualitative study of patients undergoing cardiac interventions

    Directory of Open Access Journals (Sweden)

    Bashir M Matata

    2013-09-01

    Full Text Available Objectives: To explore patients’ views on the EuroQol-5D and Coronary Revascularisation Outcome Questionnaire, tools currently used for collecting patient-reported outcome measures in the English National Health Service. The key questions were as follows: (1 whether patients consider them sensitive enough to detect change in their health after cardiovascular disease interventions and (2 whether they consider the health-related quality-of-life questions as meaningful. Methods: Data were collected on patients’ views using focus groups. We held four focus groups selecting participants on the basis of their baseline and follow-up EuroQol-5D scores. Data were analysed using framework analysis and grounded theory. Results: Focus group participants confirmed that they had derived substantial health benefits from their cardiac interventions despite the lack of measurable effects on the EuroQol-5D scores. Participants felt that the EuroQol-5D questionnaire was limited because of the following reasons: Their health fluctuates from day to day. They had difficulty assessing their general health status on the visual analogue scale. They felt that the Coronary Revascularisation Outcome Questionnaire was limited because of the following reasons: They did not understand the clinical terms used. The impact of tiredness on their quality of life was not captured. They were unable to distinguish between the effects of their heart condition and other health issues. Additionally, neither questionnaire considers the adjustments people have made to their domestic arrangements to improve their health-related quality of life. Conclusion: This study provides evidence that the two questionnaires do not capture some aspects of health that patients consider important. Furthermore, the presence of co-morbidities masks the symptoms relating to the heart disease and the effect of their cardiac interventions. Future work on patient-reported outcome measures should consider

  4. Geographic variation in the treatment of non-ST-segment myocardial infarction in the English National Health Service: a cohort study.

    Science.gov (United States)

    Dondo, T B; Hall, M; Timmis, A D; Yan, A T; Batin, P D; Oliver, G; Alabas, O A; Norman, P; Deanfield, J E; Bloor, K; Hemingway, H; Gale, C P

    2016-07-12

    To investigate geographic variation in guideline-indicated treatments for non-ST-elevation myocardial infarction (NSTEMI) in the English National Health Service (NHS). Cohort study using registry data from the Myocardial Ischaemia National Audit Project. All Clinical Commissioning Groups (CCGs) (n=211) in the English NHS. 357 228 patients with NSTEMI between 1 January 2003 and 30 June 2013. Proportion of eligible NSTEMI who received all eligible guideline-indicated treatments (optimal care) according to the date of guideline publication. The proportion of NSTEMI who received optimal care was low (48 257/357 228; 13.5%) and varied between CCGs (median 12.8%, IQR 0.7-18.1%). The greatest geographic variation was for aldosterone antagonists (16.7%, 0.0-40.0%) and least for use of an ECG (96.7%, 92.5-98.7%). The highest rates of care were for acute aspirin (median 92.8%, IQR 88.6-97.1%), and aspirin (90.1%, 85.1-93.3%) and statins (86.4%, 82.3-91.2%) at hospital discharge. The lowest rates were for smoking cessation advice (median 11.6%, IQR 8.7-16.6%), dietary advice (32.4%, 23.9-41.7%) and the prescription of P2Y12 inhibitors (39.7%, 32.4-46.9%). After adjustment for case mix, nearly all (99.6%) of the variation was due to between-hospital differences (median 64.7%, IQR 57.4-70.0%; between-hospital variance: 1.92, 95% CI 1.51 to 2.44; interclass correlation 0.996, 95% CI 0.976 to 0.999). Across the English NHS, the optimal use of guideline-indicated treatments for NSTEMI was low. Variation in the use of specific treatments for NSTEMI was mostly explained by between-hospital differences in care. Performance-based commissioning may increase the use of NSTEMI treatments and, therefore, reduce premature cardiovascular deaths. NCT02436187. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. 英国国家卫生服务改革与启示%National Health Service in the UK:Reform and Inspiration

    Institute of Scientific and Technical Information of China (English)

    黄清华

    2013-01-01

    The Reform of National Health Service (NHS) in the UK, which is the biggest one in the history of NHS, is being taken in accordance with The Health and Social Care Act 2012. Nevertheless, it is impossible to shake the bases of NHS, because the reform is for further reducing the links of management rather than changing the characters of NHS and giving up NHS. The reason of the UK government choosing NHS instead of commercial health insurance, to which the government is keeping alert, is that some risks of health are uninsurable. For commercial insurance, over-medication, resource waste and insurance fraud are easier to take place, and the cost of management is obvious higher than the spending of operating NHS.%根据《2012年卫生与社会照护法》,英国国家卫生服务(NHS)正在进行史上最大规模的改革。但是,这次改革不可能动摇NHS的基础,改变NHS的本质,放弃国家卫生服务,而是进一步减少管理环节。英国政府之所以选择国家卫生服务而对商业健康保险保持警惕,是因为决策者意识到,商业健康保险并非解决贫困人口医疗服务需求的一剂良药。有些健康风险具有不可保性,商业健康保险易生过度医疗、浪费资源和骗保问题,各种(商业)健康保险的管理成本显著高于国家基本卫生服务的经营成本。

  6. Building National Infrastructures for Patient-Centred Digital Services

    DEFF Research Database (Denmark)

    Thorseng, Anne; Jensen, Tina Blegind

    2015-01-01

    Patient-centred digital services are increasingly gaining impact in the healthcare sector. The premise is that patients will be better equipped for taking care of their own health through instant access to relevant information and by enhanced electronic communication with healthcare providers. One...... infrastructure theory, we highlight the enabling and constraining dynamics when designing and building a national infrastructure for patient-centred digital services. Furthermore, we discuss how such infrastructures can accommodate further development of services. The findings show that the Danish national e...

  7. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Science.gov (United States)

    2010-07-01

    ... 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...

  8. Effects of health-care services and commodities cost on the patients ...

    African Journals Online (AJOL)

    Effects of health-care services and commodities cost on the patients at the primary ... the monthly income of the clients and the experience of financial stress and a ... Commodities, National Health Act, primary health care, regulation, services ...

  9. 75 FR 60459 - National Committee on Vital and Health Statistics; Nominations

    Science.gov (United States)

    2010-09-30

    ... financing health care services, integrated computerized health information systems, health services research... HUMAN SERVICES National Committee on Vital and Health Statistics; Nominations AGENCY: Office of the... statutory public advisory body to the U.S. Department of Health and Human Services (HHS) in the areas...

  10. National Atlas of Ecosystem Services

    Science.gov (United States)

    The nation’s ecosystems provide a vast array of services to humans from clean and abundant water to recreational opportunities. The benefits of nature or “ecosystem services” are often taken for granted and not considered in environmental decision-making. In some cases, decis...

  11. QUALITY IN HEALTH SERVICES MANAGEMENT

    Directory of Open Access Journals (Sweden)

    DORU CÎRNU

    2017-04-01

    Full Text Available The service sector plays an increasingly large modern market economies. By being unable to provide customers a tangible product in the hands of service providers makes the situation more difficult. Their success depends on customer satisfaction, which expect a certain benefit for the money paid, on quality, on mutual trust and many other attributes. What is very interesting is that they may differ from client to client, and there is no guarantee satisfaction to all customers, even if the service provided is the same. This shows the complex nature of services and efforts on service providers would have to be made permanent in order to attract more customers. This paper addresses the issues of continuous quality improvement of health services as an important part of the services sector. Until recently, these services in Romania although under strict control of the state, had a large number of patients who are given very little attention, which is why quality improvement acestoraa was compulsory. Opening and changing economic environment, increasing customer demands, forced hospitals that serve as a nodal point between these services and their applicants to adopt modern management methods and techniques to become competitive and to give patients the quality service expected. Modern society has always sought to provide the means to ensure good health closer to the needs of modern man. These have become more complex and more expensive and naturally requires financial resources increasingly mari.Este why, every time, all the failures alleging lack of money and resources in general. Is it true? Sometimes yes, often, no! The truth is that human and material resources are not used in an optimal way. The answer lies mainly in quality management. We will see what should be done in this regard.

  12. MedlinePlus Health Topic Web Service

    Data.gov (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...

  13. Pelvic inflammatory disease: identifying research gaps--proceedings of a workshop sponsored by Department of Health and Human Services/National Institutes of Health/National Institute of Allergy and Infectious Diseases, November 3-4, 2011.

    Science.gov (United States)

    Darville, Toni

    2013-10-01

    In November 2011, the National Institutes of Health convened a workshop of basic researchers, epidemiologists, and clinical experts in pelvic inflammatory disease to identify research gaps hindering advances in diagnosis, treatment, and prevention. This article summarizes the presentations, discussions, and conclusions of this group and highlights significant controversies that reveal aspects of pelvic inflammatory disease research that would most greatly benefit from the application of newer molecular, immunologic, and radiologic techniques. Multiple limitations to performing new clinical trials exist; however, emerging data from ongoing clinical trials will add to the current body of knowledge regarding prevention and treatment strategies. In addition, use of established health care databases could serve as a valuable tool for performance of unbiased epidemiologic outcome studies.

  14. CGH observes National Women’s Health Week

    Science.gov (United States)

    This week, the U.S. Department of Health and Human Services is observing the 17th annual National Women’s Health Week. The goal of the National Women's Health Week is to empower women to make their health a priority. In celebration, the NCI Center for Global Health held a seminar on the Knowledge Summaries for Comprehensive Breast Cancer Control: Pathways for Advanced Cancer Planning.

  15. National Satellite Disaster Reduction Application Service

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ The groundbreaking ceremony for National Satellite Disaster Reduction Application Service was held on January 22,2008 in Beijing.The establishment of the center will further improve the disaster monitoring system using remote sensing technology and provides a platform for the application of remote sensing technology and satellite constellation in China's disaster reduction and relief services.

  16. HEALTH SERVICES FOR UNMARRIED MOTHERS.

    Science.gov (United States)

    BERNSTEIN, ROSE; HERZOG, ELIZABETH

    FROM REPORTS AND DATA THAT WERE AVAILABLE TO THE UNITED STATES CHILDREN'S BUREAU THROUGH 1962, A REVIEW WAS MADE OF RESEARCH AND DEMONSTRATIONS THAT RELATED TO AVAILABILITY AND USE OF HEALTH SERVICES BY UNMARRIED MOTHERS. INCLUDED ARE COMPLICATIONS OF PREGNANCY IN BIRTHS OUT OF WEDLOCK--(1) STUDIES OF PRENATAL MEDICAL CARE FOR UNMARRIED MOTHERS,…

  17. 78 FR 22890 - National Advisory Council on Migrant Health; Notice of Meeting

    Science.gov (United States)

    2013-04-17

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health... given of the following meeting: Name: National Advisory Council on Migrant Health Dates and Times: May... meeting is to discuss services and issues related to the health of migrant and seasonal...

  18. Volunteer Service and Service Learning: Opportunities, Partnerships, and United Nations Millennium Development Goals.

    Science.gov (United States)

    Dalmida, Safiya George; Amerson, Roxanne; Foster, Jennifer; McWhinney-Dehaney, Leila; Magowe, Mabel; Nicholas, Patrice K; Pehrson, Karen; Leffers, Jeanne

    2016-09-01

    This article explores approaches to service involvement and provides direction to nurse leaders and others who wish to begin or further develop global (local and international) service or service learning projects. We review types of service involvement, analyze service-related data from a recent survey of nearly 500 chapters of the Honor Society of Nursing, Sigma Theta Tau International (STTI), make recommendations to guide collaborative partnerships and to model engagement in global and local service and service learning. This article offers a literature review and describes results of a survey conducted by the STTI International Service Learning Task Force. Results describe the types of service currently conducted by STTI nursing members and chapters, including disaster response, service learning, and service-related responses relative to the Millennium Development Goals (MDGs). The needs of chapter members for information about international service are explored and recommendations for promoting global service and sustainability goals for STTI chapters are examined. Before engaging in service, volunteers should consider the types of service engagement, as well as the design of projects to include collaboration, bidirectionality, sustainability, equitable partnerships, and inclusion of the United Nations Sustainable Development Goals. STTI supports the learning, knowledge, and professional development of nurses worldwide. International service and collaboration are key to the advancement of the nursing profession. Culturally relevant approaches to international service and service learning are essential to our global organization, as it aims to impact the health status of people globally. © 2016 Sigma Theta Tau International.

  19. What do we know about medical tourism? A review of the literature with discussion of its implications for the UK National Health Service as an example of a public health care system.

    Science.gov (United States)

    Hanefeld, Johanna; Smith, Richard; Horsfall, Daniel; Lunt, Neil

    2014-01-01

    Medical tourism is a growing phenomenon. This review of the literature maps current knowledge and discusses findings with reference to the UK National Health Service (NHS). Databases were systematically searched between September 2011 and March 2012 and 100 papers were selected for review. The literature shows specific types of tourism depending on treatment, eg, dentistry, cosmetic, or fertility. Patient motivation is complex and while further research is needed, factors beyond cost, including availability and distance, are clearly important. The provision of medical tourism varies. Volume of patient travel, economic cost and benefit were established for 13 countries. It highlights contributions not only to recipient countries' economies but also to a possible growth in health systems' inequities. Evidence suggests that UK patients travel abroad to receive treatment, complications arise and are treated by the NHS, indicating costs from medical travel for originating health systems. It demonstrates the importance of quality standards and holds lessons as the UK and other EU countries implement the EU Directive on cross-border care. Lifting the private-patient-cap for NHS hospitals increases potential for growth in inbound medical tourism; yet no research exists on this. Research is required on volume, cost, patient motivation, industry, and on long-term health outcomes in medical tourists. © 2014 International Society of Travel Medicine.

  20. 75 FR 22411 - National Institute of Mental Health; Notice of Closed Meeting

    Science.gov (United States)

    2010-04-28

    ... Review Group; Interventions Committee for Adult Disorders. Date: June 8-9, 2010. Time: 8:30 a.m. to 5 p.m... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Initial Review Group; Mental Health Services in...

  1. Community mental health services and the elderly: retrenchment or expansion?

    Science.gov (United States)

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

    1986-01-01

    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.

  2. Financiando o SUS: algumas questões para o debate Funding the Brazilian National Health Service (SUS: some issues for the debate

    Directory of Open Access Journals (Sweden)

    Ruben Araujo de Mattos

    2003-09-01

    Full Text Available Este debate discute questões relacionadas ao financiamento do Sistema Único de Saúde (SUS. Na primeira parte, Ruben de Mattos defende a criação de dispositivos para a elevação progressiva dos gastos públicos em saúde. Segundo o debatedor, o maior desafio do governo será viabilizar - e sustentar - um sistema que garanta, de fato, o acesso universal e igualitário. Mattos também destaca a importância dos repasses federais entre os níveis de governos, por vê-los como instrumentos capazes de reduzir as desigualdades entre as regiões e incentivar políticas que contribuam para a consolidação do SUS. Na segunda parte, Nilson do Rosário afirma que o ajuste fiscal da década de 1990, conseqüência da política de estabilização monetária, limitou a capacidade de financiamento governamental na atenção à saúde, gerando efeitos perversos devido à ampliação da desigualdade social. A seguir, explica como o setor saúde respondeu às exigências de ajuste macroeconômico nas despesas públicas através de estratégias substitutivas, contexto em que o Programa de Saúde da Família (PSF se expandiu rapidamente, tornando-se estratégico na agenda da ampliação da atenção ambulatorial básica do país.This work discusses some of the issues related to the funding of the Brazilian National Health Service (SUS. In the first part of the paper, Ruben de Mattos advocates the creation of devices to guarantee a progressive increase in the public health budget. In the debater's view, the greatest challenge facing the government is the development - and the maintenance - of a system that can de facto guarantee universal and equalitarian access. Mattos also emphasizes the importance of the federal government's transfers of funds to local governments since the latter are seen as instrumental in the attempts to reduce inequality between regions and to encourage policies that will contribute to the SUS' consolidation. In the second part, Nilson

  3. Juvenile justice mental health services.

    Science.gov (United States)

    Thomas, Christopher R; Penn, Joseph V

    2002-10-01

    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

  4. Variabilidad en la utilización de los servicios de urgencias hospitalarios del Sistema Nacional de Salud Variability in Spanish National Health System hospital emergency services utilization

    Directory of Open Access Journals (Sweden)

    Salvador Peiró

    2010-01-01

    Full Text Available Objetivo: Los objetivos de este estudio fueron estimar las tasas de frecuentación a los servicios de urgencias hospitalarios (SUH del Sistema Nacional de Salud (SNS por áreas de salud, el porcentaje de ingresos, las razones estandarizadas de utilización de urgencias y analizar la relación con los recursos hospitalarios. Métodos: Estudio ecológico combinando información de diversas fuentes (Encuesta de Establecimientos Sanitarios con Régimen de Internado 2006 y Conjunto Mínimo de Datos Básicos 2006 para estimar la frecuentación a los SUH y el porcentaje de ingresos asociado en 164 áreas de salud de 14 comunidades autónomas (CC.AA.. Resultados: Los 35,3 millones de habitantes de las 164 áreas de salud incluidas realizaron 16,2 millones de visitas (45,7 por 100 habitantes a los SUH del SNS, y de ellos ingresaron algo más de 2 millones (12,6%. Excluyendo el 5% de áreas extremas por cada cola, la frecuentación osciló entre 31,6 y 78,7 urgencias/100 habitantes y el porcentaje de ingresos entre el 7,6% y el 27,9%. Estas diferencias apenas se atenuaron al estandarizar. El factor CC.AA. explicó un 29% de la varianza en frecuentación y un 82% en ingresos. La frecuentación no se asoció al volumen poblacional de camas o médicos de plantilla, aunque sí al de médicos de urgencias, hospitales de menor tamaño y no docentes. Conclusiones: Las áreas de salud del SNS mantienen una gran variabilidad en frecuentación a urgencias e ingresos por urgencias, que parece asociarse a un uso diferencial por problemas de menor entidad.Objective: The aims of this study were to estimate the rate of hospital emergency services (HES visits per health area, the associated percentage of admissions and the standardized HES utilization ratio, and to analyze their relationship with hospital resources. Methods: We performed an ecological study that combined information from distinct sources (Survey of Health Care Hospitalization Establishments 2006 and

  5. National Survey of Substance Abuse Treatment Services (N-SSATS-2008)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  6. National Survey of Substance Abuse Treatment Services (N-SSATS-2005)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  7. National Survey of Substance Abuse Treatment Services (N-SSATS-2003)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  8. National Survey of Substance Abuse Treatment Services (N-SSATS-2004)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  9. National Survey of Substance Abuse Treatment Services (N-SSATS-2007)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  10. National Survey of Substance Abuse Treatment Services (N-SSATS-2014)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  11. National Survey of Substance Abuse Treatment Services (N-SSATS-1997-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  12. National Survey of Substance Abuse Treatment Services (N-SSATS-2009)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  13. National Survey of Substance Abuse Treatment Services (N-SSATS-2002)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  14. National Survey of Substance Abuse Treatment Services (N-SSATS-2006)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  15. National Survey of Substance Abuse Treatment Services (N-SSATS-2000)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  16. 1997 through 2010 National Survey of Substance Abuse Treatment Services (N-SSATS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) (formerly titled Uniform Facility Data Set (UFDS)) is designed to collect information from all...

  17. National Survey of Substance Abuse Treatment Services (N-SSATS-2013)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  18. National Survey of Substance Abuse Treatment Services (N-SSATS-2012)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  19. National Survey of Substance Abuse Treatment Services (N-SSATS-2010)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  20. National Survey of Substance Abuse Treatment Services (N-SSATS-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  1. [Health services waste management: a biosafety issue].

    Science.gov (United States)

    Garcia, Leila Posenato; Zanetti-Ramos, Betina Giehl

    2004-01-01

    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.

  2. The Ghana community-based health planning and services initiative for scaling up service delivery innovation.

    Science.gov (United States)

    Nyonator, Frank K; Awoonor-Williams, J Koku; Phillips, James F; Jones, Tanya C; Miller, Robert A

    2005-01-01

    Research projects demonstrating ways to improve health services often fail to have an impact on what national health programmes actually do. An approach to evidence-based policy development has been launched in Ghana which bridges the gap between research and programme implementation. After nearly two decades of national debate and investigation into appropriate strategies for service delivery at the periphery, the Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. Over a 2-year period, 104 out of the 110 districts in Ghana started CHPS. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces. Evidence from the national monitoring and evaluation programme provides insights into CHPS' success and identifies constraints on future progress.

  3. The enactment of knowledge translation: a study of the Collaborations for Leadership in Applied Health Research and Care initiative within the English National Health Service.

    Science.gov (United States)

    D'Andreta, Daniela; Scarbrough, Harry; Evans, Sarah

    2013-10-01

    We contribute to existing knowledge translation (KT) literature by developing the notion of 'enactment' and illustrate this through an interpretative, comparative case-study analysis of three Collaborations for Leadership in Applied Health Research and Care (CLAHRC) initiatives. We argue for a focus on the way in which the CLAHRC model has been 'enacted' as central to the different KT challenges and capabilities encountered. A comparative, mixed method study created a typology of enactments (Classical, Home-grown and Imported) using qualitative analysis and social network analysis. We identify systematic differences in the enactment of the CLAHRC model. The sources of these different enactments are subsequently related to variation in formative interpretations and leadership styles, the implementation of different governance structures, and the relative epistemic differences between the professional groups involved. Enactment concerns the creative agency of individuals and groups in constituting a particular context for their work through their local interpretation of a particular KT model. Our theory of enactment goes beyond highlighting variation between CLAHRCs, to explore the mechanisms that influence the way a particular model is interpreted and acted upon. We thus encourage less focus on conceptual models and more on the formative role played by leaders of KT initiatives.

  4. The nursing contribution to chronic disease management: a whole systems approach: Report for the National Institute for Health Research Service Delivery and Organisation programme

    OpenAIRE

    Kendall , Sally; Wilson, Patricia M.; Procter, Susan; Brooks, Fiona; Bunn, Frances; Gage, Heather; McNeilly, Elaine

    2010-01-01

    Background Transforming the delivery of care for people with Long Term Conditions (LTCs) requires understanding about how health care policies in England and historical patterns of service delivery have led to different models of chronic disease management (CDM). It is also essential in this transformation to analyse and critique the models that have emerged to provide a more detailed evidence base for future decision making and better patient care. Nurses have made, and continue to make, ...

  5. Non-specific low back pain in primary care in the Spanish National Health Service: a prospective study on clinical outcomes and determinants of management

    Directory of Open Access Journals (Sweden)

    Muriel Alfonso

    2006-05-01

    Full Text Available Abstract Background The Spanish National Health Service is a universal and free health care system. Non-specific low back pain (LBP is a prevalent disorder, generating large health and social costs. The objectives of this study were to describe its management in primary care, to assess patient characteristics that influence physicians' decisions, and to describe clinical outcome at 2 months. Methods A cross-sectional sample of 648 patients with non-specific low back pain was recruited by 75 physicians (out of 361 – 20.8% working in 40 primary care centers in 10 of the 17 administrative regions in Spain, covering 693,026 out of the 40,499,792 inhabitants. Patients were assessed on the day they were recruited, and prospectively followed-up 14 and 60 days later. The principal patient characteristics that were analyzed were: sex, duration of the episode, history of LBP, working status, severity of LBP, leg pain and disability, and results of straight leg raising test. Descriptors of management were: performance of the straight leg raising test, ordering of diagnostic procedures, prescription of drug treatment, referral to physical therapy, rehabilitation or surgery, and granting of sick leave. Regression analysis was used to analyze the relationship between patients' baseline characteristics and physicians' management decisions. Only workers were included in the models on sick leave. Results Mean age (SD of included patients was 46.5 (15.5 years, 367 (56.6% were workers, and 338 (52.5% were females. Median (25th–75th interquartile range duration of pain when entering the study was 4 (2–10 days and only 28 patients (4.3% had chronic low back pain. Diagnostic studies included plain radiographs in 43.1% of patients and CT or MRI scans in 18.8%. Drug medication was prescribed to 91.7% of patients, 19.1% were sent to physical therapy or rehabilitation, and 9.6% were referred to surgery. The main determinants of the clinical management were duration

  6. Health care services, information systems & sustainability.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2010-01-01

    This chapter gives an educational overview of: * many competing characteristics within national health systems * national primary information and knowledge flows between health care entities * the role of information technologies in assisting health organizations become sustainable enterprises * the business of maintaining healthy populations for any nation * desirable e-health strategy objectives.

  7. 77 FR 10758 - National Institute of Child Health and Human Development Proposed Collection; Comment Request...

    Science.gov (United States)

    2012-02-23

    ... HUMAN SERVICES National Institutes of Health National Institute of Child Health and Human Development... Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Building 6100... comment on proposed data collection projects, the National Institute of Child Health and ]...

  8. 76 FR 7225 - National Institute of Environmental Health Sciences; Notice of Meetings

    Science.gov (United States)

    2011-02-09

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice..., National Institute of Environmental Health Sciences, 615 Davis Dr., KEY615/3112, Research Triangle Park, NC..., National Institute of Environmental Health Sciences, 615 Davis Dr., KEY615/3112, Research Triangle Park, NC...

  9. 76 FR 31620 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2011-06-01

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis..., Division of Extramural Research and Training, National Institute of Environmental Health Sciences, P.O....

  10. 76 FR 46823 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2011-08-03

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice....), notice is hereby given of a meeting of the National Advisory Environmental Health Sciences Council. The... of Committee: National Advisory Environmental Health Sciences Council. Date: September 1-2,...

  11. Model-based analysis of costs and outcomes of non-invasive prenatal testing for Down's syndrome using cell free fetal DNA in the UK National Health Service.

    Directory of Open Access Journals (Sweden)

    Stephen Morris

    Full Text Available BACKGROUND: Non-invasive prenatal testing (NIPT for Down's syndrome (DS using cell free fetal DNA in maternal blood has the potential to dramatically alter the way prenatal screening and diagnosis is delivered. Before NIPT can be implemented into routine practice, information is required on its costs and benefits. We investigated the costs and outcomes of NIPT for DS as contingent testing and as first-line testing compared with the current DS screening programme in the UK National Health Service. METHODS: We used a pre-existing model to evaluate the costs and outcomes associated with NIPT compared with the current DS screening programme. The analysis was based on a hypothetical screening population of 10,000 pregnant women. Model inputs were taken from published sources. The main outcome measures were number of DS cases detected, number of procedure-related miscarriages and total cost. RESULTS: At a screening risk cut-off of 1∶150 NIPT as contingent testing detects slightly fewer DS cases, has fewer procedure-related miscarriages, and costs the same as current DS screening (around UK£280,000 at a cost of £500 per NIPT. As first-line testing NIPT detects more DS cases, has fewer procedure-related miscarriages, and is more expensive than current screening at a cost of £50 per NIPT. When NIPT uptake increases, NIPT detects more DS cases with a small increase in procedure-related miscarriages and costs. CONCLUSIONS: NIPT is currently available in the private sector in the UK at a price of £400-£900. If the NHS cost was at the lower end of this range then at a screening risk cut-off of 1∶150 NIPT as contingent testing would be cost neutral or cost saving compared with current DS screening. As first-line testing NIPT is likely to produce more favourable outcomes but at greater cost. Further research is needed to evaluate NIPT under real world conditions.

  12. Systemic factors of errors in the case identification process of the national routine health information system: A case study of Modified Field Health Services Information System in the Philippines

    Directory of Open Access Journals (Sweden)

    Murai Shinsuke

    2011-10-01

    Full Text Available Abstract Background The quality of data in national health information systems has been questionable in most developing countries. However, the mechanisms of errors in the case identification process are not fully understood. This study aimed to investigate the mechanisms of errors in the case identification process in the existing routine health information system (RHIS in the Philippines by measuring the risk of committing errors for health program indicators used in the Field Health Services Information System (FHSIS 1996, and characterizing those indicators accordingly. Methods A structured questionnaire on the definitions of 12 selected indicators in the FHSIS was administered to 132 health workers in 14 selected municipalities in the province of Palawan. A proportion of correct answers (difficulty index and a disparity of two proportions of correct answers between higher and lower scored groups (discrimination index were calculated, and the patterns of wrong answers for each of the 12 items were abstracted from 113 valid responses. Results None of 12 items reached a difficulty index of 1.00. The average difficulty index of 12 items was 0.266 and the discrimination index that showed a significant difference was 0.216 and above. Compared with these two cut-offs, six items showed non-discrimination against lower difficulty indices of 0.035 (4/113 to 0.195 (22/113, two items showed a positive discrimination against lower difficulty indices of 0.142 (16/113 and 0.248 (28/113, and four items showed a positive discrimination against higher difficulty indices of 0.469 (53/113 to 0.673 (76/113. Conclusions The results suggest three characteristics of definitions of indicators such as those that are (1 unsupported by the current conditions in the health system, i.e., (a data are required from a facility that cannot directly generate the data and, (b definitions of indicators are not consistent with its corresponding program; (2 incomplete or

  13. LABORATORY SERVICES IN HEALTH CENTRES WITHIN ...

    African Journals Online (AJOL)

    1999-05-05

    May 5, 1999 ... the technicians aimed at improving the services in health centres within ... Settings: Twenty seven health centres in Amhara region, north .... man power in the laboratory .... service consumption in a teaching hospital in Gondar,.

  14. 75 FR 48698 - National Advisory Council on Migrant Health; Notice of Meeting

    Science.gov (United States)

    2010-08-11

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health...-463), notice is hereby given of the following meeting: Name: National Advisory Council on Migrant... of the meeting is to discuss services and issues related to the ] health of migrant and...

  15. 77 FR 2734 - National Advisory Council on Migrant Health; Notice of Meeting

    Science.gov (United States)

    2012-01-19

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health...-463), notice is hereby given of the following meeting: Name: National Advisory Council on Migrant... purpose of the meeting is to discuss services and issues related to the health of migrant and...

  16. 76 FR 22107 - National Advisory Council on Migrant Health; Notice of Meeting

    Science.gov (United States)

    2011-04-20

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health...-463), notice is hereby given of the following meeting: Name: National Advisory Council on Migrant.... Purpose: The purpose of the meeting is to discuss services and issues related to the health of migrant...

  17. 77 FR 19294 - National Advisory Council on Migrant Health; Notice of Meeting

    Science.gov (United States)

    2012-03-30

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health...-463), notice is hereby given of the following meeting: Name: National Advisory Council on Migrant... discuss services and issues related to the health of migrant and seasonal farmworkers and their...

  18. 75 FR 1397 - National Advisory Council on Migrant Health; Notice of Meeting

    Science.gov (United States)

    2010-01-11

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health...-463), notice is hereby given of the following meeting: Name: National Advisory Council on Migrant... meeting is to discuss services and issues related to the health of migrant and seasonal farmworkers...

  19. 78 FR 41412 - National Advisory Council on Migrant Health; Notice of Meeting

    Science.gov (United States)

    2013-07-10

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health...-463), notice is hereby given of the following meeting: Name: National Advisory Council on Migrant.... Purpose: The purpose of the meeting is to discuss services and issues related to the health of migrant...

  20. 76 FR 1185 - National Advisory Council on Migrant Health; Notice of Meeting

    Science.gov (United States)

    2011-01-07

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health...-463), notice is hereby given of the following meeting: Name: National Advisory Council on Migrant... meeting is to discuss services and issues related to the health of migrant and seasonal farmworkers...

  1. Prevention and dental health services.

    Science.gov (United States)

    Widström, Eeva

    2004-01-01

    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.

  2. US Forest Service National Forest System Land Units

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the www depicting National Forest Service land units. An NFS Land Unit is nationally significant classification of Federally owned forest, range,...

  3. Service Areas at Cedar Breaks National Monument, Utah (srvcarea)

    Data.gov (United States)

    National Park Service, Department of the Interior — This coverage contains service areas at Cedar Breaks National Monument. The service areas were collected by a Trimble GeoXT GPS unit and post processed for...

  4. National Service: Can We Afford It?

    Science.gov (United States)

    1987-12-01

    would become a much needed rite of passage for many young Ameri- cans." 12 A 1977 Gallup Poll, indicating that a national service program was favored...used, since the 18-24 year olds are the group who will be called upon to volunteer. Contrary to the " rite of passage ," newspaper articles are written

  5. 75 FR 45133 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-08-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Development in the Environmental Health Sciences; 93.113, Biological Response to Environmental Health Hazards...

  6. 76 FR 50235 - National Institute of Environmental Health Sciences; Notice of Meetings

    Science.gov (United States)

    2011-08-12

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice..., Director, Division of Extramural Research and Training (DERT), Nat. Inst. of Environmental Health Sciences... Health Sciences, National Institutes of Health, 615 Davis Dr., KEY615/3112, Research Triangle Park,...

  7. 76 FR 67748 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2011-11-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... Environmental Health Sciences, National Institutes of Health, 615 Davis Dr., KEY615/3112, Research Triangle Park... and Education; 93.894, Resources and Manpower Development in the Environmental Health Sciences;...

  8. Student Health Services at Orchard Ridge.

    Science.gov (United States)

    Nichols, Don D.

    This paper provides a synoptic review of student health services at the community college level while giving a more detailed description of the nature of health services at Orchard Ridge, a campus of Oakland Community College. The present College Health Service program provides for a part-time (24 hrs./wk.) nurse at Orchard Ridge. A variety of…

  9. Principles of youth participation in mental health services.

    Science.gov (United States)

    James, Anthony M

    2007-10-01

    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. 292 The State of Administration of Health Services among ...

    African Journals Online (AJOL)

    FIRST LADY

    2011-01-18

    Jan 18, 2011 ... health services, nursing services, and health education. Other areas ... (2001) sees school health services to be those services that take care of the health needs ..... Network, Family Health International 14:2:30. Chisango, T.

  11. Definition and scope of health services administration.

    Science.gov (United States)

    Begun, James W; Kaissi, Amer

    2004-01-01

    The definition and scope of health services administration are important to public policy, educational programs, new entrants to the field, and practitioners. Formal definition of the field of health services administration has not received concerted attention since 1975. Significant changes in the field have occurred since that time, widening opportunities for graduates of educational programs and increasing interdependencies between health services organizations and public policy organizations, supplier organizations, insurers, and other businesses that are not involved directly in health services delivery. Stakeholders in the field of health services administration should consider a broadened definition of the field that would institutionalize and build on those increased opportunities and interdependencies.

  12. Customer satisfaction survey with the National Vaccine Cold Chain Delivery Service.

    Science.gov (United States)

    Meara, M O; Morrissey, Y; Corcoran, B

    2009-05-01

    In 2008 the Health Service Executive (HSE) carried out a survey to assess general practitioners (GPs) satisfaction with the National Vaccine Cold Chain Service. This survey found high levels of satisfaction (> 90%) with the service. Over half of those surveyed had used the vaccine returns service with the majority (89.2%) finding it good or very good.

  13. Homeless health needs: shelter and health service provider perspective.

    Science.gov (United States)

    Hauff, Alicia J; Secor-Turner, Molly

    2014-01-01

    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.

  14. 78 FR 27974 - National Advisory Council on Migrant Health; Cancellation of Meeting

    Science.gov (United States)

    2013-05-13

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health; Cancellation of Meeting Name: National Advisory Council on Migrant Health. Dates and Times: May 21, 2013, 8:30... Advisory Council on Migrant Health, scheduled for May 21 and 22, 2013, is cancelled. This...

  15. 77 FR 70788 - National Advisory Council on Migrant Health; Cancellation of Meeting

    Science.gov (United States)

    2012-11-27

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Migrant Health; Cancellation of Meeting Name: National Advisory Council on Migrant Health. Dates and Times: December 4, 2012, 8... Advisory Council on Migrant Health, scheduled for December 4 and 5, 2012, is cancelled. This...

  16. The Department of Veterans Health Administration Office of Nursing Service, "transforming nursing in a national healthcare system: an example of transformation in action".

    Science.gov (United States)

    Wertenberger, Sydney; Chapman, Kathleen M; Wright-Brown, Salena

    2011-01-01

    The Department of Veterans Health Administration Office of Nursing Service has embarked on a multiyear transformational process, an example of which is the development of an organization-wide nursing handbook. The development of this handbook offered the opportunity to improve collaboration, redefine expectations and behavior, as well as prepare for the future of Nursing within the Veterans Health Administration. The lessons learned from this process have revolved around the themes of leadership skills for managing high-level change often in a virtual environment; constant collaboration; that the practice of nursing will continue to evolve on the basis of new evidence, technology, customer expectations, and resources; and that the process to accomplish this goal is powerful.

  17. Furthering the quality agenda in Aboriginal community controlled health services: understanding the relationship between accreditation, continuous quality improvement and national key performance indicator reporting.

    Science.gov (United States)

    Sibthorpe, Beverly; Gardner, Karen; McAullay, Daniel

    2016-01-01

    A rapidly expanding interest in quality in the Aboriginal-community-controlled health sector has led to widespread uptake of accreditation using more than one set of standards, a proliferation of continuous quality improvement programs and the introduction of key performance indicators. As yet, there has been no overarching logic that shows how they relate to each other, with consequent confusion within and outside the sector. We map the three approaches to the Framework for Performance Assessment in Primary Health Care, demonstrating their key differences and complementarity. There needs to be greater attention in both policy and practice to the purposes and alignment of the three approaches if they are to embed a system-wide focus that supports quality improvement at the service level.

  18. 75 FR 6398 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

    Science.gov (United States)

    2010-02-09

    ... HUMAN SERVICES Office of the National Coordinator for Health Information Technology; HIT Policy Committee's Adoption/Certification Workgroup Meeting; Notice of Meeting AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces...

  19. 1990 through 2011 National Survey on Drug Use and Health (NSDUH)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) is the general civilian population aged 12 and...

  20. National Pregnancy and Health Survey: Drug Use Among Women Delivering Live Births (NPHS-1992)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The primary objective of the National Pregnancy and Health Survey (NPHS) was to produce national annual estimates of the percentages and numbers of mothers of live...

  1. US Forest Service National Wilderness Areas 2 - Green Polygon Fill

    Data.gov (United States)

    US Forest Service, Department of Agriculture — A map service on the www depicting parcels of Forest Service land congressionally designated as wilderness such as National Wilderness Areas. This map service...

  2. 75 FR 56549 - National Institute for Occupational Safety and Health (NIOSH), Safety and Occupational Health...

    Science.gov (United States)

    2010-09-16

    ... HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and... occupational safety and health, and allied areas. It is the intent of NIOSH to support broad-based research... delivery of occupational safety and health services, and the prevention of work-related injury and...

  3. Clinical applicability and cost of a 46-gene panel for genomic analysis of solid tumours: Retrospective validation and prospective audit in the UK National Health Service

    Science.gov (United States)

    Kaur, Kulvinder; Camps, Carme; Kaisaki, Pamela; Gupta, Avinash; Talbot, Denis; Middleton, Mark; Henderson, Shirley; Cutts, Anthony; Vavoulis, Dimitrios V.; Housby, Nick; Taylor, Jenny C.; Schuh, Anna

    2017-01-01

    Background Single gene tests to predict whether cancers respond to specific targeted therapies are performed increasingly often. Advances in sequencing technology, collectively referred to as next generation sequencing (NGS), mean the entire cancer genome or parts of it can now be sequenced at speed with increased depth and sensitivity. However, translation of NGS into routine cancer care has been slow. Healthcare stakeholders are unclear about the clinical utility of NGS and are concerned it could be an expensive addition to cancer diagnostics, rather than an affordable alternative to single gene testing. Methods and findings We validated a 46-gene hotspot cancer panel assay allowing multiple gene testing from small diagnostic biopsies. From 1 January 2013 to 31 December 2013, solid tumour samples (including non-small-cell lung carcinoma [NSCLC], colorectal carcinoma, and melanoma) were sequenced in the context of the UK National Health Service from 351 consecutively submitted prospective cases for which treating clinicians thought the patient had potential to benefit from more extensive genetic analysis. Following histological assessment, tumour-rich regions of formalin-fixed paraffin-embedded (FFPE) sections underwent macrodissection, DNA extraction, NGS, and analysis using a pipeline centred on Torrent Suite software. With a median turnaround time of seven working days, an integrated clinical report was produced indicating the variants detected, including those with potential diagnostic, prognostic, therapeutic, or clinical trial entry implications. Accompanying phenotypic data were collected, and a detailed cost analysis of the panel compared with single gene testing was undertaken to assess affordability for routine patient care. Panel sequencing was successful for 97% (342/351) of tumour samples in the prospective cohort and showed 100% concordance with known mutations (detected using cobas assays). At least one mutation was identified in 87% (296/342) of

  4. Clinical applicability and cost of a 46-gene panel for genomic analysis of solid tumours: Retrospective validation and prospective audit in the UK National Health Service.

    Directory of Open Access Journals (Sweden)

    Angela Hamblin

    2017-02-01

    Full Text Available Single gene tests to predict whether cancers respond to specific targeted therapies are performed increasingly often. Advances in sequencing technology, collectively referred to as next generation sequencing (NGS, mean the entire cancer genome or parts of it can now be sequenced at speed with increased depth and sensitivity. However, translation of NGS into routine cancer care has been slow. Healthcare stakeholders are unclear about the clinical utility of NGS and are concerned it could be an expensive addition to cancer diagnostics, rather than an affordable alternative to single gene testing.We validated a 46-gene hotspot cancer panel assay allowing multiple gene testing from small diagnostic biopsies. From 1 January 2013 to 31 December 2013, solid tumour samples (including non-small-cell lung carcinoma [NSCLC], colorectal carcinoma, and melanoma were sequenced in the context of the UK National Health Service from 351 consecutively submitted prospective cases for which treating clinicians thought the patient had potential to benefit from more extensive genetic analysis. Following histological assessment, tumour-rich regions of formalin-fixed paraffin-embedded (FFPE sections underwent macrodissection, DNA extraction, NGS, and analysis using a pipeline centred on Torrent Suite software. With a median turnaround time of seven working days, an integrated clinical report was produced indicating the variants detected, including those with potential diagnostic, prognostic, therapeutic, or clinical trial entry implications. Accompanying phenotypic data were collected, and a detailed cost analysis of the panel compared with single gene testing was undertaken to assess affordability for routine patient care. Panel sequencing was successful for 97% (342/351 of tumour samples in the prospective cohort and showed 100% concordance with known mutations (detected using cobas assays. At least one mutation was identified in 87% (296/342 of tumours. A locally

  5. Area health education centers and health science library services.

    Science.gov (United States)

    West, R T; Howard, F H

    1977-07-01

    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.

  6. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

    Science.gov (United States)

    Dixon, Decia Nicole

    2009-01-01

    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…

  7. National telemental health responses to a major bushfire disaster.

    Science.gov (United States)

    Reifels, Lennart; Bassilios, Bridget; Pirkis, Jane

    2012-06-01

    In response to the Victorian bushfire disaster in 2009, various telemental health services were provided by three national agencies: Kids Helpline (BoysTown), MensLine Australia (Crisis Support Services) and Lifeline Australia. All provider agencies used their existing national service structures and staff resources, which were expanded to respond to bushfire-related service demand. We examined service provider reports and conducted key informant interviews. Despite a lack of quantitative data on consumer outcomes and perspectives, it appears that all three telemental health services experienced significant increases in overall service uptake levels in the wake of the bushfires. Uptake of specialized telephone-, web-, email- and crisis counselling services was substantial, although that of callback services was very limited. Potential clients encountered specific barriers in relation to service access and the callback model. The bushfire experience highlighted the impact of transitory living circumstances and the increased complexity of post-disaster calls on service provision. Telemental health services need to be integrated into mainstream services and disaster response structures.

  8. [JICA Leprosy Control and Basic Health Services Project in Myanmar].

    Science.gov (United States)

    Ishida, Yutaka; Hikita, Kazuo

    2005-09-01

    Japan International Cooperation Agency (JICA) implemented a 5-year long bilateral technical cooperation project, "Leprosy Control and Basic Health Services Project" in Myanmar. The project was implemented by National Leprosy Control Program, Department of Health with close technical collaboration of JICA experts mainly from International Medical Center of Japan (IMCJ) and National Sanatoriums of leprosy in Japan. It accelerated to achieve the elimination of leprosy at national level, which was declared in January 2003, and at sub-national level onward. It also developed the appropriate technologies for prevention of disability and prevention of worsening of disability (POD/POWD), which were introduced in 9 townships as a pilot service program. The Government stratified the POD/POWD services as a national program since 2005 by taking up the former pilot area to start with. The project also strengthened the function of referral system of leprosy control (Diagnosis and treatment), POD/POWD and physical rehabilitation. Beside leprosy, the project conducted a series of refresher trainings for primary health care givers, Basic Health Service Staff (BHS), of project areas (48 townships) to improve the services on tuberculosis, Malaria, Leprosy, Trachoma and HIV/AIDS for 3 years (2001-2003), which was evaluated in 2004. It contributed to improve the services at township level hospitals in procurement of audio-visual equipments and in conducting microscope training on leprosy, Malaria and tuberculosis at project areas.

  9. Forest health monitoring: 2006 national technical report

    Science.gov (United States)

    Mark J. Ambrose; Barbara L. Conkling

    2009-01-01

    The Forest Health Monitoring Program’s annual national technical reportpresents results of forest health analyses from a national perspective usingdata from a variety of sources. The report is organized according to the

  10. 75 FR 36100 - Eunice Kennedy Shriver National Institute of Child Health & Human Development; Notice of Closed...

    Science.gov (United States)

    2010-06-24

    ... Development Special Emphasis Panel National Childrens Study. Date: July 12, 2010. Time: 8 a.m. to 5 p.m... of Scientific Review, National Institute of Child Health and Human Development, 6100 Executive... HUMAN SERVICES National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health...

  11. The National Library Service (SBN towards digital

    Directory of Open Access Journals (Sweden)

    Giuliana Sgambati

    2003-12-01

    Full Text Available In the sector of technologies for the Information Society, the General Direction for Library Heritage and Cultural Institutes has promoted two programs: · SBN: The National Library Service (Servizio Bibliotecario Nazionale · BDI: The Italian Digital Library (Biblioteca Digitale Italiana and another project, which was approved on March 18, 2003: · BDI&NTC: The Italian Digital Library and Cultural Tourist Network

  12. Terminology Management at the National Language Service

    OpenAIRE

    Mariëtta Alberts

    2011-01-01

    Abstract: Terminology is a strategic resource in a multilingual country. It is the medium through which knowledge and information is disseminated. lhrough the use of correct, standardised terminology, effective scientific and technical communication skills are developed. A brief overview is given of terminology development in South Africa, with special emphasis on the work of the Terminology Division of the National Language Service. Aspects of present terminology practice such as te...

  13. National Coal Board Medical Service annual report 1981-82

    Energy Technology Data Exchange (ETDEWEB)

    1983-01-01

    Sections report on: medical examinations and consultations; protection from health hazards, such as pneumoconiosis and other prescribed diseases; problems such as vitamin D in miners' blood, Legionnaires' disease, rehabilitation and physiotherapy, high pressure injection injuries, pump packing; National Coal Board (Coal Products) Ltd.; injuries and treatment; and nursing service. A list of staff and their publications and a supplement on occupational toxicology are included.

  14. Comparative cost-effectiveness of robot-assisted and standard laparoscopic prostatectomy as alternatives to open radical prostatectomy for treatment of men with localised prostate cancer: a health technology assessment from the perspective of the UK National Health Service.

    Science.gov (United States)

    Close, Andrew; Robertson, Clare; Rushton, Stephen; Shirley, Mark; Vale, Luke; Ramsay, Craig; Pickard, Robert

    2013-09-01

    Robot-assisted laparoscopic prostatectomy is increasingly used compared with a standard laparoscopic technique, but it remains uncertain whether potential benefits offset higher costs. To determine the cost-effectiveness of robotic prostatectomy. We conducted a care pathway description and model-based cost-utility analysis. We studied men with localised prostate cancer able to undergo either robotic or laparoscopic prostatectomy for cure. We used data from a meta-analysis, other published literature, and costs from the UK National Health Service and commercial sources. Care received by men for 10 yr following radical prostatectomy was modelled. Clinical events, their effect on quality of life, and associated costs were synthesised assuming 200 procedures were performed annually. Over 10 yr, robotic prostatectomy was on average (95% confidence interval [CI]) £1412 (€1595) (£1304 [€1473] to £1516 [€1713]) more costly than laparoscopic prostatectomy but more effective with mean (95% CI) gain in quality-adjusted life-years (QALYs) of 0.08 (0.01-0.15). The incremental cost-effectiveness ratio (ICER) was £18 329 (€20 708) with an 80% probability that robotic prostatectomy was cost effective at a threshold of £30 000 (€33 894)/QALY. The ICER was sensitive to the throughput of cases and the relative positive margin rate favouring robotic prostatectomy. Higher costs of robotic prostatectomy may be offset by modest health gain resulting from lower risk of early harms and positive margin, provided >150 cases are performed each year. Considerable uncertainty persists in the absence of directly comparative randomised data. Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  15. Home health services in New Hampshire.

    Science.gov (United States)

    Hale, F A; Jacobs, A R

    1976-01-01

    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

  16. 78 FR 8156 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-02-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... of personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special.... Institute of Environmental Health Sciences, P.O. Box 12233, MD EC-30, Research Triangle Park, NC 27709,...

  17. 78 FR 14312 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2013-03-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Institute of Environmental Health Sciences, P.O. Box 12233, MD EC-30/Room 3171, Research Triangle Park,...

  18. 76 FR 29772 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2011-05-23

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Environmental Health Sciences, P. O. Box 12233, MD EC-30, Research Triangle Park, NC 27709, (919) 541-1307, bass...

  19. 76 FR 8751 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2011-02-15

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Extramural ] Research and Training, Nat. Institute Environmental Health Sciences, P.O. Box 12233, MD EC-30...

  20. 76 FR 21387 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2011-04-15

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... and Training, Nat. Institute of Environmental Health Science, P.O. Box 12233, MD EC-30/Room 3170 B...

  1. 75 FR 61765 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2010-10-06

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. ] Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Institute of Environmental Health Sciences, Office of Program Operations, Scientific Review Branch, P.O. Box...

  2. 75 FR 68367 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-11-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Institute of Environmental Health Science, P.O. Box 12233, MD EC-30/Room 3170 B, Research Triangle Park, NC...

  3. 75 FR 55807 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2010-09-14

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis...-Tilotta, PhD, Scientific Review Officer, Nat. Institute of Environmental Health Sciences, Office of...

  4. 76 FR 7572 - National Institute of Environmental Health Sciences; Notice of Meetings

    Science.gov (United States)

    2011-02-10

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice..., Director, Division of Extramural Research and Training, National Institute of Environmental Health Sciences... Environmental Health Sciences, 615 Davis Dr., KEY615/3112, Research Triangle Park, NC 27709, (919) 541-4980...

  5. 75 FR 2876 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2010-01-19

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Environmental Health Sciences, P.O. Box 12233, MD EC-30, Research Triangle Park, NC 27709, (919) 541- 0752...

  6. 77 FR 30019 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2012-05-21

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Research and Training, Nat. Institute of Environmental Health Science, P.O. Box 12233, MD EC-30/Room 3170 B...

  7. 76 FR 58521 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2011-09-21

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Environmental Health Science, P. O. Box 12233, MD EC-30/Room 3170 B, Research Triangle Park, NC 27709, (919) 541...

  8. 76 FR 13650 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2011-03-14

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Environmental Health Sciences, P.O. Box 12233, MD EC-30/Room 3171, Research Triangle Park, NC 27709, (919) 541...

  9. 75 FR 21339 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-04-23

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis.... Institute of Environmental Health Sciences, P.O. Box 12233, MD EC-30/Room 3171, Research Triangle Park, NC...

  10. 75 FR 34147 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-06-16

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Extramural Research and Training, Nat. Institute Environmental Health Sciences, P.O. Box 12233, MD EC-30...

  11. 75 FR 78719 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2010-12-16

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Environmental Health Sciences, Office of Program Operations, Scientific Review Branch, P.O. Box 12233 MD EC-30...

  12. 77 FR 37423 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2012-06-21

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis..., Division of Extramural Research and Training, Nat. Institute of Environmental Health Sciences, P.O. Box...

  13. 77 FR 19677 - Eunice Kennedy Shriver National Institute of Child Health & Human Development; Notice of Closed...

    Science.gov (United States)

    2012-04-02

    ... Institute of Child Health and Human Development Special Emphasis Panel, ZHD1 DSG-H 53 1. Date: April 16-17... Kennedy Shriver National Institute of Child Health and Human Development, NIH, 6100 Executive Blvd., Room... HUMAN SERVICES National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health...

  14. 76 FR 82313 - National Institute of Mental Health; Notice of Closed Meetings

    Science.gov (United States)

    2011-12-30

    ... Mental Health Initial Review Group Interventions Committee for Adult Disorders. Date: February 9-10, 2012... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... of Committee: National Institute of Mental Health Initial Review Group Interventions Committee...

  15. 77 FR 27469 - National Institute of Mental Health; Notice of Closed Meetings

    Science.gov (United States)

    2012-05-10

    ... Mental Health Initial Review Group Interventions Committee for Adult Disorders. Date: June 7-8, 2012... HUMAN SERVICES National Institutes of Health National Institute of Mental Health; Notice of Closed... privacy. Name of Committee: National Institute of Mental Health Initial Review Group...

  16. 77 FR 74198 - National Institute Environmental Health Sciences Notice of Meeting

    Science.gov (United States)

    2012-12-13

    ... HUMAN SERVICES National Institutes of Health National Institute Environmental Health Sciences Notice of....), notice is hereby given of a meeting of the National Advisory Environmental Health Sciences Council. The... Health Sciences Council. Date: February 20, 2013. Open: 8:30 a.m. to 4:35 p.m. Agenda: Discussion...

  17. 78 FR 56902 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-09-16

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Research and Education; 93.894, Resources and Manpower Development in the Environmental Health Sciences;...

  18. 75 FR 49500 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2010-08-13

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice....), notice is hereby given of a meeting of the National Advisory Environmental Health Sciences Council. The... Health Sciences Council. Date: September 1-2, 2010. Open: September 1, 2010, 8:30 a.m. to 5 p.m....

  19. 78 FR 18359 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2013-03-26

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Health Sciences, P.O. Box 12233, MD EC-30, Research Triangle Park, NC 27709, (919) 541-0752,...

  20. 78 FR 48695 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2013-08-09

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice....), notice is hereby given of a meeting of the National Advisory Environmental Health Sciences Council. The... Health Sciences Council. Date: September 10, 2013. Open: 8:30 a.m. to 3:15 p.m. Agenda: Discussion...

  1. 76 FR 71046 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2011-11-16

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... Sciences, National Institutes of Health, 615 Davis Dr., KEY615/3112, Research Triangle Park, NC 27709, (919....894, Resources and Manpower Development in the Environmental Health Sciences; 93.113,...

  2. 75 FR 3474 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2010-01-21

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice....), notice is hereby given of a meeting of the National Advisory Environmental Health Sciences Council. The... Health Sciences Council. Date: February 18-19, 2010. Open: February 18, 2010, 8:30 a.m. to 5 p.m....

  3. 76 FR 80954 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2011-12-27

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice.../ . Place: Nat. Inst. of Environmental Health Sciences, Building 101, Rodbell Auditorium, 111 T. W... Sciences, National Institutes of Health, 615 Davis Dr., KEY615/3112, Research Triangle Park, NC 27709,...

  4. 78 FR 25754 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-05-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special ] Emphasis.... Institute of Environmental Health Science, P.O. Box 12233, MD EC-30/Room 3170 B, Research Triangle Park,...

  5. 78 FR 27410 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-05-10

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Research and Education; 93.894, Resources and Manpower Development in the Environmental Health Sciences;...

  6. 75 FR 8976 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2010-02-26

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Extramural Research and Training, Nat. Institute of Environmental Health Science, P. O. Box 12233, MD...

  7. 76 FR 30734 - National Institute of Environmental Health Sciences; Amended Notice of Meetings

    Science.gov (United States)

    2011-05-26

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences..., 12 p.m. to 2:30 p.m., NIEHS/National Institutes of Health, Building 4401, East Campus, 79...

  8. 78 FR 35637 - National Institute of Environmental Health Sciences; Amended Notice of Meeting

    Science.gov (United States)

    2013-06-13

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences... Environmental Health Sciences Special Emphasis Panel, July 15, 2013, 8:00 a.m. to July 15, 2013, 5:00 p.m., National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park,...

  9. 77 FR 18252 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2012-03-27

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice....), notice is hereby given of a meeting of the National Advisory Environmental Health Sciences Council. The... Health Sciences Council. Date: May 22-23, 2012. Open: May 22, 2012, 8:30 a.m. to 5 p.m....

  10. 78 FR 51734 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-08-21

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Research and Education; 93.894, Resources and Manpower Development in the Environmental Health Sciences;...

  11. 77 FR 66853 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2012-11-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis Panel Career Grants in the Environmental Health Sciences. Date: November 29-30, 2012 Time: 8:00 a.m....

  12. 76 FR 11500 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2011-03-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Environmental Health Sciences, Office of Program Operations, Scientific Review Branch, P.O. Box 12233 MD...

  13. 78 FR 13358 - National Institute of Environmental Health Sciences Notice of Closed Meetings

    Science.gov (United States)

    2013-02-27

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Training, Nat. Institute Environmental Health Sciences, P.O. Box 12233, MD EC-30, Research Triangle...

  14. 77 FR 4572 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2012-01-30

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... of Extramural Research and Training, Nat. Institute of Environmental Health Science, P.O. Box...

  15. 77 FR 48164 - National Institute Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2012-08-13

    ... HUMAN SERVICES National Institutes of Health National Institute Environmental Health Sciences; Notice of....), notice is hereby given of a meeting of the National Advisory Environmental Health Sciences Council. The... Health Sciences Council. Date: September 11, 2012. Time: 8:30 a.m. to 12:00 p.m. Agenda: Discussion...

  16. 78 FR 20931 - National Institute of Environmental Health Sciences; Notice of Meeting

    Science.gov (United States)

    2013-04-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice....), notice is hereby given of a meeting of the National Advisory Environmental Health Sciences Council. The... Health Sciences Council. Date: May 14-15, 2013. ] Open: May 14, 2013, 8:30 a.m. to 5:00 p.m....

  17. 75 FR 32797 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-06-09

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Extramural Research and Training, Nat. Institute of Environmental Health Sciences, P.O. Box 12233, MD...

  18. 75 FR 41506 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2010-07-16

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... of Extramural Research and Training, Nat. Institute of Environmental Health Sciences, P.O. Box...

  19. 78 FR 14562 - National Institute of Environmental Health Sciences; Notice of Closed Meeting

    Science.gov (United States)

    2013-03-06

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Environmental Health Sciences, Office of Program Operations, Scientific Review Branch, P.O. Box 12233,...

  20. 77 FR 60445 - National Institute of Environmental Health Sciences; Notice of Closed Meetings

    Science.gov (United States)

    2012-10-03

    ... HUMAN SERVICES National Institutes of Health National Institute of Environmental Health Sciences; Notice... personal privacy. Name of Committee: National Institute of Environmental Health Sciences Special Emphasis... Institute of Environmental Health Science, P.O. Box 12233, MD EC-30/Room 3170 B, Research Triangle Park,...