MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'BMC Health Services Research' source. Sun, 21 Mar 2010 15:20:58 +0100 http://www.medworm.com/index.php?rid=3384374&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F71 Conclusion: The high prevalence of CMS in the semi-urban population especially for the population with hypertension underscores the double burden of disease in developing countries. The lesson is while infections and infestations are being tackled in these countries the non-communicable diseases should not be neglected. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3384374 Fri, 19 Mar 2010 00:00:00 +0100 3384374 http://www.medworm.com/index.php?rid=3380728&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F69 Conclusion: This study assesses the influence of socio-demographic characteristics on the migrant workers' decision to seek health care services when they fall ill, and it also indicates that the current health service system discourages migrant workers from seeking appropriate care of good quality. Relevant policies of public medical insurance and assistance program should be vigorously implemented for providing affordable health care services to the migrants. Feasible measures need to be taken to reduce the health risks associated with current hygiene practices and equity should be assured in access to health care services among migrant workers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3380728 Fri, 19 Mar 2010 00:00:00 +0100 3380728 http://www.medworm.com/index.php?rid=3380727&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F70 The objective of the study was to evaluate the impact of a Serology-CDSS providing point of care reminders of previous existing serology results, embedded in a Computerized Physician Order Entry at a university teaching hospital in Paris, France. Methods: A CDSS was implemented in the Cardiovascular Surgery department of the hospital in order to decrease inappropriate repetitions of viral serology tests (HBV).A time series analysis was performed to assess the impact of the alert on physicians' practices. The study took place between January 2004 and December 2007. The primary outcome was the proportion of unnecessarily repeated HBs antigen tests over the periods of the study. A test was considered unnecessary when it was ordered within 90 days after a previous test for the same patient. A ... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3380727 Fri, 19 Mar 2010 00:00:00 +0100 3380727 http://www.medworm.com/index.php?rid=3376093&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F68 Conclusion: Among person's not taking statins, the socio-economically disadvantaged are more likely to be eligible and among those on statins, the socio-economically disadvantaged are less likely to achieve statin treatment goals. Further study is needed to identify specific amenable patient and/or physician factors that contribute to these disparities. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3376093 Wed, 17 Mar 2010 00:00:00 +0100 3376093 http://www.medworm.com/index.php?rid=3371838&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F67 Conclusions: There is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with government paying for the poor. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3371838 Wed, 17 Mar 2010 00:00:00 +0100 3371838 http://www.medworm.com/index.php?rid=3364692&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F66 Conclusions: Our study provides information on the willingness of ED patients to accept reorientation and shows the limits of its feasibility. Alternative structures such as PCUs near the ED seem to respond appropriately to the growing demands of nonurgent patients. Reorientation, however, will be successful only if the new structures adapt their opening hours to the needs of nonurgent patients and if their physicians can perform specific technical skills. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3364692 Mon, 15 Mar 2010 00:00:00 +0100 3364692 http://www.medworm.com/index.php?rid=3363317&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F65 Conclusions: A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3363317 Sat, 13 Mar 2010 00:00:00 +0100 3363317 http://www.medworm.com/index.php?rid=3356291&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F64 Conclusions: There are significant public/private, urban/rural gaps in provision of services in Ecuador; which in turn affect people's use of services. It is necessary to strengthen the public health care delivery system (which includes addressing distribution of health workers) and national health information systems. These efforts could improve access to health care, and inform the civil society and policymakers on the advances of health care reform. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3356291 Fri, 12 Mar 2010 00:00:00 +0100 3356291 http://www.medworm.com/index.php?rid=3352083&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F63 Background: Burnout in the healthcare workers is formally defined as a state of physical, emotional and mental exhaustion caused by long-term involvement in situations that are emotionally demanding. Methods: Using a random stratified sampling method and taking into account geographical location, specialty and type of employment, 172 physiotherapists working both in the private and public sectors completed an anonymous questionnaire that included several aspects related to burnout; the MBI scale, questions related to occupational stress, and questions pertaining to self image. Results: Almost half (46%) of the 172 participants believed that their job is stressful. Approximately 57% of the physiotherapists who worked in the public sector and 40% of those who worked in the private sector (p=... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3352083 Thu, 11 Mar 2010 00:00:00 +0100 3352083 http://www.medworm.com/index.php?rid=3352084&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F62 DiscussionThe development of the CCTV training protocol and the design of the RCT in the present study may serve as an example to obtain an evidence-based training program. The training program was adjusted to the needs and learning abilities of individual patients, however, for scientific reasons it might have been preferable to standardize the protocol further, in order to gain more comparable results.Trial registration: www.trialregister.nl, identifier: NTR1031 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3352084 Wed, 10 Mar 2010 00:00:00 +0100 3352084 http://www.medworm.com/index.php?rid=3348295&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F60 Conclusions: Our experiential findings indicate that patient's adherence to home-based exercise is more likely to happen when care providers' style and the content of exercise programme are positively experienced. These findings provide additional information to health care providers, by showing which issues should be considered when delivering health care to patients presenting chronic neck or back pain. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3348295 Wed, 10 Mar 2010 00:00:00 +0100 3348295 http://www.medworm.com/index.php?rid=3348294&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F61 Conclusions: The nurse-led intervention was superior, resulting in an absolute increase of approximately 30% more people with SMI receiving screening for each CVD risk factor. The feasibility of the trial was confirmed in terms of CMHT recruitment and the intervention, but the response rate for outcome collection was disappointing; possibly a result of the cluster design. The trial was not large or long enough to detect changes in risk factors.International Standard Randomised Controlled Trial Registration Number (ISRCTRN) 58625025 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3348294 Wed, 10 Mar 2010 00:00:00 +0100 3348294 http://www.medworm.com/index.php?rid=3340510&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F59 Conclusions: Diabetic patients have higher rates of hospital admission and fatality rates during the hospitalization after an AMI than nondiabetic patients. Diabetic adults who have suffered an AMI have a greater than expected increase in direct hospital costs over the period 2001-2006. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3340510 Mon, 08 Mar 2010 00:00:00 +0100 3340510 http://www.medworm.com/index.php?rid=3340511&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F58 Conclusion: These STI case studies reveal the potential for expanding integrated syphilis/HIV services at public STI clinics in China. More health services research is needed to guide scale-up of syphilis/HIV testing in China. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3340511 Sun, 07 Mar 2010 00:00:00 +0100 3340511 http://www.medworm.com/index.php?rid=3336767&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F57 Conclusions: Health plans and other payers should address statistical uncertainty when they use physician cost-profiles to categorize physicians into low or high-cost tiers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3336767 Fri, 05 Mar 2010 00:00:00 +0100 3336767 http://www.medworm.com/index.php?rid=3333173&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F56 Conclusions: The economic costs generated by chronic fatigue are high and mostly borne by patients and their families. Enquiry about the functional consequences of fatigue on the social and occupational lives of patients may help doctors understand the impact of fatigue, and make patients feel better understood. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3333173 Thu, 04 Mar 2010 00:00:00 +0100 3333173 http://www.medworm.com/index.php?rid=3328792&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F55 Conclusions: In the light of patient's experiences the DMP enhances the process quality of medical care for type 2 diabetes in Germany. The lack of significant differences in outcome quality between enrolled and not enrolled patients might be due to the short program duration. Our data suggest that the DMP for type 2 diabetes should not be withdrawn unless an evidently more promising approach is found. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3328792 Wed, 03 Mar 2010 00:00:00 +0100 3328792 http://www.medworm.com/index.php?rid=3315589&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F54 This study evaluates behavioral outcomes associated with a new approach - the Government Social Franchise (GSF) model - developed to improve RHFP service quality and capacity in Vietnam's commune health stations (CHSs). Methods: The project involved networking and branding 36 commune health station (CHS) clinics in two central provinces of Da Nang and Khanh Hoa, Vietnam. A quasi-experimental design with 36 control CHSs assessed GSF model effects on client use as measured by: 1) clinic-reported client volume; 2) the proportion of self-reported RHFP service users at participating CHS clinics over the total sample of respondents; and 3) self-reported RHFP service use frequency. Monthly clinic records were analyzed. In addition, household surveys of 1,181 CHS users and potential users were con... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3315589 Sun, 28 Feb 2010 00:00:00 +0100 3315589 http://www.medworm.com/index.php?rid=3313137&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F53 Conclusions: The reporting of patient deaths to the police by physicians increased significantly from 1998 to 2008 while those made by next-of-kin and others did not. The resulting criminal prosecutions of healthcare providers increased significantly during the same time period. The reasons for these increases are unclear and should be the focus of future research. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3313137 Fri, 26 Feb 2010 00:00:00 +0100 3313137 http://www.medworm.com/index.php?rid=3308865&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F52 Conclusions: If answering calls was a high priority among nursing tasks, staff would perceive calls as being important, requiring nursing staff's attention, and being meaningful. Therefore, answering calls should not be perceived as preventing staff from doing the critical aspects of their role. Additional efforts are necessary to reach the ideal or even a reasonable level of patient safety-first practice in current hospital environments. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3308865 Fri, 26 Feb 2010 00:00:00 +0100 3308865 http://www.medworm.com/index.php?rid=3304352&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F50 DISCUSSIONThe baseline cohort includes 10,498 Australian doctors, representing an overall response rate of 19.36%. This includes 3,906 general practitioners, 4,596 specialists, 1,072 specialists in training, and 924 hospital non-specialists. Respondents were more likely to be younger, female, and to come from non-metropolitan areas, the latter partly reflecting the effect of a financial incentive on response for doctors in remote and rural areas. Specialists and specialists in training were more likely to respond, whilst hospital non-specialists were less likely to respond. The distribution of hours worked was similar between respondents and data from national medical labour force statistics. The MABEL survey provides a large, representative cohort of Australian doctors. It enables investi... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3304352 Thu, 25 Feb 2010 00:00:00 +0100 3304352 http://www.medworm.com/index.php?rid=3304351&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F51 Conclusions: This study corroborates previous reports of frequent physical and verbal aggression towards care workers in the various areas of health care. The present study highlights differences between various areas of health care in Germany and the aggravating effect of prevention neglect such as missing social support at the workplace. Therefore our data suggest the need for improved target group specific prevention of aggressive incidents towards care workers and the need for effective aftercare in Germany. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3304351 Thu, 25 Feb 2010 00:00:00 +0100 3304351 http://www.medworm.com/index.php?rid=3296253&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F48 Conclusion: Our population-based study suggested that women's treatment decisions might be shaped by the information provided by physicians, and that women might request different information from their physicians based on their preferred treatment options. These results might need to be confirmed in other studies of treatment decisions. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3296253 Tue, 23 Feb 2010 00:00:00 +0100 3296253 http://www.medworm.com/index.php?rid=3296252&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F49 This study is intended to determine not only the components and processes, but also the possible effectiveness of this set of health interventions, and contribute to the evidence base about smoking cessation interventions aimed at priority groups in Scotland. It is also anticipated that this study will contribute to the ongoing debate about the role and challenges of 'realist' evaluation approaches in general, and the utility of logic modelling and TOC approaches in particular, for evaluation of complex health interventions. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3296252 Tue, 23 Feb 2010 00:00:00 +0100 3296252 http://www.medworm.com/index.php?rid=3296255&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F46 Conclusions: Asking whether someone ever had a time when they needed healthcare but did not receive it can either underestimate or overestimate unmet need. Measuring unmet need using single items is likely insufficient since more detail in a revised question could begin to clarify whether the reporting of an unmet need was based on an expectation or a clinical need. Who defines what an unmet healthcare need is depends on the context (insured versus uninsured health services, experience in two or more healthcare systems versus experience in one healthcare system) and who is defining it (provider, patient, insurer). (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3296255 Mon, 22 Feb 2010 00:00:00 +0100 3296255 http://www.medworm.com/index.php?rid=3296254&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F47 Conclusion: Chronic disease care is a joint commitment by health care providers and patients. This combined approach proved successful in most areas of the project, but the area of patient self management requires further improvement. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3296254 Mon, 22 Feb 2010 00:00:00 +0100 3296254 http://www.medworm.com/index.php?rid=3292954&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F45 Conclusion: Our study has found that the role of European patient organisations in the reimbursement process is still limited, especially for small patient organisations. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3292954 Mon, 22 Feb 2010 00:00:00 +0100 3292954 http://www.medworm.com/index.php?rid=3285679&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F42 Conclusion: This study demonstrates that routine data in African health facilities can be used to monitor antiretroviral adherence at the patient and system level. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3285679 Fri, 19 Feb 2010 00:00:00 +0100 3285679 http://www.medworm.com/index.php?rid=3285678&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F43 Conclusions: Field tests showed that data to measure adherence can be collected systematically from health facilities in resource-poor settings. Most patients and facilities showed high levels of adherence; however, poor levels of performance in some facilities provide a target for quality improvement efforts. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3285678 Fri, 19 Feb 2010 00:00:00 +0100 3285678 http://www.medworm.com/index.php?rid=3285677&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F44 Conclusions: Utilization of advanced brain imaging and invasive diagnostic testing was greater at the university hospital, but was not associated with improved clinical outcomes. This could not be explained on the basis of stroke severity or patient characteristics. This variation of practice suggests substantial opportunities exist to reduce costs and improve efficiency of diagnostic resource use as well as reduce patient exposure to risk from diagnostic procedures. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3285677 Fri, 19 Feb 2010 00:00:00 +0100 3285677 http://www.medworm.com/index.php?rid=3285681&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F40 Conclusion: The results of the present study reflect socially-rooted gender role stereotypes. Taking into account the feminization of medicine, special attention needs to be paid to female physicians, especially those with children. At an early stage of their career, they should be advised to be more proactive in seeking mentoring and career-planning opportunities. If gender equity in terms of career chances is to be achieved, special career-support measures will have to be provided, such as mentoring programs, role models, flexitime and flexible career structures. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3285681 Thu, 18 Feb 2010 00:00:00 +0100 3285681 http://www.medworm.com/index.php?rid=3285680&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F41 Conclusions: The linkage strategy described in this paper has allowed the linking of multiple large aged care service datasets using a statistical linkage key while allowing for variation in its reporting. More widely, our deterministic algorithm, based on statistical properties of match keys, is a useful addition to the linker's toolkit. In particular, it may prove attractive when insufficient data are available for clerical review or follow-up, and the researcher has fewer options in relation to probabilistic linkage. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3285680 Thu, 18 Feb 2010 00:00:00 +0100 3285680 http://www.medworm.com/index.php?rid=3274081&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F39 This study will be able to evaluate the clinical and cost impact of a comprehensive program on continuity of care and associated patient safety.Trial registrationDutch trial register: NTR1519 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3274081 Tue, 16 Feb 2010 00:00:00 +0100 3274081 http://www.medworm.com/index.php?rid=3260740&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F38 The objective of this study was to assess the effects of non-response in the Norwegian part of the Commonwealth Fund international health policy survey in 2009. Methods: As part of an international health policy survey in 2009 a cross-sectional survey was conducted in Norway among a representative sample of Norwegian general practitioners. 1 400 randomly selected GPs were sent a postal questionnaire including questions about the Norwegian health care system, the quality of the GPs' own practice and the cooperation with specialist health care. The survey included three postal reminders and a telephone follow-up of postal non-respondents. The main outcome measures were increase in response rate for each reminder, the effects of demographic and practice variables on response, the effects of n... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3260740 Wed, 10 Feb 2010 00:00:00 +0100 3260740 http://www.medworm.com/index.php?rid=3256717&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F37 Conclusions Overall, GPs used the open access echocardiography service efficiently (i.e. with a high chance of finding relevant pathology), but efficiency decreased slightly over the years. To meet the needs of the GPs, indications might be widened with 'suspicion LVH'. Further specification of the indications for open access echocardiography - by defining a stepwise diagnostic approach including ECG and (NT-pro)BNP - might improve the service. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3256717 Wed, 10 Feb 2010 00:00:00 +0100 3256717 http://www.medworm.com/index.php?rid=3256718&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F36 DiscussionThe primary aim of the trial is to determine whether a communication skills training intervention for specialist paediatric diabetes teams will improve clinical and psychological outcomes for young people with type 1 diabetes. Previous research indicates the effectiveness of specialist psychological interventions in achieving sustained improvements in glycaemic control. This trial will evaluate an intervention which does not require the involvement of trained psychologists, maximising the potential feasibility of delivery in a wider NHS context.Trial registrationCurrent Controlled Trials ISRCTN61568050. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3256718 Tue, 09 Feb 2010 00:00:00 +0100 3256718 http://www.medworm.com/index.php?rid=3252340&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F35 Conclusions: The GPs' suggestions are in line with international research and debate. It is thought-provoking that the majority of GPs call for increased capacity in secondary care, and also better collaboration with secondary care. Some GPs made comparisons to the health care system for physical disorders, which is described as better-functioning. Our study identified no simple short-term cost-effective interventions likely to improve treatment for mental disorders within primary health care. Under-treatment of mental disorders is, however, also associated with significant financial burdens. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3252340 Tue, 09 Feb 2010 00:00:00 +0100 3252340 http://www.medworm.com/index.php?rid=3245455&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F34 This study aims to test a specific intervention package that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications - Hypertension Adherence Program in Pharmacy (HAPPY). Methods: The HAPPY trial is a multi-centre prospective randomised controlled trial. Fifty-six pharmacies have been recruited from three Australian states. To identify potential patients, a software application (MedeMine CVD) extracted data from a community pharmacy dispensing software system (FRED Dispense(R)). The pharmacies have been randomised to either 'Pharmacist Care Group' (PCG) or 'Usual Care Group' (UCG). To check for 'Hawthorne effect' in the UCG, a third group of patients 'Hidden Control Group' (HCG) will be... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3245455 Fri, 05 Feb 2010 00:00:00 +0100 3245455 http://www.medworm.com/index.php?rid=3252341&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2Fbmchealthservres%2F Background: Clinimetric data for the fire fighting simulation test (FFST), a new test proposed for the Workers' Health Surveillance (WHS) of Dutch fire fighters, were evaluated. Methods: Twenty-one fire fighters took the FFST three times with one and three weeks between testing. Clinimetric quality was determined by means of reliability, agreement and validity. For reliability and agreement, the intraclass correlation coefficient (ICC), and standard error of measurement (SEM), were analysed. For construct validity, the tests from 45 fire fighters were correlated with their own and their supervisors' rated work ability. Results: The ICCs were 0.56 and 0.79 at the one-week and three-week test-retest periods, respectively. Testing times ranged from 9 to 17 minutes; the SEMs were 70 s at the o... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3252341 Thu, 04 Feb 2010 00:00:00 +0100 3252341 http://www.medworm.com/index.php?rid=3237538&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F32 Background: Clinimetric data for the fire fighting simulation test (FFST), a new test proposed for the Workers' Health Surveillance (WHS) of Dutch fire fighters, were evaluated. Methods: Twenty-one fire fighters took the FFST three times with one and three weeks between testing. Clinimetric quality was determined by means of reliability, agreement and validity. For reliability and agreement, the intraclass correlation coefficient (ICC), and standard error of measurement (SEM), were analysed. For construct validity, the tests from 45 fire fighters were correlated with their own and their supervisors' rated work ability. Results: The ICCs were 0.56 and 0.79 at the one-week and three-week test-retest periods, respectively. Testing times ranged from 9 to 17 minutes; the SEMs were 70 s at the o... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3237538 Thu, 04 Feb 2010 00:00:00 +0100 3237538 http://www.medworm.com/index.php?rid=3237537&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F33 Conclusion: CHI is perceived as a relevant policy option and potential source of funds for health care. It is also considered a means of raising the quality of health care in both public and private health units. To assess whether it is also feasible to introduce CHI in the public sector, there is an urgent need to investigate the willingness and readiness of stakeholders, in particular high level political authorities, to follow this new path. The current ambiguity and contradictions in the health financing policy of the Uganda MOH need to be addressed and clarified. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3237537 Thu, 04 Feb 2010 00:00:00 +0100 3237537 http://www.medworm.com/index.php?rid=3225944&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F31 Conclusions: Poor agreement between administrative and survey data for IBS may account for differences in the results of health services and outcomes research using these sources. Further research is needed to identify the optimal method(s) to ascertain IBS cases in both data sources. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3225944 Mon, 01 Feb 2010 00:00:00 +0100 3225944 http://www.medworm.com/index.php?rid=3221935&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F30 Conclusions: Although residents require a similar intensive level of nursing home care, their characteristics differ among small-scale living facilities and regular psychogeriatric wards. These differences may limit research into effects and feasibility of various types of dementia care settings. Therefore, these studies should take resident characteristics into account in their design, for example by using a matching procedure. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3221935 Fri, 29 Jan 2010 00:00:00 +0100 3221935 http://www.medworm.com/index.php?rid=3218492&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F29 Conclusions: Uptake of PMTCT services in resource-limited settings can be improved by utilizing innovative alternatives to mitigate the effects of human resource shortage such as by providing technical assistance and mentorship beyond regular training courses, integrating PMTCT services into existing maternal and child health structures, addressing information gaps, mobilizing traditional and opinion leaders and building strong relationships with the government. These health system based approaches provide a sustainable improvement in the capacity and uptake of services. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3218492 Thu, 28 Jan 2010 00:00:00 +0100 3218492 http://www.medworm.com/index.php?rid=3214197&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F28 Conclusion: The Turkish version of HSOPS was found to be valid and reliable in determining patient safety culture. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Turkey. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3214197 Thu, 28 Jan 2010 00:00:00 +0100 3214197 http://www.medworm.com/index.php?rid=3210104&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F27 Conclusions: In this nationwide study, quality of colorectal cancer care still shows room for improvement. These preliminary results indicate that core measures for cancer can be developed systematically and applied for internal quality improvement. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3210104 Wed, 27 Jan 2010 00:00:00 +0100 3210104 http://www.medworm.com/index.php?rid=3206428&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F26 DiscussionNew forms of evidence give a triangulated understanding about the promotion of well-being in mental health services. The academic discipline of positive psychology is developing evidence-based interventions to improve well-being. This complements the results emerging from synthesising narratives about recovery from mental illness, which provide ecologically valid insights into the processes by which people experiencing mental illness can develop a purposeful and meaningful life. The implications for health professionals are explored. In relation to working with individuals, more emphasis on the person's own goals and strengths will be needed, with integration of interventions which promote well-being into routine clinical practice. In addition, a more societally-focussed role for... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3206428 Tue, 26 Jan 2010 00:00:00 +0100 3206428 http://www.medworm.com/index.php?rid=3206429&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F25 This study was conducted in four CHCs using a quasi experimental study design. Two comparison sites offered usual care ("expanded vital sign" chart stamp that prompted providers to ask about tobacco use, advice smokers to quit, assess readiness, and offer assistance (4As)) and two intervention sites received the chart stamp plus an office-based fax referral link to the New York State Quitline. The fax referral system links patients to a free proactive telephone counseling service. Provider adherence to the 4 As was assessed with 263 pre and 165 post cross sectional patient exit interviews at all four sites. Results: Adherence to the 4As increased significantly over time in the intervention sites with no change from baseline in the comparison sites. Intervention sites were 2.4 (p (Source: B... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3206429 Mon, 25 Jan 2010 00:00:00 +0100 3206429 http://www.medworm.com/index.php?rid=3202726&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F24 Conclusion: This case suggests that a well-balanced HRM bundle can stimulate organisational commitment of health workers. Such practices can be implemented even with narrow decision spaces. Realist evaluation provides an appropriate approach to increase the usefulness of case studies to managers and policymakers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3202726 Mon, 25 Jan 2010 00:00:00 +0100 3202726 http://www.medworm.com/index.php?rid=3199317&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F23 Background: The increasing demand on hospitalisation, either due to elective activity from the waiting lists or due to emergency admissions coming from the Emergency Department (ED), requires looking for strategies that lead to effective bed management. The aim of this study was to evaluate the effectiveness of a surgery admission unit for major elective surgery patients who were admitted for same-day surgery. Methods: We included all patients admitted for elective surgery in a university tertiary hospital between the 1st of September and the 31st of December 2006, as well as those admitted during the same period of 2008, after the introduction of the Surgery Admission Unit. The main outcome parameters were global length of stay, pre-surgery length of stay, proportion of patients admitted ... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3199317 Fri, 22 Jan 2010 00:00:00 +0100 3199317 http://www.medworm.com/index.php?rid=3195538&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F22 Conclusion: Understandably, pharmacy spending is more predictable using pharmacy-based risk markers compared with diagnosis-based risk markers. Pharmacy-based PMs can assist plan administrators and medical directors in planning the health budget and identifying high-cost-risk patients amenable to care management programs. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3195538 Thu, 21 Jan 2010 00:00:00 +0100 3195538 http://www.medworm.com/index.php?rid=3191111&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F21 Conclusion: The views of GPs on safety and risk in primary care did not completely match those presented in published papers and policy documents. The GPs in the present study judged a broader range of factors than in previously published research on patient safety in primary care, including a poor doctor-patient relationship, to pose a potential threat to patient safety. Other risk factors such as infection prevention, deviation from guidelines and incident reporting were judged to be less relevant than by policy makers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3191111 Thu, 21 Jan 2010 00:00:00 +0100 3191111 http://www.medworm.com/index.php?rid=3191112&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F20 Conclusions: This experience demonstrates how drawing upon existing instruments can inspire and rationalize the process of developing a new, tailor-made instrument. Two tools that came out of this experience can be useful to other teams: a conceptual framework for the quality of obstetric care and an analysis grid of existing evaluation instruments. These provide an easily accessible synthesis of the literature and are useful in integrating it with the context-specific knowledge of local actors, resulting in evaluation instruments that have both scientific and local legitimacy. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3191112 Wed, 20 Jan 2010 00:00:00 +0100 3191112 http://www.medworm.com/index.php?rid=3183693&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F18 Conclusions: This study represents one step in the quality improvement process. The interviews encouraged reflection by staff. We obtained valuable data which have been used to plan behaviour change interventions addressing identified barriers. Our methods may assist other researchers who need to design similar behaviour change interventions. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3183693 Tue, 19 Jan 2010 00:00:00 +0100 3183693 http://www.medworm.com/index.php?rid=3183692&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F19 Conclusions: Although studies did not fulfil all criteria of the CHEC-list, collaborative care is a promising intervention and it may be cost-effective. However, to conclude on the cost-effectiveness, depression research should follow economic guidelines to improve the quality of the economic evaluations. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3183692 Tue, 19 Jan 2010 00:00:00 +0100 3183692 http://www.medworm.com/index.php?rid=3179698&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F17 Conclusion: Comparative qualitative studies of GPs attitudes to clinical guidelines may reveal cross-national differences relating to the varying histories of guideline development. Further studies are needed to explore this hypothesis. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3179698 Sat, 16 Jan 2010 00:00:00 +0100 3179698 http://www.medworm.com/index.php?rid=3177429&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F16 Conclusions: This cross-cultural adaptation has produced an Italian Question Prompt List that is now available for multi-center international studies and can be safely used with Italian-speaking cancer patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3177429 Fri, 15 Jan 2010 00:00:00 +0100 3177429 http://www.medworm.com/index.php?rid=3173804&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F14 Conclusions: Assessing and enhancing the broader evaluation culture of IHC clinics prior to implementing outcomes research may be a critical step towards ensuring productive and cost-effective research programs. However, as IHC clinics are often complex systems, a whole systems approach to research should be used taking into account the multidimensional and complex nature of such treatment systems so that the results are useful and reflect real life. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3173804 Thu, 14 Jan 2010 00:00:00 +0100 3173804 http://www.medworm.com/index.php?rid=3173803&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F15 Conclusions: Despite potentially negative policy and market changes during the 1990s, safety net activities do not appear to have imperiled the survival of hospitals. There may, however, be concerns about the long-term quality of the services for hospitals serving low socioeconomic population. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3173803 Thu, 14 Jan 2010 00:00:00 +0100 3173803 http://www.medworm.com/index.php?rid=3161322&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F12 This study will undertake an analysis of the effectiveness of a multidisciplinary intervention compared to usual clinical care to reduce disability, severity of pain, anxiety and depression, and to improve quality of life, reducing incidence of chronic low back pain in the working population with non-specific low back pain. Methods: A Cluster randomised clinical trial will be conducted in 38 Primary Health Care Centres located in Barcelona, Spain and surrounding area. They are randomly allocated to a multidisciplinary intervention or usual clinical care. Patients between 18 and 65 years old (n=932; 466 per arm) and with a diagnostic of a non-specific sub-acute low back pain are included. Patients in the intervention group are receiving the recommendations of clinical practice guidelines, i... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3161322 Tue, 12 Jan 2010 00:00:00 +0100 3161322 http://www.medworm.com/index.php?rid=3161321&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F13 Conclusions: Since 51% of prescribing errors occurred on the first day of stay, pharmacist should concentrate his analysis of drug prescriptions on this day. The difference of overriding behavior between wards and according drug Anatomical Therapeutic Chemical class or type of error could also guide the validation tasks and programming of electronic alerts. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3161321 Tue, 12 Jan 2010 00:00:00 +0100 3161321 http://www.medworm.com/index.php?rid=3158560&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F11 Conclusions: Although gains in life expectancy may be modest at the individual level, the results indicate that prophylactic HPV vaccination of preadolescent girls in Taiwan would result in substantial population benefits with a favorable cost-effectiveness ratio. Nevertheless, we should not overlook the urgency to improve the compliance rate of cervical screening, particularly for older individuals. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3158560 Mon, 11 Jan 2010 00:00:00 +0100 3158560 http://www.medworm.com/index.php?rid=3158561&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F10 Background: Tajikistan has the highest incidence rate of tuberculosis (TB) in Central Asia. Its health system still bears many features from Soviet times and is under-funded. Affordability is a major barrier to health care. Little is known about health care seeking of TB patients in post-Soviet countries and their delay until the start of TB therapy. The low estimated case detection rate in Tajikistan suggests major problems with access to care and consequently long delays are likely. Methods: The study investigated extent and determinants of patient and health system delays for TB. A questionnaire was administered to a cohort of TB patients in twelve study districts representing a wide range of conditions found in Tajikistan. Common patterns of health care seeking were analysed. Cox propo... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3158561 Sun, 10 Jan 2010 00:00:00 +0100 3158561 http://www.medworm.com/index.php?rid=3154759&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F9 Conclusions: HDAD might be a helpful tool for cancer registries to reach their goals. The findings suggest that, for automating cancer registries, algorithms combining diagnoses and procedures are the best option. However, for cancer surveillance purposes, in those cancers like prostate cancer in which care is not only hospital-based, combining inpatient and outpatient information will be required. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3154759 Fri, 08 Jan 2010 00:00:00 +0100 3154759 http://www.medworm.com/index.php?rid=3150853&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F8 Conclusions: The improvement programme proved to have moderate impact on patient care. Its effectiveness should be tested in a larger rigorous evaluation study using modifications based on the pilot experiences. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3150853 Fri, 08 Jan 2010 00:00:00 +0100 3150853 http://www.medworm.com/index.php?rid=3150854&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F7 Conclusions: The results indicated that the layout of a process map does influence perceptions of quality and safety problems in a process. In quality improvement work it is important to carefully consider the type of process map to be used and to consider using more than one map to ensure that different aspects of the process are captured. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3150854 Thu, 07 Jan 2010 00:00:00 +0100 3150854 http://www.medworm.com/index.php?rid=3147465&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F6 Conclusions: Variations in district allocations made using either the simple or composite indicators of socioeconomic status are not statistically different to recommend one over the other. However, the single variable indicator is favourable for its ease of computation. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3147465 Wed, 06 Jan 2010 00:00:00 +0100 3147465 http://www.medworm.com/index.php?rid=3144100&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F3 DiscussionEmpirical studies and social science theory are used to examine the utility of Wenger's concept. Its value lies in emphasizing learning from peers and through practice in settings where innovation is valued. Yet the communities of practice concept lacks conceptual clarity because Wenger defines it so broadly and sidelines issues of decision making within CoPs. We consider the implications of his broad definition to establishing an informed nomenclature around this specific type of collaborative group. The CoP Project under CPAC and communities of practice in Canadian health care are discussed.SummaryThe use of communities of practice in Canadian health care has been shown in some instances to facilitate quality improvements, encourage buy in among participants, and generate high ... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3144100 Tue, 05 Jan 2010 00:00:00 +0100 3144100 http://www.medworm.com/index.php?rid=3144099&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F4 Conclusions: No significant differences were found between the health and social outcomes of patients in the mental health nurse supplementary prescribers' group, and those prescribed for by the independent medical prescribers. The cost appraisal also showed that there was no significant difference in the costs of the two types of prescribing, although the pattern of resources used differed between patients in the two prescriber groups. The results suggest that mental health nurse supplementary prescribers can deliver similar health benefits to patients as consultant psychiatrists without any significant difference in patients' service utilisation costs. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3144099 Tue, 05 Jan 2010 00:00:00 +0100 3144099 http://www.medworm.com/index.php?rid=3144098&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F5 Conclusion: We found that there remained significant regional disparities in access to coronary angiography after accounting for clinical need. These disparities are partially explained by variations in supply of both procedural capacity and physician services, most notably in elective and semi-urgent patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3144098 Tue, 05 Jan 2010 00:00:00 +0100 3144098 http://www.medworm.com/index.php?rid=3140292&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F2 Conclusions: From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown. Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3140292 Mon, 04 Jan 2010 00:00:00 +0100 3140292 http://www.medworm.com/index.php?rid=3138200&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F10%2F1 Conclusions: Despite a seemingly well-organised system for transition of patients from the GEMU to their homes, one or more unwanted incidents occurred in most patients during discharge or four weeks post discharge. The study has revealed areas of importance for improving transitional care of geriatric patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3138200 Mon, 04 Jan 2010 00:00:00 +0100 3138200 http://www.medworm.com/index.php?rid=3134606&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F247 Conclusions: Network analyses provide useful ways to assess social structures in clinical settings by allowing us to understand how ED staff relate within their social and professional structures. This can provide insights of potential benefit to ED staff, their leaders, policymakers and researchers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3134606 Thu, 31 Dec 2009 00:00:00 +0100 3134606 http://www.medworm.com/index.php?rid=3127763&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F245 Conclusions: A complex, hospital-based, interdisciplinary intervention in a large health care organization spread rapidly due to a synergy between organizational 'push' strategies and grassroots-level pull. The combination of push and pull may be especially important when the organizational context or the practice to be spread is complex. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3127763 Tue, 29 Dec 2009 00:00:00 +0100 3127763 http://www.medworm.com/index.php?rid=3127762&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F246 Conclusions: Four out of five persons in a sample of adult Canadians reported they would support a tax increase to fund unrestricted access to a hypothetical, new AD medication. These results signal a willingness to pay for at least some relaxation of reimbursement restrictions on AD medications. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3127762 Tue, 29 Dec 2009 00:00:00 +0100 3127762 http://www.medworm.com/index.php?rid=3125472&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F244 Conclusion: Early in their experience with a deductible, patients had limited awareness of the deductible and little knowledge of the details. Many who knew of the deductible reported that it would cause them to delay or avoid seeking care and were concerned about their healthcare costs. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3125472 Tue, 29 Dec 2009 00:00:00 +0100 3125472 http://www.medworm.com/index.php?rid=3112952&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F243 Conclusion: The results indicate that the WHO developed responsiveness elements are relevant and important in measuring the performance of voluntary HIV counselling and testing. However, the tool needs substantial revision in order to capture other important dimensions or perspectives. The findings also confirm the importance of careful assessment and recognition of locally specific aspects when conducting comparative studies on responsiveness of HIV testing services. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3112952 Tue, 22 Dec 2009 00:00:00 +0100 3112952 http://www.medworm.com/index.php?rid=3109434&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F242 Conclusions: These findings add new perspectives to the understanding of continuity within chronically ill children's health care. They are relevant to contemporary initiatives to improve continuity of services to children with special health care needs, demonstrate the need for parental support of their important role in maintaining continuity, and suggest avenues for further research. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3109434 Mon, 21 Dec 2009 00:00:00 +0100 3109434 http://www.medworm.com/index.php?rid=3107538&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F240 Conclusions: We observed very few differences among Hispanics respondents as a function of their ethnic subgroup designation. While our findings somewhat contradict previous research, they do suggest that other underlying factors may influence the quality of perceived interactions with healthcare providers. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3107538 Mon, 21 Dec 2009 00:00:00 +0100 3107538 http://www.medworm.com/index.php?rid=3107537&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F241 Conclusions: Laboratory parameters showed good agreement and non-laboratory acceptable agreement of the SRP with the EMR. Data from a structured registration program can be used validly for research purposes and quality assessment in general practice. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3107537 Mon, 21 Dec 2009 00:00:00 +0100 3107537 http://www.medworm.com/index.php?rid=3103167&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F239 Conclusions: The results of this research suggest that the SERVQUAL instrument is a useful measurement tool in assessing and monitoring service quality in kidney disease screening services, enabling the staff to identify where service improvements are needed from the patients' perspectives. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3103167 Sat, 19 Dec 2009 00:00:00 +0100 3103167 http://www.medworm.com/index.php?rid=3103169&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F237 Conclusion: Claim signatures for HF vary greatly in their relative sensitivity and specificity. These findings may facilitate efforts to identify HF patients for research and quality improvement efforts. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3103169 Fri, 18 Dec 2009 00:00:00 +0100 3103169 http://www.medworm.com/index.php?rid=3103168&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F238 Conclusions: Managerial and policy implications emerged mainly related to the support to GPs in the provision of high quality primary care and decision-making processes in promoting similar services. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3103168 Fri, 18 Dec 2009 00:00:00 +0100 3103168 http://www.medworm.com/index.php?rid=3094257&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F236 Background: Body mass index (BMI) will be a reportable health measure in the United States through implementation of Healthcare Effectiveness Data and Information Set (HEDIS) guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network. Methods: We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m^2), overweight (OW, 25-29.9), and obese (OB, [greater than or equal to]30). We measured documentation (yes/no) and control (above/below) of the following three risk factors: blood pressure (BP) [less than or equal to]130 / [... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3094257 Wed, 16 Dec 2009 00:00:00 +0100 3094257 http://www.medworm.com/index.php?rid=3090983&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F232 Conclusions: The new standards have proven feasible and posed reasonable challenges in the pilot study. We hope the new standards will strengthen teaching and research, and improve the quality of hospital services at the same time. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3090983 Tue, 15 Dec 2009 00:00:00 +0100 3090983 http://www.medworm.com/index.php?rid=3090982&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F233 We describe the rationale, design, and characteristics of the baseline cohort of the first randomized clinical trial to study the impact of group versus individual hearing aid fitting and follow-up visits. Methods: Participants were recruited from the VA Puget Sound Health Care System Audiology Clinic. Eligible patients had no previous hearing aid use and monaural or binaural air-conduction hearing aids were ordered at the evaluation visit. Participants were randomized to receive the hearing aid fitting and the hearing aid follow-up in an individual or group visit. The primary outcomes were hearing-related function, measured with the first module of the Effectiveness of Aural Rehabilitation (Inner EAR), and hearing aid adherence. We tracked the total cost of planned and unplanned audiology... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3090982 Tue, 15 Dec 2009 00:00:00 +0100 3090982 http://www.medworm.com/index.php?rid=3090981&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F234 Conclusions: To date, no completely satisfactory measures of organizational context are available for use in healthcare. The ACT assesses several core domains to provide a comprehensive account of organizational context in healthcare settings. The tool's strengths are its brevity (allowing it to be completed in busy healthcare settings) and its focus on dimensions of organizational context that are modifiable. Refinements of the instrument in acute, long term care, and home care settings are ongoing. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3090981 Tue, 15 Dec 2009 00:00:00 +0100 3090981 http://www.medworm.com/index.php?rid=3090980&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F235 Conclusions: The clinicians in these eleven very different hospitals want evidence-based guidelines. However they are frustrated by guideline development processes that are enormously time, skill and resource intensive. They feel strongly that "there's got to be a better way".The fact that the great majority of the identified barriers were shared across settings may provide an opportunity to develop a more pragmatic way of developing guidelines that can be applied in many contexts. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3090980 Tue, 15 Dec 2009 00:00:00 +0100 3090980 http://www.medworm.com/index.php?rid=3086775&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F231 Background: Previous evidence indicates potential variation in the quality of care of cancer patients. We aimed to examine whether recent changes in the treatment of oesophagogastric cancers have been distributed equally among different patient subgroups.MethodWe analysed population-based cancer registry data about the treatment patterning of oesophagogastric cancer (other than oesophageal squamous cell carcinoma) during 1995-2006. Results: There were 14,077 patients aged [greater than or equal to]40 years (69% men). There was only limited information on stage, and no information on co-morbidity status. During successive triennia, curative surgery use decreased from 28% to 20% (p (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3086775 Tue, 15 Dec 2009 00:00:00 +0100 3086775 http://www.medworm.com/index.php?rid=3080805&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F230 Conclusions: We found that a considerable proportion of farmers were satisfied with the NRCMS. Gender, age, and self-rated health status had significant effects on farmers' attitudes towards the NRCMS. The Chinese Central Government attempted to adopt active measures in the future to continuously improve the NRCMS, including initiating educational programs, building new medical facilities and increasing financial investment. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3080805 Sat, 12 Dec 2009 00:00:00 +0100 3080805 http://www.medworm.com/index.php?rid=3077358&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F228 Conclusion: This work reaffirms the importance of routine medication reviews, especially in patients exposed to polypharmacy regimens with 7 or more drugs, including antiarrhythmics or antiparkinson drugs), in order to reduce the risk of fall-related injuries during nursing home stays. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3077358 Fri, 11 Dec 2009 00:00:00 +0100 3077358 http://www.medworm.com/index.php?rid=3077357&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F229 Conclusions: The PCQ-C has been found to be acceptable to carers and service providers having been used successfully in hospitals in England. It is ready for use to measure the aspects of care that need to be addressed to improve the quality of prostate cancer care, and for research. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3077357 Fri, 11 Dec 2009 00:00:00 +0100 3077357 http://www.medworm.com/index.php?rid=3077359&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F227 Background: Analyses of utilization trends (cost drivers) allow us to understand changes in colorectal cancer (CRC) costs over time, better predict future costs, identify changes in the use of specific types of care (eg, hospice), and provide inputs for cost-effectiveness models. This retrospective cohort study evaluated healthcare resource use among US Medicare beneficiaries diagnosed with CRC between 1992 and 2002.MethodCohorts included patients aged 66+ newly diagnosed with adenocarcinoma of the colon (n=52,371) or rectum (n=18,619) between 1992 and 2002 and matched patients from the general Medicare population, followed until death or December 31, 2005. Demographic and clinical characteristics were evaluated by cancer subsite. Resource use, including the percentage that used each type ... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3077359 Thu, 10 Dec 2009 00:00:00 +0100 3077359 http://www.medworm.com/index.php?rid=3073291&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F226 Conclusions: Our methods break new ground by generating and synthesising multiple sources of evidence, connecting scientific understanding with the perspectives of users, in order to develop innovative ways to meet the mental health needs of under-served groups. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3073291 Thu, 10 Dec 2009 00:00:00 +0100 3073291 http://www.medworm.com/index.php?rid=3068922&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F224 This paper presents a Mixed Integer Programming (MIP) model for designing the layout of the Intensive Care Units' (ICUs) patient care space. In particular, this MIP model was developed for optimizing the layout for materials to be used in interventions.The first task was to identify the relevant information to define the characteristics of the new vehicles and, in particular, to obtain a satisfactory interior layout to locate all the necessary materials. This information was gathered from health workers related to ICUs. With that information an optimization model was developed in order to obtain a solution.From the MIP model, a first solution was obtained, consisting of a grid to locate the different materials needed for the ICUs. The outcome from the MIP model was discussed with health wo... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3068922 Tue, 08 Dec 2009 00:00:00 +0100 3068922 http://www.medworm.com/index.php?rid=3068921&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F225 Conclusions: Prescription drug utilization is much greater in Spanish children than in immigrant children, particularly with reference to bronchodilators (montelukast and terbutaline) and attention-disorder hyperactivity drugs such as Methylphenidate. There are important differences regarding drug type and depending on immigrants' geographical backgrounds that suggest there are social, cultural and access factors underlying these disparities.KeywordsEmigration and Immigration, health services, drug utilization, cross-sectional studies, health resources utilization, pediatrics (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3068921 Tue, 08 Dec 2009 00:00:00 +0100 3068921 http://www.medworm.com/index.php?rid=3062265&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F223 Conclusions: Patients adhering to the DM visit guidelines were less likely to use the ED for less-urgent problems. Maintaining normal A1c levels for their diabetes also has the positive impact to reduce less-urgent ED usages. It suggests that successful DM programs may reduce inappropriate ED use. In contrast to expectations, uninsured patients were less likely to use the ED for less-urgent care. Patients in the DM program with Medicaid coverage were 1.3 times more likely to seek care in the ED for non-emergencies while commercially insured patients were nearly1.7 times more likely to do so. Further research to understand inappropriate ED use among insured patients is needed. We suggest providing visit reminders, a call centre, or case managers to reduce the likelihood of less-urgent ED vi... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3062265 Mon, 07 Dec 2009 00:00:00 +0100 3062265 http://www.medworm.com/index.php?rid=3058433&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F222 Conclusion: Despite a common belief that patients seek care in the urgent care setting primarily for economic reasons, this study suggests that patients choose the urgent care setting based largely on convenience and more timely care. This information is especially applicable to the potential increase in urgent care volume in a universal healthcare system. Additionally, this study adds to the body of literature supporting the important role of timely primary care in healthcare maintenance. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3058433 Fri, 04 Dec 2009 00:00:00 +0100 3058433 http://www.medworm.com/index.php?rid=3054411&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F220 Conclusions In case of a request for euthanasia, in the Netherlands as well as in Belgium similar consultation services by independent qualified physicians have been developed. In countries where legalising physician-assisted death is being contemplated, the development of such a consultation provision could also be considered in order to safeguard the practice of euthanasia (as it can provide safeguards to adequate performance of euthanasia and assisted suicide). (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3054411 Fri, 04 Dec 2009 00:00:00 +0100 3054411 http://www.medworm.com/index.php?rid=3054410&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F221 Conclusions: Ambulatory office-based pediatric care provided by specialists includes a large share of non referred routine and preventive care for common problems for patients already known to the physician. It is likely that many of these services could be managed in primary care settings, lessening demand for specialists and improving coordination of care. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3054410 Fri, 04 Dec 2009 00:00:00 +0100 3054410 http://www.medworm.com/index.php?rid=3050078&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F218 Conclusions: The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3050078 Thu, 03 Dec 2009 00:00:00 +0100 3050078 http://www.medworm.com/index.php?rid=3050077&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F219 Conclusion: More than one third of the medical students and health care professionals showed problematic alcohol-drinking behaviour. Although the proportion of non-smokers in the investigated sample was higher than in the general population, when compared to the general population, medical students between 18-24 reported higher consumption of illegal substances.These results indicate that methods for educating and promoting healthy lifestyle, particularly with respect to excessive alcohol consumption, tobacco use and abuse of illegal drugs should be considered. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3050077 Thu, 03 Dec 2009 00:00:00 +0100 3050077 http://www.medworm.com/index.php?rid=3037854&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F217 Conclusions: The data present a map of greater interaction with and dependency on the health care system with advancing age. The magnitudes are substantial and indicate high demands on patients and families, on professional health care providers, and on the health care system itself. There is the need to create and evaluate innovative models of care of multiple chronic conditions in the late life course. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3037854 Mon, 30 Nov 2009 00:00:00 +0100 3037854 http://www.medworm.com/index.php?rid=3028122&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F216 Conclusion: A positive choice to remain in employment does not necessarily signal reluctance to care. Caring arrangements need to be understood from the common and separate interests of carers and the people they support. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3028122 Wed, 25 Nov 2009 00:00:00 +0100 3028122 http://www.medworm.com/index.php?rid=3024470&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F215 Conclusion: Intervention for mild Alzheimer's disease can be undertaken at a relatively low cost to public funds. However, policy planners should pay attention to the significant private costs associated with an intervention, which may ultimately pose a threat to equity in access to health care.Trial registration: Current Controlled Trials ISRCTN74848736. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3024470 Wed, 25 Nov 2009 00:00:00 +0100 3024470 http://www.medworm.com/index.php?rid=3014086&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F214 Conclusions: Health care utilisation patterns differ between insured and uninsured workers and insurance status appears to be a significant factor. The health insurance system is inequitably distributed amongst migrant workers. Younger less educated women who are paid less are more likely to be uninsured and therefore to pay out of pocket for their care. For greater equity this group need to be included in the insurance schemes as they develop. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3014086 Sat, 21 Nov 2009 00:00:00 +0100 3014086 http://www.medworm.com/index.php?rid=3010350&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F212 Conclusion: Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did not necessarily facilitate reforms in the hospital structure. Keeping politics at an arm's length may simply be unrealistic and further complicate the politics of local hospital reforms. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3010350 Fri, 20 Nov 2009 00:00:00 +0100 3010350 http://www.medworm.com/index.php?rid=3010349&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F213 Conclusion: The TPB is applicable to students' care delivery intentions in the context of HIV and AIDS across the two SSA countries investigated. It is suggested that attitudes, subjective norms, moral norms and perceived behavioural control are key factors in students' willingness to treat AIDS and HIV infected patients and should be targets of interventions aimed at promoting quality health care delivery in this context. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3010349 Fri, 20 Nov 2009 00:00:00 +0100 3010349 http://www.medworm.com/index.php?rid=3010351&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F211 This study is a cost analysis based on the findings of a multicenter prospective non-randomised study comparing two groups of nulliparous women with different preferences for where to give birth, at home or in a short-stay hospital setting. Data were collected using cost diaries, questionnaires and birth registration forms. Analysis of the data is divided into a base case analysis and a sensitivity analysis. Results: In the group of home births, the total societal costs associated with giving birth at home were E3,695 (per birth), compared with E3,950 per birth in the group for short-stay hospital births. Statistically significant differences between both groups were found regarding the following cost categories 'Cost of contacts with health care professionals during delivery' (E138.38 vs.... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3010351 Thu, 19 Nov 2009 00:00:00 +0100 3010351 http://www.medworm.com/index.php?rid=3006011&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F210 Conclusions: Lack of register data in 16 EU countries, shortage of data on healthcare utilization, and the diversity in the definition of migrant status hampers cross-national comparisons and calls for an urgent establishment of registers, expansion of the existing register information, and adoption of a common, generally acceptable definition and identification method of migrants across EU. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3006011 Wed, 18 Nov 2009 00:00:00 +0100 3006011 http://www.medworm.com/index.php?rid=3001715&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F208 Conclusion: Over the last years, the shelter-based convalescence care facility users were mainly homeless single males, around 45 years of age, with chronic problems due to substance use, mental health disorders and a frail physical condition, many of whom died a premature death. The facility has been flexible and responsive to the needs of the users and services available. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3001715 Wed, 18 Nov 2009 00:00:00 +0100 3001715 http://www.medworm.com/index.php?rid=3001714&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F209 Conclusions: Future investigations should be oriented toward strategies that involve GPs in the planning and management of drug cost control mechanisms. The proposals in this study may be considered by the health administration as a means to move toward the rational use of drugs while avoiding concerns about injustice and feelings of impotence on the part of the GPs, which can lead to lack of interest in and disaffection with the current measures. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=3001714 Wed, 18 Nov 2009 00:00:00 +0100 3001714 http://www.medworm.com/index.php?rid=2997476&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F207 Conclusions: In Hong Kong, most patients have chosen WM provided in the public sector as their sole outpatient service provider for NCD. Amongst TCM service users, middle aged NCD patients are more likely to choose both TCM and WM outpatient services. Meanwhile, older people without NCD are more likely to use TCM as their main form of care, but the size of this population group is small. These utilization patterns show that patients choose both modalities to manage their NCD and TCM should be considered within policies for supporting patients with NCD under the wider primary health and social care system that supports patient choice. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2997476 Tue, 17 Nov 2009 00:00:00 +0100 2997476 http://www.medworm.com/index.php?rid=2997477&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F206 Conclusion: A theory-driven program development process has resulted in the successful initial implementation of a fall prevention program. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2997477 Mon, 16 Nov 2009 00:00:00 +0100 2997477 http://www.medworm.com/index.php?rid=2986900&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F205 Background: Geriatric health is a neglected and under-explored area internationally and in Pakistan. We aimed to ascertain the expectations of the geriatric patients from their physicians and the factors associated with patient satisfaction in this particular age bracket. Methods: A cross-sectional survey was carried out at a tertiary care teaching hospital in Karachi, Pakistan. Data collection was carried out via face-to-face interviews based on structured, pre-tested questionnaires. All consenting individuals aged 65 years or above were recruited into the study. Convenience sampling was used to draw the sample. The data was analyzed using SPSS version 16. Geriatric patient's expectations from physicians were elicited using a set of questions that were graded on a scale of 1-3 where 1=not... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2986900 Fri, 13 Nov 2009 00:00:00 +0100 2986900 http://www.medworm.com/index.php?rid=2982914&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F204 Conclusion: There has been considerable progress in reforming oesophago-gastric cancer services but the process of reorganisation is still incomplete and regional differences in service provision exist that may lead to variation in patient outcomes. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2982914 Thu, 12 Nov 2009 00:00:00 +0100 2982914 http://www.medworm.com/index.php?rid=2982915&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F203 This study investigates the effects of an orientation program on levels of anxiety and self-efficacy amongst newly registered cancer patients who are about to undergo chemotherapy and/or radiation therapy in the cancer care centre of a large tertiary Australian hospital. Methods: The concept of interventions for orienting new cancer patients needs revisiting due to the dynamic health care system. Historically, most orientation programs at this cancer centre were conducted by one nurse. A randomised controlled trial has been designed to test the effectiveness of an orientation program with bundled interventions; a face-to-face program which includes introduction to the hospital facilities, introduction to the multi-disciplinary team and an overview of treatment side effects and self care st... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2982915 Wed, 11 Nov 2009 00:00:00 +0100 2982915 http://www.medworm.com/index.php?rid=2972608&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F202 Conclusions: The number of days spent in hospital after breast cancer surgery has continued to decline for several decades. The change from mastectomy to BCS accounts for only 9% of the overall decrease in LOS. Other explanations include the adoption of new techniques and practices, such as sentinel lymph node biopsy and early discharge. This study has identified wide variation in practice with substantial cost implications for the NHS. Further work is required to explain this variation. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2972608 Mon, 09 Nov 2009 00:00:00 +0100 2972608 http://www.medworm.com/index.php?rid=2971546&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F201 DiscussionA socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider explorations of ICT's potential benefits, yet firm evidence of the effects of role changes on health service outcomes is limited. This project will provide important evidence about the role of ICT in supporting new models of care delivery across multiple healthcare organizations and about the ... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2971546 Sun, 08 Nov 2009 00:00:00 +0100 2971546 http://www.medworm.com/index.php?rid=2968941&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F200 Conclusion: Road distance and travel time measurements are the most accurate estimates, but cannot be directly implemented in spatial analytical modeling. Euclidean distance tends to underestimate road distance and travel time; Manhattan distance tends to overestimate both. The optimized Minkowski distance partially overcomes their shortcomings; it provides a single model of travel over the network. The method is flexible, suitable for analytical modeling, and more accurate than the traditional metrics; its use ultimately increases the reliability of spatial analytical models. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2968941 Fri, 06 Nov 2009 00:00:00 +0100 2968941 http://www.medworm.com/index.php?rid=2961088&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F198 Conclusions: As the utilization of statins continues to grow, their impact on the health care system will continue to be important. Future studies are needed to continue to ensure that those who would realize significant benefit from the medication receive it. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2961088 Wed, 04 Nov 2009 00:00:00 +0100 2961088 http://www.medworm.com/index.php?rid=2961087&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F199 Conclusions: The PCQ-P has been found to be acceptable to patients and service providers, and is ready for use for the measurement of patient experience in routine practice, service improvement programmes, and research. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2961087 Wed, 04 Nov 2009 00:00:00 +0100 2961087 http://www.medworm.com/index.php?rid=2941331&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F197 DiscussionA search was conducted to explore the availability, accessibility and utility of publicly-accessible datasets in the MENA region. Although datasets were found in most countries in the region, those were limited in terms of their relevance, quality and public-accessibility. With rare exceptions, publicly-accessible datasets - as present in the developed world - were absent. Based on this, we proposed a gradual approach and a set of recommendations to promote the development and use of publicly-accessible datasets in the region. These recommendations target potential actions by governments, researchers, policy makers and international organizations.SummaryWe argue that the limited number of publicly-accessible datasets in the Middle East and North Africa (MENA) region represents a ... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2941331 Thu, 29 Oct 2009 00:00:00 +0100 2941331 http://www.medworm.com/index.php?rid=2936589&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F196 Conclusion: There is a considerable delay in TB case detection in Pwani mainly contributed by patients. Risk factors for delay include misconception about TB/HIV and poor knowledge of TB symptoms. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2936589 Thu, 29 Oct 2009 00:00:00 +0100 2936589 http://www.medworm.com/index.php?rid=2921862&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F195 Conclusion: There is clear value in developing a theoretical systems approach to achieving quality in health care. The introduction of the systematic surveyor-based search for improvements creates an adaptive-control system to optimize health care quality. It is hoped that these outcomes will stimulate further research in the development of strategic planning using systems theoretic approach for the improvement of quality in health care. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2921862 Fri, 23 Oct 2009 23:00:00 +0100 2921862 http://www.medworm.com/index.php?rid=2918054&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F194 Conclusion: We have developed quality indicators and criteria to evaluate registries for occupational diseases on the ability to provide appropriate information for preventive policy on a national level. Together, these indicators form a tool which can be used for quality improvement of registries of occupational diseases. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2918054 Thu, 22 Oct 2009 23:00:00 +0100 2918054 http://www.medworm.com/index.php?rid=2918055&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F193 DiscussionThe findings will provide new knowledge on how to improve blood pressure control and patient adherence in ethnic minority persons with a high risk of negative hypertension-related health outcomes.Trial registration: ISRCTN35675524 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2918055 Wed, 21 Oct 2009 23:00:00 +0100 2918055 http://www.medworm.com/index.php?rid=2914120&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F192 Conclusion: Task-shifting results in substantial cost and physician personnel savings in ART follow-up in Uganda and can contribute to mitigating the heath worker crisis. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2914120 Tue, 20 Oct 2009 23:00:00 +0100 2914120 http://www.medworm.com/index.php?rid=2910371&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F190 Conclusions: Patient fatigue, as reported by the QoL fatigue scale, was an independent significant predictor of overall patient satisfaction. This finding argues for special attention and programs for cancer patients who report higher levels of fatigue given that fatigue is the most frequently reported symptom in cancer patients. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2910371 Tue, 20 Oct 2009 23:00:00 +0100 2910371 http://www.medworm.com/index.php?rid=2910370&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F191 Conclusion: The study suggests that different interpretations of what constitutes health promotion can lead to unnecessary misunderstandings and pose barriers to further development of a health promoting practice. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2910370 Tue, 20 Oct 2009 23:00:00 +0100 2910370 http://www.medworm.com/index.php?rid=2903802&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F189 DiscussionThe main argument of the present paper is that current studies on patient delay do not sufficiently consider existing theories on symptom interpretation. It is illustrated that the interpretation of bodily sensations as symptoms related to a specific cancer diagnosis is embedded within a social and cultural context. We therefore cannot assume that respondents define delay periods in identical ways.SummaryIn order to improve the validity of patient delay studies, it is suggested that research be strengthened on three counts: More research should be devoted to symptom interpretation processes, more research should seek to operationalise patient delay, and, importantly, more research is needed to develop valid instruments for measuring patient delay. (Source: BMC Health Services Res... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2903802 Sun, 18 Oct 2009 23:00:00 +0100 2903802 http://www.medworm.com/index.php?rid=2896599&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F188 DiscussionIf collaborative care is demonstrated to be effective we will have evidence to enable the NHS to substantially improve the organisation of depressed patients in primary care, and to assist primary care providers to deliver a model of enhanced depression care which is both effective and acceptable to patients.Trial Registration Number: ISRCTN32829227 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2896599 Thu, 15 Oct 2009 23:00:00 +0100 2896599 http://www.medworm.com/index.php?rid=2896600&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F187 Conclusions: Attitudes and practices regarding communication with LFP patients vary across professions and hospital departments. In order to foster an institution-wide culture conducive to ensuring adequate communication with LFP patients will require both the development of a hospital-wide policy and service-level activities aimed at reinforcing this policy and putting it into practice. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2896600 Wed, 14 Oct 2009 23:00:00 +0100 2896600 http://www.medworm.com/index.php?rid=2884397&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F184 DiscussionOn completion of the project, users and primary care practitioners will be more informed of the value and utility of including family history in CHD risk assessment. Further, this approach will also act as a model of how familial risk information can be integrated within mainstream primary care preventive services for common chronic diseases. Trial Registration: Current Controlled Trials ISRCTN17943542 (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2884397 Sun, 11 Oct 2009 23:00:00 +0100 2884397 http://www.medworm.com/index.php?rid=2884396&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F185 Conclusion: The results from this study suggest that cancer screening test utilization is consistent with guideline age information regarding the age of screening initiation. Screening test and adherence rates increased by approximately 100% at the breast and colorectal cancer guideline recommended ages compared to only a 50% increase in the screening test rate for prostate cancer screening. Since information regarding the age of cancer screening initiation varies across countries, results from this study also potentially have implications for cross-country comparisons of cancer incidence and survival statistics. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2884396 Sun, 11 Oct 2009 23:00:00 +0100 2884396 http://www.medworm.com/index.php?rid=2884395&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F186 Conclusions: Higher quality of care during hospitalization with hip fracture was associated with lowered 30 day mortality. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2884395 Sun, 11 Oct 2009 23:00:00 +0100 2884395 http://www.medworm.com/index.php?rid=2881901&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F183 Conclusions: This feasibility study shows that prior interest in EPA is low in the GP community. We encountered a number of logistic and organisational problems. It proved attractive to participants, but it can be augmented by coaching of participants in more than a one-off project to identify and achieve targets for quality improvement. In the absence of commitment of the government, a network of universities and one scientific organisation will offer EPA as a service to training practices. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2881901 Sat, 10 Oct 2009 23:00:00 +0100 2881901 http://www.medworm.com/index.php?rid=2877860&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F182 Conclusions: This research provides insights into the economic stressors associated with managing chronic illness, demonstrating that economic hardship requires households to make difficult decisions between care and basic living expenses. These decisions may cause less than optimal health outcomes and increased costs to the health system. The findings support the necessity of a critical analysis of health, social and welfare policies to identify cross-sectoral strategies to alleviate such hardship and improve the affordability of managing chronic conditions. In a climate of global economic instability, research into the economic impact of chronic illness on individuals' health and well-being and their disease management capacity, such as this study, provides timely evidence to inform poli... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2877860 Thu, 08 Oct 2009 23:00:00 +0100 2877860 http://www.medworm.com/index.php?rid=2873773&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F181 Conclusions: CVDs were identified by the communities as priority health problems. Future health programs should focus on smoking, physical inactivity and unhealthy eating behaviours. Behaviour change strategies should take predisposing factors, enabling factors and reinforcing factors into consideration. Policies, organization and human resource need strengthening. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2873773 Thu, 08 Oct 2009 23:00:00 +0100 2873773 http://www.medworm.com/index.php?rid=2867278&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F179 Conclusions: IDCT's operating on the interface between primary and specialty care are associated with improved outcomes of care. More research is required on what team and program characteristics contribute to improvements in diabetes care.Trial registration. NTR 1369. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2867278 Tue, 06 Oct 2009 23:00:00 +0100 2867278 http://www.medworm.com/index.php?rid=2867277&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F180 Conclusions: At the current medical school enrollment capacity, the number of physicians per population is expected to continue to increase because of the skewed age distribution of physicians and the declining population in Japan. However, with changes in young physicians' choices of medical specialties and as the percentage of female physicians increases, patterns of physician supply will vary between specialties. Specialties less often chosen by young physicians and where males have dominated will face a decline in physician supply. These results highlight the necessity for developing a work environment that attracts female physicians to these types of specialties. This will also lead to improved gender equality in the workforce and more effective use of human resources. (Source: BMC He... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2867277 Tue, 06 Oct 2009 23:00:00 +0100 2867277 http://www.medworm.com/index.php?rid=2848650&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F178 Conclusions: Based on NHSDW caller surveys responses and applying a transparent rule set to caller actions a large majority of subsequent actions were assessed as appropriate, with insufficient contacts particularly infrequent. The challenge for NHSDW is to reduce the number of unnecessary contacts made following calls to the service, whilst maintaining safety. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2848650 Tue, 29 Sep 2009 23:00:00 +0100 2848650 http://www.medworm.com/index.php?rid=2840415&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F177 Conclusions: The reports' evaluations of health evidence in relation to questions of effect lacked transparency and, overall, showed little use of systematic processes. A systematic, explicit and transparent approach, following the standards laid down in the ISQ, may help generate the evidence-based decision-making that Norway, the UK, the EU and the WHO desire and seek. However, policy-makers may find the ISQ criteria for assessing the scientific quality of a report too narrow to adequately inform policy-making. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2840415 Sun, 27 Sep 2009 23:00:00 +0100 2840415 http://www.medworm.com/index.php?rid=2837333&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F176 Conclusions: Prison inmates' satisfaction with the health services provided are low compared with patient satisfaction measured in other health areas. The substantial differences observed between services - even when adjusting for several known factors associated with patient satisfaction - indicate a potential for quality improvement. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2837333 Sun, 27 Sep 2009 23:00:00 +0100 2837333 http://www.medworm.com/index.php?rid=2835158&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F175 DISCUSSION: This paper discusses complications and dilemma's observed in the set-up of data management for QICs. An overview is presented of signals that were picked up by the data management team. These signals were used to improve the strategies for data management during the program and have, as far as possible, been translated into practical solutions that have been successfully implemented.The recommendations coming from this study are:- From our experience it is clear that quality improvement programs deviate from experimental research in many ways. It is not only impossible, but also undesirable to control processes and standardize data streams. QIC's need to be clear of data protocols that do not allow for change. It is therefore minimally important that when quantitative results a... BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2835158 Fri, 25 Sep 2009 23:00:00 +0100 2835158 http://www.medworm.com/index.php?rid=2826245&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F172 Conclusions: The "demographic window" between the present and 2011 is critical in developing policies to cope with the anticipated burgeoning LTC burden, in concert with the related issues of health care financing and retirement planning. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2826245 Wed, 23 Sep 2009 23:00:00 +0100 2826245 http://www.medworm.com/index.php?rid=2826244&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F173 Conclusions: Key Points: positive change occurs over time and repeated audit seems to deliver some improvement in services. It is necessary to assess interventions such as the Peer Review used in NCROP to achieve more comprehensive and rapid change. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2826244 Wed, 23 Sep 2009 23:00:00 +0100 2826244 http://www.medworm.com/index.php?rid=2826243&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F174 Conclusions: Supply of beds in long term care institutions substantially differs across Italian regions, showing in every scenario some imbalances between potential care needs and other studied factors. Our study suggests the need of a comprehensive rethinking of care delivery "system". (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2826243 Wed, 23 Sep 2009 23:00:00 +0100 2826243 http://www.medworm.com/index.php?rid=2822269&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F171 Conclusions: Internal consistency was good and initial validity of the scale was adequate, it was able to discriminate differences between clinical variables, however, further work is needed to confirm the factor structure and validity of the AESED. Nevertheless, this scale may be of value in exploring and helping to improve carers' coping strategies and in examining the effectiveness of family based interventions. (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2822269 Tue, 22 Sep 2009 23:00:00 +0100 2822269 http://www.medworm.com/index.php?rid=2816624&cid=s_30438_22_f&fid=30438&url=http%3A%2F%2Fwww.biomedcentral.com%2F1472-6963%2F9%2F170 We examined new diabetes and CHD incidence, and resource utilization over the subsequent 3-year period (2005-2007) using age-sex-adjusted regression models to compare outcomes by MetS category. Results: After excluding patients with diabetes/CHD at baseline, 78,293 patients were eligible for analysis. EHR-defined MetS had 73% sensitivity and 91% specificity for directly measured MetS. Diabetes incidence was 1.4% in No MetS; 4.0% in At-risk-for MetS; and 11.0% in MetS (p (Source: BMC Health Services Research) BMC Health Services Research journals http://www.medworm.com/rss/comments.php?id=2816624 Mon, 21 Sep 2009 23:00:00 +0100 2816624