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[PMID]:27118733
[Au] Autor:McCarthy M
[Ad] Endereço:Seattle.
[Ti] Título:Patient safety took second place to research needs at NIH hospital, says report.
[So] Source:BMJ;353:i2376, 2016 Apr 26.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Pesquisa Biomédica/normas
Hospitais Federais/ética
National Institutes of Health (U.S.)/ética
Segurança do Paciente/normas
[Mh] Termos MeSH secundário: Ensaios Clínicos como Assunto/organização & administração
Ensaios Clínicos como Assunto/normas
Hospitais Federais/normas
Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160428
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.i2376


  2 / 175 MEDLINE  
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[PMID]:27096534
[Au] Autor:Benard VB; Greek A; Roland KB; Hawkins NA; Lin L; Saraiya M
[Ad] Endereço:1 Division of Cancer Prevention and Control, Centers for Disease Control and Prevention , Atlanta, Georgia .
[Ti] Título:Change in Provider Beliefs Regarding Cervical Cancer Screening Intervals After an Educational Intervention.
[So] Source:J Womens Health (Larchmt);25(5):422-7, 2016 May.
[Is] ISSN:1931-843X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Current cervical cancer screening guidelines include the option of lengthening the screening interval to 5 years for average-risk women aged 30-65 years when screened with Pap and human papillomavirus (HPV) test (co-test). Because many providers are reluctant to extend screening intervals, we launched an educational intervention to promote recommended screening practices. The study objective was to assess changes in provider attitudes and beliefs to extending screening intervals among low-income women. METHODS: The study was conducted in 15 clinics in Federally Qualified Health Centers in Illinois. Providers in the intervention arm received a multicomponent educational intervention. Fifty-six providers (n = 29 intervention and n = 27 control) completed baseline and 12-month follow-up surveys assessing beliefs and intentions about extending screening intervals. RESULTS: The 12-month assessment showed providers in the intervention arm were significantly more likely than those in the control arm to recommend a 3-year screening interval (guideline recommendation at time of study) with a normal co-test result. Providers who received the intervention were significantly more likely to agree that routine co-testing is the best way to screen for cervical cancer, that extending the screening interval would be good, easy, and beneficial, and to disagree that the increased screening interval would cause patients to lose contact with the medical system. CONCLUSION: Educating providers on the natural history of HPV infection and cervical cancer and the benefits of extended intervals increased their willingness to follow guidelines. This study provides evidence that an educational intervention delivered with HPV testing materials may be effective in encouraging appropriate cervical screening intervals.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Detecção Precoce de Câncer/métodos
Conhecimentos, Atitudes e Prática em Saúde
Pessoal de Saúde/educação
Programas de Rastreamento/psicologia
Infecções por Papillomavirus/prevenção & controle
Neoplasias do Colo do Útero/prevenção & controle
Esfregaço Vaginal/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Centers for Disease Control and Prevention (U.S.)
Estudos Transversais
Avaliação Educacional
Feminino
Seguimentos
Mau Uso de Serviços de Saúde
Hospitais Federais/utilização
Seres Humanos
Illinois
Meia-Idade
Pobreza
Guias de Prática Clínica como Assunto
Padrões de Prática Médica/normas
Fatores de Tempo
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170502
[Lr] Data última revisão:
170502
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160421
[St] Status:MEDLINE
[do] DOI:10.1089/jwh.2015.5706


  3 / 175 MEDLINE  
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[PMID]:27089668
[Au] Autor:Broderick R
[Ti] Título:Medicine behind bars.
[So] Source:Minn Med;99(2):16-9, 2016 Mar-Apr.
[Is] ISSN:0026-556X
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Doença Crônica/reabilitação
Assistência à Saúde
Acesso aos Serviços de Saúde
Hospitais Federais
Serviços de Saúde Mental
Prisões
[Mh] Termos MeSH secundário: Necessidades e Demandas de Serviços de Saúde
Minnesota
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1606
[Cu] Atualização por classe:160419
[Lr] Data última revisão:
160419
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160420
[St] Status:MEDLINE


  4 / 175 MEDLINE  
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Texto completo SciELO México
Texto completo SciELO Saúde Pública
[PMID]:25629277
[Au] Autor:Contreras-Loya D; Gómez-Dantés O; Puentes E; Garrido-Latorre F; Castro-Tinoco M; Fajardo-Dolci G
[Ad] Endereço:Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
[Ti] Título:Waiting times for surgical and diagnostic procedures in public hospitals in Mexico.
[So] Source:Salud Publica Mex;57(1):29-37, 2015 Jan-Feb.
[Is] ISSN:1606-7916
[Cp] País de publicação:Mexico
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: A retrospective evaluation of waiting times for elective procedures was conducted in a sample of Mexican public hospitals from the following institutions: the Mexican Institute for Social Security (IMSS), the Institute for Social Security and Social Services for Civil Servants (ISSSTE) and the Ministry of Health (MoH). Our aim was to describe current waiting times and identify opportunities to redistribute service demand among public institutions. MATERIALS AND METHODS: We examined current waiting times and productivity for seven elective surgical and four diagnostic imaging procedures, selected on the basis of their relative frequency and comparability with other national health systems. RESULTS: Mean waiting time for the seven surgical procedures in the three institutions was 14 weeks. IMSS and ISSSTE hospitals showed better performance (12 and 13 weeks) than the MoH hospitals (15 weeks). Mean waiting time for the four diagnostic procedures was 11 weeks. IMSS hospitals (10 weeks) showed better average waiting times than ISSSTE (12 weeks) and MoH hospitals (11 weeks). CONCLUSION: Substantial variations were revealed, not only among institutions but also within the same institution. These variations need to be addressed in order to improve patient satisfaction.
[Mh] Termos MeSH primário: Técnicas e Procedimentos Diagnósticos/estatística & dados numéricos
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos
Hospitais Públicos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Estudos Transversais
Eficiência
Hospitais Federais/estatística & dados numéricos
Hospitais Gerais/estatística & dados numéricos
Hospitais Urbanos/estatística & dados numéricos
Seres Humanos
México/epidemiologia
Estudos Retrospectivos
Amostragem
Previdência Social
Fatores de Tempo
Tempo para o Tratamento
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150129
[St] Status:MEDLINE


  5 / 175 MEDLINE  
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[PMID]:24776830
[Au] Autor:Harrison JP; Meyer S
[Ad] Endereço:Author Affiliations: Department of Public Health (Dr Harrison), and Health Administration Program (Mr Meyer), University of North Florida, Jacksonville Florida.
[Ti] Título:Measuring efficiency among US federal hospitals.
[So] Source:Health Care Manag (Frederick);33(2):117-27, 2014 Apr-Jun.
[Is] ISSN:1550-512X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study evaluates the efficiency of federal hospitals, specifically those hospitals administered by the US Department of Veterans Affairs and the US Department of Defense. Hospital executives, health care policymakers, taxpayers, and federal hospital beneficiaries benefit from studies that improve hospital efficiency. This study uses data envelopment analysis to evaluate a panel of 165 federal hospitals in 2007 and 157 of the same hospitals again in 2011. Results indicate that overall efficiency in federal hospitals improved from 81% in 2007 to 86% in 2011. The number of federal hospitals operating on the efficiency frontier decreased slightly from 25 in 2007 to 21 in 2011. The higher efficiency score clearly documents that federal hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the health care industry. This research examines benchmarking strategies to improve the efficiency of hospital services to federal beneficiaries. Through the use of strategies such as integrated information systems, consolidation of services, transaction-cost economics, and focusing on preventative health care, these organizations have been able to provide quality service while maintaining fiscal responsibility. In addition, the research documented the characteristics of those federal hospitals that were found to be on the Efficiency Frontier. These hospitals serve as benchmarks for less efficient federal hospitals as they develop strategies for improvement.
[Mh] Termos MeSH primário: Eficiência Organizacional/normas
Hospitais Federais/normas
Hospitais Militares/normas
[Mh] Termos MeSH secundário: Eficiência Organizacional/estatística & dados numéricos
Sistemas de Informação Hospitalar
Hospitais Federais/organização & administração
Hospitais Federais/estatística & dados numéricos
Hospitais Militares/organização & administração
Hospitais Militares/estatística & dados numéricos
Hospitais de Veteranos/organização & administração
Hospitais de Veteranos/normas
Hospitais de Veteranos/estatística & dados numéricos
Seres Humanos
Medicina Preventiva/organização & administração
Melhoria de Qualidade/organização & administração
Estados Unidos
United States Department of Defense/organização & administração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1508
[Cu] Atualização por classe:140429
[Lr] Data última revisão:
140429
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:140430
[St] Status:MEDLINE
[do] DOI:10.1097/HCM.0000000000000005


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[PMID]:24106217
[Au] Autor:John HV
[Ad] Endereço:Program in the History of Science and Medicine, Yale University, 333 Cedar Street, Sterling Hall of Medicine, L132, New Haven, Connecticut 06520.
[Ti] Título:Translating leprosy: the expert and the public in Stanley Stein's anti-stigmatization campaigns, 1931-60.
[So] Source:J Hist Med Allied Sci;68(4):659-87, 2013 Oct.
[Is] ISSN:1468-4373
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This article examines three campaigns through which patient activist Stanley Stein sought to combat the stigmatized connotations of the word "leprosy." In 1931, soon after starting the first patient newspaper at the U.S. national leprosy hospital at Carville, Stein became convinced of the necessity of finding an alternative to "leprosy." His ensuing campaign to promote the use of the words "Hansen's Disease" to describe the condition from which he and fellow Carville patients suffered became his most passionate and life-long project. In the 1950s, Stein became involved in efforts to change the translation of "leprosy" in the Bible. Finally, in 1960, he waged a campaign to de-stigmatize encyclopedia entries on leprosy. These campaigns illustrate how even elevation of the medical expert and a seeming disdain for the public can function as a protest of medical authority and reveal a presumption that a significant degree of authority actually resides with the public.
[Mh] Termos MeSH primário: Hanseníase/história
Defesa do Paciente/história
Terminologia como Assunto
[Mh] Termos MeSH secundário: Bíblia
Enciclopédias como Assunto
História do Século XX
Hospitais Federais/história
Institucionalização/história
Louisiana
Preconceito/história
Estados Unidos
United States Public Health Service
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Ps] Nome de pessoa como assunto:Stein S
[Em] Mês de entrada:1407
[Cu] Atualização por classe:131009
[Lr] Data última revisão:
131009
[Sb] Subgrupo de revista:IM; QIS
[Da] Data de entrada para processamento:131010
[St] Status:MEDLINE
[do] DOI:10.1093/jhmas/jrs018


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[PMID]:23628517
[Au] Autor:Roland KB; Benard VB; Greek A; Hawkins NA; Manninen D; Saraiya M
[Ad] Endereço:Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, 4770 Buford Hwy NE, MS K-55, Atlanta, GA 30341, USA. Electronic address: kroland@cdc.gov.
[Ti] Título:Primary care provider practices and beliefs related to cervical cancer screening with the HPV test in Federally Qualified Health Centers.
[So] Source:Prev Med;57(5):419-25, 2013 Nov.
[Is] ISSN:1096-0260
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Cervical cancer screening using the human papillomavirus (HPV) test and Pap test together (co-testing) is an option for average-risk women ≥ 30 years of age. With normal co-test results, screening intervals can be extended. The study objective is to assess primary care provider practices, beliefs, facilitators and barriers to using the co-test and extending screening intervals among low-income women. METHOD: Data were collected from 98 providers in 15 Federally Qualified Health Center (FQHC) clinics in Illinois between August 2009 and March 2010 using a cross-sectional survey. RESULTS: 39% of providers reported using the co-test, and 25% would recommend a three-year screening interval for women with normal co-test results. Providers perceived greater encouragement for co-testing than for extending screening intervals with a normal co-test result. Barriers to extending screening intervals included concerns about patients not returning annually for other screening tests (77%), patient concerns about missing cancer (62%), and liability (52%). CONCLUSION: Among FQHC providers in Illinois, few administered the co-test for screening and recommended appropriate intervals, possibly due to concerns over loss to follow-up and liability. Education regarding harms of too-frequent screening and false positives may be necessary to balance barriers to extending screening intervals.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Cultura
Detecção Precoce de Câncer/utilização
Infecções por Papillomavirus/prevenção & controle
Atenção Primária à Saúde/utilização
Neoplasias do Colo do Útero/prevenção & controle
Esfregaço Vaginal/utilização
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Mau Uso de Serviços de Saúde/estatística & dados numéricos
Pesquisa sobre Serviços de Saúde
Hospitais Federais/utilização
Seres Humanos
Illinois
Padrões de Prática Médica/utilização
Estados Unidos
Revisão da Utilização de Recursos de Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Em] Mês de entrada:1406
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130501
[St] Status:MEDLINE


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[PMID]:23265072
[Au] Autor:Burns LR; Wholey DR; McCullough JS; Kralovec P; Muller R
[Ad] Endereço:The Wharton School, University of Pennsylvania, Philadelphia, PA, USA.
[Ti] Título:The changing configuration of hospital systems: centralization, federalization, or fragmentation?
[So] Source:Adv Health Care Manag;13:189-232, 2012.
[Is] ISSN:1474-8231
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Research on hospital system organization is dated and cross-sectional. We analyze trends in system structure during 2000-2010 to ascertain whether they have become more centralized or decentralized. DESIGN/METHODOLOGY/APPROACH: We test hypotheses drawn from organization theory and estimate empirical models to study the structural transitions that systems make between different "clusters" defined by the American Hospital Association. FINDINGS: There is a clear trend toward system fragmentation during most of this period, with a small recent shift to centralization in some systems. Systems decentralize as they increase their members and geographic dispersion. This is particularly true for systems that span multiple states; it is less true for smaller regional systems and local systems that adopt a hub-and-spoke configuration around a teaching hospital. RESEARCH LIMITATIONS: Our time series ends in 2010 just as health care reform was implemented. We also rely on a single measure of system centralization. RESEARCH IMPLICATIONS: Systems that appear to be able to centrally coordinate their services are those that operate in local or regional markets. Larger systems that span several states are likely to decentralize or fragment. PRACTICAL IMPLICATIONS: System fragmentation may thwart policy aims pursued in health care reform. The potential of Accountable Care Organizations rests on their ability to coordinate multiple providers via centralized governance. Hospitals systems are likely to be central players in many ACOs, but may lack the necessary coherence to effectively play this governance role. ORIGINALITY/VALUE: Not all hospital systems act in a systemic manner. Those systems that are centralized (and presumably capable of acting in concerted fashion) are in the minority and have declined in prevalence over most of the past decade.
[Mh] Termos MeSH primário: Administração de Serviços de Saúde
Modelos Organizacionais
Análise de Sistemas
[Mh] Termos MeSH secundário: Hospitais Federais
Seres Humanos
Propriedade/organização & administração
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1301
[Cu] Atualização por classe:131106
[Lr] Data última revisão:
131106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121226
[St] Status:MEDLINE


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[PMID]:21696482
[Au] Autor:Sefton M; Brigell E; Yingling C; Storfjell J
[Ad] Endereço:College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA. marsmith@uic.edu
[Ti] Título:A journey to become a federally qualified health center.
[So] Source:J Am Acad Nurse Pract;23(7):346-50, 2011 Jul.
[Is] ISSN:1745-7599
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Since 1998, Integrated Health Care (IHC), an academic nurse-managed center of the University of Illinois at Chicago College of Nursing, has delivered primary and mental health care to people with serious and persistent mental illness who are enrolled in psychosocial rehabilitation. DATA SOURCES: Federal guidelines and experiences of the steering group. This article reports our journey of transformation to a achieve the status of a Federally Qualified Health Center (FQHC). CONCLUSIONS: Nurse-managed clinics (NMCs) have become important in the U.S. healthcare system with well documented positive impact. However, financial issues have placed may NMCs at risk for closure. Achieving FQHC status is seen as a viable option to increase revenue and therefore financial stability. IMPLICATIONS FOR PRACTICE: This discussion of the benefits of FQHC status, an overview of some common compliance issues with FQHC requirements, and the report of lessons learned along the way in meeting FQHC standards that we encountered can provide support and guidance for other NMCs in similar situations.
[Mh] Termos MeSH primário: Prática Avançada de Enfermagem/legislação & jurisprudência
Assistência à Saúde/legislação & jurisprudência
Política de Saúde/legislação & jurisprudência
Hospitais Federais/legislação & jurisprudência
Qualidade da Assistência à Saúde/legislação & jurisprudência
[Mh] Termos MeSH secundário: Prática Avançada de Enfermagem/normas
Assistência à Saúde/normas
Regulamentação Governamental
Hospitais Federais/normas
Seres Humanos
Qualidade da Assistência à Saúde/normas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1112
[Cu] Atualização por classe:110623
[Lr] Data última revisão:
110623
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:110624
[St] Status:MEDLINE
[do] DOI:10.1111/j.1745-7599.2011.00621.x


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[PMID]:21514920
[Au] Autor:Penman-Aguilar A; Tucker MJ; Groom AV; Reilley BA; Klepacki S; Cullen T; Gebremariam C; Redd JT
[Ad] Endereço:Women's Health and Fertility Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. APenmanAguilar@cdc.gov
[Ti] Título:Validation of algorithm to identify American Indian/Alaska Native pregnant women at risk from pandemic H1N1 influenza.
[So] Source:Am J Obstet Gynecol;204(6 Suppl 1):S46-53, 2011 Jun.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pregnant women and American Indian and Alaska Native people are at elevated risk of severe disease and mortality from 2009 pandemic influenza A/H1N1. We validated an electronic health record-based algorithm used by Indian Health Service to identify pregnant women in near real-time surveillance of pandemic influenza A/H1N1. We randomly selected a stratified sample of 515 patients at 3 Indian Health Service-funded hospitals with varied characteristics. With comprehensive review of patients' electronic health records as the gold standard, we calculated the positive predictive value and sensitivity of the pregnancy algorithm. The sensitivity of the algorithm at individual hospitals ranged from 94.1-96.0%. Positive predictive value ranged from 94.4-98.3%. Despite differences among hospitals on key characteristics, the pregnancy algorithm performed nearly equivalently with high positive predictive value and sensitivity at all facilities. It may prove helpful for surveillance during future epidemics and for targeting interventions for pregnant women and infants.
[Mh] Termos MeSH primário: Algoritmos
Índios Norte-Americanos/estatística & dados numéricos
Vírus da Influenza A Subtipo H1N1
Influenza Humana/etnologia
Pandemias
Vigilância da População/métodos
Complicações Infecciosas na Gravidez/etnologia
[Mh] Termos MeSH secundário: Alaska/etnologia
Registros Eletrônicos de Saúde
Feminino
Hospitais Federais
Seres Humanos
Influenza Humana/epidemiologia
Gravidez
Reprodutibilidade dos Testes
Medição de Risco/métodos
Estados Unidos/epidemiologia
United States Indian Health Service
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.; VALIDATION STUDIES
[Em] Mês de entrada:1106
[Cu] Atualização por classe:110606
[Lr] Data última revisão:
110606
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:110426
[St] Status:MEDLINE
[do] DOI:10.1016/j.ajog.2011.03.004



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