BACKGROUND There is growing evidence that patients frequently bypass primary health care (PHC) facilities in favour of higher level hospitals regardless of substantial additional time and costs. Among the reasons given for bypassing are poor services (including lack of drugs and diagnostic facilities) and lack of trust in health workers. The World Health Report 2008 "PHC now more than ever" poi...

OBJECTIVE To identify factors associated with general satisfaction among clients attending outpatient clinics in a referral hospital in Uganda. DESIGN Cross-sectional exit survey of patients and care-givers in selected outpatient clinics. SETTING Seven outpatients' clinics at Mulago National Referral and Teaching Hospital. MAIN OUTCOME MEASURES Mean score of clients' general satisfaction ...

The increasing concern regarding chronic care, which is a consequence of the current demographic progression, and the need to decrease the costs associated with its care, places a focus on social care homes caring for highly dependent patients. Simultaneously, the residential facilities are progressing in order to care for fragile patients with increasingly complexity, even though, with some ex...

Care pathways have gained popularity in the healthcare sector the last two decades [2]. A care pathway is a management tool to organize multidisciplinary care for patients with identical characteristics (i.e., disease symptoms, diagnosis, age, etcetera). The care pathway specifies the steps in the care process [1] and routes patients along a pre-defined path of care providers and diagnostic fac...

Objective To review the effects of low intensity laser therapy (LILT) on healing and to explore its role in community nursing. Setting Primary care, outpatient clinic, community health centre Primary argument Low intensity laser therapy encompasses many positive attributes that make it a useful healing mechanism in community nursing. Conclusions Laser light is non‐invasive, painless, free from ...

BACKGROUND Compared with the traditional ways of gaining health-related information from newspapers, magazines, radio, and television, the Internet is inexpensive, accessible, and conveys diverse opinions. Several studies on how increasing Internet use affected outpatient clinic visits were inconclusive. OBJECTIVE The objective of this study was to examine the role of Internet use on ambulato...

In 1989 Cathedral Healthcare System, Orange, NJ, began a strategic planning process that culminated in a decision to create a continuum of care. Converting one of its three hospitals from an acute care to an ambulatory care facility gave Cathedral an opportunity to address fiscal realities and at the same time further develop its continuum of care. The converted hospital (Saint Mary's in Orange...

India allows abortion up to 20 weeks of pregnancy but places restrictions on abortion facilities and providers. Abortion services are especially deficient in rural areas. Although vacuum aspiration is safer, sharp curettage continues to be used by providers as they lack relevant training. This paper describes the provision of first trimester abortion services using manual vacuum aspiration (MVA...

There exist various service systems that have hierarchical structure. In hierarchical service networks, facilities at different levels provide different types of services. For example, in health care systems, general centers provide low-level services such as primary health care services, while the specialized hospitals provide high-level services. Because of demand congestion in service networ...