Objective To establish whether reinstitutionalisation is occurring in mental health care and, if so, with what variations between western European countries. Design Comparison of data on changes in service provision. Setting Six European countries with different traditions of mental health care that have all experienced deinstitutionalisation since the 1970s—England, Germany, Italy, the Netherl...

OBJECTIVE To establish whether reinstitutionalisation is occurring in mental health care and, if so, with what variations between western European countries. DESIGN Comparison of data on changes in service provision. SETTING Six European countries with different traditions of mental health care that have all experienced deinstitutionalisation since the 1970s--England, Germany, Italy, the Ne...

BACKGROUND Substance use by people with severe psychiatric morbidity is associated with negative outcomes. AIMS To assess in adults with less severe psychiatric morbidity the relationship between alcohol consumption and subsequent 7-year hospital admissions, and the development and recurrence of alcohol use disorders. METHOD Follow-up data were assembled via a population-based hospital reco...

Outpatient attendance and inpatient admission records were examined to assess malaria situation in ten hospitals in Mbeya and Iringa Regions in southern highlands of Tanzania for a period of fifteen years from 1986-2000. Generally, records were deficient, some hospitals with entire annual records missing for one or several years. However, malaria maintained a high profile as the leading cause o...

INTRODUCTION There is growing evidence that in rural areas cancer mortality is higher and referral occurs later, indicating different patterns of care. In Scotland services to rural areas have been organized through 'managed clinical networks'. In some cases, these organizational networks have been structured so that the referral hospital is not the one nearest to the patient's home. This study...

INTRODUCTION Attending physician judgment is the traditional standard of care for emergency department (ED) admission decisions. The extent to which variability in admission decisions affect cost and quality is not well understood. We sought to determine the impact of variability in admission decisions on cost and quality. METHODS We performed a retrospective observational study of patients p...

Background: The Trauma is one of the most important health problems and a leading cause of death in 4th decade of life. Mortality due to accidents has a critical situation in Iran and mortality rate is increasing10-15% annually. Aim: To assess the relationship of shock index with trauma patient’s mortality after first 24 hours of admission at Khatam-al-Anbia Hospital in Iranshahr. Method A cros...

Objective: Congestive heart failure (CHF) has become one of the most important health care problems in western countries. This article focuses on the outpatient diagnosis and management of heart failure. We want to compare the outcome of patients who were treated with high dose diuretics in the emergency department (ED) without admission with patients who were admitted to hospi...

OBJECTIVE To determine whether parenteral penicillin given before admission to hospital reduces the case fatality rate in patients with meningococcal disease. DESIGN Retrospective analysis of 46 consecutive patients admitted to hospital with meningococcal disease from January 1986 to March 1991. SETTING District general hospital. MAIN OUTCOME MEASURE Hospital case fatality rate. RESULTS...

objective: congestive heart failure (chf) has become one of the most important health care problems in western countries. this article focuses on the outpatient diagnosis and management of heart failure. we want to compare the outcome of patients who were treated with high dose diuretics in the emergency department (ed) without admission with patients who were admitted to hospital for standard ...