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Supervision of thrombolysis of acute myocardial infarction using telemedicine

JOURNAL OF TELEMEDICINE AND TELECARE 2000年第1期6卷 54-58页

作者： Mavrogeni, SI Tsirintani, M Kleanthous, C Vranakis, K Secheta, E Mihelakis, D Sotiriou, D Gatzonis, M Tsolas, C Kontaratos, AN Cokkinos, DV Onassis Cardiac Surg Ctr Athens Greece Mykonos Primary Hlth Care Ctr Mykonos Greece Univ Athens Dept Phys Med Athens Greece Skiathos Primary Hlth Care Ctr Skiathos Greece

The treatment of acute myocardial infarction (MI) constitutes a significant problem in remote geographical areas of Greece. Furthermore, thrombolysis, the treatment of choice in the early phase of acute MI, requires the supervision of an expert. We have used thrombolytic treatment, using telemedicine, in remote medical centres. The Onassis Cardiac Surgery Centre was linked to six remote Aegean islands via telemedicine systems which permitted the transmission of 12-lead electrocardiograms (ECGs). The thrombolytic agent anistreplase was administered to patients with acute MI. Supervision, including consultation for treatment of complications, was achieved using the telemedicine system. One hundred and fifty-two ECGs were transmitted during 24 months, of which 108 (71%) indicated specific treatment of a cardiac condition. Ten cases were diagnosed as having acute MI and eight of these were treated with anistreplase. All patients survived acute MI and complications were treated locally. The application of thrombolytic treatment in acute MI is feasible in remote areas, with the use of a telemedicine system.

关键词：急性病阿尼普酶/治疗应用心电描记术纤维蛋白溶解药/治疗应用希腊心肌梗死/诊断心肌梗死/药物疗法远程会诊/方法乡村卫生服务/组织和管理血栓溶解疗法/方法人类

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Rationality of drug prescriptions in rural health centres in Burkina Faso

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HEALTH POLICY AND PLANNING 1999年第3期14卷 291-298页

作者： Krause, G Borchert, M Benzler, J Heinmüller, R Kaba, I Savadogo, M Siho, N Diesfeld, HJ Univ Heidelberg Inst Trop Hyg & Publ Hlth ITHOG D-6900 Heidelberg Germany Deutsch Entwicklungsdienst DED Nouna Burkina Faso Serv Sante PRAPASS Projet Rech Act Ameliorat Nouna Burkina Faso

The objective of this study is to investigate the quality of drug prescriptions in nine health centres of three districts in rural Burkina Faso. 313 outpatient consultations were studied by methods of guided observation. Additionally interviews were held with the health care workers involved in the study. A total of 793 drugs prescribed by 15 health care workers during the observation period and 2815 prescribed drugs copied from the patient register were analyzed. An average of 2.3 drugs were prescribed per visit. 88.0% of the prescribed drugs were on the essential drug list. 88.4% were indicated according to the national treatment guidelines. 79.4% had a correct dosage. The study revealed serious deficiencies in drug prescribing that could not be detected by assessing selected quantitative drug-use indicators as recommended by the WHO. In two-thirds of the cases the patients received no information on how long the drug had to be taken. Errors in dosage occurred significantly more often in children under 5 years. The combined analysis of choice and dosage of drugs showed that 59.3% of all the patients received a correct prescription. Seven out of 21 pregnant women received drugs contraindicated in pregnancy. We conclude that assessment of quantitative drug-use indicators alone does not suffice in identifying specific needs for improvement in treatment quality. We recommend that prescribing for children under 5 and for pregnant women should be targeted in future interventions and that the lay-out, content and distribution of treatment guidelines must be improved.

关键词：医务工作者的态度布基纳法索药物利用/标准评价研究卫生服务研究病人依从处方药物/统计学和数值数据卫生保健质量乡村卫生服务/组织和管理乡村卫生服务/标准女(雌)性人类妊娠

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A review of telemedicine

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JOURNAL OF TELEMEDICINE AND TELECARE 1999年第Sup1期5卷 103-106页

作者： al-Kassab, MHA Lu, DM Pan, YH Zhejiang Univ Dept Comp Sci Hangzhou 310027 Peoples R China

Moving the information instead of the patient is often sufficient and telemedicine is a useful and potentially powerful tool which fulfils this idea. It has changed the classical form of health-care delivery by providing those people living in rural and remote areas with comparable services to those in urban areas. Equally, remote hospitals can obtain specialist consultations and diagnosis without the need for the patient to travel. We have reviewed the present status of telemedicine and its future possibilities.

关键词：计算机系统卫生保健提供预测乡村卫生服务/组织和管理卫星通信远程医学/仪器和设备远程医学/发展趋势电话人类

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大力加强农村卫生工作全面提高农民健康水平

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中国卫生 2002年第12期 8-12页

作者：李岚清国务院

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A prepaid healthcare scheme in rural Africa

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TROPICAL DOCTOR 2000年第3期30卷 151-154页

作者： McFarlane, GA Sammon, AM Univ Bristol Bristol Royal Infirm Dept Surg Bristol BS2 8HW Avon England

Healthcare providers in Africa are having to increasingly rely on the resources of the populations they serve. An 8-year experience with one of the first rural-based health insurance schemes in East Africa is described. initial difficulties included adverse selection of members with chronic ill health, fraudulent claims and overuse of health services, leading to considerable financial losses. External technical assistance introduced member tracking and regular reports, reduced adverse selection, fraud and overuse of services to a minimum, and achieved financial stability. Local market research and a comprehensive marketing plan is essential for the overall success of an insurance plan. Health insurance in this part of Africa is likely to assist middle income earners rather than the poor.

关键词：非洲东部保险范围保险健康/经济学贫困乡村卫生服务/经济学乡村卫生服务/组织和管理社会经济因素人类

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Primary health care, community participation and community-financing: Experiences of two middle hill villages in Nepal

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HEALTH POLICY AND PLANNING 1996年第1期11卷 93-100页

作者： Sepehri, A Pettigrew, J UNIV CAMBRIDGE DEPT SOCIOL ANTHROPOLCAMBRIDGEENGLAND

Although community involvement in health related activities is generally acknowledged by international and national health planners to be the key to the successful organization of primary health care, comparatively little is known about its potential and limitations. Drawing on the experiences of two middle hill villages in Nepal, this paper reports on research undertaken to compare and contrast the scope and extent of community participation in the delivery of primary health care in a community run and financed health post and a state run and financed health post. Unlike many other health posts in Nepal these facilities do provide effective curative services, and neither of them suffer from chronic shortage of drugs. However, community-financing did not appear to widen the scope and the extent of participation. Villagers in both communities relied on the health post for the treatment of less than one-third of symptoms, and despite the planners' intentions, community involvement outside participation in benefits was found to be very limited.

关键词：社区和机构的关系用户参与/经济学发展中国家尼泊尔病人接受卫生保健的程度/统计学和数值数据初级卫生保健/经济学初级卫生保健/组织和管理初级卫生保健/标准问卷调查乡村卫生服务/组织和管理志愿工作者

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AHCPR-funded rural managed care centers: Report from the field

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JOURNAL OF RURAL HEALTH 1999年第1期15卷 87-93页

作者： Hartley, D Jackson, J Mueller, KJ Nichols, A Williams, V Univ So Maine Edmund S Muskie Sch Publ Serv Div Rural Hlth Portland ME 04104 USA

In 1994, the Agency for Health Care Policy and Research awarded cooperative agreements to five University-based groups to promote the establishment of managed care Institutions and development of rural health networks. This paper summarizes the experiences of these rural managed care centers in the first three years of this initiative. Key ingredients for achieving the project's goals that are identified by the project directors are reported as "foundations" that must be in place from the outset, or "building blocks" that can be developed along the way. The development of information systems and efforts to foster leadership in the medical community are areas in which grant funding of this type can be most effective.

关键词：社区网络/组织和管理卫生计划资助/组织和管理卫生服务研究领导管理医疗规划/组织和管理方案评价乡村卫生服务/组织和管理美国美国卫生保健研究和质量评估署人类

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A typological approach to the study of rural HIV service delivery networks

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JOURNAL OF RURAL HEALTH 1997年第3期13卷 216-225页

作者： Berry, DE McKinney, MM Marconi, KM BUR HLTH RESOURCES DEV OFF SCI & EPIDEMIOL HLTH RESOURCES & SERV ADM ROCKVILLE MD USA UNIV NEVADA HLTH ADM PROGRAM LAS VEGAS NV 89154 USA UNIV NEVADA COLL BUSINESS LAS VEGAS NV 89154 USA

Despite the rapid growth of AIDS cases in nonmetropolitan areas, little is known about the characteristics and needs of HIV-positive residents or how rural areas are responding to the epidemic. This paper proposes a typology for distinguishing among rural environments and examining variations in HIV service networks. The typology identifies three dimensions that have a major effect on the development of rural HIV service networks;degree of rurality, the prevalence of AIDS, and the epidemiological and demographic characteristics of the infected populations. Data from four cases studies are used to illustrate how variations in rural environments can affect the organization and delivery of HIV/AIDS care. The typology contributes to public discussions by identifying key attributes of rural environments that influence program planning and implementation and the transferability of service delivery models.

关键词：社区网络/组织和管理人口统计学 HIV感染/流行病学 HIV感染/治疗 HIV感染/传播 HIV血清患病率卫生服务需求卫生服务研究组织状况研究危险因素农村卫生乡村卫生服务/组织和管理美国/流行病学青少年成年人人类

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现行乡村卫生组织?体化管理的探索与思考

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中国农村卫生事业管理 2002年第7期22卷 40-41页

作者：刘林春王元盐都县伍佑中心卫生院

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Untangling the Web... barriers and benefits for nurse education... an Australian perspective

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NURSE EDUCATION TODAY 2000年第5期20卷 381-388页

作者： Kenny, A LaTrobe Univ Bendigo Vic Australia

The Internet... a Web of information technology. The potential exists now and increasingly in the future to use this technology to deliver widely distributed, creative, innovative learning to students across vast distances and at times which suit individual needs. The implications of this technology for nurse education, and indeed health care in general, are exciting. The technology is growing at such a vast rate that it would be easy to blindly accept it and promote its use. However, there is a need to stop and consider some of the practical barriers to the use of this technology, particularly for nursing education. (C) 2000 Harcourt Publishers Ltd.

关键词：医务工作者的态度对计算机的态度澳大利亚计算机辅助教学/经济学计算机辅助教学/发展趋势费用效益分析教育远程/组织和管理教育护理学士/组织和管理教育技术/组织和管理全体教工护理院校/组织和管理预测健康知识态度实践卫生服务需求信息服务/组织和管理因特网/组织和管理多媒体护士作用护理教育研究乡村卫生服务/组织和管理教学/组织和管理技术评估生物医学远程医学/组织和管理大学/组织和管理人类

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