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Emergency Medical Services Outcomes Project (EMSOP) II: Developing the foundation and conceptual models for out-of-hospital outcomes research

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ANNALS OF EMERGENCY MEDICINE 2001年第6期37卷 657-663页

作者： Spaite, DW Maio, R Garrison, HG Desmond, JS Gregor, MA Stiell, IG Cayten, CG Chew, JL MacKenzie, EJ Miller, DR O'Malley, PJ Univ Arizona Coll Med Div Emergency Med Arizona Emergency Med Res Ctr Tucson AZ USA Univ Michigan Med Ctr Dept Emergency Med Ann Arbor MI 48109 USA E Carolina Univ Brody Sch Med Dept Emergency Med Greenville NC 27834 USA Univ Ottawa Div Emergency Med Ottawa ON Canada Univ Ottawa Loeb Hlth Res Inst Ottawa ON Canada New York Med Coll Inst Trauma & Emergency Care Valhalla NY 10595 USA EMSSTAR Grp Annapolis MD USA Johns Hopkins Univ Sch Hyg & Publ Hlth Baltimore MD USA Hlth Span Transportat Serv St Paul MN USA Allina Hlth Syst St Paul MN USA Massachusetts Gen Hosp Pediat Emergency Serv Boston MA 02114 USA Massachusetts Dept Publ Hlth Emergency Med Serv Children Boston MA USA

Development of methodologically acceptable outcomes models for emergency medical services (EMS) is long overdue. In this article, the Emergency Medical Services Outcomes Project proposes a conceptual framework that will provide a foundation for future EMS outcomes research. The "Episode of Care Model" and the "Out-of-Hospital Unit of Service Model" are presented. The Episode of Care Model is useful in conditions in which interventions and outcomes, especially survival and major physiologic dysfunction, are linked in a time-dependent manner. Conditions such as severe trauma, anaphylaxis, airway obstruction, respiratory arrest, and nontraumatic cardiac arrest are amenable to this methodology. The Out-of-Hospital Unit of Service Model is essentially a subunit of the Episode of Care Model. it is valuable for evaluating conditions that have minimal-to-moderate therapeutic time dependency. This model should be used when studying outcomes limited to the out-of-hospital interval. An example of this is pain management for injuries sustained in motor vehicle crashes. These models can be applied to a wide spectrum of conditions and interventions. With the scrutiny of health care expenditures ever increasing, the identification of clinical interventions that objectively improve patient outcome takes on growing importance. Therefore, the development, dissemination, and use of meaningful methodologies for EMS outcomes research is key to the future of EMS system development and maintenance.

关键词：出院后医疗/组织和管理急救医疗服务/组织和管理治疗过程片断卫生工作重点卫生服务研究/组织和管理模型组织管理年患病率结果评价(卫生保健)/组织和管理规划制订/方法研究设计/标准风险调节/组织和管理存活率分析时间因素美国/流行病学人类

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Rehabilitation after traumatic brain injury

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BRITISH MEDICAL BULLETIN 1999年第4期55卷 927-943页

作者： Barnes, MP Univ Newcastle Upon Tyne Hunters Moor Reg Neurorehabil Ctr Acad Unit Neurol Rehabil Newcastle Upon Tyne NE2 4NR Tyne & Wear England

Head injury is a common disabling condition but regrettably facilities for rehabilitation are sparse. There is now increasing evidence of the efficacy of a comprehensive multidisciplinary rehabilitation team compared to natural recovery following brain injury. This chapter outlines some basic concepts of rehabilitation and emphasises the importance of valid and reliable outcome measures. The evidence of the efficacy of a rehabilitation programme is discussed in some detail. A number of specific rehabilitation problems are outlined including the management of spasticity, nutrition, pressure sores and urinary continence. The increasingly important role of assistive technology is illustrated, particularly in terms of communication aids and environmental control equipment. However, the major long-term difficulties after head injury focus around the cognitive, intellectual, behavioural and emotional problems. The complex management of these disorders is briefly addressed and the evidence of the efficacy of some techniques discussed. The importance of recognition of the vegetative state and avoidance of misdiagnosis is emphasised. Finally, the important, but often neglected, area of employment rehabilitation is covered.

关键词：出院后医疗/组织和管理行为疗法脑损伤/心理学脑损伤/康复社区和机构的关系残疾鉴定病人医疗小组/组织和管理康复职业性/利用可重复性结果治疗结果人类

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Complementary treatment of drug addicts in Malaysia

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TROPICAL DOCTOR 2000年第2期30卷 105-106页

作者： Razali, SM Univ Sains Malaysia Sch Med Sci Dept Psychiat Kubang Kerian 16150 Kelantan Malaysia

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Nairobi bomb blast - trauma and recovery

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TROPICAL DOCTOR 2000年第1期30卷 47-48页

作者： Hollander, D London UK

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Management of suicide attempts in Italy and Sweden - A comparison of services offered to consecutive samples of suicide attempters

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GENERAL HOSPITAL PSYCHIATRY 2000年第6期22卷 432-436页

作者： Runeson, B Scocco, P DeLeo, D Meneghel, G Wasserman, D Karolinska Inst St Gorans Hosp Dept Clin Neurosci Sect Psychiat S-11281 Stockholm Sweden Univ Padua Dept Neurol & Psychiat Sci WHO Collaborating Ctr Res & Training Suicide Prev Padua Italy Griffith Univ Brisbane Qld 4111 Australia Karolinska Inst Natl Inst Psychosocial Med Natl Swedish Ctr Suicide Res & Prevent Mental Ill Stockholm Sweden Karolinska Inst WHO Collaborating Ctr Stockholm Sweden

The aim of the study was to compare the management of suicide attempts by patients in Sweden and Italy with a view to providing a perspective on differences in treatment. Two consecutive samples of suicide attempters from Huddinge (n=97) and Padua (n=100) were studied in trans of sociodemographic characteristics previous care, referral, medical and psychiatric care, hospitalization, aftercare and short-term compliance. In Italian somatic management of acute suicidal crises, there are more physicians specializing in anesthesia or internal medicine working in ambulances and emergency wards, and there is a heavier emphasis on somatic care. Swedish management procedures seem to entail more medical examinations and biohumoral tests. Moreover, the procedures at the Swedish hospital give priority to early psychiatric intervention, and admission to psychiatric inpatient care is more frequent. However, it is not normal practice in emergency psychiatric care at either of the centers for specialists to serve in the immediate liaison consultation. There are differences in assessment and treatment between the two countries that may provide a perspective on their procedures, implying that current procedures for managing patients belonging to groups identified as "high-risk" in terms of suicide may be modified. (C) 2000 Elsevier Science Inc.

关键词：出院后医疗/组织和管理急诊室精神病/组织和管理住院/统计学和数值数据意大利精神卫生服务/组织和管理病人依从/心理学病人依从/统计学和数值数据精神病学/组织和管理卫生保健质量转诊和会诊/组织和管理社会经济因素自杀未遂/预防和控制自杀未遂/心理学自杀未遂/统计学和数值数据瑞典青少年成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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A collaborative program for cardiovascular patient follow-up.

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AORN journal 2001年第1期74.0卷 22-28,30-31页

作者： Deaton, C. Kurtz, S. Weintraub, W.S. Nell Hodgson Woodruff School of Nursing Emory University Atlanta USA.

Transitions from one health care system to another are common, but they can affect coordination of care and measurement of patient outcomes. In this project, a community hospital and a tertiary center collaborated to obtain follow-up information on patients 30 days after they underwent cardiac catheterization and revascularization. Results show that patients experienced similar physical and emotional concerns regardless of diagnosis or procedure. Although the intent was to gather information, nurses also provided education and arranged services for patients. This project has implications for the development of collaborative interventions to improve care for patients after undergoing coronary procedures.

关键词：出院后医疗/组织和管理病人医护连续性冠状动脉分流术/护理冠心病/病因学冠心病/护理冠心病/外科学心脏导管插入术/护理医院社区机构间关系心肌血管重建术/经济学心肌血管重建术/护理结果评价(卫生保健) 病人满意度围手术期护理/组织和管理危险因素美国女(雌)性人类男(雄)性中年人

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Creating linkages between incomplete abortion treatment and family planning services in Kenya

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STUDIES IN FAMILY PLANNING 1999年第1期30卷 17-27页

作者： Solo, J Billings, DL Aloo-Obunga, C Ominde, A Makumi, M Populat Council Int Programs Div New York NY 10021 USA Ipas Carrboro NC 27510 USA Kenya Minist Hlth Maternal & Child Hlth Family Planning Program Div Primary Hlth Care Nairobi Kenya

Postabortion care has received increasing emphasis as an important intervention to address part of the problem of unsafe abortion. Although a good deal of attention has been paid to improving emergency treatment of abortion complications, the other elements of postabortion care, including providing postabortion family planning services, have received less attention and are rarely found in health-care settings around the world. This report describes a study that was conducted in Kenya to test three different models of ways to provide postabortion family planning. The study shows that these new services are both feasible and acceptable to providers and patients, and also shows how effective they can be. Whereas only 7 percent of women received family planning counseling according to the baseline survey, this proportion increased to 68 percent in the postintervention period. In addition, 70 percent of women who decided to begin using contraceptives received a method, compared with only 3 percent at baseline. The provision of postabortion family planning counseling and methods on the gynecological ward by ward staff was found to be the preferred and most effective model.

关键词：流产违法/预防和控制流产不全/治疗出院后医疗/组织和管理卫生保健提供联合/组织和管理计划生育服务/组织和管理可行性研究健康知识态度实践医院公立肯尼亚模型组织管理方案评价青少年成年人女(雌)性人类妊娠

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The assessment of systems in promoting collaborative aftercare: religious and mental health organizations in partnership.

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Journal of pastoral care 1985年第3期39卷 236-248页

作者： Anderson Jr., R.G. Director of Pastoral Services The Connecticut Mental Health Center New Haven CT 06508 Lecturer in Pastoral Theology Yale Divinity School

Maps out the terrain in which mental health and religious organizations collaborate in meeting community life needs of the long term mentally ill. Offers, from a systems theory perspective, four principles to be followed in planning and details six steps in developing a collaboration project between a free-standing private non-profit community mental health center and a suburban Roman Catholic parish.

关键词：出院后医疗/组织和管理社区精神卫生中心/组织和管理康涅狄格职业间关系牧师心理治疗系统论人类

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The Emergence of Adult Day Care Centers as Post-A cute Care Agencies

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Journal of Aging and Health 1989年第4期1卷 521-539页

作者： Wood, Juanita B. Institute for Health & Aging University of California San Francisco United States

Research on the effects of the Medicare Prospective Payment System utilizing DRGs on community service providers indicates that a heavier-care clientele is changing the nature of the community-based long-term care system. This article reports on the impact of DRGs on one provider type, adult day care centers, and the resulting shift toward post-acute care to meet the demands of this new heavier-care clientele. The 39 adult day care centers reported on are part of a larger sample of providers studied over three years in 12 communities within five states. © 1989, Sage Publications. All rights reserved.

关键词：出院后医疗/组织和管理社区卫生中心/组织和管理数据收集日间住院医疗/发展趋势 Medicare 方案评价美国老年人人类

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Community Occupational Therapy Associates: a model for community occupational therapy

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Canadian Journal of Occupational Therapy 1975年第4期42卷 155-156页

作者： Campbell, W. Godfrey, M. Peace, S. Quinn, B. Rasminsky, K.

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