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The effectiveness of a rural nursing center in improving health care access in a three-county area

JOURNAL OF RURAL HEALTH 2000年第2期16卷 177-184页

作者： Anderko, L Robertson, JF Uscian, MM No Illinois Univ Sch Nursing De Kalb IL 60115 USA

The purpose of this article is to describe an innovative nurse-managed health center that has been effective in improving access to primary health care for residents of a Midwestern three-county rural area. Penchansky and Thomas's (1981) framework evaluating health care access was used to analyze client satisfaction and utilization data. Findings clearly indicate success in improving access. Client satisfaction surveys consistently show a high level of satisfaction across all framework dimensions, including overall satisfaction with the health cave received. Utilization data indicate a steady increase in the number of clients served, especially those who ave uninsured or underinsured. This article demonstrates that key dimensions of access can be effectively measured using the Penchansky and Thomas framework and concludes with recommendations for enhancing the model.

关键词：社区卫生中心/经济学社区卫生中心/统计学和数值数据卫生服务易得程度/统计学和数值数据伊利诺伊缺医地区未参加医疗保险者护士/利用病人满意度/统计学和数值数据乡村卫生服务/经济学乡村卫生服务/统计学和数值数据人类

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SATISFACTION WITH CARE AND THE UTILIZATION OF DENTAL SERVICES AT A NEIGHBORHOOD HEALTH CENTER

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Journal of Public Health Dentistry 1975年第3期35卷 170-176页

作者： Murray, Bruce P. Wiese, H. Jean Department of Behavioral Science College of Medicine University of Kentucky Lexington Kentucky 40506 United States Department of Behavioral Science College of Medicine University of Kentucky Lexington Kentucky 40506 United States

The purpose of this research was to develop further information relevant to the problem of utilization of dental services at neighborhood health centers. The research objectives were: (1) A descriptive assessment of the utilization trends of the population served by a neighborhood health center; (2) Some determination of any possible correlation between failed appointments and patients' satisfaction with dental care; and, (3) Some exploration of possible reasons for non-utilization of scheduled dental appointments by a sample of patients from the neighborhood health center who report a history of previous dental treatment. From dental clinic daily appointment sheets, an assessment of utilization trends of a neighborhood health center population for a seven-month period (jon trends of a neighborhood health center population for a seven-month period (June 1, 1973 to December 31,1973) was obtained. In addition, analyses of patient treatment records and information obtained from personal interviews with 40 individuals from the health center population facilitated the completion of the second and third research objectives. The results indicated: (1) Compared to the findings of earlier research,-3 the reported ratio of broken to total appointments scheduled for this study population was substantially lower; (2) There is a rather strong relation between satisfaction with care and the utilization of dental services at the neighborhood health center studied; (3) Satisfaction with care is dependent upon a number of factors; and (4) Reasons given for nonutilization of scheduled dental services are practical ones, of which some are also reflected in the reasons given ofr dissatisfaction with dental care.

关键词：病人预约和时间安排态度社区卫生中心/统计学和数值数据社区卫生服务/统计学和数值数据牙科医疗牙科诊所牙科记录牙医病人关系牙医师/标准教育程度费用牙科肯塔基研究设计成年人女(雌)性人类男(雄)性

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ASSESSING EMPLOYEE ATTITUDES IN A COMMUNITY-BASED AIDS SERVICE ORGANIZATION

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EVALUATION & THE HEALTH PROFESSIONS 1994年第3期17卷 273-289页

作者： LIOU, KT RUISE, PL FLORIDA ATLANTIC UNIV SCH PUBL ADM220 SE 2ND AVEFT LAUDERDALEFL 33301 USA

This study surveyed employees of the Comprehensive AIDS Program of Palm Beach County, Florida, a community-based AIDS service organization, to understand employees' motives for working for the organization and their attitudes toward their jobs, the organization, its clients (persons with AIDS), and governments. The study revealed that the primary reasons employees work for the organization are a desire for personal involvement in the AIDS fight and the personal lifestyle and/or feeling of each employee. These employees were highly motivated, showing some very positive attitudes toward their jobs, organization, and clients. On the other side, these employees reported concern for future funding of their organization and unhappiness with both federal and state governments' role in the fight against AIDS. Based on these findings, the authors discuss implications for the management of AIDS service organizations, the quality of the AIDS service delivery system, and the future development of AIDS service organizations.

关键词：获得性免疫缺陷综合征/心理学医务工作者的态度社区卫生中心/人力社区卫生中心/统计学和数值数据评价研究佛罗里达健康知识态度实践卫生人员/心理学卫生人员/统计学和数值数据卫生服务研究职业满意士气动机问卷调查成年人老年人女(雌)性人类男(雄)性中年人

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Risk behaviours and seroprevalence to HIV, HBV and HCV in patients of the AIDS information and prevention center in Valencia, Spain

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Gaceta sanitaria / S.E.S.P.A.S 1999年第1期13卷 16-21页

作者： Alfonso Gil, R. Hurtado Navarro, I. Espacio Casanovas, A. Santos Rubio, G. Tomás Dols, S. Centro de Información y Prevención del SIDA Centro de Salud Pública de Valencia España. Valencia 46007 Spain

OBJECTIVE: The purpose of this study was to describe the sociodemographic and serologic profiles in a first time consultant population at the Information and AIDS Prevention Center of Valencia (Spain). In addition, the HIV infection risk factors were analyzed. METHOD: A cross-sectional study was performed on 1,573 persons who consulted during the year 1995. Sociodemographic and infection risk practices data were recorded and serologic information about HIV, HBV and HCV infection were obtained. Exact binomial method with a 95% interval confidence was used to calculate infection prevalence and the chi square test to make comparisons between qualitative variables. RESULTS: Sex distribution was 66,1% males and 31,9% females;mean age was 29,01 (SD: 9.2) years. Sexual intercourse without condom (25.2%) and parenteral drug abusers (22.6%) were the more frequent risk groups seeking consultation about HIV infection. Global HIV infection prevalence was 12.7% (95% CI= 11,2-14,5%). Among HIV seropositive patients, sexual transmission accounted for 30.8% of cases, of which 69.4% were heterosexual relations. The HIV infection prevalence for different risk groups were the following: parenteral drug abusers 36.8% (95% CI= 31,7-42%), heterosexual intercourse with an HIV-infected partner 24.1% (95% CI= 17,1-32,2%) and homosexual intercourse between men 9,5% (95% CI= 5,8-14,5%). HCV antibody prevalence for parenteral drug abusers was 81.2% (95% CI= 76,7-85,1%). Risk practices with a statistically significant association with HIV infection were: being an injecting drug abuser, as well as having an HIV infected and/or a injecting drug abuser partner. CONCLUSIONS: Drug parenteral abusers are still the target population for prevention programs. Data suggest that prevention and sexual education programs must continue. The main effort should be focused on the young population and on sexual partners of injecting drug abusers and/or HIV seropositive partners.

关键词：社区卫生中心/统计学和数值数据共病现象避孕套/利用横断面研究 HIV感染/流行病学 HIV感染/预防和控制 HIV感染/传播 HIV血清患病率健康教育肝炎乙型/流行病学肝炎乙型/传播肝炎丙型/流行病学肝炎丙型/传播患病率危险因素冒险血清流行病学研究性行为/统计学和数值数据性伴侣社会经济因素西班牙/流行病学物质滥用静脉内/流行病学青少年成年人女(雌)性人类男(雄)性中年人

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Measuring time utilization in rural health centres

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HEALTH POLICY AND PLANNING 1995年第4期10卷 415-422页

作者： Bryant, M Essomba, RO MINIST HLTH YAOUNDECAMEROON

Objectives. During the recent re-design of the primary health care system in Cameroon a time-motion study was undertaken to determine how health workers at rural health centres use their time before redefining their roles. Methods. The study developed a simple, effective and inexpensive tool which uses the activity sampling technique, and was applied to 20 health centres with a total of 19 080 observations being made of 64 health workers who represented all grades of worker in the government health services. Results. The study developed a clear picture of how health centre staff apportion their time, and how the division of labour and tasks Is carried out in a rural health centre. It found that only 27% of health workers' time is currently being spent on productive, health-related activities, and of this time, the largest proportion is spent on curative, clinical work. Less than 1% of health workers' time is spent on preventive and outreach activities. Discussion. This study has developed a simple and inexpensive tool which can be used in any health facility to determine how health-related activities are carried out. This is an important step if changes in the delivery structure are to be made, because it establishes the discrepancy between expected and actual behaviour, and provides an important baseline for the evaluation of the effectiveness of any changes that are introduced within the system.

关键词：喀麦隆社区卫生中心/人力社区卫生中心/统计学和数值数据数据收集发展中国家卫生服务研究/方法护理人员/统计学和数值数据护理人员/利用乡村卫生服务/人力乡村卫生服务/统计学和数值数据时间和运动研究

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