Hospitals rural

One of the first large series of TeleStroke consultations was described in southern Germany, where seven rural hospitals were linked to a stroke unit in... 

In the REACH smdy involving the Medical College of Georgia and five rural hospitals in Georgia, 12 of 75 (16%) patients evaluated received rt-PA, all without intracranial hemorrhagic complications. 

TeleStroke consultation can therefore be performed quickly. Its efficiency compares quite favorably to the management of patients in rural Ontario" who receive rt-PA after transfer from a rural hospital to a tertiary-care center (the so-called ship and drip model). The patients located in mral Ontario had a mean total time of 138 minutes between presentation at the rural facility and dmg delivery at the tertiary-care center. The door-to-bolus time at the community hospitals linked to our TeleStroke service was 106 minutes, only 36 minutes longer than that measured by the urban acute stroke service in Houston, which permitted a mean door-to-bolus time of 70 minutes. Whereas the door-to-consult time within a telemedicine system may decrease with training and practice, interfacility transfer times, such as those observed in Ontario, are not easily shortened. 

Of note, allied health care professionals soon may routinely assume a role as referring TeleStroke providers at spoke hospitals a recent case report documented the first delivery of rt-PA by an advance practice nurse in the ED at a hospital in rural Texas networked by a TeleStroke system to a stroke center in Houston. ... 

FINANCIAL AND LEGAL CONSIDERATIONS Opportunities for Community and Rural Hospitals... 

Wang S, Gross H, Lee SB, Pardue C, Waller J, Nichols 3rd, FT, Adams RJ, Hess DC. Remote evaluation of acute ischemic stroke in rural community hospitals in Georgia. Stroke 2004 35 1763-1768. 

At age thirty-one Erica began medical school at the University of Colorado. She completed a three-year family practice residency in a Denver hospital, then went to Cuba, New Mexico, where she served as the medical director of a rural hospital as repayment for her National Health Service scholarship. After serving in that capacity she was married for two years. She has one son who is now ten years old. 

A dedicated treatment for HWWs is always desirable, especially for large hospitals in rural areas, where treated effluent may be indirectly re-used for... 

Sarker AK, Ghosh S, Barik K. 1990. A study of accidental poisoning (in children) in a rural medical college hospital of West Bengal. Indian J Public Health 34(3) 159-162. 

Basu S, Andrews JR, Poolman EM, Gandhi NR, Shah NS, Moll A et al. Prevention of nosocomial transmission of extensively drug-resistant tuberculosis in rural South African district hospitals an epidemiological modelling study. Lancet 2007 370(9597) 1500-7. 

Whatever the adverse effects of mifepristone, the risks have to be looked at realistically and compared with those of the alternatives available to a particular woman in particular circumstances. Particularly in rural areas in developing countries, the risks of surgical and non-professional abortion are high, whereas, as has been shown in a study in rural India, a regimen of mifepristone plus misoprostol can be used as effectively and safely, through family planning clinics and country hospitals, as in a European environment (2). 

Survey and Construction (Hill-Burton) Act of 1946 provided considerable funding for the renovation and expansion of existing hospitals and the construction of new ones, primarily in underserved inner-city and rural areas (Torrens, 1993). 

Gregg W, Moscovice I, Remus D. 2006. The Implementation of Pay-for-Performance in Rural Hospitals Lessons from the Hospital Quality Incentive Demonstration Project. Available at www.uppermidwestrhrc.org/pdf/ pay for performance.pdf. 

The physician at the rural clinic made arrangements to transport the child and her mother to the teaching hospital in the nearby city. At the hospital, she was given a complete examination by a physician in the Department of Family Medicine, and blood and urine samples were obtained. The weight of the patient (14.8 kg) was above the 50th percentile for fe-... 

The availability of capital resources is equally important. As mentioned, the current health care system— including the emergency, acute, and chronic care components—are all operating at maximal capacity. However, EMS vehicles, ED and hospital beds, and operating rooms will be needed in differing levels based on the incident (Auf der Heide, 2006 Pesik et al., 2001). For the EMS system, planners must know and address mutual aid issues. In upstate New York, Rural Metro Medical Services provides EMS in many cities and has a plan to shift resources between cities in event of crisis. Thus, additional ambulances, communications equipment, and maintenance facilities can be deployed throughout the region. In other areas, mutual aid compacts must be in place to allow for the immediate recruitment of as many additional EMS units as are needed (Auf der Heide, 2006). 

To deal with the health care dimensions of LEP, hospitals, clinics, and physician s offices must plan for and undertake a culturally competent response. The Rural Action Center, an initiative of the Department of Health and Human Services, defines cultural competence as... 

Reduced payments and high levels of uncompensated care have led to the closing of hospital facilities in both urban and rural blighted areas, making access to care even more difficult for some. Whiteis and Salmon refer to this phenomenon as disinvestment in the public goods. Because privately owned and not-for-profit hospitals and private clinics, pharmacies, and physician s offices must rely on their own financial soundness, any threat to that foundation may lead to closure. 

Hospitals in inner cities and blighted rural areas also care for a higher proportion of at-risk patients than hospitals in the for-profit sector generally located in more affluent areas. In fact, affluent hospitals sometimes dump their uncovered patients on charity care and other public hospitals in order to reduce their financial risks. This, however, increases the financial risks of public or charity hospitals. Again, the reimbursement levels under present schemes for large numbers of at-risk patients simply do not cover costs thus, the United States has witnessed hospital closings, particularly in those areas where such loss is most noticeable. ° ... 

Christianson, J.B. Institutional alternatives to the rural hospital. Health Care Financing Review 1990, 11 (3), 87-97. 

An observational comparison in a rural Ghanaian hospital of 2083 pregnant women and 3084 historical controls showed no serious adverse events with chloroquine chemoprophylaxis (300 mg/week), but a high rate of pruritus (34). There was a decrease in anemia in pregnancy but no increase in perinatal mortality or birth weight in the chloroquine-treated mothers, although this was only in comparison with historical controls. 

French investigators have evaluated the presence of serum markers of hepatitis A, B, and C viruses in a rural population of 303 volunteers (107). The main risk factors for positivity were past hospitalizations (72%), acupuncture (18%), conjugal unfaithfulness (11%), blood transfusion (9.4%), tattoos (5.8%), homosexuality (1.1%), and intravenous drug addiction (0.73%). 

In two-thirds of rural hospitals, nurse anesthetists provide all anesthesia services. In city hospitals, they work under anesthesiologists. These nurses also work in outpatient clinics and physicians offices. As they regulate the anesthetic, they monitor body functions to make sure they stay in balance and the patient stays out of danger. 

PHC Project (Primary Health Care) was introduced in 1981. This provides basic medical care to rural areas through hospitals and health centers. District Hospitals and Provincial Hospitals act as referral hospitals. The Philippines Department of Health has allocated 60% of its budget to the running of government hospitals. The government spends 40 million on pharmaceuticals, amounting to 16% of the Department of Health budget, but... 

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