Air medical services began in Massachusetts in 1982, and Utilization Review (UR) of both programs in the state began in 1985. The UR program consists of external review of all flights according to screening criteria established by an independent Helicopter Utilization Review Committee (HURC). Between 1982 and 1989, over 2,500 ...

This study reports the results of a retrospective analysis of the use of a range of inpatient and outpatient services by the members of a health maintenance organisation (HMO), in which most providers are salaried, and by the members of three medical aid schemes in which providers are paid on ...

The purpose of this study was to compare accident rates of helicopter emergency medical services (USA-HEMS) to domestic air taxi service (USA-Taxi) and helicopter emergency medical services in the Federal Republic of Germany (FRG-HEMS). Contingency tables compared the total hours flown to the number of fatal and non-fatal accidents for ...

This paper examines the question of access to traditional Indian medical systems in the western Canadian city of Saskatoon. The data demonstrate that many Natives desire such access, and do not see difficulties in having Indian healers available in Western-style biomedical clinics. A variety of language variables proved to be ...

Medical publications contain numerous references to obstacles or disincentives confronting patients who wish to return to work after illness or injury. Current developments of importance to this aspect of medical practice and four recent studies, conducted in Edinburgh, that may contribute to the continuing debate about how best to deal ...

The Vietnam Era Twin Registry consists of 4,774 male-male twin pairs born between 1939 and 1957 with both brothers having served in the United States military during the Vietnam War. The registry was originally developed to provide the best control group for Vietnam-exposed servicemen to study the long-term health consequences ...

The Czechoslovakian system of centralized dispatch of all emergency medical services prevents competition between ground ambulances and air medical services. Although this program is less than two years old, remarkable progress has pushed Czechoslovakia to the forefront of modern-day air medical transport. However, the future of Czechoslovakian air medical transport ...

The Danish helicopter rescue service in its present form was founded in 1966. The use of the Sikorsky (S-61) helicopter has generally been satisfactory. In 1973, the crew was supplemented by an aerospace-medically-educated and helicopter-trained physician. From 1973 to 1989 there were 5,733 missions, of which direct medical intervention occurred ...

A mail survey was conducted in rural northeastern Missouri to study the factors affecting use of Veterans Administration (VA) outpatient medical services by older veterans. During the year preceding the survey, 39.6% of the 169 responding veterans had used VA outpatient facilities. Travel time, long waiting time at the clinic, ...

The Association of Israeli and Palestinian Physicians for Human Rights was established during the first months of the uprising, against the background of a severe situation in which people were killed and wounded daily. AIPPHR works for the protection of human dignity and human life; defending physicians and patients in ...

Youths who are detained or incarcerated in correctional facilities represent a medically underserved population that is at high risk for a variety of medical and emotional disorders. These youths not only have a substantial number of preexisting health problems, they also develop acute problems that are associated with their arrest ...

The experience of an affiliation between a hospital-based clinic and a family shelter is presented. The medical implications of family shelter residence include special issues related to the spread of infectious diseases, particularly to the neonate. Preentry medical evaluation revealed that a large proportion of children and their parents had ...

The National Disaster Medical System (NDMS) was formed to provide medical assistance to civilian disaster areas. Disaster Medical Assistance Teams (DMAT) are subunits of NDMS and could be transported to the disaster area. For DMAT to function, a team must be able to provide for itself. The Bethesda DMAT established ...

The aim of the study was the determination of main motives for non-utilization of medical services by persons with symptoms of angina pectoris. We found that in the representative sample (Lodz, Poland) 38% of them fail to seek medical services. Age, occupation, self-estimation of health, the presence of a trusted ...

The social files and medical records of 98 acutely battered wives who attended a surgical emergency department were studied. Although all women had been hospitalized during the decade preceding the present incident, wife battering was documented in the records in only 18%. The majority of the women (73%) were also ...

In May 1990 a team of 12 personnel from the Royal Naval Medical Service flew to Marrakech and were then transported by truck to the village of Imlil to commence a 12-day trek into the High Atlas Mountains with the primary aim of ascending the summit of Mount Toubkal and ...

Although aviation medical support to flight deck crews and cabin staff has been the subject of numerous articles, information about occupational medical support to ground crews, maintenance personnel, and other behind-the-lines personnel who help to "keep them flying" has rarely been presented. This report discusses the occupational medical support provided ...

In this case, a medical center learns how to evaluate each of its services along a Product Life Cycle curve. Each stage of the cycle has characteristics that suggest appropriate strategic growth and action orientations. When services were plotted along the Product Life Cycle curve, many of the services were ...

The concept of the "medical home" was adopted by the Hawaii Medical Association and the Hawaii Chapter of the American Academy of Pediatrics in the Child Health Plan over 10 years ago. The medical home is an integrated system of services that focuses on the well-being of the child, within ...

The increased concern about the quality of medical services evidenced by, inter alia, the growing attention to quality of Peer Review Organizations. The purchasing and implementation of sophisticated medical data systems by hospitals, and the growing clamor from private health insurers and employers about the rapidly rising costs of health ...

This notice describes the data, standards, and methodology that we will use to establish fiscal intermediary and carrier budgets for fiscal year (FY) 1990. Intermediaries and carriers assist in the administration of the Medicare program by performing numerous functions related to paying for medical services and equipment. This notice implements ...

The French emergency medical system (EMS) is the Service d'Aide Médicale Urgente (SAMU). In case of mass casualties, involving 100 simultaneous victims, SAMU has developed a disaster plan, "The White Plan." This plan is closely correlated to the Red Plan of the Fire Department, to provide advanced life support (ALS) ...

Using a medical, social, and functional assessment form, we found several measures which were reliably associated with a criterion of impending mortality; activities of daily living were most highly correlated, medical assessment and services needed were correlated less strongly, but visual impairment and the cumulative total of all measures were ...

Expensive diagnostic and treatment services and equipment are naturally suited to large, populous medical market areas, with sufficient forecasted service demand to justify the large investment in capital, construction and staffing. Only major tertiary or secondary medical centers with shared resources can justify the first-generation investment in the multimillion-dollar purchases ...

HIV infection in the workplace reflects the dimensions and distribution of the problem in the community at large. Despite this, accommodation of ill employees has been the general pattern and disruptions of any kind the exception. Corporate medical departments can be important participants in the clinical and social response to ...

In 1980 an international working party postulated a definition for a disaster. Later this concept was formulated into a classification and scoring system. This system has now been refined to be used prospectively during the management stage of a calamity. By calculating the medical severity index, which is the product ...

This study examined physician test-ordering behavior at a large urban Veterans Administration Medical Center staffed by two medical schools. Patients are assigned randomly to the two schools' wards, which operate independently of each other. The medical records of 119 patients, admitted during a 5-month period, were abstracted for data on ...

Since 1980, cost containment efforts have radically transformed the delivery of medical services in the United States. The number and diversity of private, for-profit delivery systems have significantly increased and so has the competition among them. Some Marxists have conceptualized these changes as a transition from a non-commodity to a ...

An accurate and efficient x-ray film-retrieval service was needed in the radiology department at Los Angeles County-University of Southern California Medical Center. In July 1986, the radiology department implemented the radiology film-management system in concert with the surgery department. The centralized radiology film files were replaced by service bins, each ...

The Vietnam War heightened civilian awareness as to the use of helicopters for medical evacuations. This led to the initiation of federally funded projects aimed at determining whether helicopters were practical for civilian aeromedical transports. In 1972, a Department of Transportation (DOT) summary concluded that helicopters for civilian medical transports ...

The reintegration of the medical profession's clinical activities is a goal worth pursuing. For the patient it could have considerable advantages with continuity of care, greater coordination of services, quality assurance, and a more cost effective service. For the medical profession there would be a greater cohesion, improved peer review, ...

How does Support Services maintain user confidence while moving the laundry and central supply departments offsite? That challenge faced The Mont Sinai Medical Center, a 1112-bed Manhattan hospital and medical school, as it prepared for a 5-year, $488 million major modernization program, set to begin in the summer of 1985. ...

The Report of the Royal College of Physicians on Physical Disability in 1986 and Beyond gives details of a Medical Disability Service to redress the present imbalance in the provisions for the physically disabled. An integral part of this service should be the provision of adequate scientific and technical resources, ...

Isokinetic measurements are widely used by physical therapists for evaluation and treatment planning. We believe that some use of isokinetic measurements is unwarranted in view of the paucity of credible scientific research on these measurements. With increased emphasis from third-party payers and from the medical community for documentation of the ...

Psychotherapy, especially the intensive variety, has been put under considerable adverse pressure by changes in the economics of medicine and psychiatry. The dominance of third-party rather than out-of-pocket payment for services raises questions about the "medicality," and thus the eligibility for coverage, of some disorders treated with psychotherapy. Trends toward ...

To study the impact of airline medical departments on pilot disability, three major U.S. airlines, nominally airlines A, B, and C, were chosen because they had distinctly different medical programs. Airline A provided essentially no medical review. Airline B performed preemployment screening and assessment of individual disability claims, along with ...

A feasibility study has shown that it is possible to apply the principles of stroke unit management to patients and their families on general wards. Ninety-one consecutive stroke patients were managed by a multidisciplinary stroke therapy team which was co-ordinated by a medical registrar, met weekly, and developed a family ...

During 1984 a short summary of all recruits who failed their recruitment medical examination at Leven was kept. An overall failure rate of 19% was discovered and no recruit examined in 1984 from Army Careers Information Office, Leven, was dismissed from service on medical grounds. It seems quite likely, therefore, ...

A major policy issue in the health sector is the relationship between the outcomes of a medical procedure provided by differently qualified medical personnel, and in which the medical service supplied by the different groups of providers are differently priced. This problem, which exists in health systems which have providers' ...

A fundamental aim of medicine is to protect and promote health. The practice of medicine has, however, been used to promote political aims which may be detrimental to health. The article attempts to isolate the ways in which political abuses may interfere with good medical practice: by allowing health policies ...

This is the second of two articles highlighting Army radiography during World War II. Topics center around the certification of Army radiographers, rank structure, scope of service, adverse working conditions, improvisations, and contributions by Arthur W. Fuchs. The contributions of Army radiographers during World War II were significant in helping ...

Subsequent Nigerian Governments since independence have been committed to a policy of health-for-all. The right to medical care is now constitutionally guaranteed. But it takes more than the constitution to translate medical, and indeed all rights, to reality. In practice, as this study reveals, status, power and privileges determine whether ...

This is a report of an occupational survey of the Medical Service (AFSCs 90 2X0/A/B/C) career ladder completed by the Occupational Analysis Division, USAF Occupational Measurement Center, in May 1986. The survey was requested by the School of Health Care Sciences (SHCS/MSO), Sheppard AFB TX, to: (a) evaluate changes in ...

To obtain improved emergency medical services at the Minneapolis/St. Paul International Airport, a combination of utilization of existing fire, police, and medical services and improved technology was adopted. Exemplified by the use of EMT and an automatic cardiac defibrillator/pacer (Heart Aide), this system resulted in increased survival for victims of ...

Medical physics services maintain a pivotal role in the efficient management of diagnostic, therapeutic, and research resources in medical facilities. As cost containment pressures increase, reliance on this service, once seen as a pure "cost center," for assistance in controlling costs and maintaining quality service also increases. This article will ...

Aspects of the mental health care provided in an adolescent medical setting are examined. Over a six-month period, 38 patients were admitted to an inpatient adolescent medical unit because of drug ingestion. Following evaluation by the adolescent medical team, psychiatric consultations were requested in 47 percent of the cases. Most ...

Helicopter emergency medical services (HEMS), which are both expensive and resource intensive, lack objective measures for system evaluation. We computed the Therapeutic Intervention Scoring System (TISS) score for all patients during six consecutive months of service in a HEMS program to assess the value of this score for measuring the ...

This article has examined the application of a marketing and community planning process to the development of a regional, complete patient transportation system. The model is designed to interface with a region whose existing Emergency Medical Service System is operating at the advanced Life Support (usually paramedic) level. It is ...

A major equipment purchase represents a large outlay of cash and effort by a medical group practice. The prudent buyer will carefully negotiate with the seller in a number of areas before any final arrangements are made. These include a detailed description of what is being purchased; price; warranties and ...

Medical departments within industry vary widely. Some large companies have virtually no medical department. Some have a dispensary-type set up, where band aids or aspirin are dispensed, and the nurse refers out anything more serious. In contrast to this, some companies employ full-time internists or preventive medicine specialists, part or ...