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Showing papers by "Bethesda Hospital published in 1994"


Journal ArticleDOI
TL;DR: This article uses survey data collected in conjunction with an Indonesian self-sufficiency program to assess the differential magnitudes of contraceptive usage responses to price differentials between sample-wide and relatively poor households, and for both subsidized and full private-sector prices.
Abstract: Imposing or increasing user fees can move family planning programs toward self-sufficiency. But, economic theory predicts that quantities demanded decrease following price increases; and, that the size of the response depends, all else constant, upon the share of income accounted for by spending on the good or service. This article uses survey data collected in conjunction with an Indonesian self-sufficiency program to assess the differential magnitudes of contraceptive usage responses to price differentials between sample-wide and relatively poor households, and for both subsidized and full private-sector prices. We find a much more substantial response among poor households. As prices move up toward full cost-recovery, the effect is magnified.

18 citations


Journal Article
TL;DR: Pregnancy is a risk factor and has been associated with a high maternal and fetal mortality rate, and acyclovir appears to improve the outcome.
Abstract: Hepatitis is a rare but serious complication of a herpes simplex viral infection. Pregnancy is a risk factor and has been associated with a high maternal and fetal mortality rate. Acyclovir appears to improve the outcome.

14 citations


Journal ArticleDOI
D. Foulner1
TL;DR: A case of granular cell tumour (GCT) of the biliary tree is reported with the first published sonographic images of this tumour.

10 citations


Journal ArticleDOI
TL;DR: The use of information services to support tracking systems, process improvement teams, Hoshin planning, daily control/process management, simulation modeling, and a continuous operational assessment and response (COAR) system has been an integral part of the TQM effort at Bethesda Hospital.
Abstract: Article-at-a-Glance Background An information support system is needed to locate, integrate, and present data to track and communicate the progress of quality efforts. Bethesda Hospital’s executive information system (EIS) has been developed and refined on an ongoing basis to support a variety of total quality management (TQM) functions. Process improvement teams One basic area where information systems must support TQM is in the availability of data for use by process improvement teams; without such support the entire process of data gathering and analysis would often be prohibitively difficult. Teams also need data to evaluate the results of changes to the improved process. Daily control/process management Once core and critical work processes are identified and improvement targets are set, a system of interlinking measures can be established to allow the monitoring and improvement of the processes. Simulation modeling Models have been used to support and facilitate design or redesign of major processes. Continuous operational assessment and response system The purpose of this decision support system is to monitor a department’s core processes and to provide data and a process for quick response to environmental changes. Conclusion The use of information services to support tracking systems, process improvement teams, Hoshin planning, daily control/process management, simulation modeling, and a continuous operational assessment and response (COAR) system has been an integral part of the TQM effort at Bethesda Hospital.

7 citations


Journal Article
Ansel De1, Berte Er
TL;DR: This article examines the successful contractual relationship between the Procter & Gamble Company of Cincinnati, OH, and Bethesda Behavioral Health Services, a division of Bethesda Hospital, Inc., a multiservice regional healthcare provider also based in Cincinnati.
Abstract: With the healthcare reform process stalled, direct contracting between employers or business coalitions and regional behavioral healthcare providers remains an effective way for employers to offer enriched managed behavioral healthcare services. This article examines the successful contractual relationship between the Procter & Gamble Company of Cincinnati, OH, and Bethesda Behavioral Health Services, a division of Bethesda Hospital, Inc., a multiservice regional healthcare provider also based in Cincinnati. Although Procter & Gamble has been committed to employee assistance program (EAP) services for more than 15 years, it determined in 1989 that a comprehensive managed care/EAP gateway plan best fit its employee relations philosophy and its need to improve the quality and reduce the cost of behavioral healthcare without reducing benefits. This article describes how that idea evolved into today's successful direct contractual relationship between Procter & Gamble and Bethesda.

2 citations


Journal ArticleDOI
Rod Watts1
TL;DR: It is recommended that general practitioners should refer patients with suspected prostate cancer to a urologist and leave the decisions to the specialist, but this black box model of referral is no longer acceptable to general practitioners and patients.
Abstract: specialist colleagues, need to admit that we do not know the answers. Despite this uncertainty, Stuart Taylor recommends that general practitioners should refer patients with suspected prostate cancer to a urologist and leave the decisions to the specialist. However, this black box model of referral is no longer acceptable to general practitioners and patients. We should match patient preference for aggressive or conservative management to the specialist who is flexible enough to suit the patient's needs. General practitioners need to know what sort of advice and opinions patients will receive when referred. We will then be able to counsel our patients and help them make informed decisions about their choice of specialist and, hence, the approach taken to the management of their disease. The black box should, therefore, develop a degree of translucency, if not total transparency. Prospective studies are needed to improve our knowledge of prostate cancer.s We need to determine whether men with prostate cancer detected through screening have a better health outcome than those who are not screened. We must provide evidence to indicate whether watchful waiting or active intervention is better in a given clinical situation. Only then will general practitioners and urologists be able to treat men with this common disease objectively and effectively.

2 citations


Journal ArticleDOI
TL;DR: This paper presents a personal account of reactions that occurred after one particular accident, places it within the context of a cohort of emergency workers, and refers to current research findings.
Abstract: Reactions can and do occur among personnel after involvement in large scale road accidents and disasters in general. This paper presents a personal account of reactions that occurred after one particular accident, places it within the context of a cohort of emergency workers, and refers to current research findings. The prevalence of intrusive phenomena within the first week, particularly visual memories, is documented, as is the impact to lifestyle which they cause. Assessments at one month illustrate that psychological reactions, for the majority of workers involved, persist at least in the short-term.* These reactions continue in spite of the provision of psychological follow-up, which questions the efficacy of the provision of these strategies to personnel after a trauma.

2 citations