Bmc Health Serv Res
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Bmc Health Serv Res · Apr 2008
Emergency hospital services utilization in Lleida (Spain): A cross-sectional study of immigrant and Spanish-born populations.
The use of emergency hospital services (EHS) has increased steadily in Spain in the last decade while the number of immigrants has increased dramatically. Studies show that immigrants use EHS differently than native-born individuals, and this work investigates demographics, diagnoses and utilization rates of EHS in Lleida (Spain). ⋯ In Lleida (Spain), immigrants use more EHS than the Spanish born population. Future research should indicate whether the same pattern is found in other areas of Spain and whether EHS use is attributable to health needs, barriers to access to the primary care services or similarities in the way immigrants access health care in their countries of origin.
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Bmc Health Serv Res · Apr 2008
ReviewEffects of intensive home visiting programs for older people with poor health status: a systematic review.
Home visiting programs have been developed aimed at improving the health and independent functioning of older people. Also, they intend to reduce hospital and nursing home admission and associated cost. A substantial number of studies have examined the effects of preventive home visiting programs on older people living in the community; the findings have been inconsistent. The objective of this review was to assess the effectiveness of intensive home visiting programs targeting older people with poor health or otherwise with functional impairments. ⋯ We conclude that home visiting programs appear not to be beneficial for older people with poor health within the health care setting of Western countries.
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Bmc Health Serv Res · Apr 2008
Comparative StudyMeasuring and explaining mortality in Dutch hospitals; the hospital standardized mortality rate between 2003 and 2005.
Indicators of hospital quality, such as hospital standardized mortality ratios (HSMR), have been used increasingly to assess and improve hospital quality. Our aim has been to describe and explain variation in new HSMRs for the Netherlands. ⋯ HSMR scores vary substantially between hospitals, while rankings appear stable over time. We find no evidence that the HSMR cannot be used as an indicator to monitor and compare hospital quality. Because the standardization method is indirect, the comparisons are most relevant from a societal perspective but less so from an individual perspective. We find evidence of comparatively higher HSMRs in academic hospitals. This may result from (good quality) high-risk procedures, low quality of care or inadequate case-mix correction.