We review 1980s research on American rural hospitals within the context of a decade of increasing restrictiveness in the reimbursement and operating environments. Areas addressed include rural hospital definitions, organizational and financial performance, and strategic management activities. The latter category consists of hospital closure, diversification and vertical integration, swing-bed c...

BACKGROUND General surgeons form a crucial component of the medical workforce in rural areas of the United States. Any decline in their numbers could have profound effects on access to adequate health care in such areas. HYPOTHESIS We hypothesize that the rural areas of the United States are relatively undersupplied with general surgeons. DESIGN AND SETTING The American Medical Association'...

In this Kenyan study of patient perceptions of major surgery and involvement in decisions to operate, the attitudes of 89 female and 23 male patients who had undergone major surgery at a district hospital were studied. Semi-structured interviews were conducted in the wards by a social worker who had no employment or other relationship with the hospital. In 48 cases the decision about the operat...

AIMS To determine the characteristics of trichiasis patients presenting for surgery in Wolayta Zone of Ethiopia. METHODS Patients referred for trichiasis surgery by community health agents were evaluated by trained integrated eye care workers (IECWs) for the presence of trichiasis, locations of inturned lashes, severity of trichiasis, corneal opacity, and visual acuity. RESULTS 1635 individ...

PURPOSE The authors review their experiences during multiple cleft surgical missions to rural Bangladesh from 2006 to 2008. A significant number of patients who underwent primary palatoplasty or cheiloplasty were of adult age or size. Adult primary cleft lip and palate repair is often more challenging than repair at the standard age of fewer than 2 years. This patient population is rarely seen ...

Our professional organizations have prepared this paper as part of an integrated, multidisciplinary plan to ensure the availability of well-trained practitioner teams to sustain safe, effective and high-quality rural surgical and operative delivery services. Without these robust local (or nearby) surgical services, sustaining rural maternity care is much more difficult. This paper describes the...

BACKGROUND Patients in isolated rural communities typically lack access to surgical care. It is not feasible for most rural first-level hospitals to provide a full suite of surgical specialty services. Comprehensive surgical care thus depends on referral systems. There is minimal literature, however, on the functioning of such systems. METHODS We undertook a prospective case study of the refe...

OBJECTIVES The Australian Commission on Safety and Quality in Health Care released recommendations for antimicrobial stewardship programmes to be established within all Australian healthcare facilities. However, implementation practices are not well defined. The aim of this study was to gain an understanding of factors affecting implementation of antimicrobial stewardship programmes within Aust...

OBJECTIVE To improve the clinical management of severely malnourished children in rural hospitals in South Africa. STUDY DESIGN A pre- and post-intervention descriptive study in three stages: assessment of the clinical management of severely malnourished children, planning and implementing an action plan to improve quality of care, and monitoring and evaluating targeted activities. A particip...

Method: A retrospective comparative study, with representative samples of pregnant women, were randomly selected for the respective years 1999 and 2004. Descriptive statistics were calculated depending on measurement scale. A Z-test was carried out to assess the significant difference (p < 0.05) in proportions between pregnancy complications and outcomes of the groups. Multivariate logistic reg...