Measuring community hospital service in Michigan.

Using discharge abstracts from Michigan hospitals, we divided the state into hospital use communities with measured populations. We constructed population-based rates measuring use, cost, and some aspects of quality. The results cover 54 communities comprising 90 percent of the Michigan population and ranging in size from Detroit (population 600,000) to very small (population less than 25,000) communities. Age-adjusted patient days per 1,000 population, length of stay, cost per person per year, hospitalization rates for surgery, trauma and vascular disease, and childbirth problems show large variations, generally ranging from 2 to 1. High values usually are positively associated with each other and with population size. Patient days per 1,000 (mean 1,114, range 600-1,700) and cost per person(mean +223, range +110-+290) are distributed such that almost 75 percent of communities are below the mean. We believe this information will be useful to community hospital trustees, physicians, and administrators.     

Communities and hospitals: social capital, community accountability, and service provision in U.S. community hospitals

OBJECTIVES: The study related community social capital to the level of community accountability and provision of community-oriented services in U.S. community hospitals. STUDY SETTING: The sample included 1,383 community hospitals that participated in the 1997 American Hospital Association's (AHA) Hospital Annual and Governance Surveys. DATA SOURCES: (1) The 1997 AHA Annual Hospital Survey, (2) the 1997 AHA Hospital Governance Survey, (3) the DDB Needham Market Facts Survey, (4) the 1996 County Election Data File, and (5) the 1998 Area Resource File. RESEARCH DESIGN: The study used a mix of longitudinal and cross-sectional data. KEY FINDINGS: We identified two distinct indicators of social capital-community participation and voting participation. Community accountability in hospitals was unrelated to either indicator. Hospitals' provision of community-oriented health services was negatively associated with community participation but unrelated with voting participation. The interaction between voting participation and community representation on hospital governance was positively associated with community accountability and provision of community-oriented health services. CONCLUSION: Neither community participation nor voting participation was sufficient to influence hospital behavior. The positive finding associated with the interaction between voting participation and community representation on hospital governance underscored the importance of an active political culture in influencing hospital behavior, without which the installation of community representatives on hospital governance might be more symbolic than actually serving the health concerns of community residents.     

Twelve-step recovery and community service

Twelve-step fellowships have been viewed as possibly inhibiting participants' community involvement. This article reports on a qualitative study of 33 recovering people who attended a 12-step fellowship and involved themselves in the community to find out how this involvement was affected by their 12-step participation. This article describes the participants' community activity and their perceptions of how it related to their recovery process. Respondents reported that the fellowship prepared them for community activity by teaching them skills, giving them opportunities to practice participation with others, motivating them to contribute, and directing them toward community service. Implications for practice are discussed.     

加强社区医学科学研究 提升卫生服务内涵质量

为进一步培养和提高社区卫生服务医务人员的综合素质，提升社区卫生服务中心的工作水平。作者阐述了社区卫生服务医务人员课题研究的意义，总结了社区卫生服务医务人员课题研究设计的现状，指出了社区卫生服务医务人员课题研究设计方面的问题，并对如何提高社区卫生服务医务人员素质和课题设计提出建议。     

Service learning: integrating student learning and community service

Health professions education is directly effected by changes in health care service delivery and financing systems. In the United States, as the health care industry increasingly shifts to a market economy, service delivery venues are moving away from acute care facilities and into community-based settings. Additionally, there is increased emphasis on primary prevention programs, often provided in public health settings. For health professions programs that traditionally provide clinical training in hospitals and long-term care facilities, there are unique challenges associated with identifying new venues in order to insure that students are exposed to a wide variety of patients with a range of chronic to acute disease conditions. One set of tools that has demonstrated usefulness during these kinds of transitions is service learning. This teaching methodology emphasizes increased partnership with clinical training sites, extensive orientation to patient populations and community resources, structured reflection and instilling the ethic of service in future health care providers. Although this article describes utilization of service learning in the context of current conditions in the United States, we hope that the principles presented here can be readily adapted in any setting.     

Development of a community health service: a unique collaborative alliance.

This case study describes the development of a public health satellite facility, the Health Source of Grandview, Missouri, a collaborative alliance sponsored by a public teaching/community medical center and a religious-sponsored community medical center. The needs and alternative solutions are examined and planning processes are discussed, including the issue of community needs and values as well as roadblocks and barriers to collaboration, and how this model meets the criteria for the new paradigm of community collaboration and partnership espoused by so many in this era of health care reform.     

Volunteering and community service in adolescence

Since the 1980s, volunteering has been studied as an avenue for positive development in adolescents. Reviews in the early 1990s were mixed regarding the benefits of volunteering, questioning the ability to transfer volunteer skills to other aspects of life as well as the true reduction in risky behaviors the adolescent will go on to undertake. This article addresses the gaps in the prior reviews and looks more closely at the benefits of volunteering. The author suggests that adolescent volunteers develop fewer problem behaviors in their later teens, enjoy a sense of connection to their community, maintain a better work ethic, and show a greater concern for the welfare of others. There are innumerable options for integrating volunteering into the life of an adolescent. This article offers many options, reviews some of the most popular, and suggests conditions that may increase the success of a volunteering program.     

Levels of service in independent community pharmacies: a strategic group analysis.

A sample of independent community pharmacies was analyzed for the existence of strategic groups utilizing service variables exclusively. Results indicate that strategic groups corresponding to high, moderate, and low levels of clinically related services do exist in this sample of independent community pharmacies. In addition the performance implications of strategic group membership was tested. Results indicate there was no statistical difference in performance across strategic groups. Implications for theory and practice are discussed.     

社区卫生服务的管理模式与发展方向

社会发展规划确定后，要逐步健全服务网络，完善服务功能，落实预防保健任务，方便群众就医，减轻疾病负担。社区卫生服务适应疾病谱的转变和人口老龄化的趋势，在加强传统的传染病防治外，又将慢性非传染性疾病、地方病、职业病等的预防和控制纳入工作重点。为了切实贯彻预防为主的方针，完成三级预防的重要使命，本文对社区卫生服务的开展及其走向进行了探讨。     

Outbreak of human rotavirus infection in an adult community

INTRODUCTION: Group A rotaviruses are known as the major cause of severe dehydrating diarrhoea in infants. AIMS: In adults, the rotavirus infections are usually asymptomatic. In the present study the authors report a group A rotavirus outbreak in a psychiatric nursing home for adults. RESULTS: The outbreak lasted 3 weeks; the attack rate was 20%. The mean age of patients was 39 y (range 21 to 65; n = 25). The symptoms were mild, and most of the patients recovered within 2 or 3 days. The epidemiological data suggested that the virus was introduced by a patient, and it was transmitted by person-to-person route. Rotavirus positive specimens were characterised by serotyping and electropherotyping. The serotype-specific monoclonal antibody immunoassay demonstrated the circulation of a common strain with G1 specificity. These samples shared identical genome profile with strains circulated in the paediatric communities of the country. CONCLUSION: In Hungary, this is the first published gastroenteritis outbreak among adults caused by group A rotaviruses with G1 serotype specificity.     

关于当前社区卫生服务工作的思考

从十堰市社区卫生服务工作发展情况看 ,试点不难 ,普及不易 ,规范提高难度不小。我们认为进入全面普及、巩固提高、规范发展的阶段以后 ,重要的是要处理好 3种关系和发挥好 5个作用。1　正确处理 3种关系1.1　政府主导与卫生部门主办的关系　社区卫生服务是依靠社区组织推进的一种大众健康行为 ,包含有大量公共卫生与社会福利保障内容 ,是体现政府卫生政策的一项重要社会活动。因此 ,没有政府政策支持和主导作用 ,没有政府创造的社会环境条件 ,社区卫生服务就无法展开和健康发展。同时 ,社区卫生服务又是一种随着经济社会发展、群众健康需求…