The private practitioner in hospital quality assurance

External forces continue to dictate the necessity of delivering high-quality health care along with methods of proving that the claimed quality is attained. Gone are the days when both the institution and its practitioners could answer quality questions simply by stating that they were delivering excellent health care to their patient population. The federal government, via the Health Care Financing Administration, and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) are mandating that institutions prove, without question, that they are delivering health care of the highest quality. The essential key to attaining these goals is cooperative private practitioners.     

Correlates of honor ratings in a clinical clerkship employing a faculty forum evaluation system

5he purpose of this study was to determine whether or not suspected variables affected a surgery clerk's chances of being awarded an honor rating. Findings indicated a significant relationship between a student receiving an honor rating and his or her preceptor's predetermined level of student advocacy, the number of completed patient interview and physical examination write-ups, and final examination scores. There was no significant relationship found between honor ratings and the preceptor's status, the sequence in which the student was discussed or the length of time spent discussing the student at the final evaluation meeting, or the number of clinical faculty present at the meeting. These results lend support to the faculty forum evaluation approach, but suggest a need for further scrutiny of some influencing variables to ensure all students are fairly considered and honor ratings judiciously awarded.     

Geographic distribution of undocumented immigrants: estimates of undocumented aliens counted in the 1980 census by state

"This article presents estimates of the number of undocumented aliens counted in the 1980 [U.S.] census for each state and the District of Columbia. The estimates, which indicate that 2.06 million undocumented aliens were counted in the 1980 census, are not based on individual records, but are aggregate estimates derived by a residual technique. The census count of aliens (modified somewhat to account for deficiencies in the data) is compared with estimates of the legally resident alien population based on data collected by the Immigration and Naturalization Service in January 1980." Estimates are provided "for each of the states for selected countries of birth and for age, sex, and period of entry categories.... The origins of the undocumented alien population [are described], as well as some of their demographic characteristics. Some of the implications of the numbers and distribution of undocumented aliens are also discussed." This paper was originally presented at the 1984 Annual Meeting of the Population Association of America (see Population Index, Vol. 50, No. 3, Fall 1984, p. 435).     

Mental health services for Chinese in a community health center

Serious mental health problems exist within the Chinese population of the United States. This article describes one center's attempt to meet the psychiatric needs of both nonpsychotic and psychotic Chinese patients through bilingual, culturally relevant treatments.     

Bicol hospital reaches out to rural folk

The Ago General Hospital in Legaspi City of the Philippines was opened in 1965, antedating the national family planning movement by 5 years. The 180 bed hospital integrates family planning into the overall hospital service; sterilization is the main method used. Of the 3600 patients per year, 15% are family planning acceptors. The hospital employs 3 family planning strategies: inhospital, out patient and supportive. Inhospital strategies center on sterilization counseling and motivation. The counseling sessions include patient education. Primary targets include high risk pregnancies and young couples with a lot of children. Outpatient strategies include a referral system involving hospitals and agencies with family planning programs, lectures for community organizations and personal visits to other clinics and rural health units. The hospital's mobile clinic, staffed mainly by students, provides information, deworming, and pediatric services to the community. Supportive program strategies consist of mass communication, and an acceptor's club for previous acceptors of sterilization. These clubs meet regularly to share and discuss experiences.     

Outreach: helping achieve coordination in the field

The outreach officials of the National Population Program of the Philippines, with its 4 basic functions of research, training, information-education-communication, and clinic services, are trying to solve pressing problems which have been an outgrowth of developments of the early 1970s when population and family planning concepts were integrated into other government programs. Given the task of attacking these problems and coordinating the whole program was the newly organized Commission on Population (Popcom). The organizations which had their own programs cooperated with the government agencies. Initially thought of as workable, the early strategy was soon found to be inadequate, and in July 1975, Popcom implemented an integrated development approach in population work. The strategy is complex, and as it undergoes refinement, the program may well profit from the experiences or lessions gained by a number of agencies in carrying out population/development activities. The approach used by the Office of Nonformal Education of the Philippines Rural Reconstruction Movement is seen as potentially helpful to the outreach project in developing 3 types of leadership in order to properly integrate or link private and public agencies, and ensure a continuing development program: political, educational, and technical. It is stressed that outsiders can help, but it is the community which must basically do the job themselves. So different government technicians are trained so that they can effectively train other people from the community, and do it in such a way that the program will be continuing and self-releasing.     

Declining world fertility: trends,causes, implications

This Bulletin examines the evidence that the world's fertility has declined in recent years, the factors that appear to have accounted for the decline, and the implications for fertility and population growth rates to the end of the century. On the basis of a compilation of estimates available for all nations of the world, the authors derive estimates which indicate that the world's total fertility rate dropped from 4.6 to 4.1 births per woman between 1968 and 1975, thanks largely to an earlier and more rapid and universal decline in the fertility of less developed countries (LDCs) than had been anticipated. Statistical analysis of available data suggests that the socioeconomic progress made by LDCs in this period was not great enough to account for more than a proportion of the fertility decline and that organized family planning programs were a major contributing factor. The authors' projections, which are compared to similar projections from the World Bank, the United Nations, and the U.S. Bureau of the Census, indicate that, by the year 2000, less than 1/5 of the world's population will be in the "red danger" circle of explosive population growth (2.1% or more annually); most LDCs will be in a phase of fertility decline; and many of them -- along with most now developed countries -- will be at or near replacement level of fertility. The authors warn that "our optimistic prediction is premised upon a big IF -- if (organized) family planning (in LDCs) continues. It remains imperative that all of the developed nations of the world continue their contribution to this program undiminished."