No abstract available.
Hospitals, Community* ; Humans

In this paper strategic planning is applied for effective management to improve hospital income. Though community hospital has been set up for improving the health status of community, it must be trying to increase income for continuing with referral hospital in the community. The most useful tool of management to do this purpose is thought of strategic planning. Therefore this paper developed strategic planning a typical community hospital, which for it presenting the strategic planning process and developing the simulation model for evaluation of strategic alternatives. In the result it is represented that admission rate is the most sensitive to hospital operating income among the important variables in the model. And simulation by changing the parameter could estimate the yearly hospital income in the response of alternatives. This strategic planning simulation model has had constraints as number of date but also significant such as evaluating the alternatives by quantitative model and at first applying the hospital in our country.
Hospitals, Community* ; Referral and Consultation

No abstract available.
Family Practice* ; Hospitals, Community* ; Humans

Anjo Kosei Hospital was instituted in March 1935. In those days many people in rural areas of our country were suffering from poverty and illness. Of the numerous agricultural cooperative hospitals and clinics that were established across the nation in the 1930s with the spirit of cooperation, many were inaugurated with a heroic resolve. However, the Kosei Hospital in Anjo founded by the Maruheki Association was fraught with optimism and great promise. The reason for this was that the county of Hekikai-gun was, at the time, called the “Denmark of Japan” and boasted the largest business expenses among all the counties in the nation. In order to return the surplus to group members, a plan to build a hospital was drafted with the advice of Nobukichi Yamazaki, the first principal of Anjo Norin (Agricultural and Forestry) Senior High School. He used to say, “The greatest threats to a farmer's livelihood are accidents and sicknesses. There can be no happiness without good health. We should build an agricultural cooperative hospital to provide its members with modern health care.”Initially, the hospital had 34 beds, eight medical departments, and 40 staff members, including seven physicians. Control over the hospital was transferred to Aichi Koseiren (the Aichi Prefectural Federation of Agricultural Cooperatives for Health and Welfare) in 1948, after having tided over a shortage of labor prior to World War II and during the chaotic postwar period. The hospital began togrow rapidly, measuring up to the expectations and trust placed by local residents. Through enrichment of functions and expansion of the wards, the institution went on to become what could be called a citizens' hospital of Anjo and in fact, the largest hospital in the Nishi-Mikawa area. With the passage of time, the hospital got cramped for space and the buildings decrepit, adversely affecting not only the care environment but also disaster prevention measures. To maintain medical standards, hospital relocation was a must. In May 2002, the hospital moved to the present site, thanks in part to the support of the City of Anjo.After relocation, the hospital decided to give priority to treatment of acute diseases. Now, the number of hospital employees has been increased to 1,205, including 128 physicians and 676 nurses. In addition, there are 40 interns. Designated as an emergency medical care center, the hospital is the nucleus medical institution in the southern part of the Nishi-Mikawa area.However, due to the excessive concentration of patients in this hospital, it has come to pass that all the 692 beds are almost always occupied. This has inevitably made it difficult for the hospital to accept emergency patients. Measures to combat the situation, such as bed control, shortening the length of hospital stay and referring patients to other facilities have reached their limit. Therefore, further effort must be put into the division of hospital functions in the community. The required number of personnel such as physicians and nurses currently reaches the full quota, though only barely. Nonetheless, it would become more difficult even to maintain the present level.The 71-year history of Anjo Kosei Hospital reminds us of our predecessors' will and wishes to work hand in hand with the community to promote the health andwell-being of the people. We would like to continue to be a hospital that appeals not only to local residents but also to physicians and nurses by upholding the following basic principles:1. To contribute to the health and happiness of local residents through health care.2. To place patient care at the center of all the activities of the hospital.3. To create a work environment which the staff can be proud of and feel happy with.
Hospitals ; seconds ; Community ; Health ; cooperative

No abstract available.
Extracorporeal Membrane Oxygenation* ; Hospitals, Community*

The article introduced some advantages and models of regional general hospitals. The relationship between development of regional general hospitals and strengthening the district health centers also was recommended.
Hospitals ; Community Health Centers ; Hospitals, General

A cross sectionae descriptive survey on the military-civil combined model of health care services Center of Con Dao district, Ba Ria Vung Tau province and the Health station of Con Dao Military Commander Office was conducted from October 2000 to October 2002. In this remote Con Dao archipelago, the health care system was underdeveloped. This model was benefited by the contribution of the strong and stable basis of military health system. A comprehensive integration of health care facilities with the military health station will strengthen the combined health care service.
Community Health Centers ; Hospitals, Military ; Military Personnel

The first theme set on me is “Was there any necessity that a cooperative society had to take it upon itself to provide community medicine?” The second is “its present meaning.”About the first theme, I think we need to look into the historical factors behind the start of community medicine by the cooperative -- especially the free medical practitioner system and community movement. Regarding the second theme, we have to ponder over why community medicine must be provided by the cooperative at the present.In my opinion, what is of paramount importance is that every person, as a human being who lives an ordinary life as a citizen think about these issues. I prefer not to stand on the medical donor side but on the side of medical care recipients when considering these themes.It is we that decide on tomorrow. People who are members of the community living there have the right to determine their future as the independent persons. You would learn from the history of the cooperative movement that the “spirit of cooperation” protects your health and well-being.
Community ; cooperative ; Medicine ; Health Care ; Hospitals

This paper traces the history and development of health care at Tari up until 1991. It focuses on Tari District Hospital as the hub of district health care and describes conditions for health delivery in the district. Patterns of morbidity and mortality are contrasted between the hospital and the community, using Tari Research Unit data for comparison. Health improvements achieved over the two decades before 1991 are due mainly to curative health care. However, the pattern of disease has changed little. Pneumonia is highly prevalent and is associated with high case fatality rates among infants in hospital. Improvements in health status are only likely if living conditions improve and community-based responses develop. The implementation of a primary health care approach, and specific measures to improve hospital and health service outcomes would also assist. Health services are under severe pressure from population growth coupled with declining budgets, the breakdown in law and order, and the burdens of HIV/AIDS and noncommunicable disease.
Health Care ; Health ; Hospitals ; Community ; livin

BACKGROUND: The purpose of this study was to compare students' awareness of and satisfaction with clerkships in family medicine between a university hospital and a community hospital or clinic. METHODS: Thirty-eight 4th year medical students who were undergoing a clerkship in family medicine in the 1st semester of 2012 were surveyed via questionnaire. The questionnaire was administered both before and after the clerkship. RESULTS: External clerkships were completed in eight family medicine clinics and two regional hospitals. At preclerkship, participants showed strong expectation for understanding primary care and recognition of the need for community clerkship, mean scores of 4.3±0.5 and 4.1±0.7, respectively. At post-clerkship, participants showed a significant increase in recognition of the need for community clerkship (4.7±0.5, P<0.001). The pre-clerkship recognition of differences in patient characteristics between university hospitals and community hospitals or clinics was 4.1±0.7; at post-clerkship, it was 3.9±0.7. Students' confidence in their ability to see a first-visit patient and their expectation of improved interviewing skills both significantly increased at post-clerkship (P<0.01). Satisfaction with feedback from preceptors and overall satisfaction with the clerkship also significantly increased, but only for the university hospital clerkship (P<0.01). CONCLUSION: Students' post-clerkship satisfaction was uniformly high for both clerkships. At pre-clerkship, students were aware of the differences in patient characteristics between university hospitals and community hospitals or clinics, and this awareness did not change by the end of the clerkship.
Clinical Clerkship ; Community Medicine ; Hospitals, Community* ; Hospitals, University* ; Humans ; Primary Health Care ; Students, Medical