ABSTRACT
Health care consumers use a plethora of services which are accessible on an ambulatory basis. These include the services of pharmacists, optometrists, nurses, dentists, audiologists, orthotics, and so forth. Since many of these services are provided in physically and financially separate facilities and often are not located in close proximity to one another, consumers may spend a large amount of time traveling between locations. Economic inefficiencies due to the size and dispersion of separate and independent facilities may produce an increase in the cost of ambulatory health care services. Thus, the concept of a health care center, an ambulatory health care analog to the multispecialty shopping center, is proposed as a potential alternative and improvement in the delivery of these services. Space, location, personnel, and initial capital requirements for a model health care center are projected based on existing data for the establishment of each separate auxiliary health care facility. Projections are made to determine the appropriate and necessary site for the health care center's trade area. Potential revenues are calculated by examining some pharmacy operations which are beginning to pioneer these areas and utilizing revenue figures for the various individual services. The results indicate that the pharmacy, as a frequently visited health care facility, may be an excellent choice around which to develop the health care center concept in metropolitan areas.
Subject(s)
Ambulatory Care Facilities/organization & administration , Models, Theoretical , Pharmaceutical Services/organization & administration , Urban PopulationSubject(s)
Anesthesia , Ferricyanides , Nitroprusside , Phlebitis/chemically induced , Female , Humans , Middle AgedSubject(s)
Anesthesia , Diabetes Complications , Malignant Hyperthermia/prevention & control , Adult , Female , Humans , LaminectomySubject(s)
Foreign Bodies/therapy , Inhalation , Respiration , Adult , Age Factors , Anesthesia/adverse effects , Anesthesia/methods , Anesthesia, General/adverse effects , Anesthesia, General/methods , Bronchi , Bronchoscopy , Child , Child, Preschool , Foreign Bodies/diagnosis , Foreign Bodies/surgery , Humans , Infant , Larynx , Postoperative Complications , Respiration, Artificial , Time Factors , TracheaSubject(s)
Anesthesia, General/adverse effects , Coronary Disease/etiology , Hypotension/etiology , Female , Humans , Middle AgedSubject(s)
Anesthesia/adverse effects , Gastroesophageal Reflux/etiology , Inhalation , Respiration , Surgical Procedures, Operative/adverse effects , Anesthesia/methods , Blood , Gastric Juice , Gastroesophageal Reflux/physiopathology , Gastroesophageal Reflux/prevention & control , Humans , Intubation, Gastrointestinal/methods , Intubation, Intratracheal/methods , Postoperative Complications , Preoperative Care , Pressure , Recovery Room , Risk , Suppuration , Transportation of Patients , Vomiting/physiopathology , Wounds and Injuries/complicationsABSTRACT
A case is reported of a patient with a cerebral aneurysm in whom it was difficult to induce hypotension. The hyperadrenergic state mimicked, in some respects, that seen in patients with neural crest lesions. Possible mechanisms are discussed and the anaesthetic management described.