SveDem, the Swedish Dementia Registry - a tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice.
... crucial. Therefore, there have been substantial efforts to implement SveDem in primary care in recent years. There are differences in demographics between care within primary care and specialist care units. It was found that the mean age at diagnosis was higher in primary care than in specialist units. This may be due to the possibility that a younger person ... (47.2%) Day Care n (%) 1152 (4.4%) Home Care n (%) 8821 (32.5%) Registration at memory clinic n (%) 19629 (68.4%) Registration at primary care unit n (%) 9084 (31.6%) doi:10.1371/journal.pone.0116538.t002 PLOS ONE | DOI:10.1371/journal.pone.0116538 February 19, 2015 5 / 14 The Swedish Dementia Registry – A Tool for Improving Dementia Care Fig ... . SveDem aims to accomplish a similar high quality of dementia care in all regions in Sweden and in different clinical settings. Both specialist and primary care units are involved, making it possible to compare data from different care settings as well as follow patients through the health care system. The recruitment of memory clinics to SveDem is high
Rural-urban differences in the long-term care of the disabled elderly in China.
... products. Conclusions: The use of long-term care services varies by living area. Long-term care of the disabled elderly imposes a substantial burden on families. Our study revealed that informal care involves huge opportunity costs to the caregivers. Chinese policy makers need to promote community care and long-term care insurance to relieve the burden of ... time investment in informal care by assessing the net market wage rate of each caregiver and the time spent on care tasks . In this study, the local average hourly wage of a formal caregiver was used for the labor cost of family caregivers. Direct costs incurred by patients were the out-of-pocket expenditures for medical care, including physician ... details for caregivers was unavailable, we use the average local formal care wage to estimate the value of informal care; since over half of all caregivers were women, that informal care cost may have been overestimated. of LTC. Policymakers could use this new information in the decision-making process when allocating funds for health care. Some previous
Intellectual disability among Dutch homeless people: prevalence and related psychosocial problems.
... medical center, Department of Primary and Community Care, Netherlands Center for Social Care Research, Nijmegen, the Netherlands Abstract Background: There is a higher prevalence of intellectual disability (ID) among homeless people than in the general population. However, little is known about the additional psychosocial problems faced by homeless people ... assessment of IQ is a recommended next step in the practice of care after a positive screening result on ID, to provide efficient and tailored care. Also for future research it would be very informative to administer a full IQ test to gain a more in-depth insight in the relationship between ID and psychosocial problems and to evaluate possible dose-response relationships. With ... explore relationships between ID and psychosocial problems among homeless people in the Netherlands. The study shows that ID is indeed a relevant problem among these homeless. It also indicates that ID screening of homeless people may be an effective method to identify those who are particularly vulnerable in terms of psychosocial problems within a homeless
Collaborative Decision Support Systems for Primary Health care Managers
... planners in simulating management plans that can be used to implement decentralization, collaboration and outsourcing decisions in health care . At the primary care level, the decentralization of outpatient health care services can be achieved through the HUB & SPOKE model that is helpful in facilitating decentralization, dynamic load balancing and ... between any two networks in the problem space, through load transfer, between them. In order to show the collaboration the sample database of 15 health care centers is taken assuming that there are 5 health care centers in one network. Keywords: Decision Support Systems, Decision Process, Hub & Spoke Model, Collaboration, Collaborative DSS, HUB and SPOKE ... health care services in this paper. The concept of Meta-data is used to represent information about Hub and Spoke networks, in a Meta data table. This Meta-data table is searched to facilitate collaboration between two different networks. Thus the main objective of this research work is to show how the collaboration can be implemented between health care
Use of Fibrates Monotherapy in People with Diabetes and High Cardiovascular Risk in Primary Care: A French Nationwide Cohort Study Based on National Administrative Databases.
... study): randomised controlled trial. Lancet. 2005; 366(9500):1849–61. Epub 2005/11/29. doi: 10.1016/S0140-6736 (05)67667-2 PMID: 16310551. 4. Standards of medical care in diabetes—2013. Diabetes care. 2013; 36 Suppl 1:S11–66. Epub 2013/01/ 04. doi: 10.2337/dc13-S011 PMID: 23264422; PubMed Central PMCID: PMC3537269. 5. Executive Summary of The Third Report ... ACCESS Citation: Roussel R, Chaignot C, Weill A, Travert F, Hansel B, Marre M, et al. (2015) Use of Fibrates Monotherapy in People with Diabetes and High Cardiovascular Risk in Primary Care: A French Nationwide Cohort Study Based on National Administrative Databases. PLoS ONE 10(9): e0137733. doi:10.1371/journal.pone.0137733 Editor: Carmine Pizzi, University ... lipidbased cardiovascular risk reduction in diabetic patients with additional risk factors when not contraindicated. It is not known how these guidelines are applied in primary care. This study was therefore designed to describe the prescribing habits of family physicians in terms of their choice between statins and fibrates when initiating lipid-lowering
Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi.
... manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: email@example.com Introduction Antenatal care (ANC), along with family planning, skilled delivery care and emergency obstetric care, is a key element of the package of services aimed at improving maternal and newborn health [1,2]. In light of evidence from a 2001 ... with AM and CP) carried out regular field observations in the communities and local healthcare facilities. At each site, a group of pregnant women were selected as case studies and interviewed three to six times pre- and postpartum to elicit their experiences and care seeking as their pregnancy progressed. Individual interviews were commonly conducted ... interviews. A point of saturation approach was also applied to the total sample of healthcare workers, local opinion leaders and the relatives of pregnant women. Health workers involved in ANC were identified at the local health facilities, whereas other healthcare providers, such as traditional birth attendants (TBAs), were identified through contacts
Kongressbericht: Jahrestagung der ESC Acute Cardiovascular Care Association 2015br17.-19.10.2015, Hofburg, Wien
... ESC Acute Cardiovascular Care Association 2015 17.–19.10.2015, Hofburg, Wien K. A. Krychtiuk Der diesjährige Jahreskongress der Acute Cardiovascular Care Association (ACCA) der European Society of Cardiology (ESC) fand vom 17.–19. Oktober in der Wiener Hofburg unter dem Leitbild „Innovating to Improve Acute Cardiovascular Care? ?? statt. Die ACCA hat ... Kongressbericht: Jahrestagung der ESC Acute Cardiovascular Care Association 2015 17.-19.10.2015 Hofburg, Wien Krychtiuk KA Journal für Kardiologie - Austrian Journal of Cardiology 2016; 23 (1-2), 20-24 Offizielles Organ des Österreichischen ... Qualität der eingereichten Arbeiten unterstreicht auch die Tatsache, dass zwei der vier präsentierten Arbeiten bereits in hochkarätigen Journalen, nämlich „The Lancet“ und „Critical Care Medicine“, publiziert wurden. Young Investigator‘s Award Ein weiterer Fixpunkt für die junge wissenschaftliche Community stellt seit 2012 die „Young Investigator‘s Award-“
Towards Improving Point-of-Care Diagnosis of Non-malaria Febrile Illness: A Metabolomics Approach.
... illness attending primary health care service. The results of the test would allow first line health care workers to confidently withhold antibiotics from under-fives that are negative for the bile signature test, while those with a positive test result could be immediately referred to hospital for further diagnosis and care. Such a metabolite screening ... Microbiology, KU Leuven, Leuven, Belgium OPEN ACCESS Citation: Decuypere S, Maltha J, Deborggraeve S, Rattray NJW, Issa G, Bérenger K, et al. (2016) Towards Improving Point-of -Care Diagnosis of Nonmalaria Febrile Illness: A Metabolomics Approach. PLoS Negl Trop Dis 10(3): e0004480. doi:10.1371/ journal.pntd.0004480 Editor: Joseph M. Vinetz, University ... indistinguishable from malaria. These so-called non-malaria febrile illnesses include bacterial bloodstream infections, which are associated with a higher mortality than malaria. Most health care facilities in the tropics have malaria diagnostic tests available, but tests for non-malarial febrile illnesses are extremely limited. There is the critical need for new tests
RNI Point-of-care test (POCT): esperança ou ilusão?.
... 2012;27(2):296-301 RNI Point-of -care test (POCT): esperança ou ilusão? Point-of -care test (POCT) INR: hope or illusion? Luci Maria Sant’Ana Dusse1,2, Nataly Carvalho Oliveira1, Danyelle Romana Alves Rios1,3, Milena Soriano Marcolino2,4 DOI: 10.5935/1678-9741.20120047 Resumo Na última década, foram desenvolvidos os testes pointof -care visando à geração ... General Haematology Task Force, et al. Guidelines for point-of -care testing: haematology. Br J Haematol. 2008;142(6):904-15. 9. Murray ET, Fitzmaurice DA, McCahon D. Point of care testing for INR monitoring: where are we now? Br J Haematol. 2004;127(4):373-8. Dusse LMSA, et al. - RNI Point-of -care test (POCT): esperança ou ilusão? Rev Bras Cir Cardiovasc ... point of care, conhecidos como testes realizados próximo ao paciente ou à beira do leito, visando à geração rápida de resultados de exames, para possibilitar a tomada de decisões efetivas clinicamente em um curto espaço de tempo. Esses testes têm aplicações cada vez mais abrangentes. Na área da hemostasia, o TP expresso em RNI, RNI point of care test
Cirurgia cardíaca em uma sociedade multiétnica: a experiência do Caribbean Heart Care.
... SERVIÇO Braz J Cardiovasc Surg 2005; 20(3): 332-335 Cirurgia cardíaca em uma sociedade multiétnica: a experiência do Caribbean Heart Care Cardiac surgery in a multi-ethnic low volume service: the Caribbean Heart Care Experience Jose BURGOS-IRAZABAL, Risshi D. RAMPERSAD, Walter J. GOMES, Kamal A. RAMPERSAD, Gianni D. ANGELINI Resumo Objetivo: ... sociedade multiétnica, no Caribbean Heart Care, localizado em Port of Spain, capital de Trinidad-Tobago, no Caribe (Figura 1). Fig. 1 - Mapa detalhando a localização geográfica de Trinidad e Tobago 333 BURGOS-IRAZABAL, J ET AL - Cirurgia cardíaca em uma sociedade multiétnica: a experiência do Caribbean Heart Care Braz J Cardiovasc Surg 2005; 20(3): ... 290-3. 3. Carey JS, Robertson JM, Misbach GA, Fisher AL. Relationship of hospital volume to outcome in cardiac surgery programs in California. Am Surg. 2003;69(1):63-8. 4. Noronha JC, Martins M, Travassos C, Campos MR, Maia P, Panezzuti R. Use of hospital mortality rates following coronary artery bypass graft surgery to monitor hospital care. Cad Saúde
Innovative care for chronic health conditions
... health care systems, and their economies, in areas that include financing, resource allocation, and health care planning. Decisionmakers should focus their efforts on eight key areas, according to the new WHO report. Shifting the focus of the health care system from acute to chronic care Health care is organized around an acute, episodic model of care ... cost-effectiveness of innovative care models and strategies. Building integrated health care systems Health care systems must guard against the fragmentation of services. Care for chronic conditions needs integration to ensure shared information across health care settings and providers. That integration is also needed across time of care, from the initial patient ... as through local demonstration projects showing innovative care models and strategies. Managing the political context of health care For a successful shift in the model of care, there must be information sharing and consensus building among such stakeholders as political decisionmakers, health care leaders, and patients, their families, and other community
The dilemma of diabetes: health care crisis in the Caribbean
... improvements in documentation of care and control. Two questions must be asked. Firstly, can better glycemic and blood pressure control be achieved in the face of struggling economies and overburdened health care systems? Secondly, if glycemic control is difficult to achieve, should more effort be spent on other aspects of care? While the large and costly ... life (26). Nevertheless, care of both diabetes and hypertension is driven by drug prescribing, and there is limited long-term data on the relative cost-effectiveness of nondrug treatments. At the point of health care delivery there needs to be political, professional, patient, and public commitment to radically altering the health care paradigm of the last ... background of cultural traditions that favor female obesity (11), imposes an unmanageable burden on the limited health care resources of these small countries of the Caribbean. Enormous research effort has been dedicated to evaluating diabetes care and outcome. There is clear evidence that good glycemic control reduces complications of type 1 diabetes (12),
WHO reports on HIV and HBV transmission in the health care setting
... international experts on HIV and hepatitis B virus (I-EN) transmission in the health care setting, which was held in Geneva on 11-12 April 1991. The consultation report examines the risk of transmission of bloodborne HIV and HBV from patient to patient, from patient to health care worker, and from health care worker to patient. Transmission by any of these pathways is ... Patient-to-patient spread in the health care setting poses a greater risk in countries with limited supplies and equipment and where techniques to minimize contamination may not be rigorously practiced. HBV spread from patients to health care workers is proportional to the degree of blood exposure. For highly exposed health care workers such as surgeons and ... Organization, “Global Programme on AIDS: HIV and HBV transmission in the health care setting,” WkZy Epidemiol Ret 66(26):189-191, 1991. The risk of bloodborne spread of HIV and HBV from patient to patient is minimal wherever sufficient medical and surgical equipment is available and careful attention is paid to instrument sterilization and other procedures
Brazilian health care delivery during a recession
... follow review certain salient features of the Brazilian health care system, describe the effects of Brazil’s economic crises, assessthe apparent effects of those crises on health expenditures, and discuss certain implications for health care. Health Care in Brazil The Brazilian health care system reflects prevailing income distribution patterns. Just ... modest reductions in health care expenditures in one state. However, plans to extend this “reorientation” to the rest of the nation are meeting considerable nolitical onnosition. For one thine. the woodward l BRAZILIAN HEALTH CARE IN A RECESSION “reorientation” implicitly gives increased emphasis to primary care. Private hospitals and health care groups are ... of inflation. Health Care Impacts One interesting and important question that has been largely overlooked in the crisis atmosphere created by continued foreign debt payment problems is the impact these economic events have had on health care delivery systems. Their first obvious effect was creation of a conflict between reduction of the funds available for health care
Anaemia status and current methods for its control in Antigua. Suggested methods for its control through the Primary Health Care System
Delivery of primary medical care through a health team approach: philosophy, strategy, and methods
... getting episodic care when the patient expects continuous, comprehensive care - and because much provider frustration arises when continuous, comprehensive care is given but episodic care is desired. A Methodological . INITIAL DATA BASE *INITIAL PROBLEM LIST .INITIAL PLAN CONTINUOUS, .INITIAL FOLLOW-UP COMPREHENSIVE *HEALTH MAINTECARE FOR NANCE AND ... episodic care and those who want continuous, comprehensive care. This is just a matter of meeting the specific type of consumer demand with the corresponding type of service. As Figure 3 indicates, consumers whose community role is unstable tend to demand episodic care, while consumers with stable positions tend to demand continuous, comprehensive care. Consumers ... unhappy because they do not receive the care offered. The providers feel uneasy because their training, always disease and hospital oriented, makes them quite comfortable giving episodic care but ill at ease giving the continuous, comprehensive care they are supposed to provide. So far as they are concerned, continuous care, health maintenance, and disease
Primary health care: worldwide interest... and a U.S. perspective
... primary, secondary, and tertiary care levels; but it is possible to consider hospital and nursing home care together as roughly equivalent to secondary and tertiary care. The major health care expenditures that increased most sharply from 1960 to 1975 were in the areas of nursing home and hospital care. In particular, the increase in hospital care costs-from 32.9 ... disease prevention, altering the structure of health care, and changing the attitudes of health care personnel and patients-fall mainly within the purview of the primary care system and primary health care providers. Let us now briefly examine the allocation of central government funds for health care, focusing on allocations to the different levels ... should be noted, though, that hospital care is generally associated with the more sophisticated and costly secondary and tertiary levels of care. A significant increase in the amount of health care dollars associated with these levels of care does mean that, proportionately, fewer dollars are going to primary care. Although these data are specific for
Health care in the program of the government of national reconstruction of Nicaragua
... chief. This organization of the health sector in its responsibility of offering Comprehensive Care to the Population calls for the operation of undifferentiated "Polyvalent Units" (health centers and their dependencies) that are capable of providing this comprehensive care to the inhabitants and their environment within welldefined, relatively small territorial ... indivi- The other units in the preventive care network will support the primary operations of these units through a simple, effective referral system. This structure will make it possible to implement the regulatory centralization and operational decentralization and to introduce an operational dynamic that will assure better care to the community (with its active ... mortality 74 Meningitis 65 Measles 60 Influenza and pneumonia 60 Malaria 36 Pertusis 24 Other causes Total 1,484 3,448 Morbidity Lack of morbidity surveys and the inadequacy of the coverage of medical care greatly undermine the validity of the following data: CD26/32 Page 6 Table 3 TEN PRINCIPAL DISEASES IN NICARAGUA, 1976 Other helminthiases 45,460 Malaria 26,228 Enteritis
Advances in pediatrics and child care in Cuba, 1959-1974
... overcrowding in pediatric wards, a change permitting improvement in hospital care and adoption of a system whereby the mother stays with her baby. (It has been found that this latter procedure encourages better care of the infant and better education of the mother in how to care for her child.) a Establishment of pediatric norms making possible nationwide standardization of ... PEDIATRICS Statistics 5-Distribution Source: National Cuba. Statistics AND CHILD of pediatric 13 CARE IN CUBA beds in 1973, by intended Directorate, Public of pediatric beds in 1973, by Province. Directorate, Public for the differences in these ratios to be reduced (10). Other important resources are pediatric and child care clinics, which have been planned for all 332 of the nation’s ... laboratory work. This has contributed to better child care. For the future, substantial improvements are to be sought in the milk banks of many pediatric hospitals, and research activities at most pediatric services will be making increased use of dark-field microscopy methods. The Comprehensive Child Care Program To help bring together and systematize
CD19.R18: Report of the study group on the coordination of the medical care services of ministries of health, social security institutes, and universities
... OF THE MEDICAL CARE SERVICES OF MINISTRIES OF HEALTH, SOCIAL SECURITY INSTITUTES, AND UNIVERSITIES THE 19th DIRECTING COUNCIL, Having examined the report of the Director of the Pan American Sanitary Bureau (Document CD19/19, Rev. 1)1 apprising the Directing Council of the Final Report of the Study Group on the Coordination of Medical Care Services
Instruction on medical care organization in the basic M.P.H. curriculum of Latin American schools of public health
... The outline of subjects is as follows : 1. Concept of comprehensivemedical care. Functions. Types. Activities. Areas. Quality of good medical care. Medical care administration. 2. Utilization and cost of care. Evolution of its tiancing. Paramedical needs. 3. Analysis of medical care in Colombia. a. Organizations: Indigenous medicine. Benejicencius. Government ... of courses in the medical care field currently offered at the School of Public Health of the University of California at Los Angeles: Hours Fundamentals of medical and hospital 20 organization ........ ... Medical care organization. . 40 Problems of medical care administration 40 Seminar in medical care practice. 20 20 Seminar in medical care research. . Economics ... Medical facilities 0 Other 2. Medical care programs 0 Conceptualization 0 Charity programs 0 Governmental programs 0 Social security 0 Industrial programs 0 The private sector 0 Other 3. Administrative problems in medical care 0 Ambulatory services 0 Drugs 0 Hospital operations 0 Dental care Quality review l ON MEDICAL CARE ORGANIZATION 25 * Regionalization 0
Coordination between the medical care services of the Ministries of Health and of the social security institutions
... HEALTH COORDINATION BETWEEN THE MEDICAL CARE SERVICES OF THE MINISTRIES OF HEALTH AND OF THE SOCIAL SECURITY INSTITUTIONS , INDEX Page Io IIo Coordination between the Medical Care Services of the Ministries of Health and of the Social Security Institutions 1 io 2 Availability of hospitalbeds 2o Utilization of hospital_esources 4 3o Out-patient care (ambulatory ... coordination The cost and sources of finance Security medical care lo of Ministry and Social 19 Relative importance_of Ministry and Social Security expendituresfor medical care 19 2° The problem of capital expenditure 20 3o Directcomparisons of costs 21 4o Sourcesof financingof medicalcare 23 Table 1 Table 2 Table 3 Table 4 Table 5 Table 6 Table 7 Table 8 Table 9 24 25 26 27 27 28 29 30 31 , _ CSPI7/DT/I CHAPTER (Engo) I COORDINATICN BE%'_EN ... _ninistry of health, where the time per consultation is frequently small° @ under very The cost of ambulatory care is analyzed in Table I0, where it can be seen that the most expensive medical care is that given by mobile units (Honduras and Panama)° Care given by health centers is generally more expensive than consultations in hospital out-patient clinics
Changes in health care strategies in Costa Rica
... very 143 FIGURE2. The health care pyramid in CostaRica. PERSONNEL INVOLVED LEVEL VI - Specialized hospital care [national hospitals) - Professionals, auxiharies, and others V - Care by reglonal hospitals - Professionals, auxiliaries. and others - Professionals. auxiharies, and others IV -Care by local hospitals and outpattent clinics Ill - Care by integrated health ... whole spectrum of health measures instead of doing as was done previously and focusing primarily on healing the sick. Adoption Strategy of the Primary Care Within the national health system the primary care strategy is the key to providing service for rural and marginal urban populations. Different ways have been devised for implementing this strategy ... medical care be contained within limits that are reasonable in terms of our country’s ability to pay. 3 Integration of the preventive services with the curative and rehabilitative services must be sought. 4 The first priorities must be health promotion and disease prevention. 5 The system’s preferred arrangement for providing services must be ambulatory care. 6
Use of chloramphenicol at social security health care centers in Bogota, Colombia
... U SE OF CHLORAMPHENICOL AT SOCIAL SECURITY HEALTH CARE CENTERS IN BOGOTA, COLOMBIA1 Julio Gonz&z I NTRODUCTION Prescribing any medication without an appropriate indication exposes the patient to needless risk of adverse reactions ... to medications (such as aplastic anemia- 7) has been established. M ATERIALSAND METHODS With this in mind, a survey was made of chloramphenicol use at 35 outpatient health care centers (CABS) of the Colombian Social Security Institute (ISS) in Bogotd and the surrounding department of Cundinamarca. Most of the information analyzed was provided by the ... life-threatening conditions. Therefore, its effectiveness needs to be protected by avoiding the sort of excessive use and misuse found at 11 of the 35 Cundinamarca-Bogota health care centers. In this regard, it should be noted that only 6.7% of the 297 physicians working at these 11 centers (seeTable 1) were issuing these prescriptions, a finding suggesting
The role of medical anthropology in primary health care
... appropriate? Can traditional and modern health personnel and approaches to health care be combined, or coordinated, to achieve more comprehensive primary health care? There is evidence of new openness on the part of official medicine to the problems of extending health care coverage LO all people. It is clear that there is no consensus among medical anthropologists. They ... makes, and can continue to make, to health care. The ability of practitioners of modern medicine to modify their normal practices to more nearly meet patient expectations is one example of how this understanding can contribute to better medical care. For example, hospitalized Mexican patients expect family company and care to a degree that would disturb the routine in ... Bull Pan Am Health Organ E(4), 1978. THE ROLE OF MEDICAL HEALTH CARE? ?? ANTHROPOLOGY IN PRIMARY George M. Foster2 In order to provide health care, it must be presented in a form accejrtable to the patient. Therefore, the beliefs of a people regarding health, illness, and curing-the realm