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03:31 EDT 17th September 2014 | BioPortfolio

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Showing "Healthcare Shift Successfully Cost Care Spanish Long Term" PubMed Articles 1–25 of 31,000+

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International long-term care reform: A demographic, economic, and policy overview.

Advanced industrial countries around the world are making or contemplating major reforms of their systems for financing and organizing long-term care for the elderly. The paper describes major reform efforts including: the pursuit of cost efficiencies from further differentiation of the acute and long-term care delivery systems, promotion of home and community-based care alternatives to traditional institutions, and 'systems integration' involving consolidation of responsibility for long-term care at one le...

Using Video Capture to Investigate the Causes of Falls in Long-Term Care.

Falls and their associated injuries represent a significant cost and care burden in long-term care (LTC) settings. The evidence base for how and why falls occur in LTC, and for the design of effective interventions, is weakened by the absence of objective data collected on falls.

Advance care planning discussions among residents of long term care and designated assisted living: experience from Calgary, Alberta.

Patients, physicians and the healthcare system are faced with the challenge of determining, and respecting, the medical wishes of an aging population. Our study sought to describe who participates in advance care planning (ACP) and decision-making for patients in long-term care and designated assisted living.

A Prescription for Lean Healthcare.

The adoption of Lean in the healthcare industry has been an important advancement, and not just for healthcare management. Evidence suggests that Lean can improve labour and capital efficiencies, reduce the throughput time for patients and enhance the quality of care. However, the adoption of Lean has generated large variations in results and even wider-ranging suggestions on how to implement Lean in a healthcare setting. In this article, the author examines three very similar hospitals that implemented Lea...

Collaborative care: models for treatment of patients with complex medical-psychiatric conditions.

Patients with co-morbidity and multi-morbidity have worse outcomes and greater healthcare needs. Co-morbid depression and other long-term conditions present health services with challenges in delivering effective care for patients. We provide some recent evidence from the literature to support the need for collaborative care, illustrated by practical examples of how to deliver a collaborative/integrated care continuum by presenting data collected between 2011 and 2012 from a London Borough clinical improvem...

Addressing staffing shortages in an era of reform.

Health system leaders should understand that physician and nursing shortages threaten a hospital's ability to offer high-quality care. Integrated delivery systems should project their workforce needs for both the near term and long term. Catholic Health Initiatives (CHI) is using two new models of care that deploy staff in new ways.

Infections and use of antibiotics in residents of long-term care facilities in Hungary.

Introduction: Healthcare associated infections and antimicrobial use are common among residents of long-term care facilities. Faced to the lack of standardized data, the European Centre for Disease Prevention and Control funded a project with the aim of estimating prevalence of infections and antibiotic use in European long-term care facilities. Aim: The aim of the authors was to present the results of the European survey which were obtained in Hungary. Method: In Hungary, 91 long-term care facilities with ...

Long-Term Care for Elder Women in Spain: Advances and Limitations.

In Spain, elder women are the largest group in need of long-term care. Significant improvements in this issue took place between 2007 and 2011, thanks to the Dependency Law (2006). But severe limitations showed the difficulty of overcoming the historical backwardness of Spanish social policy. This paper reveals the situation of Spanish people with dependency in activities of daily living. It analyzes changes driven by this law, especially in their impacts on elder women. It assesses the extent to which thos...

The patient-centered medical home solution to the cost-quality conundrum.

The U.S. healthcare system has been plagued by rising costs while achieving relatively poor-quality outcomes, and the situation continues to worsen. One solution is the patient-centered medical home (PCMH) model of primary care. This model focuses on care coordination and development of long-term physician-patient relationships that are expected to lead to better quality care and higher rates of patient satisfaction than have previously been achieved. Although the PCMH features a number of core principles, ...

Long-term care for the elderly in Kyoto, Japan.

This is a descriptive study based on interviews and personal experiences of the author in Kyoto, Japan. The study examines long-term care in the Japanese context and government efforts to support home and institutional care.Because of cultural values and the prevailing health care system, Japan today maintains a tradition of providing long-term care at home. Medical and social supports for home care presently fall far short of need in Kyoto. Those who cannot afford home care or have no one at home to provid...

Quality of care and long-term care administrators' education: Does it make a difference?

Long-term care administrators (administrators) can influence the care nursing home residents receive. However, little research has examined what factors of administrators are associated with how they influence care.

Children and Adolescents in Need of Long-Term Care. An Analysis of Data Obtained by the Medical Service of Compulsory Health Insurance Funds, MDK Bavaria.

Children and adolescents among those in need of long-term care differ significantly from older long-term care patients. The aim of this investigation was to characterise the features of this group. We analysed 6 141 records of children and adolescents produced in 2011 by the medical service of the statutory health insurance of Bavaria. The need for long-term care usually occurred before school age, initially mainly to care level 1. Typically, support for long-term care was initially applied for with the d...

Nurses' Perception and Comfort Level with Diabetes Management Practices in Long-Term Care.

Increasing numbers of elderly people in long-term care have diabetes mellitus. We explored nurses' perceptions and level of comfort with current diabetes management of patients in long-term care.

Year in review 2012: Critical Care -management.

Outcomes research plays a key role in defining the effects of medical care in critical care. Last year Critical Care published a number of papers that evaluated patient-centered and policy-relevant outcomes. We present this review article focusing on key reported outcomes associated with severe community-acquired pneumonia, mortality associated with decisions regarding triage to the ICU, and both short-term and long-term mortality associated with ICU admissions. We further analyze the literature, assessing ...

Samuel Hassenbusch Young Neurosurgeon Award 139 Anterior Cervical Diskectomy and Fusion in the Ambulatory Care Setting: Defining its Value Across the Acute and Post-Acute Care Episode.

In the era of current healthcare reforms, all stakeholders have adopted value-based purchasing strategies to shift care toward higher benefit and lower cost treatment approaches. Degenerative spine disease is highly prevalent and its surgical intervention costly. In this study, we set out to quantify the potential cost savings and patient-centered benefits associated with performing anterior cervical diskectomy and fusion (ACDF) in an ambulatory surgery center vs inpatient hospital setting.

Depression in older residents with stroke living in long-term care facilities.

Stroke is the third leading cause of death in Taiwan. Poststroke older adults are often admitted to long-term care facilities. The impacts of the two concurrent life events of stroke and relocation may increase the risk of depression in stroke survivors. Depression in elderly stroke survivor residents of long-term care facilities has not been studied.

Empathy against disgust: an interpretive phenomenological analysis of healthcare professionals' experiences of caring for palliative patients with disgusting symptoms.

Disgusting symptoms are common in healthcare settings. Previous research has identified that healthcare professionals systematically avoid contact with patients with disgusting symptoms (Kray, 2004) potentially compromising patient care. Furthermore, Whitby and Gracias (2013) highlighted disgust in healthcare professionals as a possible contributory factor to dehumanization, and the abuses documented in the recent Francis report (Francis, 2013). Disgust may also have a detrimental effect on the wellbeing of...

Cost-Effectiveness of Ensuring Hepatitis B Protection for Previously Vaccinated Healthcare Personnel.

Objective. To examine the cost-effectiveness of pre- and postexposure approaches for ensuring hepatitis B protection among previously vaccinated healthcare personnel (HCP). Design. A decision-analytic model was developed for alternative strategies of ensuring hepatitis B protection under assumptions of 68% and 95% long-term protection after a primary vaccination series. Costs and quality-adjusted life years (QALYs) lost from infections were estimated, and incremental cost-effectiveness ratios (ICERs) we...

The economic impact of acute kidney injury in England.

Acute kidney injury (AKI) is one of the most common complications affecting hospital inpatients around the world. It is associated with high mortality and adverse long-term outcomes, but there is uncertainty regarding its prevalence and cost. We estimate the prevalence of AKI in hospital inpatients in a universal health-care system, and the immediate and long-term impacts on survival, quality of life and health-care costs.

Home care services in Israel-implications of the expansion of home care following implementation of the Community Long-Term Care Insurance Law.

In 1986 the Israeli Parliament enacted the Community Long-Term Care Insurance (CLTCI) Law, in response to concern over the growing need for long-term care. The principal aims of this study were to examine the extent to which the law has improved the appropriateness of care, reduced unmet needs, and lessened the burden on families of disabled elderly living in the community; and to assess the degree to which the expansion of formal services has supplemented, or substituted for, informal assistance. The findi...

Long-Term Survival and Dialysis Dependency Following Acute Kidney Injury in Intensive Care: Extended Follow-up of a Randomized Controlled Trial.

The incidence of acute kidney injury (AKI) is increasing globally and it is much more common than end-stage kidney disease. AKI is associated with high mortality and cost of hospitalisation. Studies of treatments to reduce this high mortality have used differing renal replacement therapy (RRT) modalities and have not shown improvement in the short term. The reported long-term outcomes of AKI are variable and the effect of differing RRT modalities upon them is not clear. We used the prolonged follow-up of a ...

Follow-Up Care Experiences and Perceived Quality of Care Among Long-Term Survivors of Breast, Prostate, Colorectal, and Gynecologic Cancers.

Post-treatment follow-up represents a crucial aspect of quality cancer care; however, data are lacking regarding follow-up care experiences, perception of provider involvement in care, and perceived quality of care from diverse samples of long-term survivors diagnosed as adults.

The impact of age and sex on healthcare expenditure of households in Bangladesh.

The impact of age and sex on health care expenditure has recently become one of the major concerns in many developing countries like Bangladesh. Age and sex differences in the use of health care services can be substantial at several stages of life which are reflected in overall healthcare expenditure. We examined the impact of age and sex of the population on overall healthcare expenditure of households in Bangladesh. A total of 10,705 populations who spent for receiving any type of healthcare services wer...

Comparative efficacy of two interventions to discontinue long-term benzodiazepine use: cluster randomised controlled trial in primary care.

Benzodiazepines are extensively used in primary care, but their long-term use is associated with adverse health outcomes and dependence.

Music therapy for patients who have undergone hematopoietic stem cell transplant.

Objectives. This study examines the short- and long-term QOL benefits of a music therapy intervention for patients recovering from hematopoietic stem cell transplantation (HSCT). Methods. Ninety allogeneic HSCT patients, after transplant, were randomized to receive ISO-principle (i.e., mood matching) based music therapy (MT; n = 29), unstructured music (UM; n = 30), or usual care (UC; n = 31) for four weeks. The ISO principle posits that patients may shift their mood from one state to another by listening t...


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