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Parkinson's disease psychosis (PDP) is a costly, debilitating condition that generally develops several years after diagnosis of Parkinson's disease (PD). PD is the second-most common neurodegenerative disease, and it imposes a significant burden on the healthcare system. Non-motor symptoms commonly manifest in PD, contributing to the severity of a patient's disability. The neuropsychiatric symptoms that are common in PD can be a significant source of distress to patients and caregivers. Recent studies have...
To evaluate the long-term safety of Pegvisomant (PEG) in the Spanish cohort of ACROSTUDY.
We investigated the efficacy and cost effectiveness of the KineSpring System in the Spanish healthcare system, as compared to other standard treatments methods. Cost-utility ratios were calculated using derived cost data and we calculated quality-adjusted life years (QALYs) gained for each method of treatment. Cost-utility ratios were calculated assuming lifetime and 10-year durability. Assuming lifetime durability, cost-utility ratios of total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UK...
Working in the stressful environment of the Intensive Care Unit (ICU) is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or a brain and skill drain if the healthcare professionals leave their jobs prematurely in order to preserve their own health.
An efficient primary care is of particular importance for any countries' health care system. Many differences exist on how distinctive countries try to obtain the goal of an efficient, cost-effective primary care for its population. In this article we conducted a selective literature review, which includes both scientific and socio-political publications. The findings are complemented with the experience of a Spanish physician from Seville in her last year of training in family medicine, who completed a fou...
Introduction: The aim of this study is to examine the preparedness of Dutch municipalities (in terms of system readiness for innovation) for the challenges resulting from their new responsibilities under the long-term care reform of January 1, 2015. Methods: A qualitative research approach was used by conducting semi-structured interviews with representatives of nine Dutch municipalities responsible for the long-term care of older people in their respective municipalities. Results: Municipalities consider t...
The United States has a well-documented shortage of primary care providers (PCPs) and oncologists. Cancer survivors are living longer because of advances in treatment, and, consequently, more are seeking survivorship care from PCPs; this trend is predicted to continue. One proposed solution is to increase the use of nurse practitioners (NPs). However, most NP programs do not provide adequate training or education that is specific to the needs of long-term cancer survivors. .
Although care coordination is not a new concept, it has been fraught with a myriad of definitions. Among these, core themes can be gleaned to help the home healthcare clinician understand their role and responsibilities as part of a high-functioning team. For a shift from volume to value to occur, in a way that is meaningful to the patient, a holistic paradigm needs to be fully embraced by all members of the interdisciplinary team. As healthcare continues to shift to a fair-market demand for services system...
The movement of people with dementia in long-term care continues to be an issue of concern among clinicians, caregivers and families. This article will examine the social construction "wandering" and its association with pathology, risk discourse and surveillance technologies. Further, the article will explore the recent shift from the term "wanderer" to the phrase "people who like to walk" in person-centred dementia care. Engaging with Ingold's concept of movement as wayfaring, an alternative becoming-cent...
To determine the effect of consumers' numeric abilities on the likelihood of owning private long-term care insurance.
Few data are available on the healthcare costs of those suffering from persistent orofacial pain (POFP). This cohort and cost analysis study examined the direct costs of POFP from the perspective of the healthcare provider (specifically, the UK National Health Service) in 2012 pounds sterling and sought to identify whether dichotomized (high, IIb to IV; low, 0 to IIa) graded chronic pain scale (GCPS) status is predictive of the total cost of healthcare over the last 6 mo. The healthcare utilization data of ...
As the scale of the South African HIV epidemic calls for innovative models of care that improve accessibility for patients while overcoming chronic human resource shortages, we (1) assess the cost-effectiveness of lay health worker-led group adherence clubs, in comparison to a nurse-driven 'standard of care, and (2) describe and evaluate the associated patient cost and accessibility differences.
This study examined perceptions of health and healthcare of people with intellectual and developmental disabilities (IDD) receiving Medicaid Managed Care. Exploratory, semistructured interviews were conducted with 23 participants. Findings indicate that participants generally expressed being in good health and defined good health as (a) absence of pain, disease, and symptoms; (b) adherence to or not requiring treatment; (c) physical self-care; (d) mental or spiritual self-care; and (e) ability to perform th...
Managing hyperglycemia and diabetes is challenging in geriatric patients admitted to long-term care (LTC) facilities.
In June 2015, the American Society of Clinical Oncology (ASCO) published a proposed framework for assessing the value of various cancer treatments.(1) The goal was to evaluate selected treatment regimens on the basis of their clinical benefit, toxicity, and cost. ASCO's ideas about cost had been incubating for a long time: the organization had created a Task Force on the Cost of Cancer Care in 2007, although, like most medical specialty organizations, it had generally remained silent on the issue of cost. B...
Contemporary estimates of the prevalence of diagnosed osteoporosis among long-term care facility residents are limited.
We compared the accuracy of the Brief Cognitive Assessment Tool-Short Form (BCAT-SF) and AD8 in identifying mild cognitive impairment (MCI) and dementia among long-term care residents. Psychometric analyses of 357 long-term care residents (n = 228, nursing home; n = 129, assisted living) in Maryland referred for neuropsychological evaluation evidenced robust internal consistency reliability and construct validity for the BCAT-SF. Furthermore, hierarchical logistic regression and receiver operating chara...
Numerous treatment guidelines recommend that long-term use of benzodiazepines (BZD) should be avoided primarily due to development of tolerance and a risk for BZD dependence. Despite this, long-term BZD use remains a controversial subject in clinical patient care with "for and against" debates. However, there is no explicit understanding of what is meant by long-term BZD use in real world. The aim of this study was to assess different definitions, usage patterns, prevalence and other characteristics of long...
Two-thirds of people with dementia live at home supported mainly by family carers. These carers frequently develop clinical depression or anxiety, which predicts care breakdown. We aimed to assess the clinical effectiveness (long-term reduction of depression and anxiety symptoms in family carers) and cost-effectiveness of a psychological intervention called START (STrAtegies for RelaTives).
One of the main public health concerns in medium and high-income countries is how to deal with problems of functional dependency of a growing number of elderly individuals. This study aimed to identify converging issues in 30 countries with formal long-term care systems. A systematic review included articles, studies, and comparative international reports published from 2010 to 2015. The results show three trends in the design and development of these policies: (a) focus on the oldest or most dependent elde...
Little is known about multidrug-resistant Pseudomonas aeruginosa (MDRP) outbreaks in long-term care facilities (LTCFs).
Long-Term Care (LTC) policy is at an experimental stage in China, characterised by various regional pilot programmes. The public cost of LTC is difficult to estimate due to a lack of clarity about policy detail from the central government. This paper analyses the current disabled status for vulnerable older people without sufficiently financial resources and family supports. It focuses on estimating a safety net public subsidy policy to LTC services in China, both for today and into the future, using CHARLS...
To evaluate whether a peer-coaching programme for patient lift use in British Columbia, Canada, was effective and cost-beneficial.
Hospitals are under immense pressure to reduce heart failure readmissions that occur within 30 days of discharge, and to improve the quality of care for these patients. Penalties mandated by the Affordable Care Act decrease hospital reimbursement and ultimately the overall cost of caring for these patients increases if they are not well managed. Approximately 25% of patients hospitalized for heart failure are at high risk for readmission and these rates have not changed over the past decade. As a result of ...