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Healthcare rationing

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https://www.readbyqxmd.com/read/29308534/recommendations-from-two-citizens-juries-on-the-surgical-management-of-obesity
#1
P A Scuffham, R Krinks, K Chaulkidou, P Littlejohns, J A Whitty, A Wilson, P Burton, E Kendall
BACKGROUND: It is important that guidelines and criteria used to prioritise access to bariatric surgery are informed by the values of the tax-paying public in combination with the expertise of healthcare professionals. Citizens' juries are increasingly used around the world to engage the public in healthcare decision-making. This study investigated citizens' juries about prioritising patient access to bariatric surgery in two Australian cities. OBJECTIVES: The objective of this study is to examine public priorities for government expenditure on the surgical management of obesity developed through either a one or three-day citizen jury...
January 7, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29298738/-cross-sectoral-collaboration-in-type-2-diabetes-management-in-denmark
#2
Lene Munch, Michael E Røder, Ida H Rasmussen, Helle Middelfart, Niels Kaarsberg, Birgitte Bennich, Fhilip K Knop, Tina Vilsbøll
To optimize medical care, Danish guidelines for type 2 diabetes emphasize cross-sectoral collaboration. Risk stratification is recommended as a model of organizing care in terms of distributing tasks and responsibilities between primary and secondary healthcare sectors. Collaboration between the sectors is expected to be beneficial for patients and ensure rational utilization of resources. Challenges such as inter-sectoral communication, sharing of data and unambiguous responsibility underline the need for continuous optimization of the organization of cross-sectorial diabetes management...
January 1, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29288291/transfusion-of-blood-products-in-the-neurocritical-care-unit-an-exploration-of-rationing-and-futility
#3
Deepa P Malaiyandi, Galen V Henderson, Michael A Rubin
Rationing is the allocation of scarce resources, which in healthcare necessarily requires withholding potentially beneficial treatments from some individuals. While it often entails a negative connotation, rationing is unavoidable because need is limitless and resources are not. How rationing occurs is important, because it not only affects individual lives, but also reflects society's most important values. At the core of any rationing, decision is how much a limited resource may benefit a patient, which can be particularly difficult to determine in the practice of neurocritical care, as prognosis is often uncertain...
December 29, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29282087/do-beneficiaries-views-matter-in-healthcare-purchasing-decisions-experiences-from-the-nigerian-tax-funded-health-system-and-the-formal-sector-social-health-insurance-program-of-the-national-health-insurance-scheme
#4
Ogochukwu Ibe, Ayako Honda, Enyi Etiaba, Nkoli Ezumah, Kara Hanson, Obinna Onwujekwe
BACKGROUND: Purchasing is a health financing function that involves the transfer of pooled resources to providers on behalf of a covered population. Little attention has been paid to the extent to which the views of that population  are reflected in purchasing decisions. This article explores how purchasers in two financing mechanisms: the Formal Sector Social Health Insurance Programme (FSSHIP) operating under the Nigerian National Health Insurance Scheme (NHIS), and the tax-funded health system perform their roles in light of their responsibilities to the populations...
December 28, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29233950/should-lifestyles-be-a-criterion-for-healthcare-rationing-evidence-from-a-portuguese-survey
#5
Ana Pinto Borges, Micaela Pinho
BACKGROUND: We evaluated whether different personal responsibilities should influence the allocation healthcare resources and whether attitudes toward the penalization of risk behaviours vary among individual's sociodemographic characteristics and health related habits. STUDY DESIGN: A cross-sectional study. METHODS: We developed an online survey and made it available on various social networks for six months, during 2015. The sample covered the population aged 18 yr and older living in Portugal and we got 296 valid answers...
November 18, 2017: Journal of Research in Health Sciences
https://www.readbyqxmd.com/read/29214964/the-ethics-of-making-patients-responsible
#6
Sven Ove Hansson
In their daily clinical work, healthcare professionals generally apply what seems to be a double standard for the responsibility of patients. On the one hand, patients are encouraged to take responsibility for lifestyle changes that can improve their chances of good health. On the other hand, when patients fail to follow such recommendations, they are not held responsible for the failure. This seeming inconsistency is explained in terms of the distinction between task responsibility and blame responsibility...
January 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#7
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29192463/le-secret-professionnel-soignant%C3%A2-un-enjeu-de-d%C3%A3-mocratie-sanitaire-entre-immanence-et-ali%C3%A3-nation
#8
Silvère Pautier
For a long time considered as total and absolute, healthcare professional secrecy is today difficult to reconcile with care practices. Lots of paradoxes question its preservation in favour of general interest and public order against the protection of private interest within an individualistic normative society. Exploring this interrogation, the article's objective is to initiate an ethical discussion from a professional caregiver secrecy's historical and sociological evolution perspective. Thus, with the help of theoretical understandings, especially those by Michel Foucault, medical secrecy is considered a defense of rationality specific to populations' government...
November 21, 2017: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/29189354/probiotics-for-prevention-of-clostridium-difficile-infection
#9
John P Mills, Krishna Rao, Vincent B Young
PURPOSE OF REVIEW: Probiotics may prevent Clostridium difficile infection (CDI), a leading healthcare-associated infection in the United States. However, prior studies were limited by heterogeneity in products and patient populations. Recent clinical evidence and new approaches to probiotic development are reviewed. RECENT FINDINGS: Probiotic use may reduce incident CDI in high-risk populations by as much as 50%, though prior clinical trials have yielded conflicting results...
November 17, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29178350/assessment-of-prescribing-practices-at-the-primary-healthcare-facilities-in-botswana-with-an-emphasis-on-antibiotics-findings-and-implications
#10
Yohana Mashalla, Vincent Setlhare, Amos Massele, Enoch Sepako, Celda Tiroyakgosi, Joyce Kgatlwane, Mpo Chuma, Brian Godman
BACKGROUND AND AIMS: Inappropriate drug prescribing has increased especially in developing countries where systems for monitoring medicine use are not well developed. This increases the rate of antimicrobial resistance. The study aim was to assess the prescribing patterns among urban primary health facilities in Botswana to provide future guidance including developing future quality indicators. METHODS: Retrospective data from patients' records between January and December 2013 in 19 clinics were collected in a cross-sectional study...
November 27, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29167061/implementation-and-outcomes-of-hospital-wide-computerized-antimicrobial-approval-system-and-on-the-spot-education-in-a-traumatic-intensive-care-unit-in-taiwan
#11
Tsung-Yu Huang, Chien-Hui Hung, Li-Ju Lai, Hui-Ju Chuang, Chien-Chen Wang, Pei-Tzu Lin, Wei-Hsiu Hsu
BACKGROUND/PURPOSE: Inappropriate prescribing of antibiotics is a major health-care problem in intensive care units (ICUs). This study evaluates the impact of a direct hospital-wide computerized antimicrobial approval system (HCAAS) and on-the-spot education for practitioners in a neurosurgical ICU in Taiwan. METHODS: We retrospectively analyzed the medical records monthly of patients who were admitted to the neurosurgical ICU during a period of 7 years and 7 months...
November 11, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/29160504/nasal-carriage-rate-of-methicillin-resistant-staphylococcus-aureus-among-iranian-healthcare-workers-a-systematic-review-and-meta-analysis
#12
Mohammad Emaneini, Fereshteh Jabalameli, Hosseinali Rahdar, Willem B van Leeuwen, Reza Beigverdi
Globally, methicillin-resistant Staphylococcus aureus (MRSA) remains a major cause of healthcare-associated infections. Healthcare workers (HCWs), patients and the environment may act as reservoirs for the spread of MRSA to patients and other HCWs. Screening and eradication of MRSA colonization is an effective method of reducing the MRSA infection rate. There are limited data on the prevalence of MRSA among Iranian HCWs. We performed a systematic search by using different electronic databases including Medline (via PubMed), Embase, Web of Science, and Iranian Databases (from January 2000 to July 2016)...
September 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/29151319/patients-attitudes-and-knowledge-about-drug-use-a-survey-in-turkish-family-healthcare-centres-and-state-hospitals
#13
Ahmet Akıcı, Salih Mollahaliloğlu, Başak Dönertaş, Şenay Özgülcü, Ali Alkan, Nesrin Filiz Başaran
Background/aim: Irrational drug use is a common problem. This study aimed to evaluate patients' knowledge and habits concerning drug use, and compare them in terms of some sociodemographic characteristics. Materials and methods: A face-to-face questionnaire was given to outpatients from family healthcare centres (FHCs) and state hospitals (SHs) in 12 provinces in Turkey during May 2010. A total of 4470 patients (FHCs: 2209; SHs: 2261) responded to the questionnaire (response rate: 93.1%). Results: Getting prescriptions without a physical examination was common (second place in FHCs; third place in SHs); 51...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29149875/prevalence-of-antibiotic-prescription-in-pediatric-outpatients-in-italy-the-role-of-local-health-districts-and-primary-care-physicians-in-determining-variation-a-multilevel-design-for-healthcare-decision-support
#14
Mirko Di Martino, Adele Lallo, Ursula Kirchmayer, Marina Davoli, Danilo Fusco
BACKGROUND: According to scientific literature, antibacterials are prescribed for common pediatric conditions that do not benefit from antibiotic therapy. The link between antibiotic use and bacterial resistance is well known. Antibiotic overprescribing generates high social costs and severe consequences for children. Our objectives were to analyze antibiotic prescription patterns in pediatric outpatients residing in the Lazio region (Italy), to identify physicians' characteristics associated with increased propensity for prescription, to identify the priority axes for action to improve the rational use of antibiotics...
November 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29146654/diagnostic-and-laboratory-test-ordering-in-northern-portuguese-primary-health-care-a-cross-sectional-study
#15
Luísa Sá, Andreia Sofia Costa Teixeira, Fernando Tavares, Cristina Costa-Santos, Luciana Couto, Altamiro Costa-Pereira, Alberto Pinto Hespanhol, Paulo Santos, Carlos Martins
OBJECTIVES: To characterise the test ordering pattern in Northern Portugal and to investigate the influence of context-related factors, analysing the test ordered at the level of geographical groups of family physicians and at the level of different healthcare organisations. DESIGN: Cross-sectional study. SETTING: Northern Primary Health Care, Portugal. PARTICIPANTS: Records about diagnostic and laboratory tests ordered from 2035 family physicians working at the Northern Regional Health Administration, who served approximately 3...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29129386/atrial-fibrillation-in-patients-on-haemodialysis-in-andalusia-prevalence-clinical-profile-and-therapeutic-management
#16
Carmen Sánchez Perales, Teresa Vázquez Sánchez, Daniel Salas Bravo, Sonia Ortega Anguiano, Eduardo Vázquez Ruiz de Castroviejo
Atrial fibrillation (AF) represents an important social and healthcare problem. There is wide variability in the prevalence of this arrhythmia in studies analysing patients on haemodialysis (HD). OBJECTIVE: To investigate the prevalence, clinical profile and therapeutic management of patients with AF on HD in Andalusia. METHODS: We asked the public healthcare system of Andalusia to provide us with the number of patients who were being treated with HD. We asked attending nephrologists from all hospital and outpatient centres in 5 of the 8 Andalusian provinces to perform an electrocardiogram and to fill out a questionnaire on patients selected by simple random sampling...
November 9, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29120648/the-role-of-nanoparticle-design-in-determining-analytical-performance-of-lateral-flow-immunoassays
#17
Li Zhan, Shuang-Zhuang Guo, Fayi Song, Yan Gong, Feng Xu, David R Boulware, Michael C McAlpine, Warren C W Chan, John C Bischof
Rapid, simple, and cost-effective diagnostics are needed to improve healthcare at the point of care (POC). However, the most widely used POC diagnostic, the lateral flow immunoassay (LFA), is ∼1000-times less sensitive and has a smaller analytical range than laboratory tests, requiring a confirmatory test to establish truly negative results. Here, a rational and systematic strategy is used to design the LFA contrast label (i.e., gold nanoparticles) to improve the analytical sensitivity, analytical detection range, and antigen quantification of LFAs...
November 15, 2017: Nano Letters
https://www.readbyqxmd.com/read/29116944/making-sense-of-turmoil-how-women-reconcile-their-emotional-response-to-discovery-of-a-potential-breast-cancer-symptom
#18
Máirín O'Mahony, Josephine Hegarty, Vivien M Rooney
BACKGROUND: Breast cancer continues to be a major public health problem for women. Early detection and treatment are key to improved outcomes. Whereas most women seek help promptly, some postpone seeking help for self-discovered breast symptoms. Investigation of women's help-seeking behavior and the associated influencing factors on self-discovery of a breast symptom were sought. OBJECTIVES: The aim of this article is to report the qualitative data from women who had self-discovered a breast symptom...
November 7, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/29109916/self-medication-practices-and-rational-drug-use-habits-among-university-students-a-cross-sectional-study-from-kahramanmara%C3%A5-turkey
#19
Ramazan Azim Okyay, Ayşegül Erdoğan
Background: Self-medication refers to the use of medicines to treat self-diagnosed diseases without consulting any healthcare professionals. Irrational drug use and self-medication have serious negative consequences both on health and economy. Therefore, the aim of this study is to assess the habits related to rational use of drugs (RUD) and to estimate the prevalence of self-medication practices among university students. Methods: This cross-sectional study was conducted on university students in Kahramanmaraş...
2017: PeerJ
https://www.readbyqxmd.com/read/29108141/teaching-ob-gyn-residents-bioethics-within-a-catholic-healthcare-context
#20
Andrew Steele
Residents entering training in the specialty of Obstetrics and Gynecology (OB/GYN) often have misconceptions as to what medical interventions Roman Catholic healthcare institutions prohibit, and why certain restrictions are placed on the provision of reproductive health options that are otherwise legally available to women. The Ethical and Religious Directives for Catholic Healthcare Services, produced by the United States Conference of Catholic Bishops seeks to provide a stable framework upon which reproductive health decisions can be based...
2017: Issues in Law & Medicine
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