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https://www.readbyqxmd.com/read/27923494/competition-policy-for-health-care-provision-in-the-netherlands
#1
Frederik T Schut, Marco Varkevisser
In the Netherlands in 2006 a major health care reform was introduced, aimed at reinforcing regulated competition in the health care sector. Health insurers were provided with strong incentives to compete and more room to negotiate and selectively contract with health care providers. Nevertheless, the bargaining position of health insurers vis-à-vis both GPs and hospitals is still relatively weak. GPs are very well organized in a powerful national interest association (LHV) and effectively exploit the long-standing trust relationship with their patients...
November 14, 2016: Health Policy
https://www.readbyqxmd.com/read/27921329/preventive-dental-visiting-a-critical-interpretive-synthesis-of-theory-explaining-how-inequalities-arise
#2
Rebecca V Harris, Andrew Pennington, Margaret Whitehead
BACKGROUND: In many countries, those with lower socioeconomic status are disproportionately affected by poor oral health. This can be attributed, at least in part, to differences in preventive dental visiting. While several theories have been applied to the area, they generally fail to capture the recursive nature of dental visiting behaviour, and fall short of informing the design of complex interventions to tackle inequalities. OBJECTIVE: To undertake a systematic review and synthesis of theory in order to provide an overview of the pathways which bring about socioeconomic inequalities in early dental visiting, and identify possible intervention points...
December 6, 2016: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/27918875/the-relationship-between-psychosocial-factors-in-the-patient-oncologist-relationship-and-quality-of-care-a-study-of-breast-cancer-patients
#3
Daniel Sikavi, Allyson J Weseley
This study examined the relationship between psychosocial factors in the patient-oncologist relationship and aspects of care among women with breast cancer. Breast cancer patients (N = 118) completed a questionnaire about their relationship with their oncologist, their treatment, and their health. While trust was related to several positive outcomes, physician supportiveness was most strongly related to satisfaction with care, and health care access was most strongly associated with general health. The results suggest that the addition of supportiveness and healthcare access to trust provide a more complete picture of patients' health outcomes...
December 5, 2016: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/27912748/challenges-to-access-and-provision-of-palliative-care-for-people-who-are-homeless-a-systematic-review-of-qualitative-research
#4
Briony F Hudson, Kate Flemming, Caroline Shulman, Bridget Candy
BACKGROUND: People who are homeless or vulnerably housed are a marginalized group who often experience high rates of morbidity and die young as a result of complex problems. Access to health care and support can be challenging, with access to palliative care even more so. This review presents a synthesis of published qualitative research exploring from the perspective of homeless people and those working to support them, current challenges to palliative care access and provision, in addition to suggestions for what may improve palliative care for this population...
December 3, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27911487/external-inspection-of-compliance-with-standards-for-improved-healthcare-outcomes
#5
REVIEW
Gerd Flodgren, Daniela C Gonçalves-Bradley, Marie-Pascale Pomey
BACKGROUND: Inspection systems are used in healthcare to promote quality improvements (i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes). These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of healthcare. However, the benefits of external inspection in terms of organisational-, provider- and patient-level outcomes are not clear...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27905689/development-of-quality-indicators-for-transition-from-pediatric-to-adult-care-in-sickle-cell-disease-a-modified-delphi-survey-of-adult-providers
#6
Amy E Sobota, Nishita Shah, Jennifer W Mack
BACKGROUND: Transition from pediatric to adult care is a vulnerable time for young adults with sickle cell disease (SCD); however, improvements in transition are limited by a lack of quality indicators. The purpose of this study was to establish quality indicators for transition in SCD and to determine the optimal timing between the final pediatric visit and the first adult provider visit. PROCEDURE: We conducted a modified Delphi survey to reach a consensus on which quality indicators are most important for a successful transition...
December 1, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27881105/open-trusting-relationships-underpin-safety-in-rural-maternity-a-hermeneutic-phenomenology-study
#7
Susan Crowther, Elizabeth Smythe
BACKGROUND: There are interwoven personal, professional and organisational relationships to be navigated in maternity in all regions. In rural regions relationships are integral to safe maternity care. Yet there is a paucity of research on how relationships influence safety and nurture satisfying experiences for rural maternity care providers and mothers and families in these regions. This paper draws attention to how these relationships matter. METHODS: This research is informed by hermeneutic phenomenology drawing on Heidegger and Gadamer...
November 24, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27876636/concordance-between-veterans-self-report-and-documentation-of-surrogate-decision-makers-implications-for-quality-measurement
#8
Kimberly K Garner, Patricia Dubbert, Shelly Lensing, Dennis H Sullivan
CONTEXT: The Measuring What Matters (MWM) initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. OBJECTIVES: To better understand the potential implementation of this MWM quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker...
November 19, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27875642/international-perspectives-on-physician-assistance-in-dying
#9
David Orentlicher
When the Supreme Court of Canada recognized a constitutional right to "medical assistance in dying" last year-and the nation's Parliament enacted legislation to implement the right earlier this year-Canadian lawmakers could look to two different models for guidance. The Netherlands and Belgium recognize a broad right to assistance in dying, while Oregon and elsewhere in the United States have a narrow right. In some ways, assistance in dying in Canada follows the Dutch-Belgian approach, while, in other ways, it seems more American...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27875561/the-perception-of-physician-empathy-by-patients-with-inflammatory-bowel-disease
#10
Costanza Chiapponi, Maxie Witt, Gabriele E Dlugosch, Veit Gülberg, Matthias Siebeck
BACKGROUND AND AIMS: This study focused on the difference between perceived and desired physician empathy (pPE and dPE) in the eye of patients with inflammatory bowel disease (IBD). It was investigated if a discrepancy (ΔPE) correlates with trust and satisfaction of patients. At the same time the aim was to gain detailed information about the subjective burden of disease and the resources of IBD patients, in order to better understand them. METHODS: A modified version of the German Version of the Consultation and Relational Empathy (CARE) measure was completed as a paper-and-pencil questionnaire by IBD patients attending our facility (n = 32) and as an online survey by IBD patients at other locations throughout Germany (n = 89)...
2016: PloS One
https://www.readbyqxmd.com/read/27875482/impact-of-community-health-workers-on-elderly-patients-advance-care-planning-and-health-care-utilization-moving-the-dial
#11
Debra K Litzelman, Thomas S Inui, Wilma J Griffin, Anthony Perkins, Ann H Cottingham, Kathleen M Schmitt-Wendholt, Steven S Ivy
BACKGROUND: Advance care planning (ACP) is recommended for all persons to ensure that the care they receive aligns with their values and preferences. OBJECTIVE: To evaluate an ACP intervention developed to better meet the needs and priorities of persons with chronic diseases, including mild cognitive impairment. RESEARCH DESIGN: A year-long, pre-post intervention using lay community health workers [care coordinator assistants (CCAs)] trained to conduct and document ACP conversations with patients during home health visits with pre-post evaluation...
November 21, 2016: Medical Care
https://www.readbyqxmd.com/read/27872112/too-much-detention-street-triage-and-detentions-under-section-136-mental-health-act-in-the-north-east-of-england-a-descriptive-study-of-the-effects-of-a-street-triage-intervention
#12
Patrick Keown, Jo French, Graham Gibson, Eddy Newton, Steve Cull, Paul Brown, Jo Parry, Diana Lyons, Iain McKinnon
OBJECTIVES: To describe the impact of Street Triage (ST) on the number and rate of Section 136 Mental Health Act (S136) detentions in one NHS Mental Health and Disability Trust (Northumberland, Tyne and Wear (NTW)). DESIGN: Comparative descriptive study of numbers and rates of S136 detentions prior to and following the introduction of ST in NTW. More detailed data were obtained from one local authority in the NTW area. SETTING: NTW, a secondary care NHS Foundation Trust providing mental health and disability services in the north-east of England, in conjunction with Northumbria Police Service...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27870090/the-dual-role-of-nfl-team-doctors
#13
Marvin Washington
Glenn Cohen, Holly Fernandez Lynch, and Christopher Deubert are right in their article "A Proposal to Address NFL Club Doctors' Conflicts of Interest and to Promote Player Trust" that the problem with the medical care rendered to National Football League players is not that the doctors are bad, but that the system in which they provide care is structured badly. We saw some of the problems this system causes last season in what happened to Case Kenum, a quarterback for the Los Angeles Rams who, despite having a possible concussion from a game injury, was allowed to continue to play, with a concussion spotter in the booth and coaches, teammates, seven game officials, and two full training staffs present...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27870087/nfl-physicians-committed-to-excellence-in-patient-player-care
#14
(no author information available yet)
The National Football League Physicians Society read with disappointment the article "A Proposal to Address NFL Club Doctors' Conflicts of Interest and to Promote Player Trust." In spite of the authors' suggestions, NFL physicians are accomplished medical professionals who abide by the highest ethical standards in providing treatment to all of their patients, including those who play in the NFL. It defies logic for the authors not to have engaged experienced and active NFL physicians from the very start of their effort to explore, challenge, and recommend significant alterations to the delivery of health care to NFL players...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27870084/a-response-to-commentaries
#15
I Glenn Cohen, Holly Fernandez Lynch, Christopher R Deubert
Our article "NFL Player Health Care: Addressing Club Doctors' Conflicts of Interests and Promoting Player Trust" focused on an inherent structural conflict that faces club doctors in the National Football League. The conflict stems from club doctors' dual role of providing medical care to players and providing strategic advice to clubs. We recommended assigning these roles to different individuals, with the medical staff members who are responsible for providing player care being chosen and subject to review and termination by a committee of medical experts selected equally by the NFL and the NFL Players Association...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27870082/a-proposal-to-address-nfl-club-doctors-conflicts-of-interest-and-to-promote-player-trust
#16
I Glenn Cohen, Holly Fernandez Lynch, Christopher R Deubert
How can we ensure that players in the National Football League receive excellent health care they can trust from providers who are as free from conflicts of interest as realistically possible? NFL players typically receive care from the club's own medical staff. Club doctors are clearly important stakeholders in player health. They diagnose and treat players for a variety of ailments, physical and mental, while making recommendations to the player concerning those ailments. At the same time, club doctors have obligations to the club, namely to inform and advise clubs about the health status of players...
November 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27869877/-computerized-decision-support-systems-ebm-at-the-bedside
#17
Matteo Capobussi, Rita Banzi, Lorenzo Moja, Stefanos Bonovas, Marien González-Lorenzo, Elisa Giulia Liberati, Hernan Polo Friz, Oriana Nanni, Massimo Mangia, Francesca Ruggiero
INTRODUCTION: One of the aims of Evidence-Based Medicine is to improve quality and appropriateness of care by the expedition of the knowledge transfer process. Computerized Decision Support Systems (CDSSs) are computer programs that provide alerts to the prescribing doctor directly at the moment of medical examination. In fact, alerts are integrated within the single patient electronic health record. CDSS based on the best available and updated evidence and guidelines may be an efficient tool to facilitate the transfer of the latest results from clinical research directly at the bedside, thus supporting decision-making...
November 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27864252/predictors-of-care-home-and-hospital-admissions-and-their-costs-for-older-people-with-alzheimer-s-disease-findings-from-a-large-london-case-register
#18
Martin Knapp, Kia-Chong Chua, Matthew Broadbent, Chin-Kuo Chang, Jose-Luis Fernandez, Dominique Milea, Renee Romeo, Simon Lovestone, Michael Spencer, Gwilym Thompson, Robert Stewart, Richard D Hayes
OBJECTIVES: To examine links between clinical and other characteristics of people with Alzheimer's disease living in the community, likelihood of care home or hospital admission, and associated costs. DESIGN: Observational data extracted from clinical records using natural language processing and Hospital Episode Statistics. Statistical analyses examined effects of cognition, physical health, mental health, sociodemographic factors and living circumstances on risk of admission to care home or hospital over 6 months and associated costs, adjusting for repeated observations...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27852423/collaboration-between-non-governmental-organizations-and-public-services-in-health-a-qualitative-case-study-from-rural-ecuador
#19
Olivia Biermann, Martin Eckhardt, Siw Carlfjord, Magnus Falk, Birger C Forsberg
BACKGROUND: Non-governmental organizations (NGOs) have a key role in improving health in low- and middle-income countries. Their work needs to be synergistic, complementary to public services, and rooted in community mobilization and collective action. The study explores how an NGO and its health services are perceived by the population that it serves, and how it can contribute to reducing barriers to care. DESIGN: A qualitative exploratory study was conducted in remote Ecuador, characterized by its widespread poverty and lack of official governance...
2016: Global Health Action
https://www.readbyqxmd.com/read/27843371/the-family-journey-to-diagnosis-with-systemic-juvenile-idiopathic-arthritis-a-cross-sectional-study-of-the-changing-social-media-presence
#20
Renee F Modica, Kathleen Graham Lomax, Pamela Batzel, Leah Shapardanis, Kimberly Compton Katzer, Melissa E Elder
BACKGROUND: Children with systemic juvenile idiopathic arthritis (SJIA) often encounter a delay between symptom onset and disease diagnosis, partly due to the broad differential of fever and lack of symptom recognition by providers. Families often seek multiple medical opinions and post on social media about their frustrations. This linguistic analysis observed the changing language patterns and social media posting behaviors of parents in the time leading to, during, and after SJIA diagnosis...
2016: Open Access Rheumatology: Research and Reviews
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