Ensuring quality of dermatologic care in the US health care system

1997 ◽  
Vol 133 (11) ◽  
pp. 1355-1357 ◽  
Author(s):  
M. L. Johnson
2021 ◽  
Vol 564 (3) ◽  
pp. 14-21
Author(s):  
Hanna Karaszewska

The last decade has brought a sharp rise in healthcare costs in the US. This was not accompanied by an improvement in the indicators of the quality of healthcare. The health care system in the US, based in the same amount on private insurance as public funding, proved to be ineffective. This fact is mainly attributed to the growing costs of administering the complex system and high prices of medicines. And although the share of labor costs, including the remuneration of doctors in general health care expenditures, is relatively small (20%), there is an urgent need to look for pro-efficiency solutions also in this area. However, they must be accompanied by fuses that ensure adequate quality of health services and their availability. The article presents the mechanisms of employing doctors and their remuneration as an important element of systemic solutions in health care in the USA. It also features some characteristics of the pay relation. The article uses mainly secondary sources, including OECD statistical data. The results of reports published in American literature by various bodies and institutions, including Medscape and Doximity – the most popular American portals associating doctors, were also used. The information collected during unstructured interviews with participants of the health care system (doctors, hospital directors) during their stay in the USA was used as auxiliary.


Author(s):  
Lauren Russo ◽  
Karen Willis ◽  
Natasha Smallwood

Objectives: Interstitial lung disease (ILD) is a debilitating and life-limiting condition, requiring multi-disciplinary care. While guidelines recommend early specialist palliative care referral to improve symptoms and quality of life, few patients access such care towards the end-of-life. This study aimed to explore clinicians’ perspectives regarding specialist palliative care and opioids to understand barriers to optimal care and guide clinical practice improvement initiatives. Methods: A cross-sectional, exploratory, qualitative study was undertaken with Australian respiratory clinicians caring for people with ILD (n = 17). In-depth, semi-structured interviews were audio-recorded, transcribed verbatim and coded. Thematic analysis was undertaken to extrapolate recurring ideas from the data. Results: Four themes were identified: 1) understanding how to improve patient care and support, 2) the need to dispel stigmatized beliefs and misconceptions, 3) the importance of trusted relationships and good communication and 4) the challenges of navigating the health-care system. Participants discussed the need to implement early specialist palliative care and symptom palliation to alleviate symptoms, provide emotional support and augment quality of life. Participants described challenges accessing palliative care and opioids due to stigmatized beliefs amongst patients and clinicians and difficulties navigating the health-care system. Trusted therapeutic relationships with patients and strong inter-disciplinary partnerships with collaborative education and communication were perceived to improve patients’ access to symptom palliation. Conclusion: Specialist palliative care and opioids were believed to improve patients’ quality of life, however, many barriers can make accessing such care challenging. To address these issues, multi-disciplinary collaboration, high-quality communication and trusted therapeutic relationships are crucial throughout the ILD illness journey.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mohammad Asif Salam ◽  
Saleh Bajaba

Purpose The purpose of this study is to investigate the role of the COVID-19 health-care system quality (HSQ) and its impact on the individual (satisfaction) and social (quality of life [QOL]) outcomes in the context of a transformative health-care delivery system using service-dominant logic (SDL). Design/methodology/approach A sample consisting of 1,008 individuals who have experienced the COVID-19 health-care system was drawn from four different regions of Saudi Arabia using the simple random sampling technique. The survey was conducted using an online survey and 1,008 respondents answered, based on their experience and knowledge of the COVID-19 health-care system. Partial least squares structural equation modeling was applied to test the proposed research model. Findings The study findings suggest that service system satisfaction (SAT) significantly mediates the role of the HSQ in delivering and enhancing the QOL. HSQ also has a significant role to play on the SAT as well as the QOL. These findings contribute to the body of knowledge on SDL in the context of HSQ in understanding the significant role of technologies can play in enhancing service satisfaction and better QOL during a crisis such as COVID-19. This study also improves the understanding of the importance of customer-centricity, real-time visibility through tracking and tracing of service flow, agile decision-making, fewer but better-defined service objectives, and finally shaping mindsets and behaviors of all the relevant parties involved in the HSQ service delivery process. Research limitations/implications One of the major limitations of this study is that, although COVID-19 is an ongoing global pandemic, cross-sectional data were collected in only one country. The findings may not be generalizable across subsequent waves of the pandemic. The best practices of HSQ could be studied around the globe and the results used to support continuous improvement. Originality/value This study advances the understanding of the SDL in the context of a transformative health-care system for a transitional economy by focusing on individual and social well-being during an unexpected crisis such as the COVID-19 pandemic. This study also contributes toward the understanding of the roles of enabling technologies to improve the service delivery system which results in an improved SAT, as well as better QOL for the society at large. Based on SDL this research validates the HSQ model, relevant measures and its overall impact on SAT and QOL in the context of a transformative health-care service system in Saudi Arabia.


2020 ◽  
Vol 26 (4) ◽  
pp. 108-115
Author(s):  
А.B. Zimenkovsky ◽  
◽  
T.G. Gutor ◽  

Aim - the search, analysis and systematization of historical facts concerning the formation and evo-lution of the world medical standartization; severance of its certain long-standing models for the optimization of settling and introduction of the existing, and future analogs, particularly, in the clinical audit format. Material and Methods. In order to study the medical standard as a historical component the fol-lowing methods were used: bibliographic, historical, analytical and methods of systematization and comparison. Results and Discussion. As a result of the conducted research the main historical events in the world development of the medical standartization starting from 1500 up till nowadays were col-lected. In order to study the evolution of the medical standartization, the analysis of the normative documents that have regulated the process of standartization, especially the Doctor's statute(s) in Russia, Minimal standard of the medical equipment and works of the American college of surgeons, was carried out. The scientific works that initiated the introduction of the clinical audit in the Health Care system in Ukraine, Turkey, the USA and Great Britain were throroughly analyzed. Conclusions. The improvement of quality as to rendering the medical aid is a job priority in the health care systems in many countries. For that reason, the search for its optimization was and is still retrieved for many centuries. The territorial formation of medical standartization is associated with England, Russia and the USA, but the occurrence of clinical audit is connected with Ukraine, Turkey, the USA and Great Britain. The foundations of the medical standardization was lauched in 1500 year, while the clinical audit - in 1854 year. The medical standartization is a reflection of the history of development of the organization of health care system, that's why the expertness (knowl-edge) of historical stages concerning the setting and the introduction of medical standartization may give a new impulse in its improvement and development under present-day conditions of reforma-tion in the medical sphere in Ukraine. The earlier beginning of implementation of the medical stan-dartization in the health care system in different countries makes it possible to actualize its introduc-tion into the clinical audit format, that, in its turn, allows to improve the quality of rendering the medical aid. Key words: medical standartization, clinical audit, quality of medical aid


JAMA ◽  
2019 ◽  
Vol 322 (15) ◽  
pp. 1501 ◽  
Author(s):  
William H. Shrank ◽  
Teresa L. Rogstad ◽  
Natasha Parekh

2018 ◽  
pp. 38-54
Author(s):  
John Fry ◽  
Donald Light ◽  
Jonathan Rodnick ◽  
Peter Orton

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