Competing health care systems and complex patients: An inter-professional collaboration to improve outcomes and reduce health care costs

Chronic nonhealing wounds are a severe burden to health care systems worldwide, causing millions of patients to have lengthy hospital stays, high health care costs, periods of unemployment, and reduced quality of life. Moreover, treating chronic nonhealing wounds effectively and reasonably in countries with limited medical resources can be extremely challenging. With many outstanding questions surrounding chronic nonhealing wounds, in this review, we offer changes to the microbiome as a potentially ignored mechanism important in the formation and treatment of chronic wounds. Our analysis helps bring a whole new understanding to wound formation and healing and provides a potential breakthrough in the treatment of chronic nonhealing wounds in the future.

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Financial management within the health system

ARS Medica Tomitana ◽

10.2478/arsm-2013-0015 ◽

2013 ◽

Vol 19 (2) ◽

pp. 84-90

Author(s):

M.F. Popa ◽

Ionut Parlica

Keyword(s):

Health Care ◽

Health Insurance ◽

Health Care System ◽

Health Care Costs ◽

Financial Management ◽

Health Care Systems ◽

State Budget ◽

Care Systems ◽

Care Costs ◽

Care System

Abstract The financial management within the medical management plays a very important role considering the fact that health care costs a lot of money. The health care system is greatly influenced by the allocated funds so that there are types of health care systems depending on the allocation and collection of funds and depending on the payments of the services providers. There are several mechanisms for financing the health care system of which the most important are represented by the state budget funding and voluntary health insurance. In terms of financial management, is a reform within the Romanian health care system mainly focused on reducing the number of hospitals and restructuring the County Health Houses

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Countering the Tragedy of the Health Care Commons by Exnovation: Bringing Unexpected Problems and Solutions into View

Sustainability ◽

10.3390/su132313082 ◽

2021 ◽

Vol 13 (23) ◽

pp. 13082

Author(s):

Willemine Willems

Keyword(s):

Primary Care ◽

Health Care ◽

Health Care Costs ◽

Health Care Professionals ◽

Care Delivery ◽

Health Care Systems ◽

Ethnographic Study ◽

Triple Aim ◽

Care Systems ◽

Care Costs

In the health sciences and policy, it is common to view rising health care costs as a tragedy of the commons, i.e., a situation in which the unhampered use of a resource by rational individuals leads to its depletion. By monitoring a set of outcomes, not only the costs but also patient experience and population health, simultaneously, it is claimed that the “triple aim” approach changes what is rational for health care stakeholders and, thus, can counter the rapidly rising health care costs. This approach has an important limitation: it reduces the monitored innovations to merely their outcomes; yet, how health care professionals and patients give shape to care delivery remains invisible. To get a more in-depth understanding of the consequences of adopting such an approach, in this article I use the method of exnovation instead. Exnovation foregrounds the everyday accomplishments of health care practices to enable reflection and learning. I draw on an ethnographic study into an innovation in care delivery aimed at rendering it more sustainable: Primary Care Plus. I reflected with both professionals and patients on what happened during 40 Primary Care Plus consultations. By presenting and analyzing three of these consultations, I foreground what is rendered invisible with the triple aim: improvisations, surprises and habits unfolding in practice. With exnovation, health care innovations can provide fertile soil for creating new forms of sustainable care that can help prevent the impending exhaustion of health care systems.

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Need, competence and compliance: Selective empowering in the distribution of medical technologies in the Norwegian health care system

Acta Sociologica ◽

10.1177/0001699320976745 ◽

2020 ◽

pp. 000169932097674

Author(s):

Emil Øversveen

Keyword(s):

Health Care ◽

Health Care Systems ◽

Medical Decision ◽

Social Production ◽

Medical Technologies ◽

The Social ◽

Care Systems ◽

Sociological Studies ◽

Care Costs

The development of medical technologies is often assumed to improve medical treatment, but may also reproduce health inequalities if their benefits are unequally distributed. Sociological studies have shown that social and moral evaluations matter for medical decision making, and that inequalities in access and outcome exist even in universal health care systems. This article uses the distribution of medical technologies in the treatment of type 1 diabetes as a case for examining the social production of health care inequalities. Drawing on observational data and in-depth interviews with physicians and nurses working in a Norwegian hospital, I demonstrate that medical staff evaluate patients based on a combination of medical, social and moral criteria. The concept of selective empowering is then elaborated and refined as a term for the practice in which medical professionals steer resources towards patients based on evaluations of need, competence and compliance. While previous studies of inequalities in medical care have often focused on medical staff’s cognitive dispositions, I argue that selective empowering may be interpreted as a reflexive response to increasing health care costs and a structural dependency on expensive and commercially produced medical technologies.

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Examining the Influence of Information Technology on Modern Health Care

Effective Methods for Modern Healthcare Service Quality and Evaluation - Advances in Medical Diagnosis, Treatment, and Care ◽

10.4018/978-1-4666-9961-8.ch006 ◽

2016 ◽

pp. 110-136 ◽

Cited By ~ 1

Author(s):

Edward T. Chen

Keyword(s):

Health Care ◽

Information Technology ◽

Health Care Organizations ◽

Health Care Systems ◽

Medical Personnel ◽

Bundled Payments ◽

Modern Health Care ◽

Designed Environment ◽

Care Systems ◽

Care Costs

Health care costs continue to rise at a level that far exceeds the rate of inflation. IT will be necessary in the computation and organization of complex algorithms presented in bundled payments and other initiatives. Currently in health care, a patient's medical history is not easily accessible by physicians and other medical personnel. IT can play the pivotal role in rectifying this problem in tracking the record in a universally designed environment. Advanced databases are needed to integrate facilities within health care systems. This chapter is to explore the current framework of Information Technology in the U.S. health care industry and to examine the topic covering the following areas: (a) IT's influence on the Affordable Care Act, (b) the emergence of the Electronic Health Record (EHR), also known as the Electronic Medical Record (EMR), and (c) the integration of databases across health care organizations through advanced systems like Epic.

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Prevalence and costs of defensive medicine: a national survey of Italian physicians

Journal of Health Services Research & Policy ◽

10.1177/1355819617707224 ◽

2017 ◽

Vol 22 (4) ◽

pp. 211-217 ◽

Cited By ~ 16

Author(s):

Massimiliano Panella ◽

Carmela Rinaldi ◽

Fabrizio Leigheb ◽

Sanita Knesse ◽

Chiara Donnarumma ◽

...

Keyword(s):

Health Care ◽

Health Care Systems ◽

Defensive Medicine ◽

Evidence Based ◽

Cross Sectional ◽

National Health Expenditure ◽

Care Systems ◽

Italian National Health ◽

Near Future ◽

Care Costs

Objective To identify the prevalence of the practice of defensive medicine among Italian hospital physicians, its costs and the reasons for practising defensive medicine and possible solutions to reduce the practice of defensive medicine. Methods Cross-sectional web survey. Main outcome measures Number of physicians reporting having engaged in any defensive medicine behaviour in the previous year. Results A total of 1313 physicians completed the survey. Ninety-five per cent believed that defensive medicine would increase in the near future. The practice of defensive medicine accounted for approximately 10% of total annual Italian national health expenditure. Conclusions Defensive medicine is a significant factor in health care costs without adding any benefit to patients. The economic burden of defensive medicine on health care systems should provide a substantial stimulus for a prompt review of this situation in a time of economic crisis. Malpractice reform, together with a systematic use of evidence-based clinical guidelines, is likely to be the most effective way to reduce defensive medicine.

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Examining the Influence of Information Technology on Modern Health Care

Data Analytics in Medicine ◽

10.4018/978-1-7998-1204-3.ch097 ◽

2020 ◽

pp. 1943-1962

Author(s):

Edward T. Chen

Keyword(s):

Health Care ◽

Information Technology ◽

Health Care Organizations ◽

Health Care Systems ◽

Medical Personnel ◽

Bundled Payments ◽

Modern Health Care ◽

Designed Environment ◽

Care Systems ◽

Care Costs

Health care costs continue to rise at a level that far exceeds the rate of inflation. IT will be necessary in the computation and organization of complex algorithms presented in bundled payments and other initiatives. Currently in health care, a patient's medical history is not easily accessible by physicians and other medical personnel. IT can play the pivotal role in rectifying this problem in tracking the record in a universally designed environment. Advanced databases are needed to integrate facilities within health care systems. This chapter is to explore the current framework of Information Technology in the U.S. health care industry and to examine the topic covering the following areas: (a) IT's influence on the Affordable Care Act, (b) the emergence of the Electronic Health Record (EHR), also known as the Electronic Medical Record (EMR), and (c) the integration of databases across health care organizations through advanced systems like Epic.

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Health Care Efficiency In Transition Economies: An Application Of Data Envelopment Analysis

International Business & Economics Research Journal (IBER) ◽

10.19030/iber.v7i2.3221 ◽

2011 ◽

Vol 7 (2) ◽

Cited By ~ 7

Author(s):

Sam Mirmirani ◽

H.C. Li ◽

Joseph A. Ilacqua

Keyword(s):

Health Care ◽

Data Envelopment Analysis ◽

Transition Economies ◽

Health Care Systems ◽

Financial Burden ◽

Policy Implications ◽

Data Envelopment ◽

Care Systems ◽

Care Costs ◽

Health Care Efficiency

Health care costs are a financial burden for developing and transition economies which have experienced a faster growing demand on their health care systems while aiming to improve efficiency. As costs become more complex, attention has shifted to the efficiency of an entire system. Through system-wide assessments, countries with higher health care efficiency can be identified. These systems can be replicated to allow provision of good care at lower costs. Data Envelopment Analysis is used to measure health care efficiencies and to discuss policy implications.

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Micronesian Migrants in Hawaii

Californian Journal of Health Promotion ◽

10.32398/cjhp.v3i4.1782 ◽

2005 ◽

Vol 3 (4) ◽

pp. 59-72 ◽

Cited By ~ 5

Author(s):

Ann M. Pobutsky ◽

Lee Buenconsejo-Lum ◽

Catherine Chow ◽

Neal Palafox ◽

Gregory G. Maskarinec

Keyword(s):

Health Care ◽

Health Care Systems ◽

Academic Programs ◽

Mariana Islands ◽

Epidemiologic Transition ◽

Northern Mariana Islands ◽

Job Opportunities ◽

Care Systems ◽

The Impact ◽

Care Costs

More than 20,000 Micronesians have migrated to Guam, Hawaii, or the Commonwealth of the Northern Mariana Islands. Of these migrants, more than 8,000 now live in Hawaii. Factors in their home islands driving the recent emigration include the limited economic resources and struggling health care systems. Education systems in Micronesia are inadequate, and there are few job opportunities. The rates of infectious diseases remain high while at the same time, the epidemiologic transition in health has led to an explosion of non-communicable diseases. In Hawaii, the impact of the Micronesians emigration has been significant with most health and education expenses un-reimbursed. The health care costs alone are substantial as many Micronesians travel to Guam or Hawaii for medical treatment unavailable in their home islands. At the same time, Micronesians have difficulty accessing and navigating the health care system. While governmental, private, and academic programs already provide innovative and communitybased services to the Micronesian population, more work remains to be done. Not only are additional services, tailored to the culture and needs of Micronesian migrants, needed but a keener awareness and understanding of the issues surrounding Hawaii’s migrant population must be promoted among all public health stakeholders to ensure that the priority necessary to successfully address these challenges is recognized.

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