Who Gets how much Care in Psychiatric Outpatient Clinics and Why?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
F. Wedegaertner ◽  
G. Holler ◽  
H.M. Emrich
Keyword(s):  
Nursing Home ◽  
Outpatient Clinics ◽  
Linear Regression Models ◽  
Functional Deficits ◽  
Care Givers ◽  
Lump Sum ◽  
Psychiatric Outpatient ◽  
Independent Life ◽  
The Individual ◽  
Best Fit

Aims:German psychiatric outpatient clinics have been established to treat the sickest among outpatients. They receive a lump sum per patient and quarter. This reimbursement is currently under scrutiny, because it can act as a disincentive for the care-givers and to the disadvantage of the patients. It was the aim of this study to elucidate the connections between individual aspects and concerns of the patients and the amount of care administered.Method:Clients of one of the largest health insurers, who visited a preselected outpatient clinic were followed for six months (p=339). All treatment activities were logged individually. Relevant sociodemographic data, the diagnoses, the individual needs and idiosyncracies, the course of the symptoms and case history were noted. Associations between the factors and utilization were tested by ANOVA and multiple linear regression models.Results:The regression model with the best fit (r²=0,48, p< 0,001) included five variables. Lower utilization is associated with living in nursing home (ß=-0,378; p< 0,001), higher age (ß=-0,273; p< 0,001), legal incapacity (ß=-0,306,p=0,002) and lower social functioning (ß=-0,187; p=0,033); higher utilization with inpatient days prior to outpatient treatment (ß=0,168; p=0,015). Treatment aims, isolated functional deficits, diagnoses and graveness of symptoms did not have a significant influence.Conclusions:Outpatient clinics should address the needs of younger patients with the aspiration of an independent life despite of a grave psychiatric disorder. Treatments administered to nursing-home inhabitants are much less complex, although these patients are even sicker. A corresponding reallocation of financial resources is suggested.

Who Gets How Much Care in Psychiatric Outpatient Clinics and Why?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
F. Wedegaertner ◽  
G. Holler ◽  
H.M. Emrich
Keyword(s):  
Nursing Home ◽  
Outpatient Clinics ◽  
Linear Regression Models ◽  
Functional Deficits ◽  
Care Givers ◽  
Lump Sum ◽  
Psychiatric Outpatient ◽  
Independent Life ◽  
The Individual ◽  
Best Fit

Aims:German psychiatric outpatient clinics have been established to treat the sickest among outpatients. They receive a lump sum per patient and quarter. This reimbursement is currently under scrutiny, because it can act as a disincentive for the care-givers and to the disadvantage of the patients. It was the aim of this study to elucidate the connections between individual aspects and concerns of the patients and the amount of care administered.Method:Clients of one of the largest health insurers, who visited a preselected outpatient clinic were followed for six months (p=339). All treatment activities were logged individually. Relevant sociodemographic data, the diagnoses, the individual needs and idiosyncracies, the course of the symptoms and case history were noted. Associations between the factors and utilization were tested by ANOVA and multiple linear regression models.Results:The regression model with the best fit (r2=0,48, p< 0,001) included five variables. Lower utilization is associated with living in nursing home (ß=-0,378; p< 0,001), higher age (ß=-0,273; p< 0,001), legal incapacity (ß=-0,306,p=0,002) and lower social functioning (ß=-0,187; p=0,033); higher utilization with inpatient days prior to outpatient treatment (ß=0,168; p=0,015). Treatment aims, isolated functional deficits, diagnoses and graveness of symptoms did not have a significant influence.Conclusions:Outpatient clinics should address the needs of younger patients with the aspiration of an independent life despite of a grave psychiatric disorder. Treatments administered to nursing-home inhabitants are much less complex, although these patients are even sicker. A corresponding reallocation of financial resources is suggested.

scholarly journals Factors Associated with Non-Remission in Bipolar Disorder: The Multicenter Treatment Survey for Bipolar Disorder in Psychiatric Outpatient Clinics (MUSUBI)

2020 ◽  
Vol Volume 16 ◽  
pp. 881-890 ◽  
Author(s):  
Takashi Tsuboi ◽  
Takefumi Suzuki ◽  
Takaharu Azekawa ◽  
Naoto Adachi ◽  
Hitoshi Ueda ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Outpatient Clinics ◽  
Factors Associated ◽  
Psychiatric Outpatient

scholarly journals Reinsurance of Third Party Motor Insurance and Motor Insurance in Finland

1962 ◽  
Vol 2 (1) ◽  
pp. 174-176 ◽  
Author(s):  
Teivo Pentikäinen
Keyword(s):  
Point Of View ◽  
Third Party ◽  
Lump Sum ◽  
Legal Limits ◽  
Physical Injuries ◽  
Insurance Cover ◽  
Motor Insurance ◽  
Full Compensation ◽  
The Individual ◽  
Risk Limits

The need and extent of reinsurance of third party motor insurance depends fundamentally on the risk limits prescribed in the legislation of the country in question (and on the other hand the legal limits of the compulsory insurance may have been fixed with regard to the reasonable possibilities of the insurers getting reinsurance). There are two kinds of risk limits which are applied in different countries: total limits and individual limits. The former defines the maximum joint indemnity for an accident, paid to all claiments together, and the latter defines the maximum indemnity paid to each claiment separately. From the social point of view limits of this sort are not expedient, especially in regard to physical injuries. Owing to this total limit the indemnity for a single claiment can depend on the number of other claiments, which is quite inadequate from the point of view of the actual need to get insurance cover for injuries. The individual lump sum limit allows full compensation for slight injuries but can cut down the compensation for serious ones, which is an irrational method of settling an indemnity system. Owing to these risk limits motor car drivers may also be held responsible for the extra claims personally on the basis of civil (or criminal) law, which compels them to take an extra third party liability insurance (which often also has risk limits).

Cross-Cultural Study of Initial Visits to Psychiatric Outpatient Clinics

1979 ◽  
Vol 28 (2) ◽  
pp. 81???83 ◽  
Author(s):  
Roslyn R. Elms ◽  
John Kevany ◽  
Captane Thomson ◽  
Marcus Webb
Keyword(s):  
Cultural Study ◽  
Cross Cultural ◽  
Outpatient Clinics ◽  
Cross Cultural Study ◽  
Psychiatric Outpatient

scholarly journals Monitoring of Adverse Drug Reaction-Related Parameters in Children and Adolescents Treated With Antipsychotic Drugs in Psychiatric Outpatient Clinics

2021 ◽  
Vol 12 ◽  
Author(s):  
Lenneke Minjon ◽  
Ivona Brozina ◽  
Toine C. G. Egberts ◽  
Eibert R. Heerdink ◽  
Els van den Ban
Keyword(s):  
Children And Adolescents ◽  
Antipsychotic Drug ◽  
Medical Records ◽  
Antipsychotic Drugs ◽  
Patient Characteristics ◽  
Outpatient Clinics ◽  
Physical Parameters ◽  
Laboratory Parameters ◽  
Psychiatric Outpatient ◽  
Antipsychotic Drug Treatment

Aim: To assess the frequency of monitoring of adverse drug reaction (ADR) related parameters in children and adolescents treated with antipsychotic drugs in psychiatric outpatient clinics and the considerations when monitoring was not performed.Methods: This retrospective follow-up study included 100 randomly selected outpatients aged ≤18 years who had a first prescription of an antipsychotic drug recorded in the electronic medical records of psychiatric outpatient clinics between 2014 and 2017. They were followed for up to 3 years. This study assessed the frequency of monitoring for physical parameters (weight, height, body mass index, waist circumference, pulse, blood pressure, and an electrocardiogram) and laboratory parameters (glucose, lipids, and prolactin) before the first prescription of an antipsychotic drug as well as during its use. Monitoring frequencies were stratified by the patient characteristics (sex, age, cardiovascular risk factors, and use of other psychotropic drugs), and by location of antipsychotic drug initiation (psychiatric outpatient clinic or elsewhere). Additionally, this study assessed the considerations mentioned in the medical records for not monitoring ADR-related parameters.Results: Overall, physical parameters were monitored more frequently (weight: 85.9% during the first half-year) than laboratory parameters (glucose and cholesterol: both 23.5%). There were no significant differences in monitoring at least one physical as well as in monitoring at least one laboratory parameter during the baseline period and during the total follow-up of antipsychotic drug treatment between the patient characteristics. In total, 3% of the children and adolescents were never monitored for any physical parameter, and 54% were never monitored for any laboratory parameter. For a minority of the children (14.8%) who were never monitored for laboratory parameters, considerations were recorded in their medical records, including refusal by the child or parents and monitoring performed by the general practitioner or elsewhere.Conclusion: Monitoring frequencies of ADR-related parameters in children and adolescents treated with antipsychotic drugs in psychiatric outpatient clinics varied and especially monitoring of laboratory parameters was infrequent. Considerations why monitoring was not performed were rarely recorded. The optimal method of monitoring and documentation thereof should become clear to optimize the benefit-risk balance of antipsychotic drug treatment for each child.

scholarly journals WHETHER INDIVIDUALISM MAKES PEOPLE FROM THE “WEST” HAPPIER AND COLLECTIVISM MAKES PEOPLE FROM THE “EAST” MORE SATISFIED IN LIFE: AN INDIVIDUAL-LEVEL ANALYSIS

2019 ◽  
Vol 128 (6B) ◽  
pp. 57
Author(s):  
Nguyễn Hữu An ◽  
Lê Duy Mai Phương
Keyword(s):  
Interpersonal Relationships ◽  
Well Being ◽  
Cultural Dimension ◽  
Subjective Well Being ◽  
Linear Regression Models ◽  
The West ◽  
Individual Level ◽  
Collectivistic Cultures ◽  
The Individual ◽  
Level Of Analysis

Determinants of the variation of happiness have long been discussed in social sciences. Recent studies have focused on investigating cultural factors contributing to the level of individual happiness, in which the cultural dimension of individualism (IND) and collectivism (COL) has been drawing the attention of a large number of scholars. At the cultural level of analysis, happiness is associated with personal achievements as well as personal egoism in individualistic cultures, while it is related to interpersonal relationships in collectivistic cultures. Empirical research yields unconventional results at the individual level of analysis, that is, individuals in collectivistic cultures favor IND to be happy, in contrast, people in individualistic cultures emphasize COL be satisfied in life. Using data from the fifth wave of the World Values Survey (WVS), this study takes the cultural dimension of IND and COL at the individual level of analysis to detect its effects on happiness (conceptualized as subjective well-being – SWB) in the comparison between the two cultures. Multiple linear regression models reveal results that individuals from the “West” experience greater happiness when they expose themselves less individualist, while, individuals from the “East” feel more satisfied and happier in their life when they emphasize more on IND or being more autonomous.

scholarly journals Attitude towards Immigrants in Russia: Regional Aspect

2021 ◽  
Vol 17 (3) ◽  
pp. 133-155
Author(s):  
Olga Demidova ◽  
Keyword(s):  
Income Level ◽  
Individual Characteristics ◽  
Linear Regression Models ◽  
Place Of Residence ◽  
World Value Survey ◽  
Capital Cities ◽  
Regional Aspect ◽  
Local Residents ◽  
The Individual ◽  
Regional Product

The paper examines the issues related to the identifying factors that influence the attitude of Russian people towards immigrants. As such factors, we selected the individual characteristics of the respondents (gender, age, educational level, marital status, income level, etc.), as well as indicators characterizing the respondent’s place of residence (region, type of settlement) and the economic situation in the corresponding region. (gross regional product per capita, unemployment rate, share of industries in which migrants are most employed, etc.). The analysis was based on the data of the 7th World Value Survey for Russia in 2017, containing information on 1,810 respondents from 61 Russian regions. With the help of linear regression models and geographically weighted regression was shown that the best attitude towards immigrants demonstrated young people and older generation, respondents with higher education and with average or high-income level. However, attitudes towards immigrants are varying sufficiently and greatly depend on the place of residence. The best attitude towards immigrants demonstrate residents of non-capital cities, as well as residents of the Samara and Saratov regions, the worst – residents of the most poor and most rich regions.Attitude towards immigrants is also improving with an increase in the share of construction and trade in the economy of the region (these industries employ the most immigrants). Local residents are gradually getting used to immigrants, the higher the proportion of migrants who came from abroad, the better the residents of the respective region relate to immigrants

scholarly journals Short-Term Response to Cholinesterase Inhibitors in Alzheimer’s Disease Delays Time to Nursing Home Placement

2018 ◽  
Vol 15 (10) ◽  
pp. 905-916 ◽  
Author(s):  
Carina Wattmo ◽  
Elisabet Londos ◽  
Lennart Minthon
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Nursing Home Placement ◽  
Specific Response ◽  
Short Term ◽  
Chei Treatment ◽  
The Individual ◽  
Home Placement ◽  
Term Response

Background: A varying response to cholinesterase inhibitor (ChEI) treatment has been reported among patients with Alzheimer’s disease (AD). Whether the individual-specific response directly affects time to nursing home placement (NHP) was not investigated. Objective: We examined the relationship between the 6-month response to ChEI and institutionalization. Methods: In a prospective, observational, multicenter study, 881 outpatients with a clinical AD diagnosis and a Mini-Mental State Examination score of 10-26 at the start of ChEI therapy (baseline) were included. The participants were evaluated using cognitive, global, and activities of daily living (ADL) scales at baseline and semiannually over 3 years. The date of NHP was recorded. Results: During the study, 213 patients (24%) were admitted to nursing homes. The mean ± standard deviation time from baseline (AD diagnosis) to NHP was 20.8 ± 9.3 months. After 6 months of ChEI treatment, the improved/unchanged individuals had longer time to NHP than those who worsened. The prolonged time to NHP was 3 months for cognitive response (P=0.022), 4 months for global response (P=0.004), 6 months for basic ADL response (P<0.001), and 8 months for response in all three scales (P<0.001). No differences were detected between the improved and unchanged groups in any scales. Conclusion: Patients who exhibit a positive short-term response to ChEI can expect to stay in their own home for 3-8 months longer. These findings underline the importance of a comprehensive clinical examination including various assessment scales to evaluate treatment response and provide a more accurate prognosis.

scholarly journals (A296) Psychosocial Disaster Preparedness Program Form School Children

2011 ◽  
Vol 26 (S1) ◽  
pp. s83-s83 ◽  
Author(s):  
E.A. Raj ◽  
K. Sekar
Keyword(s):  
School Children ◽  
Disaster Preparedness ◽  
Tamil Nadu ◽  
Control Group ◽  
Care Givers ◽  
Effective Manner ◽  
Before And After ◽  
Teachers And Students ◽  
The Individual ◽  
The Impact

The impact of natural disasters on individuals is substantial. Among the affected population in any disaster, children are identified as the most vulnerable group along with women, aged and disabled people. An estimated 77 million children under 15, on average, had their lives severely disrupted by a natural disaster or an armed conflict, each year, between 1991 and 2000 (Plan UK, 2003). Children are most affected since they loose the familiar environment, loss of parents, witness death of their loved ones, fear of reoccurrence of the disaster event. The impact of disaster on children of different age group is multiple times greater than that of the adults. This leads to various psychological problems in children (Dave et al., 2003). Disaster preparedness, through care givers, is one among the ways to reduce the distress of individuals followed by any disaster because it reduces the vulnerability factor that minimizes the impact of any disaster on the individual. A disaster preparedness program with special reference to psychosocial aspects was developed and implemented among the school children through teachers in Kanniyakumari District, Tamil Nadu, India, one of the severely affected areas in Tsunami. The current attempt was to standardize a disaster preparedness module focusing on preparing children to deal with their psychosocial issues before and after disaster in an effective manner. The outcome of disaster preparedness input through teachers and its reach out to the students was determined through an experimental research. The results reveal that the teachers and students from the experimental group gained significantly more knowledge on psychosocial disaster preparedness after implementation of the program in comparison to control group where the program was not implemented. The implications of the study points out the need to integrate psychosocial component of disaster preparedness in to the broader Community Based Disaster Preparedness (CBDP) programs.

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