Adult Care in Cystic Fibrosis

2019 ◽  
Vol 40 (06) ◽  
pp. 857-868 ◽  
Author(s):  
J. Stuart Elborn
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Care Delivery ◽  
Health Care Systems ◽  
Well Being ◽  
Models Of Care ◽  
Adult Care ◽  
Care Systems ◽  
Expanding Population ◽  
Almost All

AbstractCystic fibrosis (CF) is now more common in adults than children in countries with well-developed health care systems. The number of adults continues to increase and will further increase if the new cystic fibrosis transmembrane conductance regulator (CFTR) modulators are disease modifying. Most of the complex morbidity and almost all the mortality of CF occur in adults and will increasingly follow this pattern even with new effective modulator therapies. Maintaining good quality of life including social functioning and maximizing survival for adults are the key priorities. This requires a highly knowledgeable and adaptable multidisciplinary team, which, though focused on maintaining lung health, requires an increasing range of other disciplines and specialties to maximize well-being. Changes in health care systems will require current models of care to adapt to provide care for the large number of adult patients. With increasing survival and age, many are likely to have both CF morbidities and additional diseases of aging. New models are needed for health care delivery for this expanding population with complex medical conditions.

An Overview of Digital Health in the Transition of Pediatric to Adult Epilepsy Care

2020 ◽  
Vol 09 (04) ◽  
pp. 106-113
Author(s):  
Ysabeau Bernard-Willis ◽  
Emily De Oliveira ◽  
Shaheen E Lakhan
Keyword(s):  
Health Management ◽  
Digital Health ◽  
Health Care Systems ◽  
Well Being ◽  
Pediatric Care ◽  
Medical Mistrust ◽  
Patient Portals ◽  
Language Therapy ◽  
Adult Care ◽  
Care Systems

AbstractChildren with epilepsy often have impairments in cognitive and behavioral functioning which may hinder socio-occupational well-being as they reach adulthood. Adolescents with epilepsy have the added worry of health problems while starting the transition from family-centered pediatric care into largely autonomous adult care. If this transition is not appropriately planned and resourced, it may result in medical mistrust, nonadherence, and worsening biopsychosocial health as an adult. In recent years, there has been increased availability of digital health solutions that may be used during this stark change in care and treating teams. The digital health landscape includes a wide variety of technologies meant to address challenges faced by patients, caregivers, medical professionals, and health care systems. These technologies include mobile health products and wearable devices (e.g., seizure monitors and trackers, smartphone passive data collection), digital therapeutics (e.g., cognitive/behavioral health management; digital speech–language therapy), telehealth services (e.g., teleneurology visits), and health information technology (e.g., electronic medical records with patient portals). Such digital health solutions may empower patients in their journey toward optimal brain health during the vulnerable period of pediatric to adult care transition. Further research is needed to validate and measure their impact on clinical outcomes, health economics, and quality of life.

scholarly journals Covid-19 FAQ’s in Paediatric and Congenital Cardiology – AEPC position paper.

2021 ◽  
pp. 1-21
Author(s):  
Skaiste Sendzikaite ◽  
Ruth Heying ◽  
Ornella Milanesi ◽  
Katarina Hanseus ◽  
Ina Michel-Behnke
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Scientific Data ◽  
Position Paper ◽  
Paediatric Cardiology ◽  
European Paediatric ◽  
Care Systems ◽  
The Times ◽  
Almost All

Abstract The Covid-19 pandemic has had a huge influence in almost all areas of life, affecting societies, economics and health care systems worldwide. The paediatric cardiology community is no exception. As the challenging battle with Covid-19 continues, professionals from the Association for the European Paediatric and Congenital Cardiology (AEPC) receive many questions regarding Covid-19 in a Paediatric and Congenital Cardiology setting. The aim of this paper is to present the AEPC position on frequently asked questions based on the most recent scientific data, as well as to frame a discussion on how to take care of our patients during this unprecedented crisis. As the times are changing quickly and information regarding Covid-19 is very dynamic, continuous collection of evidence will help guide constructive decision-making.

Direct Primary Care: A Successful Financial Model for the Clinical Practice of Lifestyle Medicine

2021 ◽  
pp. 155982762110066
Author(s):  
Amy R. Mechley
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Well Being ◽  
The United States ◽  
Fee For Service ◽  
Financial Model ◽  
Lifestyle Medicine ◽  
Direct Primary

Primary care has been shown to significantly decrease the overall cost of a population’s health care while improving the quality of each person’s well-being. Lifestyle medicine (LM) is ideally positioned to be delivered via primary care and has been shown to improve short- and long-term health outcomes of patients and populations. Direct primary care (DPC) represents a viable alternative to the fee-for-service reimbursement model. It has been shown to be economically and financially sustainable. Furthermore, it has the potential to fulfill the Quadruple Aim of health care in the United States. LM practiced in a DPC model has the potential to transform health care delivery. This article will discuss the need for health care systems change, provide an overview of the DPC model, demonstrate a basic understanding of the benefits, and review the steps needed to de-risk the investment of time, money, and resources for our future DPC providers.

The Future of Health Care in South Korea and the UK

2006 ◽  
Vol 5 (3) ◽  
pp. 375-385 ◽  
Author(s):  
Bob Matthews ◽  
Yoonsoon Jung
Keyword(s):  
Health Care ◽  
South Korea ◽  
Care Delivery ◽  
Health Care Systems ◽  
Public Provision ◽  
Capitalist System ◽  
Private Provision ◽  
Care Systems ◽  
Health Care Delivery Systems ◽  
The Uk

This paper discusses and compares the origin and development of the health care systems of South Korea and the UK from the end of WW2 and endeavours to compare outcomes. The paper emphasises the importance of war as a stimulus to the development of national health services in both countries and argues that there is convergence between the UK's nationalised NHS and South Korea's US-modelled capitalist system. Overall, we conclude that there is a possibility not only that the financing and nature of the Korean and UK health care delivery systems may show convergence, but it is not impossible that they will ‘change places’ with the UK system dominated by private provision and South Korea's by public provision.

A Comparison of Organized and Traditional Health Care

2005 ◽  
Vol 44 (02) ◽  
pp. 273-277
Author(s):  
D. M. Lawrence
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Health Care Systems ◽  
Delivery Systems ◽  
Traditional Health ◽  
Traditional Health Care ◽  
Care Systems ◽  
Health Care Delivery Systems

Summary Purpose: To compare organized and traditional health care delivery systems and their ability to meet several major challenges facing health care in the next 25 years. Approach: Analysis of traditional and organized health care systems based on a career spent in organized health care systems. Conclusions: The traditional health care system based on independent autonomous physicians is not able to meet the challenges of current healthcare. Stronger integration and coordination, i.e., organized health care delivery systems are required.

Developing and Measuring the Business Case for Health Information Technology

2017 ◽  
pp. 262-290 ◽  
Author(s):  
Duncan Wade Unwin ◽  
Louis Sanzogni ◽  
Kuldeep Sandhu
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Information Systems ◽  
Care Delivery ◽  
Health Care Systems ◽  
Business Case ◽  
It Adoption ◽  
Health It ◽  
Adoption Of Technology ◽  
Care Systems

This chapter examines the adoption of information technology and information systems to support the clinical process. It explores popular models of information systems adoption and success, and relates these to the health it context. The end result of successful adoption of technology should be the improvement in performance of health care delivery, yet measurement of performance is complex. The various approaches to performance measurement are discussed. As one of the challenges in predicting the outcomes of adoption is the lack of consistent taxonomy, a solution to which is proposed. The chapter then looks at evaluation of it projects and considers what special factors may affect health it adoption and benefits in developing health care systems.

Toward More Patient-Centered and Prevention-Oriented Oral Health Care

2016 ◽  
Vol 2 (1) ◽  
pp. 5-9 ◽  
Author(s):  
H. Leggett ◽  
D. Duijster ◽  
G.V.A. Douglas ◽  
K. Eaton ◽  
G.J.M.G. van der Heijden ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Disease Prevention ◽  
Care Delivery ◽  
Health Care Systems ◽  
Oral Care ◽  
Oral Health Care ◽  
Patient Centered ◽  
Care Systems ◽  
European Union Member States

ADVOCATE (Added Value for Oral Care) is a project funded by the European Commission’s Horizon 2020 program, which aims to develop strategies for a system transition toward more patient-centered and prevention-oriented oral health care delivery within health care systems. This system should balance the restorative and preventive approaches in dental and oral health care. ADVOCATE is a partnership among 6 European Union member states, which involves collaboration among universities, state-funded health care providers, and private insurance companies in Denmark, Germany, Hungary, Ireland, the Netherlands, the United Kingdom, and Aridhia, a biomedical informatics company based in Scotland. There are 6 interrelated work packages, which aim to address the following objectives: 1) in-depth evaluation of oral health care systems in European Union member states to identify best system designs for oral disease prevention, 2) development of a set of measures to provide information on oral care delivery and oral health outcomes, 3) evaluation of a feedback approach in dental practice that aims to facilitate a change toward preventive oral health care delivery, and 4) economic evaluation of strategies to promote preventive oral health care and development of policy recommendations for oral health care systems. The project is novel in its use of data that are routinely collected by health insurance organizations, as well as the engagement of key stakeholders from dental teams, insurers, patients, and policy makers in guiding the development and progress of the project. This article outlines in detail the objectives and research methodology of the ADVOCATE project and its anticipated impact. Knowledge Transfer Statement: This commentary describes the development of policy options to promote a greater focus on disease prevention in general dental practice. The approach builds on identifying the comparative effectiveness of alternative incentive schemes, as well as methods to monitor clinical and patient-derived measures of success in creating health for patients. The article describes the development and application of the measures and the evaluation of their success in orienting clinical practice more toward disease prevention.

Health care and the future of economic growth: exploring alternative perspectives

2019 ◽  
Vol 15 (4) ◽  
pp. 419-439 ◽  
Author(s):  
Martin Hensher ◽  
John Tisdell ◽  
Ben Canny ◽  
Craig Zimitat
Keyword(s):  
Economic Growth ◽  
Health Care ◽  
Health Expenditure ◽  
Global Economy ◽  
Global Financial Crisis ◽  
Health Care Systems ◽  
Health Financing ◽  
Well Being ◽  
Gdp Growth ◽  
Care Systems

AbstractThe strong and positive relationship between gross domestic product (GDP) and health expenditure is one of the most extensively explored topics in health economics. Since the global financial crisis, a variety of theories attempting to explain the slow recovery of the global economy have predicted that future economic growth will be slower than in the past. Others have increasingly questioned whether GDP growth is desirable or sustainable in the long term as evidence grows of humanity's impact on the natural environment. This paper reviews recent data on trends in global GDP growth and health expenditure. It examines a range of theories and scenarios concerning future global GDP growth prospects. It then considers the potential implications for health care systems and health financing policy of these different scenarios. In all cases, a core question concerns whether growth in GDP and/or growth in health expenditure in fact increases human health and well-being. Health care systems in low growth or ‘post-growth’ futures will need to be much more tightly focused on reducing overtreatment and low value care, reducing environmental impact, and on improving technical and allocative efficiency. This will require much more concerted policy and regulatory action to reduce industry rent-seeking behaviours.

Rapid Process Optimization

2016 ◽  
Vol 32 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Jennifer L. Wiler ◽  
Kelly Bookman ◽  
Derek B. Birznieks ◽  
Robert Leeret ◽  
April Koehler ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Process Optimization ◽  
Process Improvement ◽  
Care Delivery ◽  
Health Care Systems ◽  
Process Redesign ◽  
Rapid Process ◽  
Left Without Being Seen ◽  
Care Systems

Health care systems have utilized various process redesign methodologies to improve care delivery. This article describes the creation of a novel process improvement methodology, Rapid Process Optimization (RPO). This system was used to redesign emergency care delivery within a large academic health care system, which resulted in a decrease: (1) door-to-physician time (Department A: 54 minutes pre vs 12 minutes 1 year post; Department B: 20 minutes pre vs 8 minutes 3 months post), (2) overall length of stay (Department A: 228 vs 184; Department B: 202 vs 192), (3) discharge length of stay (Department A: 216 vs 140; Department B: 179 vs 169), and (4) left without being seen rates (Department A: 5.5% vs 0.0%; Department B: 4.1% vs 0.5%) despite a 47% increased census at Department A (34 391 vs 50 691) and a 4% increase at Department B (8404 vs 8753). The novel RPO process improvement methodology can inform and guide successful care redesign.

Countering Moral Hazard in Public and Private Health Care Systems: A Review of Recent Evidence

1989 ◽  
Vol 18 (2) ◽  
pp. 235-251 ◽  
Author(s):  
Cam Donaldson ◽  
Karen Gerard
Keyword(s):  
Health Care ◽  
Health Services ◽  
Moral Hazard ◽  
Financial Incentives ◽  
Care Delivery ◽  
Health Care Systems ◽  
Health Care Financing ◽  
General Effect ◽  
Health Maintenance ◽  
Care Systems

ABSTRACTWithin both publicly and privately financed health care Systems different funding mechanisms have evolved, or have been proposed, to deal with the problem of ‘moral hazard’. Moral hazard arises when financial incentives within the health care System lead to either inefficient demands for care by consumers or inefficient supply of care by providers. In this paper the problem of moral hazard is outlined in more detail, and different ways of countering moral hazard are reviewed in terms of three criteria: effect on patient utilisation of health services in general; effect on utilisation by different groups of patients; and effect on health status. It is concluded that evidence on different methods of funding health services can only be judged in the context of objectives. If the objectives of health care delivery are ‘maintenance or improvement of health’ and ‘equal access for equal need’ then charges and finance of care through health maintenance organisations both appear to be less favourable than ‘free’ care at the point of delivery whilst the latter is not necessarily more costly as a resuit. Research on other suggested alternatives is required, otherwise radical changes to health care financing in the UK will simply result in movement from one unproven system to another.

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