scholarly journals Who approves/pays for additional monitoring?

2019 ◽  
Vol 21 (Supplement_M) ◽  
pp. M64-M67 ◽  
Author(s):  
Giuseppe M C Rosano ◽  
Ilaria Spoletini ◽  
Cristiana Vitale
Keyword(s):  
New Technologies ◽  
Imaging Techniques ◽  
Healthcare Spending ◽  
Mobile Technologies ◽  
Diagnostic Systems ◽  
Healthcare Provision ◽  
Care Needs ◽  
Health Authorities ◽  
Health And Social Care ◽  
Short Period

Abstract Major considerations in the provision of healthcare are availability, affordability, accessibility, and appropriateness, especially in the setting of heart failure where disease burden is growing, developments have been rapid and newer biomarkers, diagnostic and imaging techniques, monitoring systems, devices, procedures, and drugs have all been developed in a relatively short period of time. Many monitoring and diagnostic systems have been developed but the disproportionate cost of conducting trials of their effectiveness has limited their uptake. There are added complexities, in that the utilization of doctors for the supervision of the monitoring results may be optimal in one setting and not in another because of differences in the characteristics of organization of healthcare provision, making even interpretation of the trials we have had, still difficult to interpret. New technologies are continuously changing the approach to healthcare and will reshape the structure of the healthcare systems in the future. Mobile technologies can empower patients and carers by giving them more control over their health and social care needs and reducing their dependence on healthcare professionals for monitoring their health, but a significant problem is the integration of the multitude of monitored parameters with clinical data and the recognition of intervention thresholds. Digital technology can help, but we need to prove its cost/efficacy and how it will be paid for. Governments in many European countries and worldwide are trying to establish frameworks that promote the convergence of standards and regulations for telemedicine solutions and yet simultaneously health authorities are closely scrutinizing healthcare spending, with the objective of reducing and optimizing expenditure in the provision of health services. There are multiple factors to be considered for the reimbursement models associated with the implementation of physiological monitoring yet it remains a challenge in cash-strapped health systems.

scholarly journals Introducing Care 4.0: An Integrated Care Paradigm Built on Industry 4.0 Capabilities

2019 ◽  
Vol 16 (12) ◽  
pp. 2247 ◽  
Author(s):  
Chaloner Chute ◽  
Tara French
Keyword(s):  
Industry 4.0 ◽  
Industrial Revolution ◽  
Digital Health ◽  
Medical Model ◽  
Integrated Approach ◽  
New Paradigm ◽  
Healthcare Provision ◽  
Care Needs ◽  
Care Services ◽  
Health And Social Care

Western developed health and care policy is shifting from a patriarchal medical model to a co-managed and integrated approach. Meanwhile, the fourth industrial revolution (Industry 4.0) is transforming manufacturing in line with the digital consumer revolution. Digital health and care initiatives are beginning to use some of the same capabilities to optimize healthcare provision. However, this is usually limited to self-management as part of an organization-centric delivery model. True co-management and integration with other organizations and people is difficult because it requires formal care organizations to share control and extend trust. Through a co-design lens, this paper discusses a more person-centered application of Industry 4.0 capabilities for care. It introduces ‘Care 4.0’, a new paradigm that could change the way people develop digital health and care services, focusing on trusted, integrated networks of organizations, people and technologies. These networks and tools would help people co-manage and use their own assets, in the context of their own care circle and community. It would enable personalized services that are more responsive to care needs and aspirations, offering preventative approaches that ultimately create a more flexible and sustainable set of integrated health and social care services that support meaningful engagement and interactions.

Mass Spectrometry for Proteomics and Recent Developments in ESI, MALDI and other Ionization Methodologies

2019 ◽  
Vol 16 (4) ◽  
pp. 267-276
Author(s):  
Qurat ul Ain Farooq ◽  
Noor ul Haq ◽  
Abdul Aziz ◽  
Sara Aimen ◽  
Muhammad Inam ul Haq
Keyword(s):  
Mass Spectrometry ◽  
Electrospray Ionization ◽  
New Technologies ◽  
Protein Complexes ◽  
Imaging Techniques ◽  
Desorption Electrospray Ionization ◽  
High Throughput Analysis ◽  
Enhanced Sensitivity ◽  
Recent Developments ◽  
The Way

Background: Mass spectrometry is a tool used in analytical chemistry to identify components in a chemical compound and it is of tremendous importance in the field of biology for high throughput analysis of biomolecules, among which protein is of great interest. Objective: Advancement in proteomics based on mass spectrometry has led the way to quantify multiple protein complexes, and proteins interactions with DNA/RNA or other chemical compounds which is a breakthrough in the field of bioinformatics. Methods: Many new technologies have been introduced in electrospray ionization (ESI) and Matrixassisted Laser Desorption/Ionization (MALDI) techniques which have enhanced sensitivity, resolution and many other key features for the characterization of proteins. Results: The advent of ambient mass spectrometry and its different versions like Desorption Electrospray Ionization (DESI), DART and ELDI has brought a huge revolution in proteomics research. Different imaging techniques are also introduced in MS to map proteins and other significant biomolecules. These drastic developments have paved the way to analyze large proteins of >200kDa easily. Conclusion: Here, we discuss the recent advancement in mass spectrometry, which is of great importance and it could lead us to further deep analysis of the molecules from different perspectives and further advancement in these techniques will enable us to find better ways for prediction of molecules and their behavioral properties.

scholarly journals The burden of triumph: meeting health and social care needs

The Lancet ◽  
2017 ◽  
Vol 390 (10103) ◽  
pp. 1630-1631 ◽  
Author(s):  
Andrew Dilnot
Keyword(s):  
Social Care ◽  
Care Needs ◽  
Health And Social Care

Challenging times: building a health, housing and social care local workforce strategy

2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith
Keyword(s):  
Service Delivery ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Workforce Planning ◽  
Care Needs ◽  
Fiscal Impact ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.

scholarly journals Frailty and social support: the care services response to aging in Russia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Kholostov
Keyword(s):  
Social Support ◽  
Social Services ◽  
New Technologies ◽  
Effective Interaction ◽  
Well Being ◽  
The Elderly ◽  
The State ◽  
Institutional Perspective ◽  
Term Care ◽  
Health And Social Care

Abstract In the twenty-first century, ageing of population, having become a global phenomenon, raised questions about the need to consider the social services of the elderly from an institutional perspective. Thus, the number of Russians over the age of 100 in 2018 exceeded 15.7 thousand people. In Moscow, as in the mega polis, in 2018 more than 3.4031 million people (27.2%) are older than working age. Different countries have their own characteristics of social service systems, models and policies, it depends to a large extent on the traditions of assistance, sources of financing, the space of responsibility assumed by the State, society, the family and the individual himself. New technologies to be applied for working with the elderly in Russia. Transition to the establishment of a system of long-term care at the level of multidisciplinary cooperation (reform of the residential care system; development of community based services, formation of Social Support Services for 75+, foster family for the elderly).Development of active longevityChanging the role repertoire of an older person (formation of new types of social roles previously characteristic of younger ages; changing of intergenerational link formats, etc.).The growing social responsibility of the State contributes to a more effective interaction between health and social care authorities, as well as a more active involvement of the NGO sector in addressing the problems of older persons.The increase in the number of older persons leads to the creation and active development of a silver economy that contributes to improving the well-being of people.Transfer of retraining and advanced training systems to the competent level according to professional standards (independent assessment of qualifications, personnel diagnostics, formation of individual trajectory of education, training of multiple disciplinary teams).

scholarly journals Informing patterns of health and social care utilisation in Irish older people according to the Clinical Frailty Scale

2021 ◽  
Vol 4 ◽  
pp. 54
Author(s):  
Aisling M. O'Halloran ◽  
Peter Hartley ◽  
David Moloney ◽  
Christine McGarrigle ◽  
Rose Anne Kenny ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Markov Models ◽  
Classification Tree ◽  
Community Health Services ◽  
Health Services Use ◽  
Care Needs ◽  
Clinical Frailty Scale ◽  
Care Utilisation ◽  
Health And Social Care

Background: There is increasing policy interest in the consideration of frailty measures (rather than chronological age alone) to inform more equitable allocation of health and social care resources. In this study the Clinical Frailty Scale (CFS) classification tree was applied to data from The Irish Longitudinal Study on Ageing (TILDA) and correlated with health and social care utilisation. CFS transitions over time were also explored. Methods: Applying the CFS classification tree algorithm, secondary analyses of TILDA data were performed to examine distributions of health and social care by CFS categories using descriptive statistics weighted to the population of Ireland aged ≥65 years at Wave 5 (n=3,441; mean age 74.5 (SD ±7.0) years, 54.7% female). CFS transitions over 8 years and (Waves 1-5) were investigated using multi-state Markov models and alluvial charts. Results: The prevalence of CFS categories at Wave 5 were: 6% ‘very fit’, 36% ‘fit’, 31% ‘managing well’, 16% ‘vulnerable’, 6% ‘mildly frail’, 4% ‘moderately frail’ and 1% ‘severely frail’. No participants were ‘very severely frail’ or ‘terminally ill’. Increasing CFS categories were associated with increasing hospital and community health services use and increasing hours of formal and informal social care provision. The transitions analyses suggested CFS transitions are dynamic, with 2-year probability of transitioning from ‘fit’ (CFS1-3) to ‘vulnerable’ (CFS4), and ‘fit’ to ‘frail’ (CFS5+) at 34% and 6%, respectively. ‘Vulnerable’ and ‘frail’ had a 22% and 17% probability of reversal to ‘fit’ and ‘vulnerable’, respectively. Conclusions: Our results suggest that the CFS classification tree stratified the TILDA population aged ≥65 years into subgroups with increasing health and social care needs. The CFS could be used to aid the allocation of health and social care resources in older people in Ireland. We recommend that CFS status in individuals is reviewed at least every 2 years.

scholarly journals Advice to purchasing authorities

1993 ◽  
Vol 17 (3) ◽  
pp. 164-165
Author(s):  
Peter Urwin
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
Health Care Needs ◽  
Care Needs ◽  
District Health ◽  
Professional Advice ◽  
Health Authorities ◽  
Provision Of Services ◽  
Second Year

We are now well into the second year of the separation of purchaser and provider functions in the National Health Service. District health authorities as purchasers of services are required to assess the health care needs of their population (NHS Management Executive, 1991a) and seek professional advice regarding both the need for, and the provision of, services. The NHS Management Executive acknowledges that local clinicians in provider units will continue to make a major contribution to this advice (NHS Management Executive, 1991b).

scholarly journals Needs of patients with dementia and their caregivers in primary care: lessons learned from the Alzheimer plan of Quebec

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Vladimir Khanassov ◽  
Laura Rojas-Rozo ◽  
Rosa Sourial ◽  
Xin Qiang Yang ◽  
Isabelle Vedel
Keyword(s):  
Primary Care ◽  
Unmet Needs ◽  
Social Care ◽  
Phase 1 ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Care Plan ◽  
Phase 2 ◽  
Care Needs ◽  
Health And Social Care

Abstract Background Persons living with dementia have various health and social care needs and expectations, some which are not fully met by health providers, including primary care clinicians. The Quebec Alzheimer plan, implemented in 2014, aimed to cover these needs, but there is no research on the effect this plan had on the needs and expectations of persons living with dementia. The objective of this study is to identify persons living with dementia and caregivers’ met and unmet needs and to describe their experience. Methods This is a sequential mixed methods explanatory design: Phase 1: cross-sectional study to describe the met and unmet health and social care needs of community-dwelling persons living with dementia using Camberwell Assessment of Need of the Elderly and Carers’ Assessment for Dementia tools. Phase 2: qualitative descriptive study to explore and understand the experiences of persons living with dementia and caregivers with the use of social and healthcare services, using semi-structured interviews. Data from phase 1 was analyzed with descriptive statistics, and from phase 2, with inductive thematic analysis. Results from phases 1 and 2 were compared, contrasted and interpreted together. Results The mean total number of needs reported by the patients was 5.03 (4.48 and 0.55 met and unmet needs, respectively). Caregivers had 0.52 met needs (3.16 unmet needs). The main needs for both were memory, physical health, eyesight/hearing/communication, medication, looking after home, money/budgeting. Three categories were mentioned by the participants: Persons living with dementia and caregiver’s attitude towards memory decline, their perception of community health services and of the family medicine practice. Conclusions Our study confirms the findings of other studies on the most common unmet needs of the patients and caregivers that are met partially or not at all. In addition, the participants were satisfied with access to care, and medical services in primary practices, being confident in their family. Our results indicate persons living with dementia and their caregivers need a contact person, a clear explanation of their dementia diagnosis, a care plan, written information on available services, and support for the caregivers.

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