Optimal Peritoneal Dialysis for Patients from Hong Kong

1999 ◽  
Vol 19 (3_suppl) ◽  
pp. 26-31 ◽  
Author(s):  
Kar Neng Lai ◽  
Wai Kei Lo
Keyword(s):  
Hong Kong ◽  
Peritoneal Dialysis ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Small Volume ◽  
Developed Countries ◽  
Financial Resources ◽  
The Past ◽  
The Government

The socioeconomic statuses of Asian countries are diverse and government reimbursement policies for renal replacement programs vary greatly from one country to another. Both factors affect not only the availability of treatment but also the choice of dialysis modality. Despite the economic growth of Hong Kong over the past three decades, the resources spent by our government on health services are less than other developed countries. The National Health Service, which is run on a tight budget, supports almost 95% of the patients on renal replacement programs. Due to the cost-effectiveness and reimbursement from the government, 79% of patients with end-stage renal failure in Hong Kong are treated with continuous ambulatory peritoneal dialysis (CAPD). All new patients entering the renal replacement program run by the National Health Service are offered CAPD as the first-line dialytic treatment. Due to budgetary constraint, over the past 10 years dialysis centers in Hong Kong have adopted a small-volume regime of 3 x 2-L daily exchanges as the initial dialysis prescription. This dialysis prescription will be considered to be suboptimal by Western standards, but the survival of these patients was comparable to, or even better than, other areas despite a lower Kt/V. These preliminary studies suggest small-volume dialysis may be an acceptable compromise in Asian populations with their smaller body size, given the financial constraints. These issues are especially important in Asia, where financial resources for renal replacement therapy are still limited in most countries and many patients have to continue working to pay for their renal replacement treatment. Using this small-volume dialytic regime, more patients may be treated with the limited financial resources. Furthermore, our experience raises the question of the importance of nutritional status in patient survival.

scholarly journals Who is the right person to look after the mentally retarded?

Curationis ◽  
1980 ◽  
Vol 3 (3) ◽  
Author(s):  
V. Ehlers
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Residential Care ◽  
National Health ◽  
Mentally Retarded ◽  
Nursing Profession ◽  
Financial Resources ◽  
Mentally Handicapped ◽  
Set Up ◽  
The Right

A committee was set up in Britain in 1975 under the Chairmanship of Mrs Peggy Jay to look into the staffing of mental handicapped residential care in the National Health Service. Part of the task was to consider the Briggs Committee’s recommendation that “… a new caring profession for the mentally handicapped should emerge gradually”. The findings and recommendations of the committee were however radical and far-reaching, involving an enormous shift in financial resources and causing much concern and outcry from the nursing profession which considered the new category of care given as a threat to their existence.

More Patient Choice in England's National Health Service

2005 ◽  
Vol 35 (3) ◽  
pp. 479-483 ◽  
Author(s):  
Richard Lewis
Keyword(s):  
Health Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Urban Areas ◽  
Patient Choice ◽  
Private Provider ◽  
National Quality ◽  
The Government ◽  
English National Health

A new political consensus has emerged over the benefits of new rights for patients to choose their provider of elective health care in the English National Health Service. From December 2005, patients will be able to select from a number of alternative providers at the time they are referred for treatment. In the longer term, patients will be able to access care at any public or private provider that meets national quality and cost standards. The government intends that this policy will lead to improvements in the quality and efficiency of health care and will reduce levels of inequity among patients. Pilot schemes have shown that a majority of patients will exercise a choice of provider when this is offered. However, the policy of patient choice may involve significant costs to the NHS and may be more difficult to implement outside urban areas. Further, the information needed to support patients' choices is not yet available. Whether such a policy will increase or decrease levels of equity in the English NHS remains open to debate.

Misplaced Trust? Occupational Therapy and NHS Trusts

1994 ◽  
Vol 57 (2) ◽  
pp. 40-44 ◽  
Author(s):  
Walter Lloyd-Smith
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Occupational Therapy ◽  
National Health ◽  
Health Professionals ◽  
The Self ◽  
The Government ◽  
The Impact ◽  
Therapy Service

The present governmental reforms of the National Health Service are the most far-reaching to date and have fundamental implications for health professionals. The focus of this article is to raise some of these issues in relation to occupational therapy. The introduction of trusts, the purchaser/provider split and the internal market are some of the mechanisms by which the government hoped to tackle the funding crisis of the late 1980s. These reforms have been operating since 1991, but little has been published on the impact of the self-governing trust movement on occupational therapy. Some observations on and an evaluation of these reforms are offered. It is hoped that the article will stimulate discussion within the profession about the role of trusts and their relationship to the delivery and development of an occupational therapy service.

Learning Clinical Psychiatry in a Provincial Mental Hospital

1974 ◽  
Vol 125 (586) ◽  
pp. 303-309 ◽  
Author(s):  
Brian Barraclough ◽  
Godfrey Wace
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Clinical Psychiatry ◽  
National Health ◽  
Mental Hospital ◽  
Clinical Skills ◽  
Educational Experience ◽  
Postgraduate Teaching ◽  
The Past ◽  
Mental Hospitals

Postgraduate teaching in psychiatry has always been a function of the provincial mental hospitals, but nothing before has equalled the expansion of theoretical teaching which has taken place over the past ten years. At the heart of the training of a psychiatrist, however, there is the National Health Service job with its own demands, where the practical clinical skills are acquired. The job has not changed much, even though the arrangements for theoretical instruction have improved. Yet changes may be possible which will make the registrar's job more efficient as an educational experience by removing the unsystematic and random elements.

The Development of National Health Service Social Enterprises in England

2019 ◽  
pp. 95-108 ◽  
Author(s):  
Sebrene Margaret Maher
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Service Providers ◽  
Healthcare Services ◽  
Social Enterprises ◽  
Policy Framework ◽  
Public Healthcare ◽  
Health Service Providers ◽  
The Government

The purpose of this chapter is to examine government policy framework relating to the development of social enterprise within National Health Service providers. The number of social enterprises delivering public healthcare services is continually growing. This chapter discusses challenges and benefits for the government. Potential barriers to achieving this development are also evaluated. Although the focus is primarily upon the policy agenda in England, the chapter makes a useful contribution to the ongoing international debate on the development of social enterprises in primary and secondary care. This review identifies that National Health Service social enterprises responds to local needs, bring innovative, effective ways of managing heathcare in the community. It is clear from reviewing the literature that healthcare services are changing and being continually shaped by social enterprises providers.

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