scholarly journals Identifying Disparities in the Management of Hip Fractures Within Europe: A Comparison of 3 Health-Care Systems

2019 ◽  
Vol 10 ◽  
pp. 215145931987294 ◽  
Author(s):  
Cliodhna E. Murray ◽  
Andreas Fuchs ◽  
Heide Grünewald ◽  
Owen Godkin ◽  
Norbert P. Südkamp ◽  
...  
Keyword(s):  
Health Care ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Care Pathway ◽  
Health Care Systems ◽  
Standards Of Care ◽  
Evidence Based ◽  
Care Hospital ◽  
Care Systems ◽  
The Uk

Introduction: This study investigates the management of hip fractures in a German maximum care hospital and compares these data to evidence-based standard and practice in 180 hospitals participating in the UK National Hip Fracture Database (NHFD) and 16 hospitals participating in the Irish Hip Fracture Database (IHFD). This is the first study directly comparing the management of hip fractures between 3 separate health-care systems within Europe. Methods: Electronic medical data were collected retrospectively describing the care pathway of elderly patients with a hip fracture admitted to a large trauma unit in the south of Germany “University Hospital Freiburg” (UHF). The audit evaluated demographics, postoperative outcome, and the adherence to the 6 “Blue Book” standards of care. These data were directly compared with the data from the UK NHFD and the IHFD acquired from 180 and 16 hospitals, respectively. Results: At 36 hours, 95.8% of patients had received surgery in UHF, compared to 71.5% in the NHFD and 58% of patients in the IHFD. The rate of in-hospital mortality was 4.7% compared to 7.1% in the NHFD and 5% in the IHFD. The mean average acute length of stay was 13.4 days compared to 16.4 days in the NHFD and 20 days in the IHFD. Reoperation rates are 3.3% compared to 1% in the NHFD and 1.1% in the IHFD; 50.5% of patients were discharged on bone protection medication, compared to 47% in the IHFD and 79.3% in the UK NHFD. Discussion: Despite uniformly acknowledged evidence-based treatment guidelines, the management of hip fractures remains heterogeneous within Europe. Conclusion: These data show that different areas of the hip fracture care pathway in Germany, England, and Ireland, respectively, show room for improvement in light of the growing socioeconomic burden these countries are expected to face.

scholarly journals Telemonitoring for Patients With COVID-19: Recommendations for Design and Implementation (Preprint)

2020 ◽  
Author(s):  
Anna V Silven ◽  
Annelieke H J Petrus ◽  
María Villalobos-Quesada ◽  
Ebru Dirikgil ◽  
Carlijn R Oerlemans ◽  
...  
Keyword(s):  
Health Care ◽  
Care Pathway ◽  
Health Care Systems ◽  
Tertiary Care ◽  
Suspected Case ◽  
Care Hospital ◽  
Scarce Resources ◽  
Design And Implementation ◽  
Care Systems ◽  
Care Capacity

UNSTRUCTURED Despite significant efforts, the COVID-19 pandemic has put enormous pressure on health care systems around the world, threatening the quality of patient care. Telemonitoring offers the opportunity to carefully monitor patients with a confirmed or suspected case of COVID-19 from home and allows for the timely identification of worsening symptoms. Additionally, it may decrease the number of hospital visits and admissions, thereby reducing the use of scarce resources, optimizing health care capacity, and minimizing the risk of viral transmission. In this paper, we present a COVID-19 telemonitoring care pathway developed at a tertiary care hospital in the Netherlands, which combined the monitoring of vital parameters with video consultations for adequate clinical assessment. Additionally, we report a series of medical, scientific, organizational, and ethical recommendations that may be used as a guide for the design and implementation of telemonitoring pathways for COVID-19 and other diseases worldwide.

scholarly journals Telemonitoring for Patients With COVID-19: Recommendations for Design and Implementation

10.2196/20953 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e20953
Author(s):  
Anna V Silven ◽  
Annelieke H J Petrus ◽  
María Villalobos-Quesada ◽  
Ebru Dirikgil ◽  
Carlijn R Oerlemans ◽  
...  
Keyword(s):  
Health Care ◽  
Care Pathway ◽  
Health Care Systems ◽  
Tertiary Care ◽  
Suspected Case ◽  
Care Hospital ◽  
Scarce Resources ◽  
Design And Implementation ◽  
Care Systems ◽  
Care Capacity

Despite significant efforts, the COVID-19 pandemic has put enormous pressure on health care systems around the world, threatening the quality of patient care. Telemonitoring offers the opportunity to carefully monitor patients with a confirmed or suspected case of COVID-19 from home and allows for the timely identification of worsening symptoms. Additionally, it may decrease the number of hospital visits and admissions, thereby reducing the use of scarce resources, optimizing health care capacity, and minimizing the risk of viral transmission. In this paper, we present a COVID-19 telemonitoring care pathway developed at a tertiary care hospital in the Netherlands, which combined the monitoring of vital parameters with video consultations for adequate clinical assessment. Additionally, we report a series of medical, scientific, organizational, and ethical recommendations that may be used as a guide for the design and implementation of telemonitoring pathways for COVID-19 and other diseases worldwide.

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.

Organizing a diabetes service

2011 ◽  
pp. 2005-2011
Author(s):  
Stephen C. L. Gough
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Cost Effective ◽  
Health Care Need ◽  
Delivery Of Care ◽  
Strategic Approach ◽  
Effective Manner ◽  
Care Systems ◽  
The Individual ◽  
The Uk

The increasing worldwide incidence and prevalence of diabetes is placing substantial pressures on health care systems and economies. As a consequence individuals involved in the care of people with diabetes are looking at services currently being provided and examining ways in which care can be organized in the most cost-effective manner. Whilst the degree to which diabetes care is delivered differs from country to country, similar fundamental questions are being asked by those involved in the delivery of care, including: What are we currently providing? What do we need to provide? What are we able to provide? Although the answers to these questions are quite different not just between countries but often within specific localities within a country, the ultimate aim is the same: to provide the best possible care to as many people with diabetes as possible. The global diversity of diabetes health care need is enormous and while the solutions will be equally diverse, the approach to the development of a diabetes service will, for many organizations, be similar. The main focus of this chapter is based upon the model or the strategic approach developed in the UK, but many of the individual component parts are present in most health care settings.

Satisfaction with Primary Health Care and Confidence in General Practitioners: An Exploratory Comparison of US and UK Students

1993 ◽  
Vol 6 (2) ◽  
pp. 89-98
Author(s):  
Bodo B. Schlegelmilch ◽  
James M. Carman
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Systems ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Health ◽  
The Us ◽  
Care Systems ◽  
The Uk ◽  
Oriented System

This paper explores attitudes of university students towards two differently organised health services, ie the National Health Service in the UK and the more market oriented system in the US and analyses the level of confidence placed in primary care providers (GPs/family physicians) in both systems. Although major differences in the perception of the two health care systems are identified, hardly any differences emerge between the two countries in terms of the confidence patients place in their primary care providers.

Using Cannabis Therapeutically in the UK: A Qualitative Analysis

2003 ◽  
Vol 33 (2) ◽  
pp. 325-356 ◽  
Author(s):  
Ross Coomber ◽  
Michael Oliver ◽  
Craig Morris
Keyword(s):  
Health Care ◽  
Criminal Justice ◽  
Justice System ◽  
Therapeutic Agent ◽  
Health Care Systems ◽  
Beneficial Effects ◽  
Access Cost ◽  
Care Systems ◽  
The Uk

Thirty-three therapeutic cannabis users in England were interviewed about their experiences using an illegal drug for therapeutic purposes. Interviews were semi-structured, and responses highly qualitative. Particular issues included how and why cannabis was used therapeutically; what problems its illegality posed in terms of access, cost, reliability of supply, and quality of the product; the perceived beneficial effects of its use; and unwanted effects (problems in relation to family, friends, partners, the criminal justice system, and the health care system). The study did not seek to prove or disprove the efficacy of cannabis used as a therapeutic agent merely to report the experiences of those who use it in that way. It was found that users perceived cannabis to be highly effective in treating their symptoms, to complement existing medication, and to produce fewer unwanted effects. Smoking was the preferred method of administration, permitting greater control over dose and administration. Problems related to prescribed medication motivated many to use cannabis therapeutically. Few problems were experienced with friends, family, partners, and the criminal justice or health care systems, although other concerns about cannabis's illegality were reported. Although most were relatively unconcerned about the risk involved and were determined to continue use, many resented that they felt they were being forced to break the law. Problems relating to access to the drug (in an illegal context) and managing its administration were reported. A brief discussion of the continued prohibition of cannabis for this group is undertaken, and a harm reduction approach is suggested.

Integration vs separation in the provision of health care: 24 OECD countries compared

2018 ◽  
Vol 15 (2) ◽  
pp. 160-172 ◽  
Author(s):  
Federico Toth
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
The United States ◽  
Oecd Countries ◽  
Integrated Model ◽  
Care Providers ◽  
Five Dimensions ◽  
Care Systems ◽  
The Uk

AbstractThis article proposes a classification of the different national health care systems based on the way the network of health care providers is organised. To this end, we present two rivalling models: on the one hand, the integrated model and, on the other, the separated model. These two models are defined based on five dimensions: (1) integration of insurer and provider; (2) integration of primary and secondary care; (3) presence of gatekeeping mechanisms; (4) patient's freedom of choice; and (5) solo or group practice of general practitioners. Each of these dimensions is applied to the health care systems of 24 OECD countries. If we combine the five dimensions, we can arrange the 24 national cases along a continuum that has the integrated model and the separated model at the two opposite poles. Portugal, Spain, New Zealand, the UK, Denmark, Ireland and Israel are to be considered highly integrated, while Italy, Norway, Australia, Greece and Sweden have moderately integrated provision systems. At the opposite end, Austria, Belgium, France, Germany, the Republic of Korea, Japan, Switzerland and Turkey have highly separated provision systems. Canada, The Netherlands and the United States can be categorised as moderately separated.

Interprofessional Care and Health Care Complexity

2012 ◽  
pp. 1273-1302
Author(s):  
Kerry Johnson ◽  
Jayshiro Tashiro
Keyword(s):  
Professional Development ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Deterministic Chaos ◽  
Evidence Based ◽  
Interprofessional Care ◽  
American Health Care ◽  
Important Barrier ◽  
Care Systems

Health care systems are complex and often approach a deterministic chaos in the number and types of interactions that occur among health care providers and patients, as well as among the providers themselves. Such complexity may be an important barrier as North American health care systems are evolving into care-giving settings in which providers work to improve patient outcomes though interprofessional collaborative patient-centred care. The research on evidence-based learning and how to build new models of professional development opportunities for health information management (HIM) professionals is explored. Additionally, creating new and more effective undergraduate training programs in HIM is examined. From the perspective of interprofessional care, the authors provide a core set of interprofessional competencies and discuss how these competencies may be sensibly integrated into, and evaluated within, undergraduate curricular structures as well as professional development programs. A special emphasis of the chapter is an analysis of two case studies that highlight the barriers inherent within complex health care systems. Such barriers inhibit evidence-based education and professional development designed to improve interprofessional care.

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