scholarly journals Current structure, organization and evaluation of effectiveness of the specialized outpatient medical care for patients with blood diseases in a metropolis

2014 ◽  
Vol 95 (2) ◽  
pp. 261-267
Author(s):  
L Yu Zhiguleva
Keyword(s):  
Medical Care ◽  
Statistical Tests ◽  
Care Quality ◽  
Attendance Rate ◽  
Blood Diseases ◽  
Medical Examinations ◽  
The City ◽  
Analytical Center

Aim. To analyze the structure, organization and effectiveness of outpatient medical care for patients with blood diseases in St. Petersburg, Russia. Methods. 83 reports submitted by the heads of hematological offices at 2000-2012 were analyzed. The effectiveness was evaluated using routine statistical tests. The prevalence of the diseases was assessed by registration forms №7, 35, the data provided by information and analytical center of the Healthcare Committee and the City cancer registry. Medical aid provided to patients at 2010-2012 was studied, for this purpose 250 outpatient files (025/y form) were randomly picked out, the data were collected using specially designed registration cards (254 parameters). Results. Municipal, federal and departmental institutions provide hematologic outpatient medical care in St. Petersburg. The major burden of providing medical care to hematologic patients lays on interdistrict hematological offices, which actively follow-up and treat patients with hematologic cancers. Every sixth patient has complications, and 75% - comorbidities. During the period of study, the attendance rate increased by 33.4% (from 64 766 in 2000 to 86 405 in 2012), the number of the newly-diagnosed patients with hematologic cancers increased by 13.9% (p 0.05), the share of patients with hematologic cancers increased from 28.0 to 50.4%. Cumulative incidence of lymphomas increased from 69.9 to 96.0 per 100 thousand of population; leukemia - from 49.7 to 79.3. Mortality due to lymphomas decreased from 8.1% in 2001 to 5.3% in 2012, and due to leukemia - from 9.2% to 3.6%. Five-year survival rate of patients with leukemia increased from 56.6% to 63.2 % over the period of 2010-2012. Conclusion. The study shows the effectiveness of outpatient hematologic care in St. Petersburg. To further improve the efficiency of outpatient hematologic care in metropolis, it is important to improve the knowledge of hematologic diseases by doctors and pediatricians of general healthcare network, to review the workload of hematological office staff, to focus on preventive component of hematologic care (quality of occupational medical examinations), to develop and implement the new organizational techniques providing costs reduction and improving quality of life.

scholarly journals Health status, quality of life and medical care in adult women with Turner syndrome

2018 ◽  
Vol 7 (4) ◽  
pp. 534-543 ◽  
Author(s):  
Diana-Alexandra Ertl ◽  
Andreas Gleiss ◽  
Katharina Schubert ◽  
Caroline Culen ◽  
Peer Hauck ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Care ◽  
Turner Syndrome ◽  
Reference Population ◽  
Care Quality ◽  
Study Cohort ◽  
Adult Women ◽  
Adult Care

Background Previous studies have shown that only a minority of patients with Turner syndrome (TS) have adequate medical care after transfer to adult care. Aim of this study To assess the status of medical follow-up and quality of life (QoL) in adult women diagnosed with TS and followed up until transfer. To compare the subjective and objective view of the medical care quality and initiate improvements based on patients’ experiences and current recommendations. Methods 39 adult women with TS out of 64 patients contacted were seen for a clinical and laboratory check, cardiac ultrasound, standardized and structured questionnaires (SF-36v2 and Beck depression inventory). Results 7/39 of the patients were not being followed medically at all. Only 2/39 consulted all the specialists recommended. Comorbidities were newly diagnosed in 27/39 patients; of these, 11 related to the cardiovascular system. Patients in our cohort scored as high as the mean reference population for SF-36v2 in both mental and physical compartments. Obese participants had lower scores in the physical function section, whereas higher education was related to higher physical QoL scores. Adult height slightly correlated positively with physical health. Conclusion Medical follow-up was inadequate in our study cohort of adults with TS. Even though their medical follow-up was insufficient, these women felt adequately treated, leaving them vulnerable for premature illness. Initiatives in health autonomy and a structured transfer process as well as closer collaborations within specialities are urgently needed.

Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

2020 ◽  
Author(s):  
Agustin Lara-Esqueda ◽  
Sergio A Zaizar-Fregoso ◽  
Violeta M Madrigal-Perez ◽  
Mario Ramirez-Flores ◽  
Daniel A Montes-Galindo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Serum Lipids ◽  
Quality Care ◽  
Premature Death ◽  
Current Standard ◽  
Anonymized Data ◽  
Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

Online Reviews of Credence Service Providers: What Do Consumers Evaluate, Do Other Consumers Believe the Reviews, and Are Interventions Needed?

2020 ◽  
Vol 40 (1) ◽  
pp. 27-44
Author(s):  
Shannon Lantzy ◽  
Rebecca W. Hamilton ◽  
Yu-Jen Chen ◽  
Katherine Stewart
Keyword(s):  
Medical Care ◽  
Service Providers ◽  
Online Reviews ◽  
Economics Of Information ◽  
Policy Interventions ◽  
Credence Attributes ◽  
Made In ◽  
Other Consumers

Consumer-generated online reviews of credence service providers, such as doctors, have become common on platforms such as Yelp and RateMDs. Yet doctors have challenged the legitimacy of these platforms on the grounds that consumers do not have the expertise required to evaluate the quality of the medical care they receive. This challenge is supported by the economics of information literature, which has characterized doctors as a credence service, meaning that consumers cannot evaluate quality even after consumption. Are interventions needed to ensure that consumers are not misled by these reviews? Data from real online reviews shows that many of the claims made in real reviews of credence service providers focus on experience attributes, such as promptness, which consumers can typically evaluate, rather than credence attributes, such as knowledge. Follow-up experiments show that consumers are more likely to believe experience claims (vs. credence claims) made by other consumers, claims that are supported by data, and longer reviews even if they are not more informative. The authors discuss implications for consumers and credence service providers and possible policy interventions.

scholarly journals Improved survival of children and adolescents with sickle cell disease

Blood ◽  
2010 ◽  
Vol 115 (17) ◽  
pp. 3447-3452 ◽  
Author(s):  
Charles T. Quinn ◽  
Zora R. Rogers ◽  
Timothy L. McCavit ◽  
George R. Buchanan
Keyword(s):  
Sickle Cell Disease ◽  
Young Children ◽  
Medical Care ◽  
Children And Adolescents ◽  
Sickle Cell ◽  
Care Quality ◽  
Transition To Adult Care ◽  
Cell Disease ◽  
Over Time

Abstract The survival of young children with sickle cell disease (SCD) has improved, but less is known about older children and adolescents. We studied the Dallas Newborn Cohort (DNC) to estimate contemporary 18-year survival for newborns with SCD and document changes in the causes and ages of death over time. We also explored whether improvements in the quality of medical care were temporally associated with survival. The DNC now includes 940 subjects with 8857 patient-years of follow-up. Most children with sickle cell anemia (93.9%) and nearly all children with milder forms of SCD (98.4%) now live to become adults. The incidence of death and the pattern of mortality changed over the duration of the cohort. Sepsis is no longer the leading cause of death. All the recent deaths in the cohort occurred in patients 18 years or older, most shortly after the transition to adult care. Quality of care in the DNC has improved over time, with significantly more timely initial visits and preventive interventions for young children. In summary, most children with SCD now survive the childhood years, but young adults who transition to adult medical care are at high risk for early death.

scholarly journals Quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension, by primary care physicians in different Russian regions

2021 ◽  
Vol 26 (4) ◽  
pp. 4332
Author(s):  
O. M. Drapkina ◽  
R. N. Shepel ◽  
L. Yu. Drozdova ◽  
A. M. Kalinina ◽  
E. S. Bulgakova ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Resistant Hypertension ◽  
Clinical Guidelines ◽  
Primary Care Physicians ◽  
Adult Population ◽  
Russian Regions ◽  
Target Values

In view of the high prevalence of hypertension (HTN) among Russian population, it becomes extremely important to meet the criteria for the medical care quality within the periodic examinations for this group of patients.Aim.  To assess the quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension (RH), by primary care physicians in different Russian regions.Materials and methods. As part of working visits of the expert group from the National Medical Research Center for Therapy and Preventive Medicine in 38 Russian regions in the period from February 1, 2020 to December 15, 2020, an analysis of ambulatory records of patients with grade 1-3 hypertension was carried out. A total of 3614 ambulatory medical records (AMRs) were analyzed, of which the grade 1-3 hypertension, with the exception of RH, was revealed in 764 ones. The analysis of records was carried out using an original checklist. Statistical processing was carried out using the software package IBM SPSS Statistics 20 (USA) and Microsoft Office Excel 2016 (USA).Results. An analysis of 764 AMRs was performed. The mean age of patients was 63,9-11,2 (women, 64,7-11,3 years; men, 62,7-10,9 years). The majority (58,9%) of participants were women. Follow-up monitoring was established in a timely manner in 450 people (58,9%) of patients, of which there were 189 men (42%) and 261 women (58%). In 87,9% (n=672) of cases, the diagnosis formulation met the established clinical guidelines criteria. In 36 cases (4,7%), there was no evidence in favor of hypertension according to the current clinical guidelines. In 21,1% (n=161) of cases, the minimum recommended periodicity of visits was not observed. In last visits of 323 patients, the blood pressure did not reach the target values. AMRs did not contain information on low-density lipoprotein cholesterol (LDL-C) in 91б4% of cases (n=698). Among patients with a known level of LDL-C, the target values were achieved only in 15,2% of cases (n=10).Conclusion. Our analysis revealed the insufficient quality of outpatient medical care to hypertensive patients within the periodic examinations. Proposals are created for monitoring and measures to improve the quality of care for this category of patients.

scholarly journals The role of thematic expertise of medical care quality in improvement of results of its performance in cases of acute pancreatitis

2020 ◽  
Vol 22 (1) ◽  
pp. 105-112
Author(s):  
O N Scryabin ◽  
K N Movchan ◽  
V V Tatarkin ◽  
O A Klitsenko ◽  
Yu M Morozov ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Medical Care ◽  
Care Quality ◽  
Diagnostic Process ◽  
Abdominal Organs ◽  
Treatment Measures ◽  
Medical Diagnostic ◽  
Surgical Teams ◽  
Operational Activity

The parameters of assessing the quality of medical care provided in 2014 to 416 patients with acute pancreatitis in 9 hospitals in St. Petersburg were expertly studied. All medical institutions were licensed in the format of providing services for the examination and treatment of patients suffering from acute surgical diseases of the abdominal organs. According to the results of the data analysis, a correlation was observed between the consequences of defects in the medical diagnostic process in medical organizations with insufficient regulation and activity in clinical expert work on the profile of “abdominal surgery”. The facts of overdiagnosis of cases of acute pancreatitis in mild variants of the severity of the disease have been established. Preservation of low operational activity indicators in the treatment of patients with acute pancreatitis without a tendency to use (when indicated) modern (primarily, endovideo surgical) technologies has been observed. It was noted that with a positive (in general) trend in the development of emergency pancreatology, in cases of assessing the particular results of the activities of specialists of specific surgical teams involved in providing medical care to patients with acute pancreatitis, compliance with systemic clinical and expert approaches with timely management decisions should be a priority in quality management of diagnostic and treatment measures. It is substantiated that the calculation of the volume of medical care for residents of a metropolis with acute pancreatitis should be based on the quality of the examination and treatment of patients with this disease on the basis of a thematic examination of assessing the conformity of the diagnostic process to the level of modern ideas about the theory of development and course of this disease.

scholarly journals The development of criteria, indices and indicators and of medical care quality for patients with syndrome of diabetic foot in out-patient practice

2019 ◽  
Vol 60 (3) ◽  
pp. 138-142
Author(s):  
Oleg V. Udovichenko ◽  
E. A. Berseneva ◽  
D. O. Meshkov
Keyword(s):  
Data Collection ◽  
Medical Care ◽  
Diabetic Foot ◽  
Care Quality ◽  
Practice Analysis ◽  
Results Of Treatment ◽  
Quality Of Structure ◽  
Chronic Course

The special techniques of evaluation of every single disease are required for assessing quality and effectiveness of treatment in out-patient practice. The purpose of study was development of criteria, indices and indicators of evaluation of quality of out-patient medical care of patients with syndrome of diabetic foot. The technique of literary searching and practice analysis were applied to develop criteria, indices and indicators for evaluating structure, processes and results of treatment. The evaluation of quality of result requires more complicated techniques of data collection as opposed to indices of quality of structure and processes. The developed indices can be also applied in evaluating effectiveness of treatment of other diseases with chronic course though curable in the main.

scholarly journals Analysis of the quality of outpatient medical care for patients with bronchial asthma

2021 ◽  
Vol 82 (1) ◽  
pp. 41-41
Author(s):  
S. B. Bender ◽  
A. A. Wiesel
Keyword(s):  
Medical Care ◽  
Bronchial Asthma ◽  
Outpatient Basis ◽  
The City

The spectrum of drugs prescribed to patients with bronchial asthma (BA) on an outpatient basis was studied. For this, an analysis of outpatient records of BA patients was carried out on the basis of two polyclinic branches in the city of Yoshkar-Ola.

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