scholarly journals An International Survey of Health Care Services Available to Patients With Tourette Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Tracy Bhikram ◽  
Rana Elmaghraby ◽  
Elia Abi-Jaoude ◽  
Paul Sandor
Keyword(s):  
Health Care ◽  
Tourette Syndrome ◽  
Health Care Services ◽  
Treatment Guidelines ◽  
Care Delivery ◽  
Clinical Care ◽  
Health Service Delivery ◽  
The United States ◽  
Dopamine Receptor Antagonists ◽  
Geographical Regions

Objective: Tourette syndrome (TS) is a neuropsychiatric disorder that is highly associated with several comorbidities. Given the complex and multifaceted nature of TS, the condition is managed by a wide variety of practitioners in different disciplines. The goal of this study was to investigate health service delivery and care practices by clinicians who see TS patients across different geographic settings internationally.Methods: A comprehensive questionnaire was developed to assess clinical care resources for patients with TS and was sent to clinicians in Canada (CA), the United States (US), Europe (EU), and the United Kingdom (UK). Responses were compared quantitatively between geographic regions.Results: The majority of respondents, regardless of region, reported that fewer than 40% of their case-load are patients with tics. The accessibility of TS services varied among regions, as indicated by differences in wait times, telemedicine offerings, comorbidity management and the availability of behavioral therapies. First-line pharmacotherapy preferences varied among physicians in different geographical regions with CA respondents preferring alpha-2-adrenergic agonists and respondents from the UK and EU preferring dopamine receptor antagonists.Discussion: The results suggest that there is a scarcity of specialized TS clinics, potentially making access to services challenging, especially for patients newly diagnosed with TS. Differences in regional pharmacotherapeutic preferences are reflected in various published treatment guidelines in EU and North America. The lack of dedicated specialists and telemedicine availability, coupled with differences in comorbidity management, highlight the need for interprofessional care and holistic management to improve health care delivery to patients with TS.

Revising the ERDs for the 21st Century

2021 ◽  
Vol 46 (8) ◽  
pp. 1-2
Author(s):  
John F. Brehany ◽  
Keyword(s):  
United States ◽  
Health Care ◽  
21St Century ◽  
Health Care Services ◽  
Care Delivery ◽  
The United States ◽  
Care Services ◽  
Moral Tradition ◽  
Modern Health Care ◽  
Catholic Health Care

Since their inception in 1948, The Ethical and Religious Directives for Catholic Health Care Services (ERDs) have guided Catholic health care ministries in the United States, aiding in the application of Catholic moral tradition to modern health care delivery. The ERDs have undergone two major revisions in that time, with about twenty years separating each revision. The first came in 1971 and the second came twenty-six years ago, in 1995. As such, a third major revision is due and will likely be undertaken soon.

Reforming Health Care in Greece: Balancing Fiscal Adjustment with Health Care Needs1

2017 ◽  
Author(s):  
Panos Kanavos ◽  
Kyriakos Souliotis
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Health Care Financing ◽  
Health Service Delivery ◽  
Reimbursement Mechanisms ◽  
Care Needs ◽  
Care Services ◽  
Fiscal Adjustment ◽  
Care Integration

The Greek health care system relies on expensive medical inputs to deliver basic health care services, and is characterized by a lack of primary care focus, which disallows care integration and coordination, particularly in chronic care management. Consequently, care delivery remains fragmented and disjointed and often results in access to care disparities. This chapter proposes three areas where structural reform is essential to address budgetary constraints, improve coverage, and deliver better quality of care. First, the health care financing and contracting model and reimbursement mechanisms need to be overhauled. Transitioning to a funding system through general taxation would be advantageous in increasing levels of coverage over the short- to medium-term, but needs to be accompanied by significant changes in the provision and contracting of services to improve efficiency and quality. Second, the role of primary health care needs to be strengthened so that it becomes the backbone of health service delivery. And, finally, pharmaceutical policy needs fundamental review, including a re-alignment of the different incentives on the supply and the demand side. These reforms require a mix of structural and tactical interventions by decision-makers.

scholarly journals Perceptions of Sexual Healthcare Provision in Tanzania: a Key Informant Qualitative Study

2021 ◽  
Author(s):  
Lucy R. Mgopa ◽  
Michael W. Ross ◽  
Gift Gadiel Lukumay ◽  
Stella Emmanuel Mushy ◽  
Ever Mkony ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Gender Equity ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Treatment Guidelines ◽  
Clinical Care ◽  
Clinical Practices ◽  
Sexual Health Care ◽  
Care Services

Abstract Introduction Sexual health care services must be standard and unbiased, guided by a structured health care system. There is a scarcity of data on how sexual health care is delivered in Tanzania. Methods To address this gap, in July 2019 we interviewed eleven key informants: cultural and public health experts, and political, religious, and community leaders, selected from different organizations in Dar es Salaam, Tanzania. Participants were asked for their opinions about clinical practices of health care professionals when providing care to patients, with an emphasis on sexual health. Results Participants’ responses were classified into three subcategories: strengths, barriers, and gaps in sexual health care. Availability of services, service delivery to adults, and code of conduct were among the strengths observed in clinical care services. Barriers included the health care provider’s attitudes, moral values, and inadequacy in health policies and treatment guidelines. Vulnerable populations including youth were frequently reported to face most challenges when seeking sexual health care services. In terms of gaps, informants emphasized gender equity in sexual health services provision within care settings. Conclusion and Implication Data indicate that lack of training in sexual health and guidelines for dealing with sexual issues are a barrier to comprehensive health care. These findings can inform the main areas for curriculum developers to focus on, when developing an Afro-centric sexual health curriculum suitable for students in health care professional courses. Moreover, these findings can be useful when developing treatment guidelines and policies that are beneficial to the sexual health wellbeing of individuals.

Health Policy and Craniofacial Care: Issues in Resource Alllocation

1994 ◽  
Vol 31 (1) ◽  
pp. 78-80 ◽  
Author(s):  
Ronald P. Strauss
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Social Issues ◽  
Care Delivery ◽  
Current System ◽  
Health Care Financing ◽  
The United States ◽  
Organizational System ◽  
The U.S

The distribution of health care services, including craniofacial services in the United States, is examined. The U.S. has a unique health care financing and organizational system in which persons are most commonly covered by health Insurance as a benefit of their employment. Current estimates are that nearly 40 million Americans have no health insurance (Himmelsteln et al., 1992). Approximately half of the uninsured persons are in low-wage employment that does not provide health insurance benefits nor allow them to qualify for Medicaid (Pepper Commission, 1990). Personal health care costs now exceed 11% of the U.S. gross domestic product, a significantly higher percentage than that found in other Industrialized nations (Consumer Reports, 1990b). Within the current system, is health care distributed in a fair or moral manner? What are the effects of the allocation scheme? Possible changes in health care financing and delivery are examined and basic ethical and social issues associated with a changing U.S. health care delivery system are explored.

Managed Mental Health Care: Implications for Administrators and Managers of Community-Based Agencies

1993 ◽  
Vol 74 (3) ◽  
pp. 171-177 ◽  
Author(s):  
Norman Winegar
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Care Delivery ◽  
Clinical Care ◽  
The United States ◽  
Health Care Delivery System ◽  
Community Based ◽  
Early Management ◽  
Financial Arrangements

A revolution is occurring in the private mental health care delivery system in the United States, marked by increased employer interest in how health care dollars are spent, new financial arrangements between payers and providers, and a reshaping of clinical practice to focus on efficacy and efficiency according to objective clinical care guidelines. Managed mental health care (MMHC) evolved from early management processes such as retroactive review into networks of providers in partnership with MMHC firms whose goal is to pursue effective management of benefits and care. Areas of cooperation and potential pitfalls of relationships between community' based agencies and MMHC entities are discussed.

The evolving use of hyperbaric oxygen therapy during the COVID-19 pandemic

2021 ◽  
Vol 30 (Sup2) ◽  
pp. S8-S11
Author(s):  
Areeg A Abu El Hawa ◽  
Karina Charipova ◽  
Jenna C Bekeny ◽  
Kelly K Johnson-Arbor
Keyword(s):  
Health Care ◽  
Hyperbaric Oxygen ◽  
Health Care Delivery ◽  
Hyperbaric Oxygen Therapy ◽  
Health Care Services ◽  
Oxygen Therapy ◽  
Care Delivery ◽  
Wound Care ◽  
The United States ◽  
Evolving Model

The Sars-CoV-2 (COVID-19) pandemic has resulted in significant and unprecedented shifts in the delivery of health care services in the United States. Although wound care remains an essential service during the COVID-19 pandemic, the financial consequences and infectious disease ramifications of the pandemic have resulted in closure or limitation of hours in many outpatient wound and hyperbaric oxygen therapy (HBOT) centers. As HBOT patients often require daily treatment sessions for a period of months, it is necessary for facilities providing HBOT services to adjust to the COVID-19 pandemic while still maintaining availability of this important service. Modification of HBOT session timing and chamber decontamination procedures, utilisation of telehealth services for initial patient evaluations, and acceptance of novel patient populations and diagnoses are mechanisms by which HBOT centers can adapt to the evolving model of health care delivery throughout a pandemic. While COVID-19 is not a currently accepted indication for HBOT, patients may be referred for HBOT consultation due to the post-infectious sequelae of the virus, and thus HBOT facilities must be aware of the potential uses of this treatment for post-viral complications. By redefining paradigms for health care delivery during the COVID-19 pandemic, HBOT and wound centers can continue to provide high-quality and uninterrupted care to vulnerable patient populations.

scholarly journals Implementation of Telemedicine in a Tertiary Hospital–Based Ambulatory Practice in Detroit During the COVID-19 Pandemic: Observational Study (Preprint)

2020 ◽  
Author(s):  
Alpana Garg ◽  
Sachin Goyal ◽  
Rohit Thati ◽  
Neelima Thati
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Clinical Care ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Urgent Care ◽  
Care Needs ◽  
Telemedicine Service ◽  
Technical Problems

BACKGROUND The COVID-19 pandemic, caused by SARS-CoV-2, has forced the health care delivery structure to change rapidly. The pandemic has further widened the disparities in health care and exposed vulnerable populations. Health care services caring for such populations must not only continue to operate but create innovative methods of care delivery without compromising safety. We present our experience of incorporating telemedicine in our university hospital–based outpatient clinic in one of the worst-hit areas in the world. OBJECTIVE Our goal is to assess the adoption of a telemedicine service in the first month of its implementation in outpatient practice during the COVID-19 pandemic. We also want to assess the need for transitioning to telemedicine, the benefits and challenges in doing so, and ongoing solutions during the initial phase of the implementation of telemedicine services for our patients. METHODS We conducted a prospective review of clinic operations data from the first month of a telemedicine rollout in the outpatient adult ambulatory clinic from April 1, 2020, to April 30, 2020. A telemedicine visit was defined as synchronous audio-video communication between the provider and patient for clinical care longer than 5 minutes or if the video visit converted to a telephone visit after 5 minutes due to technical problems. We recorded the number of telemedicine visits scheduled, visits completed, and the time for each visit. We also noted the most frequent billing codes used based on the time spent in the patient care and the number of clinical tasks (eg, activity suggested through diagnosis or procedural code) that were addressed remotely by the physicians. RESULTS During the study period, we had 110 telemedicine visits scheduled, of which 94 (85.4%) visits were completed. The average duration of the video visit was 35 minutes, with the most prolonged visit lasting 120 minutes. Of 94 patients, 24 (25.54%) patients were recently discharged from the hospital, and 70 (74.46%) patients were seen for urgent care needs. There was a 50% increase from the baseline in the number of clinical tasks that were addressed by the physicians during the pandemic. CONCLUSIONS There was a high acceptance of telemedicine services by the patients, which was evident by a high show rate during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, a shortage of providers, and increased outpatient needs, telemedicine was successfully implemented in our practice.

scholarly journals Implementation of Telemedicine in a Tertiary Hospital–Based Ambulatory Practice in Detroit During the COVID-19 Pandemic: Observational Study

10.2196/21327 ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e21327
Author(s):  
Alpana Garg ◽  
Sachin Goyal ◽  
Rohit Thati ◽  
Neelima Thati
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Clinical Care ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Urgent Care ◽  
Care Needs ◽  
Telemedicine Service ◽  
Technical Problems

Background The COVID-19 pandemic, caused by SARS-CoV-2, has forced the health care delivery structure to change rapidly. The pandemic has further widened the disparities in health care and exposed vulnerable populations. Health care services caring for such populations must not only continue to operate but create innovative methods of care delivery without compromising safety. We present our experience of incorporating telemedicine in our university hospital–based outpatient clinic in one of the worst-hit areas in the world. Objective Our goal is to assess the adoption of a telemedicine service in the first month of its implementation in outpatient practice during the COVID-19 pandemic. We also want to assess the need for transitioning to telemedicine, the benefits and challenges in doing so, and ongoing solutions during the initial phase of the implementation of telemedicine services for our patients. Methods We conducted a prospective review of clinic operations data from the first month of a telemedicine rollout in the outpatient adult ambulatory clinic from April 1, 2020, to April 30, 2020. A telemedicine visit was defined as synchronous audio-video communication between the provider and patient for clinical care longer than 5 minutes or if the video visit converted to a telephone visit after 5 minutes due to technical problems. We recorded the number of telemedicine visits scheduled, visits completed, and the time for each visit. We also noted the most frequent billing codes used based on the time spent in the patient care and the number of clinical tasks (eg, activity suggested through diagnosis or procedural code) that were addressed remotely by the physicians. Results During the study period, we had 110 telemedicine visits scheduled, of which 94 (85.4%) visits were completed. The average duration of the video visit was 35 minutes, with the most prolonged visit lasting 120 minutes. Of 94 patients, 24 (25.54%) patients were recently discharged from the hospital, and 70 (74.46%) patients were seen for urgent care needs. There was a 50% increase from the baseline in the number of clinical tasks that were addressed by the physicians during the pandemic. Conclusions There was a high acceptance of telemedicine services by the patients, which was evident by a high show rate during the COVID-19 pandemic in Detroit. With limited staffing, restricted outpatient work hours, a shortage of providers, and increased outpatient needs, telemedicine was successfully implemented in our practice.

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