scholarly journals Medical prescription vs defensive medicine: Results of a questionnaire answered by members of the Latina Board of Physicians, Surgeons and Dentists

2017 ◽  
Vol 22 (1-2-3) ◽  
pp. 39-43
Author(s):  
Ylenia Petrasso ◽  
Marco Straccamore ◽  
Edoardo Bottoni ◽  
Simone Cappelletti ◽  
Paola Antonella Fiore ◽  
...  

“Defensive Medicine” is intended as health practitioners’ behaviour aimed at limiting any medical - legal disputes and in addition to limiting a doctor’s responsibilities; specifically, DM is implemented by prescribing diagnostically useless tests, or by avoiding procedures that are potentially beneficial for the patient, but burdened by risk. The final effect of this medical conduct is to nullify the efficiency of health care, as well as increase times and costs. Our Group asked doctors registered with the Professional Board of Latina to answer a questionnaire aimed at investigating the perception of this issue and their behaviour in this regard, both in terms of prescriptions and insurance coverage. The results show a general attitude of distrust towards a disputed doctor and a series of behaviours aimed at avoiding such situations; the doctors interviewed asked for increased protection and less pressure in order to better carry out their work. ---------- Per “Medicina Difensiva” si intende una condotta, posta in essere dal personale sanitario, volta a limitare eventuali contenziosi medico – legali e finalizzata a limitare le responsabilità del medico; nello specifico, la MD si realizza attraverso prescrizione di esami inutili dal punto di vista diagnostico, ovvero tramite evitamento di procedure potenzialmente benefiche per il paziente, ma gravate da rischio. L’effetto finale di questa condotta medica è quello di vanificare l’efficienza dell’operato sanitario, aumentandone anche tempistiche e costi. Il Nostro Gruppo ha somministrato ai medici iscritti presso l’Ordine Professionale di Latina un questionario, volto ad indagare la percezione del problema esposto e il comportamento adottato a riguardo, sia in termini di prescrizioni che di copertura assicurativa. I risultati mostrano un atteggiamento generale di diffidenza nei confronti del contenzioso medico ed una serie di comportamenti volti ad evitare tali situazioni; i medici intervistati richiedevano una maggior tutela e una minore pressione, al fine di svolgere al meglio il proprio operato. ---------- “Medicina Defensiva” significa un comportamiento llevado a cabo por el personal de salud, dirigido a limitar cualquier disputa médicolegal y dirigido a limitar las responsabilidades del médico; específicamente, la MD se lleva a cabo prescribiendo pruebas innecesarias desde el punto de vista del diagnóstico, o evitando procedimientos que son potencialmente beneficiosos para el paciente, pero cargados por el riesgo. El efecto final de esta conducta médica es anular la eficacia de la atención médica, lo que también aumenta el tiempo y los costos. Nuestro Grupo ha entregado a los doctores inscritos en la Orden Profesional de Latina un cuestionario, dirigido a investigar la percepción del problema expuesto y el comportamiento adoptado al respecto, tanto en términos de prescripciones como de cobertura de seguro. Los resultados muestran una actitud general de desconfianza hacia el conflicto médico y una serie de comportamientos dirigidos a evitar tales situaciones; los médicos entrevistados requieren una mayor protección y menos presión, para realizar mejor su trabajo.

2017 ◽  
Vol 4 (2) ◽  
pp. 99-104
Author(s):  
Agus Nursikuwagus

Information system at community health center is an information system that has several activities, such as registration, medical record, health care, and reporting.  Day to day operation, community health service, is using process manually. It is cause the stack of service. Sometime, the patient has to wait within several times. For Further, the patient did not know that the queuing is full. In order to help the problem, this paper wants to show about E-Health as service software. The research is completed by conveying the model like UML diagram. The UML diagrams are consisting such as usecase, class, activity, and component. The sequence of system construct is using Prototype Paradigm. The result is the software which has ability to service patient start from registration, medical check, medical prescription, until reporting. As an impact for Community health service is the service more efficiency. The system is able to control the medicine and reporting on day to day operation.   REFERENCES[1] Susanto, Gunawan,” Sistem Informasi Rekam Medis PadaRumah Sakit Umum Daerah (RSUD) Pacitan Berbasis WebBase”. Pacitan. 2012.[2] B, Nugroho, S.H. Fitriasih, B. Widada, “Sistem InformasiRekam Medis Di Puskesmas Masaran I Sragen”. JournalTIKomSiN, vol.5, no.1, p.49-56, 2017.[3] G.G.S. Bagja,” Membangun Sistem Informasi KesehatanPuskesmas Cibaregbeg”, Univ. Komp. Indonesia, 2010.[4] A.M. Herdy, Aulia, M. Amran, D. Novita, “PerancanganSistem Informasi Pelayanan Medis Di Puskesmas SungaiDua”, STMIK MDP. 2014.[5] J. Sundari, “Sistem Informasi Pelayanan Puskesmas BerbasisWeb”, Int.Journal.on Soft.Eng, vol.2, no.1, p.57-62, 2016.[6] R.S. Pressman, Software Engineering A PractitionersApproach. Nineth Edition, Addsion Wesley, 2011.[7] G. Booch, J. Rumbaugh, I. Jacobson, Unified ModelingLanguage User Guide, Addison-Wesley, 1999.[8] I, Daqiqil. (2011, August 2). Framework CodeIgnite. [Online].Available: http://koder.web.id/buku-codeigniter-gratis/


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomon Nyame ◽  
Edward Adiibokah ◽  
Yasmin Mohammed ◽  
Victor C. Doku ◽  
Caleb Othieno ◽  
...  

Abstract Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.


Author(s):  
Alena Kamenshchikova ◽  
Marina M. Fedotova ◽  
Olga S. Fedorova ◽  
Sergey V. Fedosenko ◽  
Petra F. G. Wolffs ◽  
...  

Author(s):  
Roger Muremyi ◽  
Dominique Haughton ◽  
François Niragire ◽  
Ignace Kabano

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.


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