ORGANIZATION OF MEDICAL SERVICES FOR TRAUMA PATIENTS: CURRENT REQUIREMENTS AND BEST PRACTICES OF COOPERATION BETWEEN TRAUMATOLOGISTS AND THERAPISTS

Is HCFA's reimbursement policy controlling quality of care for end-stage renal disease patients?

Correction.

Introduction This study aimed to evaluate the effectiveness of the Palliative Outreach Program in improving the quality of palliative care for patients with advanced cancer in a Tertiary Hospital in the Al Ain region of the United Arab Emirates (UAE). Methods & Material One hundred patients who met the inclusion criteria were included in the study and administered the patient version of the Consumer Quality (CQ) Index Palliative Care Instrument to assess their perception of the quality of care they received. The demographics, diagnosis, and questionnaire responses were analyzed to determine the effectiveness of the Palliative Outreach Program. Results A total of one hundred patients met the criteria for the study. Most patients were above 50, female, female, Non-Emiratis, and had high school certificates. The top three cancer diagnoses were breast (22%), lung (15%), and head & neck (13%). The patients reported high levels of support from their caregivers regarding physical, psychological, and spiritual well-being, as well as information and expertise. The mean scores for most variables were favorable, except for information (mean = 2.9540, SD= 0.25082) and general appreciation (mean = 6.7150, sd = 0.82344). Overall, the patients rated the care they received positively, with high mean scores for physical/psychological well-being (mean = 3.4950, SD = 0.28668), autonomy (mean = 3.7667, SD= 0.28623), privacy (mean = 3.6490, SD = 0.23159), and spiritual well-being (mean =3.7500, SD = 0.54356). The patients would recommend their caregivers to others in similar situations. Discussion The findings demonstrate that the Palliative Outreach Program effectively improves the quality of palliative care for patients with advanced cancer in the UAE. The CQ Index Palliative Care Instrument proved a novel method for assessing palliative care quality from patients' perspectives. However, there is room for improvement in providing more favorable information and general appreciation outcomes. Caregivers should focus on all areas to enhance their physical/psychological well-being, autonomy, privacy, spiritual well-being, expertise, and general appreciation of their patients. Conclusion In conclusion, the Palliative Outreach Program is an effective intervention to improve the quality of palliative care for patients with advanced cancer in the UAE. The patients reported high levels of support from their caregivers in all aspects of care, except for information and general appreciation. These findings provide valuable insights into the effectiveness of palliative care interventions and highlight the need for continued efforts to improve the quality of care for patients with advanced cancer.

Target Aortic Stenosis: A National Initiative to Improve Quality of Care and Outcomes for Patients With Aortic Stenosis.

Opportunities in mental health services research.

Patient gender influences the quality of medical care whilst the role of physician gender is not well established. To investigate the influence of physician gender on quality of care in patients with type 2 diabetes. Cross-sectional study in 51 053 outpatients (48.6% male), treated by 3096 office-based physicians (66.3% male; 74.0% general practitioners, 21.8% internists and 4.2% diabetologists). Outcome measures included processes of care, intermediate outcomes and medical management. Quality of care measures were based on current ADA guidelines. Hierarchical regression models were used to avoid case-mix bias and to correct for physician-level clustering. Adjusted odds ratios were calculated controlling for age, gender, disease duration and presence of atherosclerotic disease. The patients of female physicians were more often women, more obese, older and had more often atherosclerotic disease (34% in the total cohort). The patients of female physicians more often reached target values in glycaemic control (HbA1c < 6.5%; OR 1.14; 1.05-1.24, P = 0.002), blood lipoproteins (LDL-C < 100 mg dL(-1); OR 1.16; 1.06-1.27, P = 0.002), and blood pressure (systolic values < 130 mmHg; OR 1.11; 1.02-1.22, P = 0.018). They were more likely to receive antihypertensive drug therapy in general (OR 1.35; 1.24-1.46, P < 0.0001) and angiotensin converting enzyme (ACE) inhibitors in particular (OR 1.17; 1.09-1.25, P < 0.0001). The patients of female physicians less often performed glucose self-monitoring (OR 0.83; 0.76-0.91, P < 0.0001) and less often received oral hypoglycaemic agents (OR 0.88; 0.82-0.95, P = 0.001). Physician gender influences quality of care in patients with type 2 diabetes. Female physicians provide an overall better quality of care, especially in prognostically important risk management.

The aim of this study was to develop indicators of conformance in clinical practice with guidelines for care in schizophrenia. Recommended guidelines rarely apply to all patients and need to allow for social ability, family context, and phase of the disorder. These indicators were therefore devised for tailoring to patient characteristics and allowing for factors that may justify the lack of adherence to clinical guidelines. A team of senior clinicians and methodologists reviewed three clinical guidelines (from the Schizophrenia Patient Outcomes Research Team, McEvoy and colleagues, and the National Institute for Health and Clinical Excellence) and defined criteria for their operationalization into clinical indicators. For each indicator, the team defined criteria for eligibility (requirements to be met to qualify for evaluation), conformance (criteria to be satisfied to comply with each recommendation), and moderators (factors that could justify the lack of application of a given recommendation). These indicators were tested with a random sample of 807 patients with schizophrenia or schizoaffective disorders in outpatient facilities, long-term residential facilities, and hospital units for acute care in the Piedmont region of Italy. A set of 15 indicators was derived, nine concerning pharmacological treatment and six for general care and psychosocial rehabilitation. Moderators such as patient or family refusal of antipsychotic treatment and the patient's level of disability helped to justify a considerable proportion of nonconformant care. The indicators developed are a simple and useful tool to monitor the conformance of care with recommended practices and to identify areas needing improvement.

Indicators of Conformance With Guidelines of Schizophrenia Treatment in Mental Health Services

To examine the relationship between quality improvement activities reported to a peer review organization (PRO) and improvements in quality of care for patients with acute myocardial infarction (AMI). Time-series, comparative study of changes in care for AMI patients from 1992 to 1995 in hospitals reporting self-measurement or system changes compared to all other hospitals in the state. One-hundred and seventeen acute care hospitals in Iowa. Patients hospitalized with a principal diagnosis of AMI. Each hospital was given hospital-specific performance data, statewide aggregate data, and peer comparisons and was asked to provide the PRO with a plan to improve care for AMI patients. Chart audits were performed before and after the intervention. Quality of care was based on eight explicit process measures of the quality of AMI care (quality indicators). Statewide, quality of care improved on five out of eight quality indicators. Of the 117 hospitals, 44 (38%) reported that they had implemented their own measurement activities or systematic improvements. These 44 hospitals showed significantly greater improvements than the other hospitals in use of aspirin during the hospitalization, recommendations for aspirin at discharge, and prescriptions for beta blockers at discharge. While quality of care for AMI patients throughout Iowa is improving, the pace of improvement is greatest in hospitals reporting that they are measuring their own performance or implementing systematic changes in care processes. Continued efforts to encourage hospitals to implement these types of improvement activities are warranted.

The effectiveness of structured interdisciplinary collaboration for adult home hospice patients on patient satisfaction and hospital admissions and re-admission: a systematic review protocol

Evaluating the quality of medical care. 1966.

The pneumonia controversy: Hospitals grapple with 4 hour benchmark

Background: Diabetes is a major metabolic disorder, and the number of people affected by it is continuously increasing worldwide. Numerous risk factors, such as improper nutrition and physical inactivity, play significant roles in its incidence, prevalence, and complications. Proper care and management of diabetes are essential actions in addressing this disease. Objectives: The present study aims to evaluate the quality of care provided to diabetic patients in Behbahan city. Methods: This cross-sectional study was conducted from January to March 2021 in Behbahan city (southwest of Iran). A total of 310 diabetic patients were selected using random sampling. Data were collected using a questionnaire that included demographic information, variables related to disease care, a Health-Related Quality Of Life (HRQOL) Questionnaire, and a mental distress questionnaire. For data analysis, structural equation modeling (SEM) was performed using the partial least squares (PLS) method. Results: The PLS-SEM showed the effect sizes of various factors on the quality of diabetic patient care. The effect sizes were as follows: Comorbidity (-0.29), family history (-0.30), moderate physical activity (0.20), mental distress (-0.13), marital status (0.081), physical dimension of quality of life (QOL) (0.20), and psychological dimension of QOL (0.10). The mean and standard deviation of HbA1c values — one of the most important indicators of diabetes care — were 9.71 ± 2.13. Conclusions: The quality of care for diabetic patients was found to be below desirable standards, with more than 70% of patients receiving poor quality care. Therefore, strengthening care programs for diabetic patients — particularly within the framework of the IraPEN (package of essential non-communicable) program, which includes psychosocial interventions — can help improve the quality of care for patients with type 2 diabetes.

Quality of Care and Outcomes for Patients with Acute Ischemic Stroke and Transient Ischemic Attack During the COVID-19 Pandemic

The NHS: free and caring or a market commodity?