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Encoding truths? Diagnosis-Related Groups and the fragility of the marketisation discourse (Book chapter)

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ISBN: 9781138735736 Year: Language: English
Publisher: Taylor & Francis
Subject: Medicine (General)
Added to DOAB on : 2018-01-17 11:02:33
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This chapter will take as an example a particular change in healthcare financing at the meso-level: Diagnosis-Related Groups. DRGs marked a shift in the way hospitals were oriented and were the means to operationalise the market-logic in healthcare. The DRG system is a case classification system: each hospital case is related to a ‘pre-standardised product’ of treatment. Depending on how a patient’s case is encoded, the hospital is reimbursed for the services provided. In this way, hospital care can be matched with pre-calculated resources. Case volumes can be predetermined according to the profit needs of a hospital and an economy’s ‘healthcare sector’ as a whole. Developed in the early 1980s by Robert B. Fetter and John D. Thompson, a management and a public health scholar at Yale, DRGs were first introduced in New Jersey, and have become the key accounting system throughout Western and increasingly LMI countries’ healthcare systems. (Mathauer and Wittenbecher 2013) Here I will particularly draw on examples from Germany, Switzerland and Scandinavia, but also to the NHS in England

Keywords

financing --- meso-level --- healthcare

Vignettes in Patient Safety - Volume 2

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ISBN: 9789535137306 9789535137313 9789535140764 Year: Pages: 202 DOI: 10.5772/intechopen.69032 Language: English
Publisher: IntechOpen
Subject: Public Health
Added to DOAB on : 2019-10-03 07:51:50

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Over the past two decades, the healthcare community increasingly recognized the importance and the impact of medical errors on patient safety and clinical outcomes. Medical and surgical errors continue to contribute to unnecessary and potentially preventable morbidity and/or mortality, affecting both ambulatory and hospital settings. The spectrum of contributing variables-ranging from minor errors that subsequently escalate to poor communication to lapses in appropriate protocols and processes (just to name a few)-is extensive, and solutions are only recently being described. As such, there is a growing body of research and experiences that can help provide an organized framework-based upon the best practices and evidence-based medical principles-for hospitals and clinics to foster patient safety culture and to develop institutional patient safety champions. Based upon the tremendous interest in the first volume of our Vignettes in Patient Safety series, this second volume follows a similar vignette-based model. Each chapter outlines a realistic case scenario designed to closely approximate experiences and clinical patterns that medical and surgical practitioners can easily relate to. Vignette presentations are then followed by an evidence-based overview of pertinent patient safety literature, relevant clinical evidence, and the formulation of preventive strategies and potential solutions that may be applicable to each corresponding scenario. Throughout the Vignettes in Patient Safety cycle, emphasis is placed on the identification and remediation of team-based and organizational factors associated with patient safety events. The second volume of the Vignettes in Patient Safety begins with an overview of recent high-impact studies in the area of patient safety. Subsequent chapters discuss a broad range of topics, including retained surgical items, wrong site procedures, disruptive healthcare workers, interhospital transfers, risks of emergency department overcrowding, dangers of inadequate handoff communication, and the association between provider fatigue and medical errors. By outlining some of the current best practices, structured experiences, and evidence-based recommendations, the authors and editors hope to provide our readers with new and significant insights into making healthcare safer for patients around the world.

Vignettes in Patient Safety - Volume 3

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ISBN: 9781789236620 9781789236637 Year: Pages: 192 DOI: 10.5772/intechopen.71975 Language: English
Publisher: IntechOpen
Subject: Public Health
Added to DOAB on : 2019-10-03 07:51:51

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Over the past decade it has been increasingly recognized that medical errors constitute an important determinant of patient safety, quality of care, and clinical outcomes. Such errors are both directly and indirectly responsible for unnecessary and potentially preventable morbidity and/or mortality across our healthcare institutions. The spectrum of contributing variables or ""root causes"" - ranging from minor errors that escalate, poor teamwork and/or communication, and lapses in appropriate protocols and processes (just to name a few) - is both extensive and heterogeneous. Moreover, effective solutions are few, and many have only recently been described. As our healthcare systems mature and their focus on patient safety solidifies, a growing body of research and experiences emerges to help provide an organized framework for continuous process improvement. Such a paradigm - based on best practices and evidence-based medical principles- sets the stage for hardwiring ""the right things to do"" into our institutional patient care matrix. Based on the tremendous interest in the first two volumes of The Vignettes in Patient Safety series, this third volume follows a similar model of case-based learning. Our goal is to share clinically relevant, practical knowledge that approximates experiences that busy practicing clinicians can relate to. Then, by using evidence-based approaches to present contemporary literature and potential contributing factors and solutions to various commonly encountered clinical patient safety scenarios, we hope to give our readers the tools to help prevent similar occurrences in the future. In outlining some of the best practices and structured experiences, and highlighting the scope of the problem, the authors and editors can hopefully lend some insights into how we can make healthcare experiences for our patients safer.

Immunization - Vaccine Adjuvant Delivery System and Strategies

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ISBN: 9781789845389 9781789845396 Year: Pages: 122 DOI: 10.5772/intechopen.74198 Language: English
Publisher: IntechOpen
Subject: Public Health
Added to DOAB on : 2019-10-03 07:51:52

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Immunization plays a key role in maintaining human health and each year, saves millions of lives from lethal pathogens and other fatal diseases in the most economical way, thanks to the advanced development of model vaccines. Subunit vaccines are regarded as a safer product than the whole microbe based-conventional vaccines and can be entrapped in various nanocarriers to form a vaccine adjuvant-delivery system (VADS) able to further boost their immunostimulatory activity. In this book, six groups of authors introduce immunization advances in VADSs designed for infection prophylaxis and cancer immunotherapy, problems and their resolution in both human and poultry immunization, and also, the mathematical model for assay of the basic immunization problem (BIP) understood from a finance point of view.

Smoking Prevention and Cessation

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ISBN: 9781789846287 9781789846294 Year: Pages: 126 DOI: 10.5772/intechopen.71425 Language: English
Publisher: IntechOpen
Subject: Public Health
Added to DOAB on : 2019-10-03 07:51:52

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Smoking was and remains one of the most important public healthcare issues. It is estimated that every year six million people die as a result of tobacco consumption. Several diseases are caused or worsened by smoking: different cancer types, heart disease, stroke, lung diseases and others. In this book we describe the different toxic effects of smoke on the human body in active and in passive smokers. It is also well known that many people who smoke wish to quit, but they rarely succeed. Smoking prevention and cessation are of utmost importance, thus we also describe different strategies and aspects of these issues. We hope that this book will help readers to understand better the effects of smoking and learn about new ideas on how to effectively help other people to stop smoking.

Breast Imaging

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ISBN: 9789535137320 9789535137337 9789535139966 Year: Pages: 142 DOI: 10.5772/66022 Language: English
Publisher: IntechOpen
Subject: Medical technology
Added to DOAB on : 2019-10-03 07:51:50

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Early detection of breast cancer with screening mammography is still the best method we have in saving countless women's lives and decreasing the harms of overtreatment. This textbook encompasses relevant topics in daily patient care with breast imaging to technical innovations for improving breast cancer detection and treatment.

eHealth - Making Health Care Smarter

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ISBN: 9781789235227 9781789235234 Year: Pages: 184 DOI: 10.5772/intechopen.71820 Language: English
Publisher: IntechOpen
Subject: Medical technology
Added to DOAB on : 2019-10-03 07:51:51

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eHealth has revolutionized health care and the practice of medicine. Internet technologies have given the most rural communities access to healthcare services, and automated computer algorithms are improving medical diagnoses and speeding up the delivery of care. Handheld apps, wearable devices, and artificial intelligence lead the way, creating a global healthcare solution that is smarter and more accessible. Read what leaders in the field are doing to advance the use of electronic technology to improve global health.

Assistive Technologies in Smart Cities

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ISBN: 9781789844764 9781789844771 Year: Pages: 120 DOI: 10.5772/intechopen.72240 Language: English
Publisher: IntechOpen
Subject: Medical technology
Added to DOAB on : 2019-10-03 07:51:52

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Cities are the places where the greatest technological advances will take place in the near future, and important efforts are being directed towards autonomy and independence for each and every citizen. However, these efforts are rarely coordinated or integrated among governments, citizens, and private firms. In this book, assistive technology solutions are approached considering the smart cities scenario. The book discusses how assistive technologies can be adapted to this new reality. In fact, several challenges arise, stimulating the evolution of current technologies, relying on ubiquitous sensing, big data, and anytime/anywhere access and control. The book presents research under development, not necessarily with consolidated results. Even though the idea of smart cities is still not a recognized concept in most countries, its relevance and application are spreading rapidly.

Undocumented Migrants and Healthcare: Eight Stories from Switzerland

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Book Series: Open Reports Series ISSN: 23996668 23996676 ISBN: 9781783744787 9781783744800 Year: Volume: 1 Pages: 166 DOI: https://doi.org/10.11647/OBP.0139 Language: English
Publisher: Open Book Publishers Grant: Stiftung Lindenhof Bern and the Swiss Red Cross
Subject: History --- Migration
Added to DOAB on : 2018-05-30 11:53:50
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What do undocumented migrants experience when they try to access healthcare? How do they navigate the (often contradictory) challenges presented by bureaucratic systems, financial pressures, attitudes to migrants, and their own healthcare needs?This urgent study uses a grounded theory approach to explore the ways in which undocumented migrants are included in or excluded from healthcare in a Swiss region. Marianne Jossen explores the ways migrants try to obtain healthcare on their own, with the help of NGOs or via insurance, and how they cope if they fail, whether by using risky strategies to access healthcare or leaving serious health issues untreated. Jossen shows that even for those who succeed, inclusion remains partial and fraught with risks.Based on interviews with migrants, health practitioners and NGO staff and using a rigorous academic approach, Undocumented Migrants and Healthcare is an important contribution to a vital contemporary issue. It is necessary reading for researchers in Public Health and Migration Studies, as well as government and non-governmental organisations in Switzerland and beyond. It will be of interest to anyone concerned with healthcare and migration in the twenty-first century.

23 Care Coordination, Samhandling and Patient Safety (Book chapter)

Authors: ---
ISBN: 9788202535025 Year: Pages: 22 DOI: 10.23865/noasp.36.ch23 Language: English
Publisher: Cappelen Damm Akademisk/NOASP (Nordic Open Access Scholarly Publishing)
Subject: Sociology --- Social Sciences
Added to DOAB on : 2019-01-15 13:34:08
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"This chapter focus on Norwegian healthcare policies and regulations for care coordination and patient safety. The Norwegian Coordination Reform implemented in 2012 emphasizes patient engagement, care pathways, and competence development in municipal healthcare services. Moreover, protocols for division of work tasks and collaboration between specialist and municipal healthcare services are key aspects. The reform identifies fragmented health services and the lack of coordinated care as main challenges. The authors introduce the concepts of care coordination, continuity of care and patient handovers, and relate these to patient safety. Results from a Norwegian observational study, identifying factors affecting care coordination and patient safety in care transitions between hospital and municipal care, are presented. Finally, the authors introduce relevant measures to improve care coordination and patient safety, including the regulatory work and follow-up of health services through nationwide audits performed by the Norwegian Board of Health Supervision."

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