This document discusses primary care in Europe and ways to reform primary care delivery and organization. It touches on several key topics:
1. Policy levers that can successfully drive change, including payment/incentives and enabling new professional roles.
2. A health policy triangle framework involving context, actors/players, and content/process for developing and implementing primary care policies.
3. Barriers and facilitators to primary care reform, including cultural, political, and international factors.
Sickness Funds and the Pharmaceutical Industry: a New Relationship?Beapp_Bcpm
On Friday 3rd March, Dr Jan Van Emelen, Innovation Director at Neutral Mutualities presented on “Mutualities and pharmaceutical industry: a new relationship?”. Access to new, often very expensive medications is a hot topic and our speaker discussed the role of the mutualities in this process, using new models for disease management. He shared ideas on our potential interaction with this process as pharmaceutical physicians.
Health 2020 is a new policy framework from the WHO European Region that aims to improve health and well-being for populations and reduce health inequities. It recognizes rapid changes in demographics, technology, and the economy that impact health. The goals are to improve health for all, reduce divides in health status, and ensure sustainable health systems. It takes a whole-of-government and societal approach and emphasizes action on social determinants of health.
The document summarizes Tunisia's social protection system, including both contributory and non-contributory pillars. The contributory system covers retirement, health insurance, and family benefits through various public and private funds. However, these face challenges of an aging population and high unemployment. The non-contributory system provides assistance through cash transfers, food and fuel subsidies, and unemployment programs, but has issues with targeting, coverage, and cost-efficiency. Reforms are needed to address demographic changes and ensure fiscal sustainability of Tunisia's social protection.
This document introduces Intellect's campaign to increase the UK government's investment in healthcare IT to 4% of the NHS budget as recommended by the 2002 Wanless Report. The campaign aims to highlight how increased IT spending can benefit patients, the government, and industry. Specifically, IT can help manage an aging population and chronic diseases, improve patient care and safety, and reduce costly medical errors. The document argues sustained investment is needed to implement larger IT systems and realize these benefits over time through improved processes and access to records.
Primary health care focuses on social determinants of health, lifestyle factors, and providing both medical and social support services to improve overall health and wellbeing. It aims to responsively meet both medical and non-medical needs through a community health manager and various models for delivery of services, including mobile care, ambulatory care, and support from professional caregivers. Key technologies include electronic health record systems to facilitate integrated care across different levels of the health system.
This document discusses promoting health and well-being during times of austerity in Europe. It outlines the changing environment for health, including demographic shifts, globalization, and slowed economic growth. It introduces the Health 2020 policy framework to support action across governments and societies. The document also discusses Europe's major health challenges, promoting healthy choices, and strengthening health systems. Finally, it discusses the economic impacts of noncommunicable diseases and how investing in health promotion and disease prevention can help avoid costs and support economic engines.
Sickness Funds and the Pharmaceutical Industry: a New Relationship?Beapp_Bcpm
On Friday 3rd March, Dr Jan Van Emelen, Innovation Director at Neutral Mutualities presented on “Mutualities and pharmaceutical industry: a new relationship?”. Access to new, often very expensive medications is a hot topic and our speaker discussed the role of the mutualities in this process, using new models for disease management. He shared ideas on our potential interaction with this process as pharmaceutical physicians.
Health 2020 is a new policy framework from the WHO European Region that aims to improve health and well-being for populations and reduce health inequities. It recognizes rapid changes in demographics, technology, and the economy that impact health. The goals are to improve health for all, reduce divides in health status, and ensure sustainable health systems. It takes a whole-of-government and societal approach and emphasizes action on social determinants of health.
The document summarizes Tunisia's social protection system, including both contributory and non-contributory pillars. The contributory system covers retirement, health insurance, and family benefits through various public and private funds. However, these face challenges of an aging population and high unemployment. The non-contributory system provides assistance through cash transfers, food and fuel subsidies, and unemployment programs, but has issues with targeting, coverage, and cost-efficiency. Reforms are needed to address demographic changes and ensure fiscal sustainability of Tunisia's social protection.
This document introduces Intellect's campaign to increase the UK government's investment in healthcare IT to 4% of the NHS budget as recommended by the 2002 Wanless Report. The campaign aims to highlight how increased IT spending can benefit patients, the government, and industry. Specifically, IT can help manage an aging population and chronic diseases, improve patient care and safety, and reduce costly medical errors. The document argues sustained investment is needed to implement larger IT systems and realize these benefits over time through improved processes and access to records.
Primary health care focuses on social determinants of health, lifestyle factors, and providing both medical and social support services to improve overall health and wellbeing. It aims to responsively meet both medical and non-medical needs through a community health manager and various models for delivery of services, including mobile care, ambulatory care, and support from professional caregivers. Key technologies include electronic health record systems to facilitate integrated care across different levels of the health system.
This document discusses promoting health and well-being during times of austerity in Europe. It outlines the changing environment for health, including demographic shifts, globalization, and slowed economic growth. It introduces the Health 2020 policy framework to support action across governments and societies. The document also discusses Europe's major health challenges, promoting healthy choices, and strengthening health systems. Finally, it discusses the economic impacts of noncommunicable diseases and how investing in health promotion and disease prevention can help avoid costs and support economic engines.
Presntation by Zorayda E. Leopando, MD, MPH
Professor of Family and Community Medicine University of the Philippines Manila at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Sian Griffiths presentation part 2 WSPCR 2010angewatkins
The document outlines China's plan for establishing a universal basic healthcare system called "Phase 3: Healthy China". The overall objective is to provide safe, effective, affordable healthcare for both rural and urban residents. The new health system reform plan includes public health services, medical services, health insurance, and drug production/supply systems. It also describes primary care services in China which are provided through community health centers and integrated with public health. The community health services package includes health maintenance, treatment/referral, health education, and family planning.
Health Financing System of United KingdomAditya Sood
Discussing in brief bout the latest statistics of Health Financing in UK, with emphasis on National Health Services (NHS) model and the key challenges being faced by the UK health system financing.
This document summarizes research on the impact of global health initiatives (GHIs) on Angola's health system. It finds that GHIs have both positive and negative effects. Positively, they have increased resources, knowledge transfer, and strategic planning. However, they also compete for skilled workers and use parallel monitoring systems. The research calls for continued harmonization between GHIs and the government to jointly strengthen the health system and ensure sustainability.
Primary Health Care, Objectives, Principles and Policy DirectionsHealth and Labour
Presentation by Dr.Hans Kluge e.a., director of Health Systems, WHO-Euro at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
The document discusses the role of registered dietitians in primary health care. It begins by explaining that primary health care focuses on wellness promotion rather than just illness treatment. It also notes that nutrition is important for health but access to nutrition services is limited. The document then describes key elements of primary health care, including using a population health approach, comprehensive services, coordination of care, interdisciplinary teams, and cost-effectiveness. It outlines the practice of registered dietitians in primary health care, including their skills in health promotion, education, and working with communities. Examples are provided of how dietitians contribute to quality of life, health outcomes, and cost containment through various strategies and actions.
This document summarizes a speech given by Zsuzsanna Jakab, the WHO Regional Director for Europe, about priorities in European health. It discusses:
1) The changing environment for health in Europe, including demographic shifts, globalization, new technologies, and more informed citizens.
2) WHO Europe's work to adapt to this changing environment through its "vision" and reform efforts. This includes developing the new European policy for health called "Health 2020."
3) Health 2020 aims to improve health and well-being, reduce health inequities, and ensure sustainable health systems. It focuses on stronger equity, better governance, and four common policy priorities: investing in health over the lifespan, tack
This document discusses healthcare innovation and its role in sustaining regional healthcare systems, using Andalusia, Spain as a case study. It summarizes that Andalusia has implemented an electronic health record system called Diraya that integrates patient data across primary care, hospitals, and pharmacies. Diraya has led to benefits like improved patient safety, time savings for doctors and patients, cost reductions from fewer repeat visits and tests, and increased efficiency in scheduling appointments. Analysis shows the cumulative economic benefits of Diraya have exceeded costs since its implementation.
The impact of eHealth on Healthcare Professionals and Organisations: e-health and Healthcare Organization. Piqué J. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)
This document discusses the changing landscape for integration between the NHS and social care in England. It outlines the new legislative, fiscal, and ideological contexts, including the creation of clinical commissioning groups, health and wellbeing boards, and increased competition in the healthcare system. It questions how compatible competition and collaboration are and whether these changes will facilitate deeper integration or more tactical partnerships between organizations.
The document summarizes a panel discussion on electronic health records (EHR) adoption. It introduces the moderator and four panelists who will discuss their experiences with EHR implementation. It then outlines the agenda which includes an EHR implementation panel, overview of the national healthcare landscape and legislation influencing health IT, and a question and answer session. Key pieces of national healthcare legislation discussed are the HITECH Act, Meaningful Use, Beacon Communities, and the Affordable Care Act.
This document outlines a digital health (mobile health) pilot project involving various components:
1. An mHealth management platform connecting hospitals, communities, doctors, nutritionists, and experts.
2. The platform includes modules for monitoring lung health, kidney health services, and an mHealth management system for monitoring blood sugar.
3. It provides background on chronic disease prevalence in China, noting over 92 million diabetes and 260 million chronic disease patients by 2012.
Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...MCIHealthyLiving
Presentation carried out by Niels Boye during the presention of MCI Healthy Living in Valencia the 29th Setember, 2011.
Healthy Ageing, Chronic Disease Management, and Co-production of Health and Care in the European Union
This document discusses community-oriented primary care (COPC), which is a systemic approach to medicine that is built on principles of epidemiology and community organizing. COPC aims to integrate public health and personal healthcare by addressing factors like housing, sanitation, and health promotion at the community level. The document traces the origins and evolution of COPC from its roots in primary healthcare initiatives in South Africa and the US to its principles of accessibility, accountability, continuity, comprehensiveness, and coordination. Challenges to COPC are discussed, as well as the roles of primary care physicians and factors influencing health outcomes between countries with strong versus weak primary care systems.
This document summarizes strategies for adopting new chronic patient services at the Hospital Clinic of Barcelona. It discusses:
1. Implementing patient summary records and electronic prescriptions to improve interoperability among providers in Barcelona and across Spain/Europe.
2. Deploying an integrated care model at Barcelona Esquerra involving hospitals, primary care, social services, and mental health to better coordinate care for chronic respiratory patients through structures like an integrated health sector and chronic care unit.
3. Developing integrated care strategies for chronic patients using enhanced lifestyle programs, standardized care paths, and remote monitoring to modulate disease progression and efficiently manage patients in a network of community providers.
students wonder exactly what health economics is. is it about money in health, more health for the same money ? about health in hospitals or health of the country.
The document outlines objectives for a nursing fundamentals course focusing on health care delivery and professional nursing. It discusses the current U.S. health care delivery system, the role of nursing within it, and different levels of health care providers. It also covers primary, secondary, and tertiary health care services; diversity in health care; trends in health care delivery systems; and examples of health care institutions and practitioners.
Material de (1) la conferencia “La E-Salud en mundo global” realizada el 17 de febrero de 2.012 por el Sr. Joan Cornet, Presidente Ejecutivo de la Fundación TicSalud (1er ciclo de conferencias en el ámbito TIC-Salud organizado por las Escuelas Universitarias de Informática y de Enfermería con la colaboración de la Fundación Tic-Salud, en el marco del Máster Oficial en Gestión de la Información y el Conocimiento en el Ámbito de la Salud)
La ciencia y la tecnología no tienen fronteras en un mundo global en el que están apareciendo innovaciones por todas partes. La eSalud tiene por vocación dar mejores servicios en el seno de los sistemas de salud. A pesar de las diferencias culturales, lingüísticas y de práctica de la medicina, el ser humano y la salud se convierten en lo mismo en todas partes. Las nuevas tecnologías permiten la comunicación rápida, la compartición de experiencias, el aprendizaje de las mejores prácticas y el contraste de resultados. Por eso la implementación de procesos de eSalud es un fenómeno de alcance local, pero su éxito depende del conocimiento global. Es por ello que cada vez hay más redes y organizaciones que facilitan la transferencia de conocimiento y el compilado de las mejores prácticas. El reto, pues, tanto para las organizaciones sanitarias como para las universidades y empresas innovadoras es lograr que las TICs, una vez probadas y homologadas, sean implementadas en los servicios de salud. Todo un reto tecnológico, legal, ético y financiero.
La conferencia fue impartida por el Sr. Joan Cornet, Presidente Ejecutivo de la Fundación TicSalud. El Sr. Cornet es Ingeniero técnico y Licenciado en psicología. A lo largo de su dilatada experiencia profesional, ha ocupado los cargos de Presidente Consorcio Hospitalario de Cataluña, Vicepresidente de la Federación de Municipios de Cataluña y Coordinador de la Comisión de Sanidad y Servicios Sociales de la FEMP, alto funcionario en la Comisión Europea , y Secretario General del Departamento de Salud de la Generalitat de Catalunya. En septiembre 2005 el Gobierno le encargó la puesta en marcha de la Bioregión de Cataluña y desde Enero 2007 por encargo del Departamento de Salud está al frente de la Fundación TicSalut.
Presntation by Zorayda E. Leopando, MD, MPH
Professor of Family and Community Medicine University of the Philippines Manila at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Sian Griffiths presentation part 2 WSPCR 2010angewatkins
The document outlines China's plan for establishing a universal basic healthcare system called "Phase 3: Healthy China". The overall objective is to provide safe, effective, affordable healthcare for both rural and urban residents. The new health system reform plan includes public health services, medical services, health insurance, and drug production/supply systems. It also describes primary care services in China which are provided through community health centers and integrated with public health. The community health services package includes health maintenance, treatment/referral, health education, and family planning.
Health Financing System of United KingdomAditya Sood
Discussing in brief bout the latest statistics of Health Financing in UK, with emphasis on National Health Services (NHS) model and the key challenges being faced by the UK health system financing.
This document summarizes research on the impact of global health initiatives (GHIs) on Angola's health system. It finds that GHIs have both positive and negative effects. Positively, they have increased resources, knowledge transfer, and strategic planning. However, they also compete for skilled workers and use parallel monitoring systems. The research calls for continued harmonization between GHIs and the government to jointly strengthen the health system and ensure sustainability.
Primary Health Care, Objectives, Principles and Policy DirectionsHealth and Labour
Presentation by Dr.Hans Kluge e.a., director of Health Systems, WHO-Euro at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
The document discusses the role of registered dietitians in primary health care. It begins by explaining that primary health care focuses on wellness promotion rather than just illness treatment. It also notes that nutrition is important for health but access to nutrition services is limited. The document then describes key elements of primary health care, including using a population health approach, comprehensive services, coordination of care, interdisciplinary teams, and cost-effectiveness. It outlines the practice of registered dietitians in primary health care, including their skills in health promotion, education, and working with communities. Examples are provided of how dietitians contribute to quality of life, health outcomes, and cost containment through various strategies and actions.
This document summarizes a speech given by Zsuzsanna Jakab, the WHO Regional Director for Europe, about priorities in European health. It discusses:
1) The changing environment for health in Europe, including demographic shifts, globalization, new technologies, and more informed citizens.
2) WHO Europe's work to adapt to this changing environment through its "vision" and reform efforts. This includes developing the new European policy for health called "Health 2020."
3) Health 2020 aims to improve health and well-being, reduce health inequities, and ensure sustainable health systems. It focuses on stronger equity, better governance, and four common policy priorities: investing in health over the lifespan, tack
This document discusses healthcare innovation and its role in sustaining regional healthcare systems, using Andalusia, Spain as a case study. It summarizes that Andalusia has implemented an electronic health record system called Diraya that integrates patient data across primary care, hospitals, and pharmacies. Diraya has led to benefits like improved patient safety, time savings for doctors and patients, cost reductions from fewer repeat visits and tests, and increased efficiency in scheduling appointments. Analysis shows the cumulative economic benefits of Diraya have exceeded costs since its implementation.
The impact of eHealth on Healthcare Professionals and Organisations: e-health and Healthcare Organization. Piqué J. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)
This document discusses the changing landscape for integration between the NHS and social care in England. It outlines the new legislative, fiscal, and ideological contexts, including the creation of clinical commissioning groups, health and wellbeing boards, and increased competition in the healthcare system. It questions how compatible competition and collaboration are and whether these changes will facilitate deeper integration or more tactical partnerships between organizations.
The document summarizes a panel discussion on electronic health records (EHR) adoption. It introduces the moderator and four panelists who will discuss their experiences with EHR implementation. It then outlines the agenda which includes an EHR implementation panel, overview of the national healthcare landscape and legislation influencing health IT, and a question and answer session. Key pieces of national healthcare legislation discussed are the HITECH Act, Meaningful Use, Beacon Communities, and the Affordable Care Act.
This document outlines a digital health (mobile health) pilot project involving various components:
1. An mHealth management platform connecting hospitals, communities, doctors, nutritionists, and experts.
2. The platform includes modules for monitoring lung health, kidney health services, and an mHealth management system for monitoring blood sugar.
3. It provides background on chronic disease prevalence in China, noting over 92 million diabetes and 260 million chronic disease patients by 2012.
Healthy Ageing, Chronic Disease Management, and Co-production of Health and C...MCIHealthyLiving
Presentation carried out by Niels Boye during the presention of MCI Healthy Living in Valencia the 29th Setember, 2011.
Healthy Ageing, Chronic Disease Management, and Co-production of Health and Care in the European Union
This document discusses community-oriented primary care (COPC), which is a systemic approach to medicine that is built on principles of epidemiology and community organizing. COPC aims to integrate public health and personal healthcare by addressing factors like housing, sanitation, and health promotion at the community level. The document traces the origins and evolution of COPC from its roots in primary healthcare initiatives in South Africa and the US to its principles of accessibility, accountability, continuity, comprehensiveness, and coordination. Challenges to COPC are discussed, as well as the roles of primary care physicians and factors influencing health outcomes between countries with strong versus weak primary care systems.
This document summarizes strategies for adopting new chronic patient services at the Hospital Clinic of Barcelona. It discusses:
1. Implementing patient summary records and electronic prescriptions to improve interoperability among providers in Barcelona and across Spain/Europe.
2. Deploying an integrated care model at Barcelona Esquerra involving hospitals, primary care, social services, and mental health to better coordinate care for chronic respiratory patients through structures like an integrated health sector and chronic care unit.
3. Developing integrated care strategies for chronic patients using enhanced lifestyle programs, standardized care paths, and remote monitoring to modulate disease progression and efficiently manage patients in a network of community providers.
students wonder exactly what health economics is. is it about money in health, more health for the same money ? about health in hospitals or health of the country.
The document outlines objectives for a nursing fundamentals course focusing on health care delivery and professional nursing. It discusses the current U.S. health care delivery system, the role of nursing within it, and different levels of health care providers. It also covers primary, secondary, and tertiary health care services; diversity in health care; trends in health care delivery systems; and examples of health care institutions and practitioners.
Material de (1) la conferencia “La E-Salud en mundo global” realizada el 17 de febrero de 2.012 por el Sr. Joan Cornet, Presidente Ejecutivo de la Fundación TicSalud (1er ciclo de conferencias en el ámbito TIC-Salud organizado por las Escuelas Universitarias de Informática y de Enfermería con la colaboración de la Fundación Tic-Salud, en el marco del Máster Oficial en Gestión de la Información y el Conocimiento en el Ámbito de la Salud)
La ciencia y la tecnología no tienen fronteras en un mundo global en el que están apareciendo innovaciones por todas partes. La eSalud tiene por vocación dar mejores servicios en el seno de los sistemas de salud. A pesar de las diferencias culturales, lingüísticas y de práctica de la medicina, el ser humano y la salud se convierten en lo mismo en todas partes. Las nuevas tecnologías permiten la comunicación rápida, la compartición de experiencias, el aprendizaje de las mejores prácticas y el contraste de resultados. Por eso la implementación de procesos de eSalud es un fenómeno de alcance local, pero su éxito depende del conocimiento global. Es por ello que cada vez hay más redes y organizaciones que facilitan la transferencia de conocimiento y el compilado de las mejores prácticas. El reto, pues, tanto para las organizaciones sanitarias como para las universidades y empresas innovadoras es lograr que las TICs, una vez probadas y homologadas, sean implementadas en los servicios de salud. Todo un reto tecnológico, legal, ético y financiero.
La conferencia fue impartida por el Sr. Joan Cornet, Presidente Ejecutivo de la Fundación TicSalud. El Sr. Cornet es Ingeniero técnico y Licenciado en psicología. A lo largo de su dilatada experiencia profesional, ha ocupado los cargos de Presidente Consorcio Hospitalario de Cataluña, Vicepresidente de la Federación de Municipios de Cataluña y Coordinador de la Comisión de Sanidad y Servicios Sociales de la FEMP, alto funcionario en la Comisión Europea , y Secretario General del Departamento de Salud de la Generalitat de Catalunya. En septiembre 2005 el Gobierno le encargó la puesta en marcha de la Bioregión de Cataluña y desde Enero 2007 por encargo del Departamento de Salud está al frente de la Fundación TicSalut.
Similar to Toni Dedeu: accelerating reform of primary care delivery (20)
This document discusses the potential impacts of automation on healthcare employment and discusses alternative views beyond job loss. It notes that automation may lead to reconfiguring of healthcare work rather than outright job loss. Examples of existing technologies that have automated tasks in healthcare like pharmacy automation and emerging technologies like decision support systems and personal health tracking are provided. The document advocates that automation could lead to a virtuous cycle in healthcare if it allows workers to focus on tasks that require human skills and judgment.
Evaluation of the Integrated Care and Support Pioneers ProgrammeNuffield Trust
This document summarizes the findings of evaluations of the Integrated Care and Support Pioneers Programme in the UK. The evaluations found that while Pioneers aspired to comprehensive system change, their activities focused more narrowly on initiatives like risk stratification and care coordination teams. Progress was difficult to measure against indicators and Pioneers faced challenges from financial pressures and competing priorities. The evaluations concluded that further integration will be challenging under increasing demands on the health system.
The document discusses lessons learned from the Southwark and Lambeth Integrated Care (SLIC) program in London. Key points:
- SLIC aimed to reduce hospital admissions and care home placements for older adults through risk stratification, holistic assessments, and care management.
- Success required agreement on the problem, dedicated teams, funding shifts to support community care, and leadership development.
- Future programs need a strong business case, co-design with citizens, and a dedicated "engine room" team to drive local transformation.
Effectiveness of the current dominant approach to integrated care in the NHSNuffield Trust
Jonathan Stokes of the Greater Manchester Primary Care Patient Safety Translational Research Centre presents a systematic review of case management in integrated care.
Providing actionable healthcare analytics at scale: Understanding improvement...Nuffield Trust
This document discusses measurement for quality improvement. It explains that measurement in improvement aims to provide a basis for action to improve processes and outcomes, rather than just estimating parameters. Improvement measures should be simple, specific, and available in real-time. Statistical process control methods are important to separate normal variation from changes resulting from interventions. Examples are provided of run charts measuring improvements in recording BMI for mental health patients and compliance with care bundles. The document advocates making the theories behind improvement efforts more explicit.
Ramani Moonesinghe, Associate National Clinical Director for Elective Care at NHS England, discusses the use of data for monitoring care quality at various levels within the system.
This document discusses using statistical process control (CUSUM) charts to monitor mortality rates at the level of individual general practitioners and health authorities. It describes how CUSUM charts could potentially have detected Harold Shipman, a GP who murdered over 200 patients, by spotting outliers in the routine mortality data. The document also discusses challenges in risk adjusting outcomes to account for differences in patient characteristics and casemix between providers. Accurately adjusting for factors like age, comorbidities, and emergency status is important for fair comparisons but difficult using only administrative data.
Martin Utley, Director of the Clinical Operational Research Unit at University College London, reflects upon his involvement in the launch of specific tools to monitor care quality for paediatric cardiac surgery.
Evaluating new models of care: Improvement Analytics UnitNuffield Trust
Martin Caunt, Improvement Analytics Unit Project Director and NHS England and Adam Steventon, Director of Data Analytics at The Health Foundation share insights into how they have approached evaluating new models of care.
Lisa Annaly, Head of Provider Analytics at the Care Quality Commission, discusses lessons learned from the CQC as they have worked to monitor care quality over time.
- Real-time monitoring of healthcare services requires defining both a reporting window and data window to accurately capture demand, activity, and wait times.
- Using only a reporting window (e.g. a single month) to request data can result in invalid or misleading performance metrics, as it does not account for patients with long wait times.
- Defining a larger data window that includes all patients requested before the end of the reporting window and reported after the start avoids this problem, but requires a counterintuitive data request.
- Without properly defining both windows, real-time monitoring can provide an inaccurate picture of service performance and falsely suggest the need for more resources.
Monitoring quality of care: making the most of dataNuffield Trust
Chris Sherlaw-Johnson, Senior Research Analyst at the Nuffield Trust, introduced the Monitoring quality of care conference and gives an overview of some of the approaches that we've been using at the Trust to identify where care quality has been improving, especially for frail and older people.
Providing actionable healthcare analytics at scale: Insights from the Nationa...Nuffield Trust
Christopher Boulton, Falls and Fragility Fracture Audit Programme Manager at the Royal College of Physicians and Rob Wakeman, Clinical Lead for Orthopaedic Surgery at the National Hip Fracture Database talk about what they have learned by analysing the national hip fracture database.
Providing actionable healthcare analytics at scale: A perspective from stroke...Nuffield Trust
Benjamin Bray, Research Director and the Sentinel Stroke National Audit Programme, presents at the Monitoring quality of care conference about stroke care analytics.
New Models of General Practice: Practical and policy lessonsNuffield Trust
Nuffield Trust policy researchers Rebecca Rosen and Stephanie Kumpunen present findings from our upcoming report on large scale general practice models.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
NAVIGATING THE HORIZONS OF TIME LAPSE EMBRYO MONITORING.pdfRahul Sen
Time-lapse embryo monitoring is an advanced imaging technique used in IVF to continuously observe embryo development. It captures high-resolution images at regular intervals, allowing embryologists to select the most viable embryos for transfer based on detailed growth patterns. This technology enhances embryo selection, potentially increasing pregnancy success rates.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Toni Dedeu: accelerating reform of primary care delivery
1. Primary care in
Europe: can we
make it fit for
the future?
European Health Summit 2013: Primary care case studies
January 2013
Dr. Toni Dedeu
Senior International Officer. Ministry of Health of Catalonia
President Elect. EUREGHA (European Regional & Local Health Authorities)
2. KEY TOPIC 3
ACCELERATING REFORM OF PRIMARY CARE
DELIVERY AND ORGANISATION
• Policy levers that can succesfully drive change
• Including the role of payment and incentives
• How to enable new professional roles and skill mix
3. HEALTH POLICY TRIANGLE (WALT & GILSON, 1994) (BUSE ET AL, 2005)
Context
Actors / Players
Individuals
Groups
Organitsations
Content Process
4. FRAMEWORK FOR THE Structure
EUROPEAN PRIMARY Process
CARE MONITOR Outcome
Governance of PC PC Workforce
Economic Conditions
system development
Access to PC Comprehensiveness
Continuity of PC
Services of PC services
Coordination of PC Quality of Care Efficiency of PC
5. PROCESS
HEALTH POLICY
Process
› Identification of the problem:
› which topics are in the political agenda?
PC Reform needed?
6. Departament de Salut
Devolution process to Autonomous Communities
Catalan healthcare system
2001
1987
1990 2001
2001
1990
1981
2001 2001
2001 1987
2001
2001
2001
1984
1994 2001
7. PROCESS
HEALTH POLICY
Process
› Formulation of a health policy:
A policy for PC?
› Who is involved in the formulation of the health policy
› Is there any consensous about the policies
›Implementation of a health policy:
Pilots? / Development and
implementation?
› Evaluation of the policy implemented
› Once an specific policy has been implemented, is there
any evaluation?
Has PC been evaluated sufficiently?
8. Context
CONTEXT
›Situational factors:
› wars,
› epidemies,
› heat waves,
› new governement with new
policies / new Minister
9. Context
CONTEXT
Structural Factors:
› Political system,
› Type of economy
› Demographic factors
10. Departament de Salut
Health care models in Europe
Health care financing in the EU (andCatalan healthcare system
beyond)
Health financing policy encompasses a range of functions:
Collection of funds
Pooling funds
Purchasing health services
Coverage, benefits and cost sharing
Source: Kutzin J (2001). A descriptive framework for country-led analysis of health care 10
financing arrangements. Health Policy, 56(3):171-203
11. Context
CONTEXT
›Cultural factors:
› Status quo,
Good for providers
For the people, far from optimal
› lobbies,
› ethnic minorities,
› jerarquies, religion, etc.
12. Context
CONTEXT
›External or international factors:
› EU: Any evidence PC is a prority in the EU?
› % of FP7 projects in PC
› HORIZON 2020
› Directives
› Joint Actions
› WHO
› Cooperation and agreements between countries.
13. CONTENT
Content
What have we got in the basket?
What are the limits of PC?
14. RELATIONSHIP BETWEEN HEALTHCARE EXPENDITURE AND LEVELS OF CARE
Decreasing patient episodes
Self-care
or care by
families, Primary care Secondary Terciary
friends or care care
other carers
Lower costs
Source: Peckham and Exworthy 2003 Proportion of expenditure on healthcare
15. ACTORS
actors
Stakeholders with interests involved in the decision
making process in health policy
Ideologies, Political parties
Mass media: press, TV, radio blogs, tweets, comentators,
Health care providers, Insurance companies, professional organisations
and bodies, pharmaceutical companies
Professionals: doctors, nurses, dentists, pharmacists, phisiotherapists,
social workers, healthcare managers, etc
Payers of services: Governments, workers, interest groups in the health
sector who contribute somehow financing the system, ...
Citizens: groups of patients, communities, local governments, associations,
carers, ...
16. Departament de Salut ACTORS
(Some of them) Catalan healthcare system
Catalan
Parliament Catalan Government
€ Ministry of Health
Financing
Planning
Catalan Public Health Insurance
CatSalut
Commissioning and Buying
Contract
Providers Social-Health
Care
ICS PC 1 PC2 Hospital
CATALAN HEALTH INSTITUTE - Consortium
Hospital Hospital 3
Hospitals Primary Mental
Other Consortium 1 Consortium 2 Ambulanc
Health
Care e Trust 2
Mental 16
Mental Ambulanc
Health 1
Health 1 e Trust 1 Other
17. Departament de Salut
Catalan Healthcare System Catalan healthcare system
• NHS based system - Beveridge
• Universal coverage and free
• Public financing of the services
• Purchaser - Provider split
• Providers with various ownership formula
• Access equity (365 Primary Health Centers
and 69 hospitals – towards a cluster formula)
Investments in Primary Care produce more
equity than investments in the health system in
general
Source: PHAMEU Project
18. Departament de Salut
CATALONIA Catalan healthcare system
Population over 60 years (2009): 21,7%
Immigrant population (2010) 19%
High urban concentration (5M citizens around
BCN)
Middle size cities spread in the territory
Geographically diverse and well communicated
Distance between towns – less than 10
km
98% of the population has a
Primary Health Centre closer
than 10km
19. Catalan Healthcare System
Departament de Salut
Catalan healthcare system
Citizen’s Pathways. Gatekeeping based
Emergencies
HOSPITALS
C
H1 H2 H3
I
T
I PRIMARY Social &
Z HEALTH Healthcare
CENTRE Services
E
N
Emergency/ Triage Mental Health
S
Call Centre 061 /112 Care
20. Primary
Departament de Salut care (Health and Social?)
Multidisciplinary TeamCatalan healthcare system
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The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer, and then open the file again. If the red x still appears, you may have to delete the image and then insert it again.
Pharmacists
Maternal
Community
approach Care
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Midwife and
Gynaecologist
Community GP
Activities Paediatritian
Nurse
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The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer, and then open the file again. If the red x still appears, you may have to delete the image and then insert it again.
Patient Physiotherapy
Consultants
Social
Dentist
Worker
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Nurse
Patient
Liason Mental Health
Groups
21. GOVERNANCE
Vision and direction of a primary care system
Policiy on equity in access to primary care systems
(De)centralisation of primary care management and
service development
Quality management infraestructure
Appropriate technology in primary care
Patient advocacy
Ownership status of primary care practices
Integration of primary care in the health care system
Source: PHAMEU Project
22. HEALTH PLAN - Priorities and Projects
9 priority areas and 31 projects
1
Objectives and Health Programmes
Chronic Performance Improvement
2 Care improvement of quality at
Orientation at primary care high
level specialization
level
Focus to patients and their families and carers
New purchasing and commissioning of health services
3 Clinical and professional knowledge at the front line
Governance improvement and professional and citizen’s participation
Strengthening the information system, transparency and evaluation
23. 3
Departament de Salut
Primary Care: Scope of Services
Performance
Catalan healthcare system
improvement
at primary
care level
Free choice of Primary Health Centre, GP, Paediatrician and
Nurse
Acute medicine (GP/P, N, Dentist)
Acute homecare (GP/P/N/SW/D)
Chronic Care (All the Team + Call Center + Nurse Liaison +
Coordination + …
Promotion and Prevention of care (GP/P, N, D)
Homecare (SW, GP/P, N,D)
Minor surgery (GP)
Other techniques: anticoagulant control and treatment, spirometry,
ultrasound, etc. (GP, N)
Vocational Training (GP, N)
Continuous Medical Education (All the Team)
Research (All the Team)
Community Care (All the Team + Community agents
/Community Plans)
24. GOVERNANCE
Vision and direction of a primary care system
Policiy on equity in access to primary care systems
(De)centralisation of primary care management and
service development
Quality management infraestructure
Appropriate technology in primary care
Patient advocacy
Ownership status of primary care practices
Integration of primary care in the health care system
Source: PHAMEU Project
25. 3
Departament de Salut
Primary Care: Scope of Services
Performance
Catalan healthcare system
improvement
at primary
care level
+
Free choice of Primary Health Centre, GP, Paediatrician and Nurse
Acute medicine (GP/P, N, Dentist)
Acute homecare (GP/P/N/SW/D)
Chronic Care (All the Team + Call Center + Nurse Liaison + Coordination + …
Promotion and Prevention of care (GP/P, N, D)
Homecare (SW, GP/P, N,D)
Minor surgery (GP)
Other techniques: anticoagulant control and treatment, spirometry, ultrasound, etc. (GP,
N)
Vocational Training (GP, N)
Continuous Medical Education (All the Team)
Research (All the Team)
Community Care (All the Team + Community agents/Community Plans)
High performance in
Dematology Ophtalmology ENT (Ear Nose & Throat diseases)
Mental Health Mucolosketetal disesases
26. Appropriate
Departament de Salut technology in primary care
Catalan healthcare system
Key ICT Projects – Governing characteristics
Medical Image
Telemedicine
Digitization Plan
NETWORKING MODEL RESOURCES SHARING
Catalan Shared
Medical Record
INTEROPERABILITY
Personal Health Electronic
Folder Prescribing
CO-RESPONSIBILITY COLLABORATION MODEL
26
27. GOVERNANCE
Quality management infrastructure
Patients receive higher quality care in geographical
areas where performance measures and monitoring
has been established
Pay for performance schemes provide financial
incentives that can change professional behaviour
and improve the quality of care
Source: PHAMEU Project
28. ECONOMIC CONDITIONS
OF THE PRIMARY CARE
SYSTEM
Health care funding system
Health care expenditures
Primary care expenditure
Employment status of primary care workforce
Remuneration system of primary care workforce
Income of primary care workforce
29. PRIMARY CARE
WORKFORCE
DEVELOPMENT
Profile of primary care workforce
Recognition and responsibilities
Education and retention
Professional associations
Academic status of the primary care discipline
Future development of the primary care
workforce