Management In Health, MIH (National School of Public Health, Management, Romania)
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Jurnalul de bord, ca instrument în managementul calităţii asistenţei medicale primare
Get PDFManagement express the activity to rule an organization, all the actions by which it follows an efficiency realization of a purpose with or by other people. Management functions are represented by planification, organization, control, communication, training, leadership, commanding, monitoring and evaluation.Health management are evaluating health primordial, primary (family doctor), secondary (hospital) and tertiary services costs, using the process who establish the organization objectives and the necessary activities for getting those basing on disposable sources.Quality is a characteristics set of goods, offered by the organization to the clients in purpose to satisfy their needs in a proper time with an accesible cost.Donabedian defines the quality of health services as a balance level between the benefits and losts brought to the health.The purpose of the study is the evaluation of the health quality primary services from an individual medical office, usind own board – table and indicators of health quality als HEDIS and OECD’s systems.On display in a board - table the descriptive analysis of the propre inputs, process, outputs, outcomes and own indicators of health quality’s results.In future we will use the review to transform our resources into a real activities value.Keywords: health management, quality of medical activity, board-table, indicators of health quality, primary health servicesContent available only in Romanian
Intervenţii şi strategii pentru renunţarea la fumat
Get PDFThis Best Practice Information Sheet has been derived from a commissioned review undertaken by The Joanna Briggs Institute. This review sought to identify existing systematic reviews on smoking cessation interventions and strategies. Fifteen systematic reviews were identified that met the inclusion criteria and were assessed as being of sufficient methodological quality. Reviews specific to paediatric and obstetric patients were not included in this review.Assisting patients to quit smoking is complex and requires a systematic and multifaceted approach. The benefits of promoting smoking cessation particularly amongst hospital inpatients are well recognised not only for the individual concerned but the whole community. There are a range of interventions and strategy alternatives that are supported by quality research based evidence. Although they may be effective in isolation, a program of multiple interventions including appropriate pharmacotherapy with advice and support tailored to the individual, are more likely to achieve success. These interventions can only be effectively applied if there are systems in place to screen, assess and follow up patients who wish to quit smoking.Keywords: smoking cessation, intervention, strategies, background, screening, advice to quit, treatment formats, follow-up, assessment, procedures, recommendations.Content available only in Romanian
Însuşirea cunoştinţelor prin informarea preoperatorie a pacientului
No full textThis Best Practice Information Sheet had been compiled by The Joanna Briggs Institute based on a Systematic Review of research, entitled Knowledge Retention from Pre-operative Patient Information.The objective of this Best Practice Information Sheet was to present the best available evidence related to knowledge retention following pre-operative patient education.Patient knowledge was a measure of the surgical procedure and the events that surround it. Results of the review suggested that: pre-admission pamphlets are more effective than providing no information and at least as effective as providing a post-admission pamphlet combined with instruction that explains the contents of the pamphlet; providing a pre-admission pamphlet only, is as effective as providing the same pamphlet with instruction pre- or post-admission; the instructional method is more effective if provided pre-admission.The patient’s ability to perform specific skills or exercises was also measured and the conclusion was that providing pre-admission pamphlets was more effective than providing post-admission ones. When exercises or skills were performed incorrectly the time required for each patient to master the skills was recorded and patients provided with pre-admission pamphlets learned proper exercise technique or skills faster than patients provided with information post-admissionKeywords: use of pamphlets, videos, learning packages, instructionContent available only in Romanian
Inegalităţi în domeniul sănătăţii publice: starea de sănătate a populaţiei şi cheltuielile de sănătate
No full textThe documents of the EU regarding sustainable development, place public health as one of the most important areas of interest, a growing attention is being paid to reducing inequalities in health among countries. The objective of this article is to identify major inequalities in health in Romania and compare them with other countries members of the EU, regarding health status and health expenditure. The analysis is based on the specific indicators for each category of problems mentioned. For this purpose the most relevant indicators are used, from the statistics of the WHO, Eurostat and the national statistics of Romania. The comparison is done using the data from the last available year, and where possible trends are shown –pozitive or negative – especially after year 2000. Keywords: public health, inequalities, health status, health expenditures, Romania, EUContent available only in Romanian
Modelul credinţelor cu privire la sănătate
Get PDFThis article presents an introduction to the Health Belief Model (HBM). The HBM states that the perception of a personal health behavior threat is influenced by at least three factors: general health values, interest and concern about health; specific beliefs about vulnerability to a particular health threat; and beliefs about the consequences of the health problem. Once an individual perceives a threat to his health and is simultaneously cued to action, if his perceived benefits outweighs his perceived costs, then the individual is most likely to undertake the recommended preventive health action.Key words: health promotion, health belief model, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy.Content available only in Romanian
Analiza Cost-Eficacitate R-CHOP VS. CHOP în limfoamele agresive non-Kodkin (NHL)
No full textThe CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone) is the standard treatment for younger and elderly patients with diffuse large-B-cell lymphoma, but it induces complete responses in only 40 to 50 percent of elderly patients. The benefit of adding Rituximab (R) – a chimeric anti-CD20 IgG1 monoclonal antibody, to CHOP was observed among patients with relatively low risk disease or high risk disease. In comparative studies of CHOP and R-CHOP, the rate of complete response was significantly higher in the group that received R-CHOP than in the group that received CHOP alone. In several EU countries there are cost-effectiveness studies regarding the treatment of aggressive NHL with CHOP vs. R-CHOP, but in Romania there is no such a study done.The authors used a cost-effectiveness model where they compared the costs of both type of treatments and the benefits expressed in gained years of life, in order to have the Romanian perspective for the economic evaluation of treatment of aggressive NHL with CHOP vs. R-CHOP. The Romanian cost-effectiveness analysis is based on a model developed by Best et al. which calculates the cost-effectiveness ratio of R-CHOP vs. CHOP over time horizon of 10 years for patients with diffuse large B-cell lymphoma DLCL. The analysis was done based on local Romanian costs and the clinical benefits from the GELA study. Rituximab administered together with CHOP gives patients an increased chance of cure, a significantly superior survival and represents a cost-effective therapy compared to standard treatment with CHOP. When costs and survival benefits are considered over 10 years, the additional cost per patient on R-CHOP is 12,929 Euro. Over a 10 years time frame, the estimated survival benefit of R-CHOP compared to standard CHOP treatment alone in this group of patients is on average 0.60 extra years of life gained per patient. The estimated additional cost per extra year of life gained for the combination therapy is 21,549 Euro. Using the same cost-effectiveness model we observed that using R-CHOP vs. CHOP we obtained in Romania the lowest cost per additional year of life gained compared with France or United Kingdom.Keywords: cost-effectiveness analysis, cost per life year gained, NHL non-Hodgkin lymphoma Tratamentul cu CHOP (Cyclophosphamide, Doxorubicin, Vincristine şi Prednisone) reprezintă tratamentul standard pentru limfomul difuz cu celule B mari (forma cea mai frecventă a limfoamelor non-Hodgkin) la pacienţii tineri sau vârstnici, dar acesta induce un răspuns complet doar la 40-50% dintre pacienţii vârstnici. Beneficiul adăugării Rituximab (R) – un anticorp IgG1 chimeric monoclonal anti-CD20, la CHOP a fost observat la pacienţii cu risc mare sau redus de boală. În studiile comparative de eficacitate între CHOP şi R-CHOP, rata de răspuns complet a fost semnificativ mai mare la grupul ce a primit R-CHOP faţă de grupul ce a primit CHOP simplu. Studii economice de cost-eficacitate a CHOP vs. R-CHOP în tratamentul limfoamelor agresive non-Hodgkin au fost efectuate în mai multe ţări ale Uniunii Europene, dar în România nu s-au efectuat astfel de studii până în acest moment.Autorii au utilizat un model de analiză economică de tip cost-eficacitate în care au comparat costurile ambelor tipuri de tratament şi au exprimat rezultatele în ani de viaţă câştigaţi, pentru a avea o perspectivă locală a evaluării economice a tratamentului cu CHOP vs. R-CHOP a limfoamelor agresive non-Hodgkin. Analiza românească a cost-eficacităţii se bazează pe un model dezvoltat de Best et al. care a calculat raportul cost-eficacităţii pentru R-CHOP vs. CHOP la pacienţii cu limfoame agresive non-Hodgkin pentru un orizont de timp de 10 ani. Analiza a fost făcută pe baza datelor de cost din România şi a datelor privind beneficiile din studiul GELA. Rituximab administrat împreună cu CHOP oferă pacienţilor o şansă mai mare la vindecare, supravieţuire mai mare, semnificativă şi reprezintă o terapie cost-eficace în comparaţie cu tratamentul cu CHOP. În momentul în care luăm în considerare costurile şi beneficiile pe o perioadă de studiu de 10 ani pentru pacienţii vârstnici cu limfoame difuze cu celule B mari, rezultatele arată un cost adiţional pe pacient tratat cu R-CHOP de 12.929 Euro. De-a lungul a 10 ani, beneficiul suplimentar în supravieţuire al tratamentului cu R-CHOP faţă de tratamentul cu CHOP la aceşti pacienţi este de 0,6 ani de viaţă câştigaţi per pacient. În acest fel, costul adiţional al tratamentului cu R-CHOP faţă de CHOP pentru un an de viaţă câştigat este de 21.549 Euro.Utilizarea aceluiaşi model de analiză cost-eficacitate în Franţa şi Marea Britanie ne arată că în România se obţine cel mai redus cost per an de viaţă câştigat adiţional prin tratamentul cu R-CHOP faţă de tratamentul cu CHOP.Cuvinte cheie: analiză cost-eficacitate, cost pe an de viaţă câştigat, limfoame non-Hodgki
Aspecte epidemiologice ale sarcomului Kaposi epidemic în România
No full textKaposi's sarcoma is a rare disease, both in its classic form, as well as in theepidemic. This paper aims to identify the epidemiological aspects of epidemicKaposi's sarcoma at the national level starting from data reported by hospitals inRomania in a period of almost 4 years.The conclusions of the study were consistent with those of literature, suggestingthat the epidemic Kaposi's sarcoma occurs in much younger patients than theclassic form, a tendency of decreasing in of men:women ratio and a shorter lifeexpectancy. In addition, the study suggests the agglomeration of cases in thesouth-east region of the country.Keywords: epidemic Kaposi's sarcoma, age, territorial distribution, lifeexpectancyContent available only in RomanianKaposi's sarcoma is a rare disease, both in its classic form, as well as in theepidemic. This paper aims to identify the epidemiological aspects of epidemicKaposi's sarcoma at the national level starting from data reported by hospitals inRomania in a period of almost 4 years.The conclusions of the study were consistent with those of literature, suggestingthat the epidemic Kaposi's sarcoma occurs in much younger patients than theclassic form, a tendency of decreasing in of men:women ratio and a shorter lifeexpectancy. In addition, the study suggests the agglomeration of cases in thesouth-east region of the country.Keywords: epidemic Kaposi's sarcoma, age, territorial distribution, lifeexpectanc
