1,721,026 research outputs found
ELABORAREA PROTOCOALELOR DE PRACTICĂ LA NIVELUL SPITALELOR DIN ROMÂNIA
No full textThe benefits of standardizing medical practices are obvious and known, both at the level of the patient and hospital or health sector. Knowing the clinical pathways that a patient can follow during his hospital stay can simplify the case management of the hospitalized patient only if the standard algorithm for diagnosing and treating each pathology is known, mastered and applied at hospital level. The existence of national guidelines or standardized protocols for certain pathologies can guide the medical practice (where local conditions allow the application of the guidance) or the development of practice protocols adapted at the local level (ward/hospital). In Romania, hospitals are required by law to apply a therapeutic standard (national, European or international) adapted to the local level for each pathology, but this often becomes impractical due to the real gaps for the implementation of this goal. Political will is needed to be translated into support in promoting the standardization of hospital medical practices (by types of hospitals/specialties) so that the costs generated at the hospital sector or health system level can be predicted, based on cost standards related to the standardized medical activity. There is a need for professional discipline in exercising the roles of actors and those responsible with the development and implementation of practice protocols at the hospital level, but there is also a need for strategic measures to ensure that hospital medical practice is processed, declared, known, mastered and applied locally, taking into account the local specificities. Keywords: medical practice, guide, protocol, hospitalBeneficiile standardizării practicii medicale sunt evidente și cunoscute, atât la nivel de pacient, spital sau sector de sănătate. Cunoașterea traseelor clinice ce le poate urma un pacient de-a lungul șederii lui în spital poate simplifica managementul de caz al pacientului spitalizat doar dacă la nivelul spitalului este cunoscut, însușit și aplicat un anumit protocol pentru fiecare patologie tratată la nivelul unității. Existența ghidurilor naționale sau a protocoalelor standardizate pentru anumite patologii poate orienta practica medicală (acolo unde condițiile locale permit aplicarea ghidului) sau elaborarea de protocoale de practică adaptate la nivel local (secție/spital). În România, spitalele sunt obligate prin lege să aplice un standard terapeutic (național, european sau internațional) adaptat la nivel local pentru fiecare patologie, dar acest lucru devine adeseori impracticabil datorită verigilor lipsă pentru punerea în practică a acestui deziderat. Este nevoie de voință politică care să fie transpusă în sprijin în promovării standardizării practicii medicale spitalicești (pe tipologii de spitale/specialități) astfel încât să se poată previziona costurile generate la nivel de sector sau sistem de sănătate, pe baza unor standarde de cost aferente activității medicale astfel standardizată. Este nevoie de o disciplină profesională în exercitarea funcțiilor deținute de către actorii și responsabilii cu elaborarea și implementarea protocoalelor de practică la nivelul spitalelor, dar este nevoie, suplimentar, și de măsuri strategice care să garanteze că practică medicală spitalicească este procedurată, declarată, cunoscută, însușită și aplicată la nivel local, luând în considerare specificitățile locale. Cuvinte cheie: practică medicală, ghid, protocol, spita
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
SPECTRUL MORBIDITĂȚII SPITALICEȘTI ÎN RÂNDUL COPIILOR 0-17 ANI, ROMÂNIA
No full textCONTEXT: At the hospitals level, a large volume of resources is consumed, and efficient allocation of resources must be done based on valid and scientific evidence. As these resources are complex and vary for different categories of the population, the analysis of needs by age groups can support decision-making and the development of appropriate policies. The purpose of this analysis was to identify patterns of hospital morbidity among children 0-17 years and to provide evidence that can support the decision making process in the field of efficient allocation of resources. METHOD: Cross-sectional study performed on data on hospital activity at patient level, in the year 2019. The DRGNational 2019 database was interrogated and data on the level of hospital morbidity in children 0-17 years were extracted. Indicators were calculated, for measuring the level of hospital activity, such as: number of hospitalization episodes, proportion of hospitalizations in total hospitalizations, density of hospitalizations among children. Data were analyzed by age categories 0-1 years, 1-4 years, 5-9 years, 10-14 years and 15-17 years; data were aggregated at national level, and for certain aspects, the data were also aggregated at county level. RESULTS: The analysis of the spectrum of pathologies highlights major differences between the age groups within the category of children 0-17 years, both in terms of their frequency in the top of pathologies for each major age category and in terms of their proportion of total hospitalizations. The spectrum of pathologies among children 0-17 years old hospitalized in Romanian hospitals is dominated by respiratory and digestive diseases, parasitic diseases and ENT diseases, and for each age group there are specificities of the hospitalization model. CONCLUSIONS: The evidence from this study shows that there are large variations between pediatric hospital morbidity models identified, and these variations require in-depth analysis, on each population segment, in order to provide valid evidence to support decisions on efficient allocation of hospital resources in territorial profile. Keywords: major diagnosis categories, pediatric, Romania, morbidityCONTEXT: La nivelul spitalelor se consumă un mare volum de resurse, iar alocarea eficientă a resurselor trebuie să se facă având la bază evidențe valide, științifice. Deoarece aceste resurse sunt complexe și diferite pentru categorii diferite de populație, analiza nevoilor pe categorii de vârstă poate spijini actul decizional și elaborarea politicilor adecvate. SCOPUL ANALIZEI a fost de identificare a unor modele de morbiditate spitalicească în rândul copiilor 0-17 ani și de furnizare de evidențe ce pot spijini elaborarea deciziilor în domeniul alocării eficiente de resurse. METODĂ: Studiu transversal realizat pe date privind activitatea spitalicească la nivel de pacient, la nivelul anului 2019. Baza DRGNational 2019 a fost interogată pentru extragerea datelor privind nivelul morbidității spitalicești la copii 0-17 ani. Au fost calculați indicatori ce măsoară nivelul activității spitalicești precum: număr episoade spitalizare, ponderea spitalizărilor din total spitalizări, densitatea spitalizărilor în rândul copiilor. Datele au fost analizate pe categoriile de vârstă 0-1 an, 1-4 ani, 5-9 ani, 10-14 ani și 15-17 ani; nivelul de agregare a fost cel natțonal, iar pentru anumite aspecte, datele au fost agregate și la nivel de județ. REZULTATE: Analiza spectrului patologiilor evidențiază diferențe majore între grupurile de vârstă din cadrul categoriei copiilor 0-17 ani, atât în ceea ce privește frecvența acestora în topul patologiilor din fiecare categorie majoră de vârstă, cât și în ceea ce privește ponderea acestora din totalul spitalizărilor. Spectrul patologiilor în rândul copiilor 0-17 ani spitalizați în spitalele din România este dominat de bolile aparatului respirator și digestive, bolile parazitare și afecțiunile ORL, iar pentru fiecare grupă de vărstă există specificități ale modelului de spitalizare. CONCLUZII: Evidențele din acest studiu arată că, între modelele de morbiditate spitaliceasacă pediatrică există variații mari, iar aceste variații reclamă aprofundarea analizei, pe fiecare segment populațional, în vederea furnizării unor evidențe valide pentru sprijinirea deciziilor de alocare eficientă a resurselor spitalicești în profil teritorial. Cuvinte cheie: categorii diagnostice majore, pediatrie, România, spital, morbiditat
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Modele de organizare şi finanţare a sistemelor de sănătate europene (sistemul britanic versus sistemul olandez)
Get PDFThe improving of health represents the main goal of all health systems, and this target can be reached through a adequate national policy; a good image of a health policy could be reflected in the organization and the financing model of the health system, which includes all organizations, institutions and resources established for the improvement of the population health status. This article is a synthesis from those describing the main health systems in Europe; the presentation of each national health system contains aspects such as: the level population coverage by health insurance, types of health services covered, thegenerate revenue system, the delivery system, the quality of care, the costcontrol system.Keywords: health systems, health insurance covering, financing, delivery health system, quality of care, efficiency, cost-controlThe improving of health represents the main goal of all health systems, and this target can be reached through a adequate national policy; a good image of a health policy could be reflected in the organization and the financing model of the health system, which includes all organizations, institutions and resources established for the improvement of the population health status. This article is a synthesis from those describing the main health systems in Europe; the presentation of each national health system contains aspects such as: the level population coverage by health insurance, types of health services covered, thegenerate revenue system, the delivery system, the quality of care, the costcontrol system.Keywords: health systems, health insurance covering, financing, delivery health system, quality of care, efficiency, cost-contro
EVALUAREA CALITĂŢII ŞI MĂSURAREA REZULTATELOR ÎN SERVICIILE DE RECUPERARE MEDICALĂ – IMPLICAŢII PENTRU PERSOANELE CU DIZABILITĂŢI
No full textHealth systems have as main goal the supply of quality medical services, which involves a variety of human, material and financial resources. The insufficiency or lack of some of these resources will result in diminishing the quality of medical care, with consequences on the health of patients. In the domain of medical rehabilitation, patients have complex pathologies which require long-term treatments, teams of professionals consisting of rehabilitation doctors and other professional categories (kinesiotherapists, occupational therapists, physiotherapists, nurses, speech therapists, psychologists, etc.) and specialized equipment. As one of the important goals of medical rehabilitation is to improve the functional status of patients, reliable and valid methods of performing functional assessment are necessary. Quality assessment and measuring outcomes of rehabilitation services provides insight into how they meet the needs of persons with various disabilities. Quality rehabilitation is a gain, both for the individual (improving functionality, increasing independence and quality of life) and for society. The presentation of systems for assessment of rehabilitation programs and monitoring results from US health system support the rehabilitation professionals in our country for a better knowledge, understanding and use of them in medical practice, where possible. Keywords: quality medical services, outcomes, medical rehabilitation, functioning, disabilitySistemele de sănătate au ca deziderat principal furnizarea de servicii medicale de calitate, ceea ce implică o varietate de resurse umane, materiale şi financiare. Insuficienţa sau lipsa unora dintre aceste resurse va avea ca rezultat diminuarea calităţii îngrijirilor medicale, cu repercusiuni asupra stării de sănătate a pacienţilor. În domeniul recuperării medicale, pacienţii au patologii complexe care necesită tratamente de lungă durată, echipe de specialişti formate din medici de recuperare şi alte categorii profesionale (kinetoterapeuţi, ergoterapeuţi, fizioterapeuţi, asistenţi medicali, logopezi, psihologi etc.) şi de aparatură specializată. Deoarece unul dintre obiectivele importante ale recuperării medicale este de a îmbunătății starea funcțională a pacienților, sunt necesare metode sigure și valide de efectuare a evaluării funcționale. Evaluarea calităţii şi măsurarea rezultatelor serviciilor de recuperare oferă o imagine asupra modului în care acestea răspund nevoilor persoanelor cu diverse dizabilităţi. O recuperare de calitate este un câştig, atât pentru individ (îmbunătăţirea funcţionalităţii, creşterea independenţei şi a calităţii vieţii), cât şi pentru societate. Prezentarea unor sisteme de evaluare a programelor de recuperare şi de monitorizare a rezultatelor din sistemul sanitar american vin în sprijinul profesioniştilor din domeniul recuperării din ţara noastră pentru o mai bună cunoaștere, înţelegere şi folosire a acestora în practica medicală, acolo unde este posibil. Cuvinte cheie: calitate servicii medicale, rezultate, recuperare medicală, funcţionalitate, dizabilitat
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