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Healthcare Delivery Systems (healthcare + delivery_system)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Improving oral healthcare delivery systems through workforce innovations: an introduction

JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2010
Elizabeth A. Mertz PhD
Abstract The objective of this paper is to describe the purpose, rationale and key elements of the special issue, Improving Oral Healthcare Delivery Systems through Workforce Innovations. The purpose of the special issue is to further develop ideas presented at the 2009 Institute of Medicine (IOM) workshop, Sufficiency of the U.S. Oral Health Workforce in the Coming Decade. Using the IOM discussions as their starting point, the authors evaluate oral health care delivery system performance for specific populations' needs and explore the roles that the workforce can play in improving the care delivery model. The contributing articles provide a broad framework for stimulating and evaluating innovation and change in the oral health care delivery system. The articles in this special issue point to many deficits in the current oral health care delivery system and provide compelling arguments and proposals for improvements. The issues presented and solutions recommended are not entirely new, but add to a growing body of work that is of critical importance given the context of wider health care reform. [source]

Colorectal cancer risk in relation to use of acid suppressive medications,

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2009
Jessica Chubak PhD, MBHL
Abstract Purpose Acid suppressants are commonly prescribed medications. Laboratory studies suggest a mechanism by which they could increase colorectal cancer (CRC) risk. A few epidemiologic studies have investigated acid suppressant use and CRC risk; none has documented an overall association. We sought to investigate whether acid suppressants are associated with CRC risk. Methods We conducted a case,control study among members of an integrated healthcare delivery system in Washington State. Cases (N,=,641) were diagnosed with CRC between 2000 and 2003; controls (N,=,641) were randomly selected from enrollees and matched to cases on age, sex, and length of enrollment. We used conditional logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CI) for CRC associated with the use of any acid suppressive medication, proton pump inhibitors (PPIs) only, histamine receptor antagonists (H2 blockers) only, or both PPIs and H2 blockers in relation to the use of neither PPIs nor H2 blockers. Results Use of PPIs exclusively was modestly associated with an increased risk of CRC, however this finding was consistent with chance and based on a small number of patients exposed (OR,=,1.7; 95%CI,=,0.8, 4.0). H2 blocker use alone was not related to CRC risk (OR,=,0.8; 95%CI,=,0.6, 1.1). Conclusions PPI use may be modestly associated with CRC risk; further research should be conducted in populations with long-term PPI use. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Guidelines for treatment of neonatal jaundice.

ACTA PAEDIATRICA, Issue 3 2001
Is there a place for evidence-based medicine?
Treatment of neonatal jaundice continues to be a controversial issue. Arguments that traditional practice results in over-treatment have led to the adoption of more liberal guidelines in some countries. The importation of liberal guidelines from one country to the next, however, is fraught with danger, because differences in epidemiology, sociology and healthcare delivery systems between countries may not be adequately reflected. The unreflected extension of liberalization to non-target groups of patients can expose the latter to significant risk. It is not clear that the evidence on which guidelines for treatment of neonatal jaundice are based satisfy the requirements for evidence-based medicine. Evidence of adequate quality may be hard to obtain. Conclusions: Introduction of more liberal guidelines for the treatment of neonatal jaundice, if at all contemplated, must be adapted to local circumstances, and any available evidence pertaining to local epidemiology, sociology and healthcare organization has to be carefully weighed and incorporated. The time is ripe for a joint international effort to secure adequate funding for basic and applied research within the mechanisms of bilirubin encephalopathy in the newborn. [source]

Improving oral healthcare delivery systems through workforce innovations: an introduction

Comparing health care delivery systems , initiating a student exchange project between Europe and the United States

MEDICAL EDUCATION, Issue 7 2001
Elizabeth G Armstrong
Background Cross-cultural contact among different health care systems can provide a framework for identifying the strengths and weaknesses of one's own healthcare system. However, such contact has rarely had much impact upon medical education curricula. Despite intense debate on reforming the healthcare delivery systems (HCDS) in Europe and the United States, there is very little formal representation of this interdisciplinary field in our educational programs. Description To address this problem, a medical student exchange program was conducted in which students developed case studies that produced comparative analyses of HCDS in Germany, Sweden, Denmark and the United States. Each case is intended to highlight critical differences among the systems. Evaluation Students and their faculty preceptors completed pre- and post-exchange questionnaires to assess perceived knowledge of the HCDS and the adequacy of time devoted to it in their curricula. Both perceived that too little attention was devoted to this content in their programs. Following the exchange, students described clear increases in perceived knowledge. Discussion Our common interest in curriculum reform was key to implementing the exchange. The written cases generated by the students are being developed as course material in some of the schools and a conference is planned to disseminate the cases and the implementation strategies for their inclusion in medical curricula. [source]