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Healthcare Planning (healthcare + planning)
Selected AbstractsPatient,physician communication during oncology consultationsPSYCHO-ONCOLOGY, Issue 10 2008Hanna Fagerlind Abstract Objective: The aim of this study was to characterize the content of patient-physician communication in standard oncology care. Methods: The sample consisted of 19 patients with gastrointestinal cancer. The consultations were audio-recorded, transcribed verbatim, and analyzed according to qualitative content analysis. Results: The analysis resulted in seven main categories: Disease and treatment, Healthcare planning, Everyday living, Psychological well-being, Coping with disease, Expressions of concerns and feelings, and Other aspects of communication. The main focus during the consultations was on disease and treatment. Physicians tended to concentrate on response to treatment and types and severity of side effects and how to treat them. More patient-centered subjects of psychosocial character like coping and psychological well-being were discussed only briefly, if at all. Conclusions: This study adds to the information given by the existing communication analysis systems, and hence we suggest a development of the psychosocial content categories of those systems to make them more valid. Copyright © 2008 John Wiley & Sons, Ltd. [source] Patient expectation and satisfaction with nursing care in Turkey: a literature reviewINTERNATIONAL NURSING REVIEW, Issue 3 2007S. A. Özsoy phd Background:, Patient satisfaction is used as an important indicator of care quality and is frequently included in healthcare planning and evaluation. This study presents a review of research on patient expectation and satisfaction with nursing care in Turkey. Aim:, To review the national literature on patient expectations and satisfaction with nursing care. Methods:, The researchers reviewed 3089 articles of which 27 were discussed in detail. Of these 3089 articles, 1812 were from all issues of 14 Turkish nursing journals which have been published in the last 50 years, and 1277 articles were from 24 nursing congress and symposium books. Results:, The results of this study are divided into two categories: expectations concerning ,nursing care', and ,satisfaction with nursing care'. The findings show that there exist conceptual and philosophic deficiencies in the approaches to patient satisfaction and that there is a need to use standardized instruments to study and assess patient satisfaction in the future. Conclusion:, Over the last 20 years, studies of patient expectation and satisfaction with nursing care have been gaining high importance, but it is also noticed that in a national and philosophical approach the studies are not based on clearly defined concepts. Moreover, it has been concluded that there is a need for valid and reliable tools in the evaluation of satisfaction. [source] Prescription Duration After Drug Copay Changes in Older People: Methodological AspectsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2002Sebastian Schneeweiss MD OBJECTIVES: Impact assessment of drug benefits policies is a growing field of research that is increasingly relevant to healthcare planning for older people. Some cost-containment policies are thought to increase noncompliance. This paper examines mechanisms that can produce spurious reductions in drug utilization measures after drug policy changes when relying on pharmacy dispensing data. Reference pricing, a copayment for expensive medications above a fixed limit, for angiotensin-converting enzyme (ACE) inhibitors in older British Columbia residents, is used as a case example. DESIGN: Time series of 36 months of individual claims data. Longitudinal data analysis, adjusting for autoregressive data. SETTING: Pharmacare, the drug benefits program covering all patients aged 65 and older in the province of British Columbia, Canada. PARTICIPANTS: All noninstitutionalized Pharmacare beneficiaries aged 65 and older who used ACE inhibitors between 1995 and 1997 (N = 119,074). INTERVENTION: The introduction of reference drug pricing for ACE inhibitors for patients aged 65 and older. MEASUREMENTS: Timing and quantity of drug use from a claims database. RESULTS: We observed a transitional sharp decline of 11%± a standard error of 3% (P = .02) in the overall utilization rate of all ACE inhibitors after the policy implementation; five months later, utilization rates had increased, but remained under the predicted prepolicy trend. Coinciding with the sharp decrease, we observed a reduction in prescription duration by 31% in patients switching to no-cost drugs. This reduction may be attributed to increased monitoring for intolerance or treatment failure in switchers, which in turn led to a spurious reduction in total drug utilization. We ruled out the extension of medication use over the prescribed duration through reduced daily doses (prescription stretching) by a quantity-adjusted analysis of prescription duration. CONCLUSION: The analysis of prescription duration after drug policy interventions may provide alternative explanations to apparent short-term reductions in drug utilization and adds important insights to time trend analyses of drug utilization data in the evaluation of drug benefit policy changes. J Am Geriatr Soc 50:521,525, 2002. [source] Dementia incidence continues to increase with age in the oldest old: The 90+ studyANNALS OF NEUROLOGY, Issue 1 2010María M. Corrada ScD Objective The oldest old are the fastest growing segment of the US population, and accurate estimates of dementia incidence in this group are crucial for healthcare planning. Although dementia incidence doubles every 5 years from ages 65 to 90 years, it is unknown if this exponential increase continues past age 90 years. Here, we estimate age- and sex-specific incidence rates of all-cause dementia in people aged 90 years and older, including estimates for centenarians. Methods Participants are from The 90+ Study, a population-based longitudinal study of aging and dementia. Three hundred thirty nondemented participants aged 90 years and older at baseline were followed between January 2003 and December 2007. Age- and sex-specific incidence rates of all-cause dementia were estimated by person-years analysis. Results The overall incidence rate of all-cause dementia was 18.2% (95% confidence interval [CI], 15.3,21.5) per year and was similar for men and women (risk ratio, 0.94; 95% CI, 0.65,1.37). Rates increased exponentially with age from 12.7% per year in the 90,94-year age group, to 21.2% per year in the 95,99-year age group, to 40.7% per year in the 100+-year age group. The doubling time based on a Poisson regression was 5.5 years. Interpretation Incidence of all-cause dementia is very high in people aged 90 years and older and continues to increase exponentially with age in both men and women. Projections of the number of people with dementia should incorporate this continuing increase of dementia incidence after age 90 years. Our results foretell the growing public health burden of dementia in an increasingly aging population. ANN NEUROL 2010;67:114,121 [source] | ||||||||||