High quality care for people with chronic diseases.
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ABSTRACT:
SUBMITTER: Groves T
PROVIDER: S-EPMC554891 | biostudies-literature | 2005 Mar
REPOSITORIES: biostudies-literature
Publications
High quality care for people with chronic diseases.
Groves Trish T Wagner Edward H EH
BMJ (Clinical research ed.) 20050301 7492
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Project description:BackgroundChronic Non-Communicable Diseases (NCDs) represent a significant global challenge, especially in low- and middle-income countries. The introduction of digital health in Primary Health Care (PHC) has the potential to improve the quality of care for people with NCDs by offering tools such as telemedicine, mobile applications and other information and communication technologies. The aim of this study is to identify and map global experiences of using Information and Communication Technologies (ICTs) in primary care for non-communicable diseases and assess their impact on the quality of care in PHC.MethodsThis study presents a scoping review protocol based on the Joanna Briggs Institute criteria and the PRISMA-ScR guidelines. The review will be carried out in nine stages, including defining the aim and research questions, developing inclusion and exclusion criteria, and searching, selecting, extracting and analyzing the evidence. The databases consulted include MEDLINE/PubMed, JBI Evidence Synthesis and Open Science Framework.ResultsThe review will identify and map global experiences in the use of ICTs in primary care for NCDs and assess their impact on the quality of care in PHC. It is hoped to find studies that address the use of digital technologies for early detection, management and follow-up of NCDs, as well as their integration with traditional health systems.ConclusionsThe integration of digital technologies into PHC has the potential to improve the quality of care, but it can also accentuate inequities. It is necessary to consider digital health literacy, access to tools, and legal and ethical aspects of data protection. The review will highlight the need for robust policies and adequate infrastructure to support the effective implementation of digital health in PHC.
| S-EPMC11844851 | biostudies-literature
Project description:IntroductionIt is well-known that the prevalence of chronic diseases is high among older people, especially those who are poor. Moreover, chronic diseases can result in catastrophic health expenditure. The relationship between chronic diseases and their financial burden on households is thus double-sided, as financial difficulties can give rise to, and result from, chronic diseases. Our aim was to examine the levels of catastrophic health expenditure imposed by private out-of-pocket payments among older people diagnosed with diabetes mellitus, cardiovascular diseases and cancer in 15 European countries.MethodsThe SHARE dataset for individuals aged 50+ and their households, collected in 2010-2012 was used. The total number of participants included in this study was N = 51,661. The sample consisted of 43.8% male and 56.2% female participants. The average age was 67 years. We applied an instrumental variable approach for binary instrumented variables known as a treatment-effect model.ResultsWe found that being diagnosed with diabetes mellitus and cardiovascular diseases was associated with catastrophic health expenditure among older people even in comparatively wealthy countries with developed risk-pooling mechanisms. When compared to the Netherlands (the country with the lowest share of out-of-pocket payments as a percentage of total health expenditure in our study), older people diagnosed with diabetes mellitus in Portugal, Poland, Denmark, Italy, Switzerland, Belgium, the Czech Republic and Hungary were more likely to experience catastrophic health expenditure. Similar results were observed for diagnosed cardiovascular diseases. In contrast, cancer was not associated with catastrophic health expenditure.DiscussionOur study shows that older people with diagnosed chronic diseases face catastrophic health expenditure even in some of the wealthiest countries in Europe. The effect differs across chronic diseases and countries. This may be due to different socio-economic contexts, but also due to the specific characteristics of the different health systems. In view of the ageing of European populations, it will be crucial to strengthen the mechanisms for financial protection for older people with chronic diseases.
| S-EPMC4933384 | biostudies-literature
Project description:IntroductionLittle is known about how people who have abortions describe high-quality interpersonal care in Argentina. This qualitative study aimed to understand preferences and priorities in their interactions with providers.Study designWe conducted 24 in-depth interviews with people who obtained abortions at a comprehensive reproductive health clinic or with support from a feminist accompaniment group in Buenos Aires and Neuquén, Argentina. We iteratively coded transcripts using a thematic analysis approach based on interpersonal domains present in current quality of care frameworks.ResultsParticipants described high-quality abortion care as feeling acompañamiento and contención from their providers - terms that imply receiving kind, caring, compassionate and emotionally supportive care throughout their abortion. They described four key elements of interpersonal interactions: attentive communication from providers and accompaniers, clear and understandable information provision, non-judgmental support, and individualized options for pain management.ConclusionsPeople obtaining abortions in Argentina consistently identified receiving compassionate and supportive care throughout an abortion as a key aspect of care. The findings have implications for incorporating people's perspectives in the development of care guidelines, training of providers, and monitoring and improving of services. This is particularly important as the government of Argentina prepares to expand legal access to abortion.
| S-EPMC9059438 | biostudies-literature
Project description:BackgroundThe number of multiple chronically ill older people is increasing and multimorbidity is associated with high utilization of health services. Integrated care management is increasingly used to address this problem; however, there is a substantial lack of reliable data on its effectiveness in this target group.ObjectiveTo assess the effectiveness of components of integrated care management in adults of all ages and to estimate the transferability to older, multimorbid people in Germany.MethodsA systematic search was carried out in the Cochrane Library for Cochrane reviews (CR) on (a) the 13 most frequent health problems in old age, which (b) evaluated components of integrated care management in (c) adults of all ages. Experts assessed the transferability of the included CR to multiple chronically ill older people in Germany.ResultsOut of 1412 hits 126 CR were included. Regarding independence and functional health outcomes, 25 CR showed clinically relevant results with at least a moderate level of evidence. The following intervention components were estimated to be transferable and could be adapted to be part of an effective integrated care management for multimorbid chronically ill older people, specified by indications and taking identified barriers into account: (1) physical activation, (2) multidisciplinary interventions (3) interventions that enhance self-management, (4) cognitive therapy modalities, (5) telemedical interventions and (6) disease management programs.ConclusionThe effectiveness of the identified components in frail older patients should be assessed in care-related and patient-related randomized controlled studies.
| S-EPMC7835300 | biostudies-literature
Project description:The purpose of this study is to conduct a comparative analysis of the impact of the accessibility and quality of medical care provided to patients with chronic noncommunicable diseases (CNCDs) during COVID-19 pandemic on the course and outcome of COVID-19 infection. The study included 132 patients hospitalized with a diagnosis of COVID-19 and having one or more concomitant CNCDs. The patients were divided into two groups based on the quality of the initial CNCD therapy they received. Group 1 involved 58 patients (42%) who received treatment according to clinical guidelines and had a compensated CNCD. Group 2 consisted of 76 patients (58%) who received treatment that was not in line with modern clinical guidelines and/or had a decompensated CNCD. All 'red zone' hospitalized patients were surveyed. In particular, they were asked questions related to the quality and accessibility of medical care during COVID-19 pandemic and their satisfaction with the medical care received during the pandemic. Reduced access to medical care (the failure to have the therapy received timely evaluated and adjusted) during COVID-19 pandemic affects the quality of the therapy received by patients with CNCDs. Generally, an unfavorable course and outcome of COVID-19 infection are typical for patients receiving a non-optimal CNCD therapy as compared to patients receiving a therapy that meets current clinical guidelines.
| S-EPMC10063946 | biostudies-literature
Project description:During the COVID-19 outbreak, the European Reference Network on Rare Bone Diseases (ERN BOND) coordination team and Italian rare bone diseases healthcare professionals created the "COVID-19 Helpline for Rare Bone Diseases" in an attempt to provide high-quality information and expertise on rare bone diseases remotely to patients and healthcare professionals. The present position statement describes the key characteristics of the Helpline initiative, along with the main aspects and topics that recurrently emerged as central for rare bone diseases patients and professionals. The main topics highlighted are general recommendations, pulmonary complications, drug treatment, trauma, pregnancy, children and elderly people, and patient associations role. The successful experience of the "COVID-19 Helpline for Rare Bone Diseases" launched in Italy could serve as a primer of gold-standard remote care for rare bone diseases for the other European countries and globally. Furthermore, similar COVID-19 helplines could be considered and applied for other rare diseases in order to implement remote patients' care.
| S-EPMC7456755 | biostudies-literature
Project description:Many countries are introducing smaller, more home-like care facilities that represent a radically new approach to nursing home care for people with dementia. The green care farm is a new type of nursing home developed in the Netherlands. The goal of this study was to compare quality of care, quality of life and related outcomes in green care farms, regular small-scale living facilities and traditional nursing homes for people with dementia.A cross-sectional design was used. Three types of nursing homes were included: (1) green care farms; (2) regular small-scale living facilities; (3) traditional nursing homes. All participating nursing homes were non-profit, collectively funded nursing homes in the south of the Netherlands. One hundred and fifteen residents with a formal diagnosis of dementia were included in the study. Data on quality of care was gathered and consisted of outcome indicators (e.g. falling incidents, pressure ulcers), structure indicators (e.g. hours per resident per day), and process indicators (e.g. presence, accessibility and content of protocols on care delivery). Furthermore, questionnaires on cognition, dependence in activities of daily living, quality of life, social engagement, neuropsychiatric symptoms, agitation, and depression were used.Data showed that quality of care was comparable across settings. No large differences were found on clinical outcome measures, hours per resident per day, or process indicators. Higher quality of life scores were reported for residents of green care farms in comparison with residents of traditional nursing homes. They scored significantly higher on the Quality of Life - Alzheimer's disease Scale (p < 0.05, ES = 0.8) indicating a better quality of life. In addition, residents of green care farms scored higher on three quality of life domains of the Qualidem: positive affect, social relations and having something to do (p < 0.05, ES > 0.7). No differences with regular small-scale living facilities were found.Green care farms seem to be a valuable alternative to existing nursing homes. This is important as people with dementia are a heterogeneous group with varying needs. In order to provide tailored care there also is a need for a variety of living environments.
| S-EPMC5518159 | biostudies-other
Project description:Most persons with chronic hepatitis C virus (HCV) infection in the United States are undiagnosed or linked to care. We describe a program for the management of Alaska Native patients infection utilizing a computerized registry and statewide liver clinics resulting in higher linkage to care (86%) than national estimates (~25%).
| S-EPMC7047515 | biostudies-literature
Project description:The study examines the meaning of good-quality social care for people with Parkinson's disease and their carers. It identifies, from their perspective, the impact of good-quality social care on health and well-being.Qualitative case study methodology, interview and framework analysis techniques were used.community locations in the north and midlands of England.Data were collected from 43 participants including individual interviews with people with Parkinson's disease (n=4), formal and informal social care providers (n=13), 2 focus groups, 1 with people with Parkinson's disease and their carers (n=17), and 1 with professionals (n=8), plus a telephone interview with a former commissioner.Good-quality social care, delivered in a timely fashion, was reported to have a positive impact on health. Furthermore, there is an indication that good-quality social care can prevent untoward events, such as infections, symptom deterioration and deterioration in mental health. The concept of the 'Impact Gap' developed from the findings, illustrates how the costs of care may be reduced by delivering good-quality social care. Control, choice and maintaining independence emerged as indicators of good-quality social care, irrespective of clinical condition. Participants identified characteristics indicative of good-quality social care specific to Parkinson's disease, including understanding Parkinson's disease, appropriate administration of medication, timing of care and reassessment. 'Parkinson's aware' social care was seen to generate psychological, physical and social benefits that were inter-related.The findings indicate how maximising quality in social care delivery for people with Parkinson's disease can impact on health and well-being. Long-term or short-term benefits may result in prevented events and reductions in health and social care resource. Health professionals can be instrumental in early detection of and signposting to social care.
| S-EPMC4762087 | biostudies-other
Project description:PurposeThe objective of this systematic review was to determine the characteristics of the interventions conducted by nurses that attempt to improve the health related quality of life (HRQoL) of people over 18 years of age with chronic diseases.MethodsThis systematic review with meta-analysis summarizes 24 studies, conducted in 10 countries, that evaluated HRQoL through the Short-Form Health Survey (SF). Five databases were accessed to find the available studies from December 31st, 2000 to May 22sd, 2017. Selected studies were coded according to the characteristics of the sample and the intervention. A model of random effects was adopted for the overall estimation and to explain the heterogeneity.ResultsTwenty-four studies were included in the systematic review and meta-analysis providing a sample of 4324 chronic patients aged 63.4 years. Among the 8 subscales and two summary measures that comprise the SF-36, only an overall significant effect size (ES) index was found in the Mental Health Component summary score (ES = 0.14; 95% CI:0.03 - 0.26; I2 = 44.6, p = 0.042) and the Mental Health subscale. This improvement on HRQoL was associated to interventions on "Case Management" and "Treatments and Procedures", which were based on a theory, were of shorter duration, and had a follow-up period.ConclusionsInterventions targeting people with chronic diseases resulted in a slight increase in the HRQoL that was not always significant, which suggests that there is a need for their continuous improvement.
| S-EPMC6590814 | biostudies-literature