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Background: The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study: The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Material and methods: Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results: 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions: A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.
Background: Multiple sclerosis is a chronic and highly debilitating disease with very high economic and social consequences. Designing changes to improve the functioning of the healthcare model primarily requires learning about the needs of beneficiaries. Aim of the study: The purpose of our study is the results’ description and summary of conclusions of the research conducted in the past years. These results are currently being used for the construction of a coordinated care model for MS patients. Material and methods: One questionnaire survey addressed to MS patients, carried out between 01.12.2013 and 01.02.2014 and the second one addressed to Polish and European medical professionals, carried out between 01.09.2016 and 04.10.2016 performed in 51 European centers and 2 branches of the Turkish Association of patients with MS. Results: In the first survey 84.4% patients declared that during the illness they received mental support mostly from their family: 48.5% received it from physicians; 42.1% from a nurse. 64.8% of the respondents declared that they received no support from social organizations and 77.6% received no support from religious organizations. According to the results of the survey for healthcare professionals in Poland and Europe, in 54.9% of the European institutions and in 22.4% of the Polish institutions, dedicated IT systems are used for processing MS patients’ data. Among institutions using IT, 52.9% of the European and 10.1% of the Polish ones keep the patient’s entire documentation, as well as a patient satisfaction survey, in an IT system. Conclusions: Based on our studies described above, the patients’ needs, resources and capabilities seem to indicate that the scale of system inefficiencies is such that remodeling care for this well-defined group of patients is justified and feasible.
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