Health Care

This paper presents the development of a network platform which allows connecting multiple individual wireless devices for transmitting bioelectrics and biomechanics signals for application in a hospital network, or continuous monitoring in a patient's diary life. The Zigbee platform development proposal was made in three stages: 1) Hardware development, including the construction of a prototype network node and the integration of sensors, (2) Evaluation, in order to define the specifications of each node and scope of communication and (3) The Zigbee Network Implementation for bioinstrumentation based on ZigBee Health Care public application profile (ZHC). Finally, this work presents the experimental results based on measurements of Lost Packets and LQI (Link Quality Indicator), and the Zigbee Platform configuration for Bioinstrumentation in operation.

Emergency Medical Services (EMS) constitute a unique component of health care at the interface between primary and hospital care. EMS data within the pre-hospital setting represents an unparalleled source of epidemiological and health care information that have so far been neglected for public health monitoring. The European Emergency Data Project (EED Project) thus intends to identify common indicators for European EMS systems and to evaluate their suitability for integration into a comprehensive public health monitoring strategy. The article provides a brief overview on objectives and methodology in the form of a progress report.

The GRADE method represents a new approach to grading the quality of evidence and strength of recommendations in the preparation of Clinical Practice Guidelines (CPG). In the context of a pilot study to assess the implementability of the system in Spain, we considered it relevant to gain an insight into the significance of the perceptions and attitudes expressed by the actual experts participating in the system try-out. Qualitative research with an ethnographic approach, through non-participant observation and focus groups within the context of a consensus workshop in which 19 CPG experts participated to evaluate the GRADE proposal using 12 evidence tables taken from hypertension, asthma and arthritis CPGs. The interventions were recorded, under a guarantee of confidentiality. The transcriptions and field notes were analyzed, based on a sociological discourse analysis model, and the provisional findings were re-sent to participants in order to improve their validity. 1) Certain prob...

Este artigo tem como objetivo dar uma visão geral dos estudos existentes acerca do processo de viver da pessoa ostomizada. Para tal, foi efetuada uma revisão de literatura que deu especial enfoque às alterações fisiológicas, psico-emocionais e sociais que ocorrem após a intervenção, em relação às quais, é essencial que a pessoa se re-estruture, no sentido de manter sua integridade. O suporte familiar e o atendimento profissional personalizado são indispensáveis na adaptação da pessoa à sua nova condição.

Pengkajian fisik adalah suatu cara untuk mendapatkan informasi tentang anak dan keluarganya dengan menggunakan semua pancaindra baik subjektif maupun objektif. Pengakajian fisik bayi baru lahir dan perkembangannya dilakukan bersamaan pada waktu melakukan pemeriksaan secara inspeksi maupun observasi. (Sari Wahyuni SST, 2002)

OBJECTIVES: To examine the association of medication adherence with healthcare use and costs among Medicaid beneficiaries with congestive heart failure (CHF), to investigate whether the association was a graded one, and to estimate the potential savings due to improved adherence.STUDY DESIGN: Using Medicare and Medicaid data for 4 states, adherence was estimated using the medication possession ratio (MPR).METHODS: Multivariate logistic and 2-part general linear models were estimated to study the primary objectives. The MPR was specified in multiple ways to examine its association with healthcare use and costs.RESULTS: Adherent beneficiaries were less likely to have a hospitalization (0.4 percentage points), had fewer hospitalizations (13%), had in excess of 2 fewer inpatient days (25%), were less likely to have an emergency department (ED) visit (3%), and had fewer ED visits (10%) than nonadherent beneficiaries. Total healthcare costs were $5910 (23%) less per year for adherent beneficiaries compared with nonadherent beneficiaries. The relationship between medication adherence and healthcare costs was graded. For example, beneficiaries with adherence rates of 95% or higher had about 15% lower healthcare costs than those with adherence rates between 80% and less than 95% ($17,665 vs $20,747, P <.01). The relationship between adherence and total healthcare costs was even more stark when the most adherent beneficiaries were segmented into finer subgroups.CONCLUSIONS: Healthcare costs among Medicaid beneficiaries with CHF would be lower if more patients were adherent to prescribed medication regimens. Researchers should reconsider whether a binary threshold for adherence is sufficient to examine the association of adherence with outcomes and healthcare costs.

Hurricanes Katrina and Rita brought the utility and importance of electronic, easily portable personal health records (PHRs) starkly to light in fall 2005. A new issue brief describes the role that PHRs—comprehensive paper- or electronic-based systems recording an individual&#39;s health-related information over time—can play in reducing health care disparities. The brief also looks at barriers to PHR adoption for underserved individuals and the implications of widespread use of PHRs. Based on focus groups conducted with individuals from medically underserved, low-income minority groups from New Brunswick, NJ, the brief suggests that a variety of outreach efforts may be needed by developers of PHR systems to overcome consumer mistrust before PHRs are accepted on a wider scale.

As a major provider of health care for racial and ethnic minority groups, the federal government has affirmed its commitment to the elimination of health disparities. Although numerous studies have examined health care disparities in various federal systems of care, few have examined these issues within TRICARE, the Department of Defense (DoDJ&#39;s program for providing health care coverage to members of the uniformed services and their dependents. This study provides an exploratory analysis examining apparent disparities in health status, access to and satisfaction with care, and use of preventive care using the 2007 Health Care Survey of DoD Beneficiaries. Analyses compare outcomes by race/ethnicity and between TRICARE beneficiaries and national norms derived from the National Consumer Assessment of Health Plans Study Benchmarking Database and the National Healthcare Disparities Report, and are stratified by duty status. Compared to black non-Hispanics, a higher proportion of whi...

To examine the association of medication adherence with healthcare use and costs among Medicaid beneficiaries with congestive heart failure (CHF), to investigate whether the association was a graded one, and to estimate the potential savings due to improved adherence. Using Medicare and Medicaid data for 4 states, adherence was estimated using the medication possession ratio (MPR). Multivariate logistic and 2-part general linear models were estimated to study the primary objectives. The MPR was specified in multiple ways to examine its association with healthcare use and costs. Adherent beneficiaries were less likely to have a hospitalization (0.4 percentage points), had fewer hospitalizations (13%), had in excess of 2 fewer inpatient days (25%), were less likely to have an emergency department (ED) visit (3%), and had fewer ED visits (10%) than nonadherent beneficiaries. Total healthcare costs were $5910 (23%) less per year for adherent beneficiaries compared with nonadherent benef...

Personal health information is a valuable resource to individuals and their families, as well as health care providers. This issue brief describes the features of 21 software-based Personal Health Records (PHRs) and assesses whether the features match the needs and preferences of underserved individuals, most of them minorities who face economic, cultural, or linguistic barriers to health care, and often