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Financiamento hospitalar em Portugal : incentivos à selecção e equidade

Nunes, Patrícia Sofia Oliveira Fonseca
Fonte: Universidade Nova de Lisboa. Escola Nacional de Saúde Pública Publicador: Universidade Nova de Lisboa. Escola Nacional de Saúde Pública
Tipo: Dissertação de Mestrado
Publicado em //2012 POR
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46.06%
RESUMO - Contexto: O sistema de financiamento do internamento hospitalar público Português é de natureza prospectiva, através de um orçamento global baseado no casemix para os doentes do Serviço Nacional de Saúde (SNS) e de um pagamento por episódio para os doentes dos subsistemas. Em ambos os casos, o financiamento baseia-se principalmente nos Grupos de Diagnóstico Homogéneos (GDH) correspondentes a cada episódio, seja para atribuir um preço por doente saído no caso dos doentes dos subsistemas, seja para calcular o casemix do hospital no caso dos doentes do SNS. Atendendo à heterogeneidade de utilização de recursos intra GDH, resultante das características e necessidades individuais de cada doente, é expectável que o hospital, tendo em vista a garantia da sustentabilidade económica e financeira e/ou a obtenção de mais-valias, procure que o custo de produção fique aquém do preço médio pago, o que pode resultar na selecção de doentes. Por outro lado, ao não ser tida em conta no financiamento, e na ausência de selecção, a heterogeneidade intra GDH pode resultar na injusta recompensa/penalização de uns hospitais em detrimento de outros, tendo em conta as características e necessidades da população que servem e pelas quais não são compensados. Objectivos: O presente estudo propôs-se...

Carotid artery surgery: back to the future

Bosiers,Marc; Kleinsorge,Gustavo Henrique Dumont; Koen,Deloose; Navarro,Túlio Pinho
Fonte: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) Publicador: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2011 EN
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In this study we performed 548 carotid revascularizations between 2006 and 2008 at the Department of Vascular Surgery of the A.Z. Sint-Blasius, Dendermonde, Belgium - a high-volume experienced center for carotid artery stenting (CAS). In 2006, our 30-day complication rates were 3.21 and 1.51% for symptomatic and asymptomatic patients, respectively. At that time, CAS represented approximately 86% of all cases we performed. However, the publication of the results of EVA-3S and SPACE studies drove us to reconsider our treatment allocation algorithm. In 2007 and 2008, CAS procedures only accounted for 43% of all carotid procedures, which was a result of strict patient selection with comorbidities and high-risk lesions assessment, especially in symptomatic patients. Our current 30-day stroke/death rates are 1.24% for symptomatic patients and 0.53% for asymptomatic ones, which reflects that correct patient selection is the key to maintain CAS as a valuable alternative to carotid endarterectomy.

Predictors of Patient Selection in Bariatric Surgery

Santry, Heena P.; Lauderdale, Diane S.; Cagney, Kathleen A.; Rathouz, Paul J.; Alverdy, John C.; Chin, Marshall H.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /01/2007 EN
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45.87%
Population-based studies have shown racial, gender-based, and socioeconomic disparities among bariatric surgery patients. A national survey of U.S. bariatric surgeons using clinical vignettes reveals that age, body mass index, and social support are the chief determinants of patient selection for bariatric surgery. Comorbidities, functional status, and payment source influence surgeon decisions to a lesser extent with little or no influence from patient sex or race.

Is Patient Selection Important for Hip Resurfacing?

Nunley, Ryan M.; Della Valle, Craig J.; Barrack, Robert L.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
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46.03%
The optimal implant option for hip arthroplasty in the young, active patient remains controversial. There has been renewed interest for metal-on-metal hip resurfacing due to improved design and manufacturing of implants, better materials, enhanced implant fixation, theoretical advantages over conventional total hip arthroplasty, and recent Food and Drug Administration approval of two devices. Recent studies indicate satisfactory short- and midterm clinical results (1- to 10-year followup) with low complication rates, but there is a learning curve associated with this procedure, a more extensive surgical approach is necessary, and long-term results have yet to be determined. Proper patient selection may help avoid complications and improve patient outcomes. Patient selection criteria in the literature appear based predominantly on theoretical considerations without any consensus on stratifying patient risk. The most commonly reported complications encountered with hip resurfacing include femoral neck fracture, acetabular component loosening, metal hypersensitivity, dislocation, and nerve injury. At the time of clinical evaluation, patient age; gender; diagnosis; bone density, quality, and morphology; activity level; leg lengths; renal function; and metal hypersensitivity are important factors when considering a patient for hip resurfacing. Based on our review...

Catastrophic osteomyelitis following percutaneous wire fixation of a distal radial fracture: a cautionary tale of poor patient selection followed by surgical mishap

Shields, David W; Elson, David W; Marsh, Martin; Gray, Andrew C
Fonte: BMJ Publishing Group Publicador: BMJ Publishing Group
Tipo: Artigo de Revista Científica
Publicado em 25/01/2013 EN
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We present a case of distal radius fracture. Several sequential unfortunate events resulted in a poor outcome. The patient was poorly selected because the degree of early dementia was not fully appreciated, due to intermittent periods of lucidity. Having elected to treat this distal radius fracture with Kirschner wires, a wire snapped during the procedure and was deemed safe to leave within the medullary cavity. Subsequently, the patient was left in a cast for 4 weeks without regular pin site inspection. When the cast was removed a gross osteomyelitis had developed. This series of events, led to unnecessary morbidity and extended the immobilisation time with reduced wrist function. This case highlights the importance of careful patient selection, surgical tactics and continuity of care.

Update on prescription extended-release opioids and appropriate patient selection

Brennan, Michael J
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Publicado em 23/07/2013 EN
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45.87%
Chronic pain is largely underdiagnosed, often undertreated, and expected to increase as the American population ages. Many patients with chronic pain require long-term treatment with analgesic medications, and pain management may involve use of prescription opioids for patients whose pain is inadequately controlled through other therapies. Yet because of the potential for abuse and addiction, many clinicians hesitate to treat their patients with pain with potentially beneficial agents. Finding the right opioid for the right patient is the first – often complicated – step. Ensuring that patients continue to properly use the medication while achieving therapeutic analgesic effects is the long-term goal. Combined with careful patient selection and ongoing monitoring, new formulations using extended-release technologies incorporating tamper-resistant features may help combat the growing risk of abuse or misuse, which will hopefully reduce individual suffering and the societal burden of chronic pain. The objective of this manuscript is to provide an update on extended-release opioids and to provide clinicians with a greater understanding of which patients might benefit from these new opioid formulations and how to integrate the recommended monitoring for abuse potential into clinical practice.

Patient selection for transcatheter aortic valve implantation: An interventional cardiology perspective

Mylotte, Darrren; Martucci, Giuseppe; Piazza, Nicolo
Fonte: AME Publishing Company Publicador: AME Publishing Company
Tipo: Artigo de Revista Científica
Publicado em /07/2012 EN
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46.01%
Transcatheter aortic valve implantation (TAVI) has emerged as a highly effective minimally invasive treatment symptomatic for severe calcific aortic stenosis in patients at high or prohibitive surgical risk. The success of TAVI has been determined by a number of factors, but in particular by appropriate patient selection. Appropriate patient selection involves identifying patients with the potential to benefit most from TAVI and individualizing the bioprosthesis type and size, and the vascular access site for each case. We present herein, our critical appraisal on patient selection for TAVI: an interventional cardiology perspective.

Considerations for patient selection for focal therapy

Ward, John F.; Pisters, Louis L.
Fonte: SAGE Publications Publicador: SAGE Publications
Tipo: Artigo de Revista Científica
Publicado em /12/2013 EN
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46.07%
Focal therapy for prostate cancer is a nascent and emerging field. As such, the patient selection criteria for this new treatment paradigm are evolving in parallel to both the technology on which this approach depends and to our unfolding understanding of the natural history of prostate cancer. Until, and while, prospective trials of focal therapy are being reported, patient selection criteria will be flexible and very dependent on the therapeutic goals. We must carefully define the therapeutic intentions of focal therapy before engaging in the actual process of determining optimal patient selection. The therapeutic intent will define the most appropriate candidate for such therapy. Patient selection encompasses multiple complex issues including the type of prostate biopsy (12 core transrectal versus mapping transperineal) to the type of imaging (multiparametric magnetic resonance imaging or enhanced ultrasound) to the specific anatomical location of the disease within the prostate (apex, mid-prostate, base) and a comprehensive assessment of the patient’s overall health and life expectancy. It is not as simple as saying a patient with a certain grade or a certain number of cores is or is not appropriate for focal therapy. There are many more considerations for a reasonable and thoughtful approach to this new treatment.

Strategies to optimize shock wave lithotripsy outcome: Patient selection and treatment parameters

Semins, Michelle Jo; Matlaga, Brian R
Fonte: Baishideng Publishing Group Inc Publicador: Baishideng Publishing Group Inc
Tipo: Artigo de Revista Científica
EN
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45.99%
Shock wave lithotripsy (SWL) was introduced in 1980, modernizing the treatment of upper urinary tract stones, and quickly became the most commonly utilized technique to treat kidney stones. Over the past 5-10 years, however, use of SWL has been declining because it is not as reliably effective as more modern technology. SWL success rates vary considerably and there is abundant literature predicting outcome based on patient- and stone-specific parameters. Herein we discuss the ways to optimize SWL outcomes by reviewing proper patient selection utilizing stone characteristics and patient features. Stone size, number, location, density, composition, and patient body habitus and renal anatomy are all discussed. We also review the technical parameters during SWL that can be controlled to improve results further, including type of anesthesia, coupling, shock wave rate, focal zones, pressures, and active monitoring. Following these basic principles and selection criteria will help maximize success rate.

Reducing Wrong Patient Selection Errors: Exploring the Design Space of User Interface Techniques

Sopan, Awalin; Plaisant, Catherine; Powsner, Seth; Shneiderman, Ben
Fonte: American Medical Informatics Association Publicador: American Medical Informatics Association
Tipo: Artigo de Revista Científica
Publicado em 14/11/2014 EN
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Wrong patient selection errors are a major issue for patient safety; from ordering medication to performing surgery, the stakes are high. Widespread adoption of Electronic Health Record (EHR) and Computerized Provider Order Entry (CPOE) systems makes patient selection using a computer screen a frequent task for clinicians. Careful design of the user interface can help mitigate the problem by helping providers recall their patients’ identities, accurately select their names, and spot errors before orders are submitted. We propose a catalog of twenty seven distinct user interface techniques, organized according to a task analysis. An associated video demonstrates eighteen of those techniques. EHR designers who consider a wider range of human-computer interaction techniques could reduce selection errors, but verification of efficacy is still needed.

Hematopoietic stem cell transplantation in sickle cell disease: patient selection and special considerations

Bhatia, Monica; Sheth, Sujit
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Publicado em 10/07/2015 EN
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45.87%
Hematopoietic stem cell transplantation remains the only curative treatment currently in use for patients with sickle cell disease (SCD). The first successful hematopoietic stem cell transplantation was performed in 1984. To date, approximately 1,200 transplants have been reported. Given the high prevalence of this disorder in Africa, and its emergence in the developed world through immigration, this number is relatively small. There are many reasons for this; primary among them are the availability of a donor, the risks associated with this complex procedure, and the cost and availability of resources in the developing world. Of these, it is fair to say that the risks associated with the procedure have steadily decreased to the point where, if currently performed in a center with experience using a matched sibling donor, overall survival is close to 100% and event-free survival is over 90%. While there is little controversy around offering hematopoietic stem cell transplantation to symptomatic SCD patients with a matched sibling donor, there is much debate surrounding the use of this modality in “less severe” patients. An overview of the current state of our understanding of the pathology and treatment of SCD is important to show that our current strategy is not having the desired impact on survival of homozygous SCD patients...

Accelerated partial breast irradiation with brachytherapy: patient selection and technique considerations

Trifiletti, Daniel M; Romano, Kara D; Showalter, Shayna L; Reardon, Kelli A; Libby, Bruce; Showalter, Timothy N
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Publicado em 29/07/2015 EN
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45.93%
Accelerated partial breast irradiation (APBI) through breast brachytherapy is a relatively recent development in breast radiotherapy that has gained international favor because of its reduction in treatment duration and normal tissue irradiation while maintaining favorable cancer-specific and cosmetic outcomes. Despite the fact that several large national trials have not reported final results yet, many providers are currently offering APBI to select patients and APBI is listed as a treatment option for selecting patients in the National Comprehensive Cancer Network guidelines. Multiple consensus guidelines exist in selecting patients for APBI, some with conflicting recommendations. In this review, the existing patient selection guidelines are reported, compared, and critiqued, grouping them in helpful subcategories. Unique patient and technical selection factors for APBI with brachytherapy are explored.

Systematic review of safety and effectiveness of an artificial bowel sphincter for faecal incontinence

Mundy, L.; Merlin, T.; Maddern, G.; Hiller, J.
Fonte: John Wiley & Sons Ltd Publicador: John Wiley & Sons Ltd
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
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BACKGROUND: The aim was to determine the safety and effectiveness of the implantation of an artificial bowel sphincter for the treatment of severe faecal incontinence. METHOD: Medical bibliographic databases, the internet and reference lists were searched from January 1966 to January 2003. Only the lowest level of evidence was available for inclusion in this systematic review. Case series and case reports were selected to assess safety, whereas only case series were selected to assess effectiveness. RESULTS: Fourteen studies met the inclusion criteria. A number of safety issues were reported, including high explantation rates, and rates of adverse events owing to infection, device malfunction, ulceration and pain. Results in published reports were not analysed on an intention-to-treat basis. Continence, quality of life and manometry scores were reported for patients with a functioning device at the end of follow-up. These patients experienced a significant improvement in their level of continence. As no outcome data were presented for those with a non-functioning or explanted device, it is possible that such patients may have a worsened degree of incontinence or decreased quality of life. CONCLUSION: Implantation of an artificial bowel sphincter is of uncertain benefit and may possibly harm many patients. Patient selection is therefore critical and should be enhanced by higher-quality research.; L. Mundy...

Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

Costa Filho,Francisco Flávio; Chaves,Áurea Jacob; Ligabó,Lourenço Teixeira; Santos,Eduardo Moreira dos; Silva,Danillo Taiguara da; Puzzi,Marcelo Aguiar; Braga,Sérgio Luiz; Abizaid,Alexandre; Sousa,Amanda GMR
Fonte: Sociedade Brasileira de Cardiologia - SBC Publicador: Sociedade Brasileira de Cardiologia - SBC
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
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66.01%
AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD), a clinical (non-invasive) evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77), age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26), diabetes (OR, 2.01; CI 95%, 1.40 - 2.90), dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07), typical angina (OR, 2.92; CI 95%, 1.77 - 4.83) and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27).Conclusions:In this study...

Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

Costa Filho,Francisco Flávio; Chaves,Áurea Jacob; Ligabó,Lourenço Teixeira; Santos,Eduardo Moreira dos; Silva,Danillo Taiguara da; Puzzi,Marcelo Aguiar; Braga,Sérgio Luiz; Abizaid,Alexandre; Sousa,Amanda GMR
Fonte: Sociedade Brasileira de Cardiologia - SBC Publicador: Sociedade Brasileira de Cardiologia - SBC
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2015 EN
Relevância na Pesquisa
66.01%
AbstractBackground:Guidelines recommend that in suspected stable coronary artery disease (CAD), a clinical (non-invasive) evaluation should be performed before coronary angiography.Objective:We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD.Methods:We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests.Results:A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77), age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26), diabetes (OR, 2.01; CI 95%, 1.40 - 2.90), dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07), typical angina (OR, 2.92; CI 95%, 1.77 - 4.83) and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27).Conclusions:In this study...

Effects of patient selection on the applicability of results from a randomised clinical trial (EORTC 10853) investigating breast-conserving therapy for DCIS

Bijker, N; Peterse, J L; Fentiman, I S; Julien, J-P; Hart, A A M; Avril, A; Cataliotti, L; Rutgers, E J T
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
Publicado em 09/09/2002 EN
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45.92%
Selection of patients for randomised clinical trials may have a large impact on the applicability of the study results to the general population presenting the same disorder. However, clinical characteristics and outcome data on non-entered patients are usually not available. The effects of patient selection for the EORTC 10853 trial investigating the role of radiotherapy in breast conserving therapy for ductal carcinoma in situ have been studied, in an analysis of all patients treated for ductal carcinoma in situ in five participating institutes. The reasons for not entering patients were evaluated and treatment results of the randomised patients were compared to those not entered. A total of 910 patients were treated for ductal carcinoma in situ. Of these, 477 (52%) were ineligible, with the size of the lesion being the main reason for ineligibility (30% of all ductal carcinoma in situ). Of the 433 eligible patients, 278 (64%) were randomised into the trial. The main reasons for non-entry of eligible patients were either physicians' preference for one of the treatment arms (26%) or patients' refusal (9%). These percentages showed significant variation among the institutes. At 4 years follow-up, those patients not entered in the trial and treated with local excision and radiotherapy...

The Role of Imaging in Patient Selection, Preoperative Planning, and Postoperative Monitoring in Human Upper Extremity Allotransplantation

Roth, Eira S.; Buck, David G.; Gorantla, Vijay S.; Losee, Joseph E.; Foust, Daniel E.; Britton, Cynthia A.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
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45.87%
Objective. To describe the role of imaging in vascular composite allotransplantation based on one institution's experience with upper extremity allotransplant patients. Methods. The institutional review board approved this review of HIPAA-compliant patient data without the need for individual consent. A retrospective review was performed of imaging from 2008 to 2011 on individuals undergoing upper extremity transplantation. This demonstrated that, of the 19 patients initially considered, 5 patients with a mean age of 37 underwent transplantation. Reports were correlated clinically to delineate which preoperative factors lead to patient selection versus disqualification and what concerns dictated postoperative imaging. Findings were subdivided into musculoskeletal and vascular imaging criterion. Results. Within the screening phase, musculoskeletal exclusion criterion included severe shoulder arthropathy, poor native bone integrity, and marked muscular atrophy. Vascular exclusion criterion included loss of sufficient arterial or venous supply and significant distortion of the native vascular architecture. Postoperative imaging was used to document healing and hardware integrity. Postsurgical angiography and ultrasound were used to monitor for endothelial proliferation or thrombosis as signs of rejection and vascular complication. Conclusion. Multimodality imaging is an integral component of vascular composite allotransplantation surgical planning and surveillance to maximize returning form and functionality while minimizing possible complications.

Endoscopic bronchial valve treatment: patient selection and special considerations

Eberhardt, Ralf; Gompelmann, Daniela; Herth, Felix JF; Schuhmann, Maren
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Publicado em 08/10/2015 EN
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45.91%
As well as lung volume reduction surgery, different minimally invasive endoscopic techniques are available to achieve lung volume reduction in patients with severe emphysema and significant hyperinflation. Lung function parameters and comorbidities of the patient, as well as the extent and distribution of the emphysema are factors to be considered when choosing the patient and the intervention. Endoscopic bronchial valve placement with complete occlusion of one lobe in patients with heterogeneous emphysema is the preferred technique because of its reversibility. The presence of high interlobar collateral ventilation will hinder successful treatment; therefore, endoscopic coil placement, polymeric lung volume reduction, or bronchoscopic thermal vapor ablation as well as lung volume reduction surgery can be used for treating patients with incomplete fissures. The effect of endoscopic lung volume reduction in patients with a homogeneous distribution of emphysema is still unclear and this subgroup should be treated only in clinical trials. Precise patient selection is necessary for interventions and to improve the outcome and reduce the risk and possible complications. Therefore, the patients should be discussed in a multidisciplinary approach prior to determining the most appropriate treatment for lung volume reduction.

Patient Selection in the ESRD Managed Care Demonstration

Shapiro, Jennifer R.; Dykstra, Dawn M.; Pisoni, Ron; Beronja, Nancy; Gaylin, Daniel S.; Oppenheimer, Caitlin Carroll; Rubin, Robert J.; Held, Philip J.
Fonte: CENTERS for MEDICARE & MEDICAID SERVICES Publicador: CENTERS for MEDICARE & MEDICAID SERVICES
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
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45.93%
The Centers for Medicare & Medicaid Service's (CMS') end stage renal disease (ESRD) managed care demonstration offered an opportunity to assess patient selection among a chronically ill and inherently costly population. Patient selection refers to the phenomenon whereby those Medicare beneficiaries who choose to enroll or stay in health maintenance organizations (HMOs) are, on average, younger, healthier, and less costly to treat than beneficiaries who remain in the traditional Medicare fee-for-service (FFS) sector. The results presented in this article show that enrollees into the demonstration were generally younger and healthier than a representative group of comparison patients from the same geographic areas.

Cardiac resynchronization therapy: evaluation of ventricular dysynchrony and patient selection

Baquero,Giselle; Banchs,Javier E.; Davidson,William R.; Penny-Peterson,Erica D.; Samii,Soraya M.; Wolbrette,Deborah L.; Naccarelli,Gerald V.; Gonzalez,Mario D.
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2010 EN
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45.93%
Cardiac resynchronization therapy (CRT) is an established treatment modality for systolic heart failure. Aimed to produce simultaneous biventricular stimulation and correct the lack of ventricular synchrony in selected patients with congestive heart failure, CRT has shown to improve mortality and reduce hospital admissions when compared to medical treatment. At present, the indication criteria for the implantation of a CRT device include an ejection fraction of less than 35%, heart failure symptoms consistent with NYHA functional class III-IV and a QRS complex duration equal or longer than 120 milliseconds. It has been reported that 30% of patients who meet those criteria still may not derive clinical benefit from CRT. Due to the existing diversity of imaging modalities and resources for their process and analysis, a great expectation in terms of more accurate diagnosis of ventricular dyssynchrony has been raised. Reliable identification of dyssynchrony could allow us to better predict the favorable response of an individual patient to CRT and therefore offer this procedure to those individuals most likely to benefit. We review the available techniques for the study of ventricular dyssynchrony for CRT patient selection and the results of its application in clinical trials. Despite tremendous progress in the imaging technology available for the assessment and diagnosis of ventricular dyssynchrony...