ABSTRACT
The patients being treated in our health care system are becoming increasingly older and have a greater prevalence of chronic diseases. Due to these factors, these patients require greater and easier accessibility to the system as well as continuity of medical care. Collaboration between the different levels of health care has been instrumental in the success of the system and has produced changes in the hospital medical care protocol. Our hospital has developed a care model oriented towards the patient's needs, resulting in a higher grade of satisfaction among the medical professionals. In this paper, we have given a detailed description of part of our medical model, illustrating its different components and indicating several parameters of its evaluation. We have also reviewed the current state of the various models published on this topic. In summary, we believe that this medical care model presents a different approach to management that benefits patients, medical professionals and the health system alike.
Subject(s)
Continuity of Patient Care , Hospitals , Primary Health Care , Continuity of Patient Care/organization & administration , Humans , Models, Organizational , Program EvaluationABSTRACT
Los pacientes atendidos en nuestro sistema sanitario tienen cada vez más edad y mayor prevalencia de enfermedades crónicas. Estas características de salud han condicionado que entre las expectativas de mayor relevancia de los pacientes, se indiquen la accesibilidad al sistema y la continuidad en los cuidados. La colaboración entre los distintos niveles asistenciales ha sido una herramienta reconocida que facilita la consecución de estas expectativas, provocando cambios en la organización del trabajo. Nuestro hospital ha desarrollado un modelo de atención sanitaria que en su orientación al enfermo facilita la colaboración entre los distintos niveles asistenciales, consiguiendo un grado de satisfacción de los profesionales elevado. En este trabajo se describe detalladamente parte del modelo, mostrando los elementos que lo caracterizan, indicando algunos parámetros de la evaluación de resultados y revisando la situación de los modelos de continuidad asistencial publicados. En resumen, consideramos que este sistema asistencial está dotado de elementos de gestión que permiten atender las expectativas de los usuarios, aportando beneficios para el paciente, el profesional y el sistema sanitario (AU)
The patients being treated in our health care system are becoming increasingly older and have a greater prevalence of chronic diseases. Due to these factors, these patients require greater and easier accessibility to the system as well as continuity of medical care. Collaboration between the different levels of health care has been instrumental in the success of the system and has produced changes in the hospital medical care protocol. Our hospital has developed a care model oriented towards the patient's needs, resulting in a higher grade of satisfaction among the medical professionals. In this paper, we have given a detailed description of part of our medical model, illustrating its different components and indicating several parameters of its evaluation. We have also reviewed the current state of the various models published on this topic. In summary, we believe that this medical care model presents a different approach to management that benefits patients, medical professionals and the health system alike (AU)
Subject(s)
Humans , Primary Health Care/methods , Hospital Departments/methods , Cooperative Behavior , Patient Care , Spain , Program EvaluationABSTRACT
BACKGROUND: Given the progressive increase in infectious endocarditis (IE) in intravenous drug addicts (IVDA) in the province of Cadiz the present study was designed with the aim of studying the epidemiologic and clinical characteristics of this disease in our environment. METHODS: One hundred fifty episodes of IE occurring in 133 IVDA admitted to 6 hospitals in the province of Cadiz were studied in an open, multicentric study with a protocol of gathering of common data. Well known diagnostic criteria were used for this process and a univariant technique was employed in the analysis of prognostic factors. RESULTS: Fifty-three percent of the episodes occurred in the county of Campo de Gibraltar and 32% in the area of the Bay of Cadiz. The increase of the disease has been progressive since 1984 and marked over the last two years. All the patients presented fever, abnormal chest radiography in 90% and the process was produced by Staphylococcus aureus in 88%. Echography was abnormal in 85% of the episodes and vegetation was identified in 75%. The IE was located as right in 90%, mixed in 5% and left in 5%. Surgical treatment was required in 4 patients. Mortality was of 9%. Mixed or left location (p = 0.00003) and the development of the respiratory distress syndrome of the adult (p = 0.00001) were significantly associated with greater mortality. CONCLUSIONS: Infectious endocarditis in intravenous drug addicts maintains a well defined pattern of clinical expressivity and presents identifiable factors of prognostic influence. The increase in its prevalence in the province of Cadiz is probably due to a parallel increase in the addiction to intravenous heroin in this area.
