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
HIV-1 infected patients frequently develop opportunistic diseases involving the liver, particularly individuals with AIDS. Nevertheless, the role of liver biopsy (LB) in these patients is controversial. The prevalence of AC in seropositive subjects and the value of LB in patients with AC was investigated. The prevalence of AC in all outpatients attended at our Unit for a three month period was 2/119 (1.6%), whereas it was 20/66 (30.3%) for inpatients for a nine month period. LB was proposed to all patients with AC but not to those with a Karnofski index < 50 and those with an ethanol intake > 80 g per day. LB was performed in 16 patients, four were excluded, and 2 refused the procedure. Among symptomatic patients, LB: a) confirmed a previous diagnosis in six patients (40%); b) showed findings of nonspecific cholangitis in four cases (27%), and c) disclosed a previously unsuspected or unconfirmed disease in five patients (33%). LB is an useful diagnostic tool for the diagnosis of seropositive patients with AC, although a previous opportunistic event may account for symptoms and the corresponding enzymatic patterns.
