RESUMO
Improving outcomes and reducing costs for individuals with frequent acute episodes of care is a high priority for community behavioral health systems and managed care organizations. This column illustrates the application of interdisciplinary, interagency teamwork-with clinical leadership by the system psychiatric medical director-to a county-level quality improvement team process, a change that resulted in significant improvements in outcomes and costs over a 7-year period.
Assuntos
Administração de Caso/organização & administração , Controle de Custos/métodos , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Melhoria de Qualidade , Anorexia Nervosa/terapia , Administração de Caso/economia , Criança , Transtornos do Comportamento Infantil/terapia , Controle de Custos/organização & administração , Feminino , Humanos , Masculino , Transtornos Mentais/terapia , Avaliação das Necessidades/economia , Avaliação das Necessidades/organização & administração , Equipe de Assistência ao Paciente/economia , Equipe de Assistência ao Paciente/organização & administração , Melhoria de Qualidade/organização & administração , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: The purpose of this study is to assess patient's satisfaction treatment outcomes and out-of-pocket expense for the fractional CO2 laser (SmartXide) in the treatment of genitourinary symptoms of menopause (GSM). MATERIALS AND METHODS: A multicenter retrospective cohort study of patients who completed a course of three vaginal treatments with the SmartXide11 Fractional CO2 laser. Patients contacted via telephone and asked to participate in questionnaires to evaluate for adverse outcomes since last treatment, symptom severity before and after treatment, patient satisfaction with treatment, patient satisfaction with out-of-pocket expense, and sexual function. RESULTS: Of the 368 patients contacted, 122 agreed to be interviewed. No patients reported seeking emergent medical treatment. Patient reported vaginal dryness significantly improved following treatment (P < 0.05). The frequency of intercourse increased from "once a month" to "few times a month" (P < 0.001). The vast majority of patients reported being satisfied with their treatment results (86%) and with the cost of treatment (78%). Satisfaction with the out-of-pocket expense did not correlate with household income (P = 0.07). CONCLUSION: The SmartXide Fractional CO2 laser is a safe and efficacious treatment for GSM. This treatment is associated with a high level of patient satisfaction with both treatment results and out-of-pocket expense. Lasers Surg. Med. 49:882-885, 2017. © 2017 Wiley Periodicals, Inc.
