摘要:

Within the US, consumers are assuming a much greater role in actively managing their own health, educating themselves regarding health problems, and facilitating interventions to improve health outcomes. The Internet is a convenient and cost-effective enabler for supporting patient-centered healthcare. It is a wellspring of knowledge; a virtual, global community center; and a simple and convenient infrastructure for enabling consumers to monitor their own health states. For the Internet to successfully fulfill its role in health and disease management, a number of significant challenges must be addressed. Foremost among these are unfamiliar and difficult clinical vocabulary, lack of quality control, unequal accessibility, and risks to personal privacy.

ISSN:1173-8790    

出版商:ADIS    

年代:2001

数据来源: ADIS

摘要:

US employers are facing an unprecedented opportunity to contribute toward positive, disruptive innovations in healthcare. The convergence of major trends will enable employers to exercise significant leverage in controlling healthcare costs and improving quality.US healthcare is ripe for disruptive innovations − cheaper, simpler, more convenient products or services that start by meeting the needs of less demanding customers. Employers view the healthcare system as overbuilt and off-focus for the needs of the average employer and employee. There are powerful driving forces and some restraining forces on employer leverage over employee health initiatives. On balance, employers have an interest in and an opportunity to leverage disruptive innovations in healthcare.One option that employers can use to leverage disruptive innovations in healthcare is partnership with health management vendors. While traditionally this association has been an arms-length customer/supplier relationship, there is an effective process for development of strategic partnerships that employers can use to better exert their latent influence on healthcare.There are at least 5 critical success factors for effective employer-vendor partnerships:establish a formalized strategic planning process;gain commitment and support early in the process;identify specific goals, objectives, and accountabilities;clearly define the partner selection process; andclarify partner roles and expectations.

ISSN:1173-8790    

出版商:ADIS    

年代:2001

数据来源: ADIS

摘要:

Hepatitis C is an important target for the development of disease management programs. Hepatitis C virus (HCV) infection is common and most infected individuals develop persistent infection. Although this is usually associated with chronic liver injury (chronic hepatitis C), the infection and liver disease may be unrecognized for years. Most patients are relatively asymptomatic and their illness remains clinically silent for at least 20 years after onset. In a substantial proportion of such individuals, the most widely available tests of the presence of liver injury, the serum aminotransferases, may be persistently normal. If unrecognized and untreated, chronic hepatitis C may lead to unfavorable outcomes including cirrhosis, the complications of end-stage liver disease, and hepatocellular carcinoma. These in turn sharply reduce health-related quality of life, lead to debilitating symptoms, decrease life expectancy by increasing premature death, and result in very high costs of care including the most expensive form of treatment − liver transplantation. In fact, end-stage liver disease due to chronic hepatitis C is now the single most common indication for liver transplantation in the US and Western Europe.Based on available data, the future illness and economic burden of chronic hepatitis C is likely to increase dramatically during the next few decades as currently infected, untreated individuals progress toward advanced liver disease. Unfortunately, treatment with the current agent of choice − the combination of interferon alfa and ribavirin − is difficult, expensive, and effective in only a proportion of patients. Nonetheless, computer-generated modeling studies indicate that current treatment diminishes the reduction in life expectancy expected in chronic hepatitis C and that cost-effectiveness ratios either fall within the bounds of other widely accepted medical interventions or are cost saving.Disease management programs in hepatitis C need to be designed to reduce unhealthy high risk behavior by education of the uninfected, promote health-seeking behavior such as the avoidance of alcohol in those infected, institute disease screening for those at risk with early confirmation of diagnosis, and initiate appropriate and effective treatment regimens, including actions designed to support adherence to treatment and appropriate follow-up. Advances in treatment such as the development of long-acting pegylated interferons which may enhance response rates, may be effective in advanced disease, and are well-tolerated should be incorporated into disease management programs when available. Disease management program design will require a multidisciplinary team approach and careful assessment of the effectiveness of these programs is needed.

ISSN:1173-8790    

出版商:ADIS    

年代:2001

数据来源: ADIS

摘要:

The 1999 reform of the Italian healthcare system has softened the effects of the 1992 shift to market mechanisms and competition within healthcare by promoting cooperation and partnerships among providers and Local Health Units (LHUs). In addition, it has facilitated the completion of transfering organizational and financial responsibility to the regional governments.Such health policy developments require both the introduction of administrative tools, which stimulates integration, and the design of a coherent policy for quality of care. A 3-fold integration between healthcare and social services has been promoted to tackle the introduction of administrative tools: institutional integration between municipalities and LHUs, managerial integration at the district level for the provision of primary care and non-hospital care, and professional integration between healthcare professionals. A similar approach has characterized the policy for quality of care: an essential benefit package is to be identified as a guarantee to all citizens, practice guidelines will be developed and implemented and an accreditation process is underway.Implementation issues aside, effective introduction of the suggested tools requires careful planning and organization of the system and, above all, coordinated interventions at the 3 levels of healthcare provision (i.e. the macro, intermediary and micro levels).

ISSN:1173-8790    

出版商:ADIS    

年代:2001

数据来源: ADIS

ISSN:1173-8790    

出版商:ADIS    

年代:2001

数据来源: ADIS