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Ημερολόγιο νεοδιόριστου ιατρού..
kdiwavvou:
[logged]στο τόπικ
PPI Use Linked to Increased Risk for Hospital-Acquired Pneumonia
« στις: σήμερα δημοσίευσα .... και έφαγε μπαν »
Δεν είναι ορατοί οι σύνδεσμοι (links).
Εγγραφή ή Είσοδος
Da Hee Han, PharmD
October 04, 2013
Outpatient Proton Pump Inhibitor Therapy Increases Community Acquired Pneumonia Risk
Δεν είναι ορατοί οι σύνδεσμοι (links).
Εγγραφή ή Είσοδος[/logged]
είναι αξιόπιστο το άρθρο ;
kdiwavvou:
[logged]τουλάχιστο εδώ δεν τρώγω ``μπαν``
για λειτουργικές απαντήσεις θα πρέπει να τεθούν τα σωστά ερωτήματα :
έστω ότι η πρόταση της Ένωσης υλοποιείται ....... μετά; χρειάζονται εργαστηριακά στην ΠΦΥ με σκοπό να καταλήξει στο 2οβάθμιο μόνο ότι πραγματικά θα έπρεπε ; [ δε μιλώ για θρομβόλυση ούτε για αντιπυρηνικά αντισώματα και ΝΑΙ έχω κατα νου ΜΟΝΟ τα 10 συχνότερα νοσήμστα του πληθυσμού και στην ακρούδα του μυαλού μου το γηρασμένο πληθυσμό και τα ταξικά επίπεδα ]
και αν χρειάζονται εργαστηριακά στην ΠΦΥ θα ήταν μια λύση αξιοπρεπής το υποχρεωτικό πέρασμα των ειδικευόμενων μικροβιολόγων και απο τριτοβάθμιο και από ΠΦΥ γιατί μάλλον λεφτά υπάρχουν [ ΔΕΝ ] ;;; [ για βεγγέρες υπάρχουν για διορισμούς στην ΠΦΥ όχι και άποψή μου δεν είναι λύσεις τα πασαλείμματα-βολέματα-αποσπάσεις βλέπε κάλυψη με προσωπικό στα αστικού τύπου ΚΥ]
επισυνάπτω έναν αλγόριθμο, αν τον μελετήσει κανείς και σταθεί στο σενάριο 2 που παρατίθεται :
είναι ασφαλές το όριο έξι μηνων παρακολούθησης πριν καταλήξει στο 2οβάθμιο το περιστατικό ;
Δεν είναι ορατοί οι σύνδεσμοι (links).
Εγγραφή ή Είσοδος[/logged]
kdiwavvou:
[logged]First 1,000 CQC visits find 10 practices with 'serious failings'
By Marina Soteriou, 12 December 2013
The watchdog outlined changes to its approach to primary care inspections under chief inspector of general practice Professor Steve Field on Wednesday.
From April 2014, a quarter of GP practices in each CCG area will face inspection every six months. Overhauled CQC inspection teams will include a GP, a practice nurse or practice manager and a trainee GP, as well as a CQC inspector.
A total of 910 GP practices have been inspected by the CQC since April this year. Inspectors have concentrated on practices that registered as non-compliant and have carried out 90 follow-up inspections to check that improvements have been made.
Launching his GP inspection blueprint, A Fresh start for the regulation and inspection of GP practices and GP out-of-hours services, CQC chief inspector of general practice Professor Steve Field said most practices inspected were good but 10 had serious failings and had received warnings.
A total of 34% of practices inspected failed in at least one of the CQC's 16 standards.
Practices with serious failings were found to have problems including maggots in treatment rooms, out-of-date oxygen cylinders and no temperature monitoring on vaccine fridges.
Two GPs in one practice referred each other to the GMC for ‘incompetence’, Professor Field said. ‘NHS England took action and both GPs are no longer working there.'
Professor Field ruled out routine unannounced inspections. ‘This is not about witch hunts,’ he said. ‘We are not looking for perfection. There is no single perfect practice in this country.’
Every GP practice is due to be inspected by 2016. GP out-of-hours services will be inspected from January.
One LMC has warned that CQC inspections have reduced some GPs and practice staff to tears.
RCGP chairwoman Dr Maureen Baker said that GPs’ high workload is risking patient safety. ‘Many GPs are now routinely working 11-hour days and conducting up to 60 patient consultations in a single day,’ she said.
‘Half of GPs believe they can no longer deliver safe patient care due to increasing pressures and unsustainable workloads.
‘It's crucial that any inspection of GP practices should have input from people who have direct experience of frontline general practice and who know first-hand about the challenges that GPs and their teams are facing in trying to deliver quality care for patients. But we must make sure that GPs, practice nurses and practice managers are not taken away from the day job of providing care to patients as a result of their involvement in inspections.
‘Breaches of procedure cannot be condoned - even if they are isolated incidents - but the inspections were largely targeted at particular practices which had already been identified as having problems. Specific areas for improvement have been found and the CQC must now work with these practices to ensure that they meet the necessary standards and that other practices can learn from their experiences.
‘Vaccine storage and cleanliness are two very important priorities for every practice and the low rates of vaccine-preventable disease should reassure patients that there is no widespread breach of "cold chain" storage for medicines.’
GPC chairman Dr Chaand Nagpaul said: 'It is encouraging that the CQC recognises the high standards of care provided by the vast majority of GP surgeries it has already inspected.
'While most patients receive high quality care from their GP, we need to understand where and why shortcomings in a small number of practices exist, and the BMA is committed to working with the chief inspector to improve standards.
'It’s important, however, that anecdotes of poor practice are not be used to distort the reality which is that the overwhelming majority of hard-working GPs provide high quality care which is appreciated by patients.'[/logged]
kdiwavvou:
[logged]Almost 1 in 3 Physicians Turn Away New Medicaid Patients
Robert Lowes
August 07, 2012
August 7, 2012 — Nearly a third of office-based physicians declined to accept new Medicaid patients last year, according to a new analysis of government survey data published in the August issue of Health Affairs.
Access to care proved substantially less difficult for new patients covered by Medicare and private insurance, who faced rejection rates of 17% and 18%, respectively.
Author Sandra Decker, PhD, an economist at the National Center for Health Statistics of the US Centers for Disease Control and Prevention, found that acceptance rates of new Medicaid patients varied widely on a state-by-state basis, with a low of 40.4% in New Jersey and a high of 99.3% in Wyoming. Acceptance rates generally were higher in states with higher Medicaid fee-for-services rates, expressed as a percentage of Medicare's rates in 2008. Medicaid rates in Wyoming in 2008, for example, were close to 150% of Medicare's — the nation's highest. Conversely, New Jersey's Medicaid rates were dead last, at 37% of Medicare. Nationwide, the average Medicaid-to-Medicare fee ratio is 74.2.
Source: National Center for Health Statistics at US Centers for Disease Control and Prevention
Dr. Decker writes that a Medicaid pay hike for primary care physicians under the Affordable Care Act (ACA) will persuade more of them to treat new Medicaid patients. The provision raises Medicaid rates to 100% of Medicare rates in 2013 and 2014 for evaluation and management services and immunization administration. However, the temporary nature of the raise might blunt its effect, she notes. Another unknown is whether there will be enough clinicians to handle the massive influx of patients who gain coverage under Medicaid and private insurance beginning in 2014 as a result of the ACA.
Self-Pay Patients the Most Popular
The willingness to welcome new Medicaid patients varied across a wide range of physician characteristics, according to the study. Physicians were more prone to keep the door open if they practiced in the Midwest or in rural areas, if they were in larger practices, and if they were younger than 45 years.
The acceptance rate for new Medicaid patients also was higher among specialists (71.7%) than primary care physicians (66.2%). The gap paled in comparison to that for new Medicare patients, who were accepted by 90.9% of specialists versus 71.4% of primary care physicians.
The most popular sort of patients in 2011 insured themselves. The acceptance rate for self-pay patients was 94.2% among specialists, 88.2% among primary care physicians, and 91.7% overall.
The author has disclosed no relevant financial relationships.[/logged]
kdiwavvou:
[logged]σιγά μην τοποθετηθεί κανείς.... [ αν και το ζητούμενο είναι να τοποθετηθείτε. Ωστόσο και να μην τοποθετηθείτε, σύμφωνα με το άσμα, σιγά μην κλάψω, σιγά μην φοβηθώ ] Καλές Εορτές
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