This article describes charitable hospitals in Brazil that provide managed care and the health management organizations themselves, considering the level of autonomy by the latter in relation to the hospitals and their degree of management development, based on a nationwide study. A random sample of individual hospitals was drawn from the hospital groups. After refusals and replacements, the final sample consisted of 112 individual hospitals and 10 hospital groups. The charitable hospitals' managed care plans do no operate precisely according to the overall Brazilian health plan market, in which most of the managed care is situated in insurance companies, group medicine, and medical cooperatives. Rather than operating as typical plans, they function "inside the organization or hospital itself", almost always with a limited management infrastructure and with little autonomy in relation to the organizations harboring them. Individual plans were more common than collective products, unlike the rest of the market, which may also result from the limited management capacity of these arrangements.
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http://dx.doi.org/10.1590/s0102-311x2008000100016 | DOI Listing |
Pediatr Blood Cancer
January 2025
Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
Background: Pediatric brain tumors are understudied compared to other pediatric malignancies in low- and middle-income countries. Care delivery is inherently dependent on collaboration between multiple departments. This study aimed to present baseline data of pediatric neuro-oncology care in Western Kenya and illustrate barriers and facilitators of multidisciplinary care.
View Article and Find Full Text PDFMil Med
January 2025
Division of Gynecologic Oncology, Department of Gynecologic Surgery & Obstetrics, Tripler Army Medical Center, Honolulu, HI 96859, USA.
Endometrial cancer is the most prevalent gynecologic cancer in the United States and has rising incidence and mortality. Endometrial intraepithelial neoplasia or atypical endometrial hyperplasia (EIN-AEH), a precancerous neoplasm, is surgically managed with hysterectomy in patients who have completed childbearing because of risk of progression to cancer. Concurrent endometrial carcinoma (EC) is also present on hysterectomy specimens in up to 50% of cases.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Centre Rijeka, 51000 Rijeka, Croatia.
Autoimmune thyroid disease (AITD) is the leading cause of thyroid dysfunction globally, characterized primarily by two distinct clinical manifestations: Hashimoto's thyroiditis (HT) and Graves' disease (GD). The prevalence of AITD is approximately twice as high in women compared to men, with a particularly pronounced risk during the reproductive years. Pregnancy exerts profound effects on thyroid physiology and immune regulation due to hormonal fluctuations and immune adaptations aimed at fostering maternal-fetal tolerance, potentially triggering or exacerbating AITD.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
Background: Head-and-neck cancer (HNC) can cause oropharyngeal dysphagia (OD). Early identification of OD in newly diagnosed HNC patients is important to better prepare patients for their cancer treatment trajectory. The aim of this study is (1) to assess the prevalence of OD in HNC patients within three weeks before the start of cancer treatment and (2) to investigate which demographic and oncological characteristics may be risk factors associated with the risk of OD at baseline.
View Article and Find Full Text PDFFoods
December 2024
Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
Celiac disease (CD) and eating disorders (EDs) are complex chronic conditions in adolescents, sharing symptoms such as weight change, malnutrition, and gastrointestinal symptoms. CD, an autoimmune disorder triggered by gluten ingestion, is managed through a strict gluten-free diet that can unintentionally foster disordered eating behaviors due to dietary restrictions. Conversely, EDs may mask and complicate CD symptoms, leading to diagnostic delays and treatment challenges.
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