Aim And Methods: A common justification of the failure to perform scientific evaluations of integrated care programs (in accordance with Sect. 140 SGB V) is the high level of expenditure which is strongly influenced by the conditions of the particular program. Two practical examples will be used to outline frameworks of integrated care programs that may create obstacles to evaluation. If possible, appropriate solutions that may help to avoid or at least reduce these obstacles will be presented.
Results: In many programs target groups and program objectives are inaccurately defined. Especially disease-specific programs bear the risk of having too small a sample size to exclude random effects. Only a few integrated care programs include evaluations that have been proactively planned from the outdet.
Conclusion: In particular, early planning of evaluations plays an important role in avoiding distortions of results and additional expenses. It may also have a positive influence on all other frameworks.
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http://dx.doi.org/10.1016/j.zefq.2015.08.004 | DOI Listing |
BMC Health Serv Res
January 2025
Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
Background: Unwarranted clinical variation presents a major challenge in contemporary healthcare, indicating potential inequalities and inefficiencies, and unrealised potential for better outcomes. Despite an increasing focus on unwarranted clinical variation, and consideration of efforts to address this challenge, evidence-based strategies which achieve this are limited. Audit and feedback of healthcare processes (process auditing) and clinician engagement are important tools which may help to reduce unwarranted clinical variation, however their application in maternity care is yet to be thoroughly explored.
View Article and Find Full Text PDFBMC Geriatr
January 2025
School of Medicine, Qom University of Medical Sciences, Qom, Iran.
Introduction: Intrinsic Capacity in integrated geriatric care emphasizes the importance of a thorough functional assessment. Monitoring the intrinsic capacity of older individuals provides standardized and reliable information to prevent early disability. This study assessed the relationship between intrinsic capacity and functional ability in older adults.
View Article and Find Full Text PDFDisabil Health J
January 2025
Disability Policy Consortium, 25 Kingston St, 4th Floor, Boston, MA, 02111, USA. Electronic address:
In this paper, we examine the critical role of Ombudsman programs in facilitating the transition from Medicare-Medicaid Plans (MMPs) to Dual Special Needs Plans (D-SNPS) for dual-eligible members. As states implement this federally mandated transition, Ombudsman programs serve as essential supports for the dual-eligible population who are navigating complex healthcare changes. Through analysis of Ombudsman programs in California, Massachusetts, Rhode Island, and Michigan, we highlight how these services address beneficiary concerns, resolve access issues, and provide valuable insights to policymakers.
View Article and Find Full Text PDFGut
January 2025
Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
Background: Low-dose amitriptyline, a tricyclic antidepressant (TCA), was superior to placebo for irritable bowel syndrome (IBS) in the AmitripTyline at Low-dose ANd Titrated for Irritable bowel syndrome as Second-line treatment (ATLANTIS) trial.
Objective: To perform post hoc analyses of ATLANTIS for predictors of response to, and tolerability of, a TCA.
Design: ATLANTIS randomised 463 adults with IBS to amitriptyline (232) or placebo (231).
Clin Nutr ESPEN
January 2025
Department of Gastroenterology and Hepatology, Intestinal Failure Unit, Radboud University Medical Centre Nijmegen, Geert Grooteplein 10, 6500 HB, Nijmegen, The Netherlands. Electronic address:
Background And Aims: Measurement of the urine sodium concentration (USC) is a simple procedure that in many patients adequately indicates their hydration status. This is of particular importance in patients suffering from short bowel syndrome (SBS), who may very rapidly dehydrate and are at risk for permanently compromising their kidney function. A point of care test (POCT) that allows reliable measurement of USC would enable these patients to effectively evaluate their sodium- and water balance in the at home setting, thereby avoiding hospital visits and delayed test results.
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