The structuring of specialized outpatient care is a bottleneck in the operation of the Unified Health System. Based on a brief discussion about this void in an organizational model, we propose the federal induction of a format of specialized services from the experiences of Centers of Support for Family Health (NASF). They adapted matrix operations and constitute an excellent prototype for the organization of specialized outpatient care. It allows for equal access and maximum proximity to the specialized care of the reality of primary care users, the personal relationship and the close relationship between the family health teams and medical and non-medical specialists, enabling mutual lifelong learning, negotiated regulation and increased efficacy of primary care. Municipal experiences of Florianopolis and Curitiba are synthesized as partial examples of the proposal. the structure of care in mental health of Florianópolis, all organized as a matrix support is briefly described; and we focus on the change in the action of the support teams of Curitiba, which gradually began to engage, involve and mediate the relationship between basic and specialized care. This format can be expanded to most medical specialties.
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http://dx.doi.org/10.1590/1413-81232017223.18842016 | DOI Listing |
Am J Emerg Med
December 2024
Department of Health Policy & Organization, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA; Center for Outcomes and Effectiveness Research and Education, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.
Background: Leaving before medically advised (BMA) is a significant issue in the US healthcare system, leading to adverse health outcomes and increased costs. Despite previous research, multi-year studies using up-to-date nationwide emergency department (ED) data, are limited. This study examines factors associated with leaving BMA from EDs and trends over time, before and during the COVID-19 pandemic.
View Article and Find Full Text PDFJMIR Perioper Med
January 2025
Societal Participation & Health, Amsterdam Public Health, Amsterdam, The Netherlands.
Background: Day surgery is being increasingly implemented across Europe, driven in part by capacity problems. Patients recovering at home could benefit from tools tailored to their new care setting to effectively manage their convalescence. The mHealth application ikHerstel is one such tool, but although it administers its functions in the home, its implementation hinges on health care professionals within the hospital.
View Article and Find Full Text PDFJMIR Form Res
January 2025
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Background: The potential of telehealth psychotherapy (ie, the online delivery of treatment via a video web-based platform) is gaining increased attention. However, there is skepticism about its acceptance, safety, and efficacy for patients with high emotional and behavioral dysregulation.
Objective: This study aims to provide initial effect size estimates of symptom change from pre- to post treatment, and the acceptance and safety of telehealth dialectical behavior therapy (DBT) for individuals diagnosed with borderline personality disorder (BPD).
Background: Nephrology has seen an uptake in transition to remote care delivery. The impact of telenephrology care on chronic kidney disease (CKD) progression is not well defined.
Methods: We analyzed data from patients naturally selected for telenephrology versus standard, in-person visits.
J Patient Saf
November 2024
From the The Doctors Company, Chagrin Falls, Ohio.
Objectives: The aims of the study were to identify the characteristics of medication-related malpractice claims occurring in the ambulatory setting across 2 time periods.
Methods: A retrospective, descriptive study was used. Ambulatory medication-related closed malpractice events from loss years of 2011-2021 were analyzed.
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