Fee-for-service, funding care on an hourly rate basis, creates an incentive for home-care providers to deliver high amounts of care. Under casemix funding, in contrast, clients are allocated-based on their characteristics-to homogenous, hierarchical groups, which are subsequently funded to promote more effective and efficient care. The first step in developing a casemix model is to understand which client characteristics are potential predictors of home-care needs. Nurses working in home care (i.e. home-care nurses) have a good insight into clients' home-care needs. This study was conducted in co-operation with the Dutch Nurses' Association and the Dutch Healthcare Authority. Based on international literature, 35 client characteristics were identified as potential predictors of home-care needs. In an online survey (May, 2017), Dutch home-care nurses were asked to score these characteristics on relevance, using a 9-point Likert scale. They were subsequently asked to identify the top five client characteristics. Data were analysed using descriptive statistics. The survey was completed by 1,007 home-care nurses. Consensus on relevance was achieved for 15 client characteristics, with "terminal phase" being scored most relevant, and "sex" being scored as the least relevant. Relevance of the remaining 20 characteristics was uncertain. Additionally, based on the ranking, "ADL functioning" was ranked as most relevant. According to home-care nurses, both biomedical and psychosocial client characteristics need to be taken into account when predicting home-care needs. Collaboration between clinical practice, policy development, and science is necessary to realise a funding model, to work towards the Triple Aim (improved health, better care experience, and lower costs).
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http://dx.doi.org/10.1111/hsc.12611 | DOI Listing |
Curr Opin Otolaryngol Head Neck Surg
October 2024
Department of Otolaryngology - Head & Neck Surgery, University of Florida, Gainesville, Florida, USA.
Purpose Of Review: Fibro-osseous lesions (FOL) are benign, slow-growing lesions that are often incidentally discovered in the sinonasal cavity. They may necessitate surgical resection in patients with postobstructive sinusitis, or in cases of cranial nerve and orbital compression. We examine the recent advancements in otolaryngology relating to diagnostic characteristics and treatments for FOL, with emphasis on new technologies to improve outcomes and reduce recurrence.
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December 2024
St John of God Subiaco, Perth, Western Australia, Australia.
Uterine leiomyomata, commonly known as fibroids, are prevalent benign tumours affecting a significant percentage of women of reproductive age. Although many patients remain asymptomatic, a substantial proportion experience severe symptoms, including abnormal uterine bleeding and adverse reproductive outcomes. Surgical intervention often becomes necessary for patients with symptomatic fibroids, despite advancements in medical therapies.
View Article and Find Full Text PDFJ Neurosurg
December 2024
Departments of1Neurological Surgery.
Objective: While the relationship between smoking and subarachnoid hemorrhage is well established, data regarding the probability of detecting unruptured intracranial aneurysms (UIAs) in smokers remain sparse. The aim of this systematic review and meta-analysis is to provide a comprehensive understanding of the relationship between smoking and the likelihood of identifying UIAs in healthy asymptomatic patients who underwent brain imaging for indications unrelated to UIAs.
Methods: A systematic review was conducted following the PRISMA guidelines.
Neurology
January 2025
Faculty of Medicine, University of Geneva, Switzerland.
Early detection of focal cortical dysplasia (FCD) using brain MRI in young children presenting with drug-resistant epilepsy may facilitate prompt surgical treatment, resulting in better control of seizures and decreased associated cognitive difficulties. Characteristics of FCD described in the literature are predominantly based on MRI findings in a fully myelinated brain; therefore, changes occurring during early brain maturation are not well known. In this case report, we describe distinct MRI features of a FCD visualized best before completion of myelination of the cortex and subcortical white matter.
View Article and Find Full Text PDFJ Med Imaging Radiat Oncol
December 2024
Department of Radiology, Grampians Health, Ballarat Central, Victoria, Australia.
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