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178 records – page 1 of 18.

5-year review of a unique multidisciplinary nonmelanoma skin cancer clinic.

https://arctichealth.org/en/permalink/ahliterature132764
Source
J Cutan Med Surg. 2011 Jul-Aug;15(4):220-6
Publication Type
Article
Author
Shaelyn Culleton
Dale Breen
Dalal Assaad
Liying Zhang
Judith Balogh
May Tsao
Juhu Kamra
Greg Czarnota
Oleh Antonyshyn
Jeffery Fialkov
Elizabeth Barnes
Author Affiliation
Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Source
J Cutan Med Surg. 2011 Jul-Aug;15(4):220-6
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Carcinoma, Basal Cell - pathology - therapy
Carcinoma, Squamous Cell - pathology - therapy
Chi-Square Distribution
Child
Delivery of Health Care, Integrated - organization & administration
Female
Humans
Male
Middle Aged
Ontario
Outcome and Process Assessment (Health Care)
Skin Neoplasms - pathology - therapy
Abstract
A multidisciplinary nonmelanoma skin cancer (NMSC) clinic is held weekly at our center, where all new patients are jointly assessed by dermatology/dermatopathology, radiation oncology, and plastic surgery. A new patient database was established in 2004. The purpose of this study was to provide a preliminary report on the patients seen in the NMSC clinic and the treatment recommendations rendered.
The new patient database was reviewed from January 2004 to December 2008, and patient demographics, tumor characteristics, and treatment recommendations were extracted. Cochran-Mantel-Harnszel (CMH) testing and chi-square analysis were used to detect any associations or relationships between variables within the database. A p value of less than .05 was considered significant.
During the 5-year study period, 2,146 new patients were seen in the NMSC clinic. The majority of patients presented with basal cell carcinoma (64%) or squamous cell carcinoma (22%), with a median tumor size of 1 to 2 cm (range 0 to > 9 cm). Tumors were located in the head and neck region (80%), extremities (14%), and torso (6%). Previous treatment included biopsy only (62%), surgery (20%), electrodesiccation and curettage (11%), topical imiquimod (3%), and radiotherapy (1%). Treatment recommendations included surgery (55%) (with either simple excision [31%] or excision with margin control under frozen-section guidance [24%]), radiotherapy (19%), topical imiquimod (10%), observation (7%), and electrodesiccation and curettage (4%).
The NMSC clinic at our center sees a high volume of patients who benefit from the multidisciplinary assessment provided. Treatment recommendations were based on patient and disease characteristics as well as patient preference.
PubMed ID
21781628 View in PubMed
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[About standardization of specialized medical care].

https://arctichealth.org/en/permalink/ahliterature291369
Source
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2016 May-Jun; 24(3):156-9
Publication Type
Journal Article
Author
I V Uspenkaia
A A Nizov
E V Manukhina
Source
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2016 May-Jun; 24(3):156-9
Language
Russian
Publication Type
Journal Article
Keywords
Delivery of Health Care, Integrated - organization & administration - standards
Health Care Reform
Hospitalization
Humans
Medicine - methods - standards
Program Development
Quality Improvement - organization & administration
Russia
Specialization - standards
Abstract
The article presents materials of studying of such important problem of health care as standardization of specialized medical care provided in conditions of hospital and modernization of regional health care. The issues of standardization of specialized medical care are considered in medical, economic and social aspects. The implementation of medical standards was determined as one of main tasks of the regional program of modernization of health care. The program was developed with direct involvement of the authors of article. The comparative analysis of classes of diseases and nosologic forms on main indices of hospitalized morbidity and lethality was used for substantiation of priority of implementing medical standards in the region. The questionnaire survey was carried out on sampling of 510 patients of hospitals. The sociological questionnaire survey was applied to sampling of 8732 patients comprised by system of mandatory medical insurance. Such an approach determined reliability of derived results. The expertise of medical standards was implemented by 124 experienced and competent physicians participating in implementation of medical standards. The results of expertise confirmed expediency of implementation of medical standards. Kepy following shortcomings were established: inadequate financing; lacking of modern equipment and analysis techniques in hospitals, etc. The article presents evidences of effectiveness of process of standardization of specialized of medical care provided in hospital conditions. The basis of such an assumption was reliable increasing of level of satisfaction of quality of its organization and achievement of planned indices of "road map" in the section of increasing of salary of medical workers and decreasing of mortality of population because of controllable causes.
PubMed ID
29553232 View in PubMed
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[About the meeting of the leaders of tuberculosis-controlling services of the subjects of the Russian Federation on progress in 2003].

https://arctichealth.org/en/permalink/ahliterature174866
Source
Probl Tuberk Bolezn Legk. 2005;(2):37-40
Publication Type
Article
Date
2005

Abuse: an integrated and coordinated health sector response is needed.

https://arctichealth.org/en/permalink/ahliterature187512
Source
Can J Gastroenterol. 2002 Nov;16(11):815-6
Publication Type
Article
Date
Nov-2002
Author
W E Thurston
Source
Can J Gastroenterol. 2002 Nov;16(11):815-6
Date
Nov-2002
Language
English
Publication Type
Article
Keywords
Canada
Colonic Diseases, Functional - diagnosis - etiology - therapy
Delivery of Health Care, Integrated - organization & administration
Health Care Sector - organization & administration
Humans
Risk factors
Sex Offenses
Notes
Comment On: Can J Gastroenterol. 2002 Nov;16(11):801-512464974
PubMed ID
12464978 View in PubMed
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Accessing timely rehabilitation services for a global aging society? Exploring the realities within Canada's universal health care system.

https://arctichealth.org/en/permalink/ahliterature145394
Source
Curr Aging Sci. 2010 Jul;3(2):143-50
Publication Type
Article
Date
Jul-2010
Author
Michel D Landry
Sudha Raman
Elham Al-Hamdan
Author Affiliation
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. mike.landry@utoronto.ca
Source
Curr Aging Sci. 2010 Jul;3(2):143-50
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aging
Canada
Cooperative Behavior
Delivery of Health Care, Integrated - organization & administration
Health Services Accessibility - organization & administration
Health Services Needs and Demand - organization & administration
Health Services for the Aged - organization & administration
Humans
Interinstitutional Relations
National health programs - organization & administration
Organizational Objectives
Physical Therapy Modalities - organization & administration
Private Sector - organization & administration
Public Sector - organization & administration
Time Factors
World Health
Abstract
The proportion of older persons is increasing in developed and developing countries: this aging trend can be viewed as a two-edged sword. On the one hand, it represents remarkable successes regarding advances in health care; and on the other hand, it represents a considerable challenge for health systems to meet growing demand. A growing disequilibrium between supply and demand may be particularly challenging within publicly funding health systems that 'guarantee' services to eligible populations. Rehabilitation, including physical therapy, is a service that if provided in a timely manner, can maximize function and mobility for older persons, which may in turn optimize efficiency and effectiveness of overall health care systems. However, physical therapy services are not considered an insured service under the legislative framework of the Canadian health system, and as such, a complex public/private mix of funding and delivery has emerged. In this article, we explore the consequences of a public/private mix of physical therapy on timely access to services, and use the World Health Organization (WHO) health system performance framework to assess the extent to which the emerging system influences the goal of aggregated and equitable health. Overall, we argue that a shift to a public/private mix may not have positive influences at the population level, and that innovative approaches to deliver services would be desirable to strengthening rather than weaken the publicly funded system. We signal that strategies aimed at scaling up rehabilitation interventions are required in order to improve health outcomes in an evolving global aging society.
PubMed ID
20158495 View in PubMed
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Acute hospital use, nursing home placement, and mortality in a frail community-dwelling cohort managed with Primary Integrated Interdisciplinary Elder Care at Home.

https://arctichealth.org/en/permalink/ahliterature123476
Source
J Am Geriatr Soc. 2012 Jul;60(7):1340-6
Publication Type
Article
Date
Jul-2012
Author
Ted Rosenberg
Author Affiliation
Department of Family Medicine, University of British Columbia and Island Medical Program, University of Victoria, Victoria, British Columbia, Canada. trosenberg@gem-health.com
Source
J Am Geriatr Soc. 2012 Jul;60(7):1340-6
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
British Columbia
Cause of Death
Chi-Square Distribution
Delivery of Health Care, Integrated - organization & administration
Demography
Emergency Service, Hospital - utilization
Female
Frail Elderly
Geriatric Assessment
Health Services for the Aged - organization & administration
Home Care Services - organization & administration
Hospitalization - statistics & numerical data
Humans
Male
Mortality - trends
Nursing Homes - utilization
Regression Analysis
Abstract
To evaluate the effect of medical Primary Integrated Interdisciplinary Elder Care at Home (PIECH) on acute hospital use and mortality in a frail elderly population.
Comparison of acute hospital care use for the year before entering the practice (pre-entry) with the most-recent 12-month period (May 1, 2010-April 30, 2011, postentry) for active and discharged patients.
Community.
All 248 frail elderly adults enrolled in the practice for at least 12 months who were living in the community and not in nursing homes in Victoria, British Columbia.
Primary geriatric care provided by a physician, nurse, and physiotherapist in participants' homes.
Acute hospital admissions, emergency department (ED) contacts that did not lead to admission, reason for leaving practice, and site of death.
There was a 39.7% (116 vs 70; P = .004) reduction in hospital admissions, 37.6% (1,700 vs 1,061; P = .04) reduction in hospital days, and 20% (120 vs 95; P = .20) reduction in ED contacts after entering the practice. Fifty participants were discharged from the practice, 64% (n = 32) of whom died, 20% (n = 10) moved, and 16% (n = 8) were admitted to nursing homes. Fifteen (46.9%) deaths occurred at home.
Primary Integrated Interdisciplinary Elder Care at Home may reduce acute hospital admissions and facilitate home deaths.
PubMed ID
22694020 View in PubMed
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Addressing the social causes of poor health is integral to practising good medicine.

https://arctichealth.org/en/permalink/ahliterature129827
Source
CMAJ. 2011 Dec 13;183(18):2196
Publication Type
Article
Date
Dec-13-2011
Author
Anne Andermann
Author Affiliation
Faculty of Medicine, McGill University, Montréal, Que.
Source
CMAJ. 2011 Dec 13;183(18):2196
Date
Dec-13-2011
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care, Integrated - organization & administration
Family Practice - standards
Health status
Humans
Socioeconomic Factors
PubMed ID
22065361 View in PubMed
Less detail

Advancing the population health agenda.

https://arctichealth.org/en/permalink/ahliterature170442
Source
Healthc Manage Forum. 2005;18(4):17-21
Publication Type
Article
Date
2005
Author
Alan Davidson
Author Affiliation
UBC-Okanagan, British Columbia.
Source
Healthc Manage Forum. 2005;18(4):17-21
Date
2005
Language
English
Publication Type
Article
Keywords
British Columbia
Cooperative Behavior
Delivery of Health Care, Integrated - organization & administration
Health Priorities
Humans
Interinstitutional Relations
Models, organizational
Organizational Objectives
Public Health
Public Health Administration
Regional Health Planning - organization & administration
Socioeconomic Factors
Abstract
Using the case of the B.C. Interior Health Authority, the paper teases out some of the bases for practical success and failure in advancing population health in a regionalized health system.
PubMed ID
16509277 View in PubMed
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After the flood: surviving Hurricane Juan.

https://arctichealth.org/en/permalink/ahliterature173389
Source
Can Oper Room Nurs J. 2005 Jun;23(2):6, 8-10, 35-6
Publication Type
Article
Date
Jun-2005
Author
Cynthia Fulmore
Sunny Russell
Author Affiliation
Victoria General Site, QEII Health Sciences Center, Halifax, NS, Canada.
Source
Can Oper Room Nurs J. 2005 Jun;23(2):6, 8-10, 35-6
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Academic Medical Centers - organization & administration
Delivery of Health Care, Integrated - organization & administration
Disaster Planning - organization & administration
Disasters
Health Facility Merger - organization & administration
Humans
Multi-Institutional Systems - organization & administration
Nova Scotia
Abstract
Capital Health is the largest integrated academic health district in Atlantic Canada. It provides tertiary health services to Atlantic Canadians and to 40 per cent of Nova Scotia's population. Capital Health consists of nine facilities, one of which is the Queen Elizabeth II Health Sciences Centre. The QEII is the largest adult academic health centre in Atlantic Canada, occupying 10 buildings on two sites. It employs 8500 staff and has 1075 beds. The QEII was created in 1996 with the merger of the Victoria General (VG), Halifax Infirmary (HI), Abbie J. Lane Memorial, Camp Hill Veterans' Memorial, Nova Scotia Rehabilitation Centre and the Nova Scotia Cancer Centre. There are 33 operating rooms at the HI and VG sites; together about 29,000 operations are performed there each year. The two hospitals are located about five city blocks away from each other. This article discusses how the two facilities coped after the devastation of Hurricane Juan in September 2003.
PubMed ID
16092569 View in PubMed
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Alternative level of care: Canada's hospital beds, the evidence and options.

https://arctichealth.org/en/permalink/ahliterature107861
Source
Healthc Policy. 2013 Aug;9(1):26-34
Publication Type
Article
Date
Aug-2013
Author
Jason M Sutherland
R Trafford Crump
Author Affiliation
Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC.
Source
Healthc Policy. 2013 Aug;9(1):26-34
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Canada
Capacity building
Delivery of Health Care, Integrated - organization & administration
Health Services Accessibility - organization & administration - statistics & numerical data
Hospitals - statistics & numerical data - supply & distribution
Humans
Patient Discharge - statistics & numerical data
Reimbursement, Incentive - organization & administration
Residential Facilities - supply & distribution
Abstract
Patients designated as alternative level of care (ALC) are an ongoing concern for healthcare policy makers across Canada. These patients occupy valuable hospital beds and limit access to acute care services. The objective of this paper is to present policy alternatives to address underlying factors associated with ALC bed use. Three alternatives, and their respective limitations and structural challenges, are discussed. Potential solutions may require a mix of policy options proposed here. Inadequate policy jeopardizes new acute care activity-based funding schemes in British Columbia and Ontario. Failure to address this issue could exacerbate pressures on the existing bottlenecks in the community care system in these and other provinces.
Notes
Cites: Healthc Pap. 2000 Spring;1(2):13-3512811063
Cites: CMAJ. 2004 May 25;170(11):1678-8615159366
Cites: Healthc Pap. 2004;5(1):34-9; discussion 96-915496813
Cites: J Aging Soc Policy. 2004;16(4):17-3815724571
Cites: J Gerontol A Biol Sci Med Sci. 2006 Apr;61(4):367-7316611703
Cites: Health Econ Policy Law. 2007 Oct;2(Pt 4):419-2718634642
Cites: Health Serv Res. 2009 Aug;44(4):1188-21019490159
Cites: CMAJ. 2010 Apr 6;182(6):53520194558
Cites: BMJ. 2011;342:d90521444642
Cites: Gerontologist. 2011 Dec;51(6):774-8521737398
Cites: Health Econ Policy Law. 2012 Jan;7(1):73-10122221929
PubMed ID
23968671 View in PubMed
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178 records – page 1 of 18.