Healthcare systems

Jai Moo Shin, George Sachs David Geffen School of Medicine, University of California at Los Angeles and Veterans Administration Greater Los Angeles Healthcare System,... 

Chief of Staff, VA Connecticut Healthcare System, West Haven, Connecticut Professor of Psychiatry, Yale University School of Medicine, New Haven, Connecticut... 

Associate Professor, Division of Psychiatry, Boston University School of Medicine Associate Chief of Psychiatry, Boston VA Healthcare System, Boston, Massachusetts... 

BUSHKIN G, BUSHKIN E (2002) Ancient alternative medicine Time-honored native natural healthcare system. Health Products Business, January, 8-13. 

Administration within 30 min of arrival into the healthcare system recommended... 

VA Connecticut Healthcare System West Haven, Connecticut... 

Managed healthcare systems also have interests in reductionist definitions of disease. The payment and reimbursement structures of Health Management Organizations (HMOs) require that conditions be identified and coded in terms of a predefined list of syndromes with pre-established measures of cost and risk. Calling for evidence-based medicine , HMOs are more likely to reimburse conditions that are defined as biological because diagnosis appears objective. 

In the second study, Ruscio, Ruscio, and Keane (2002) examined the taxonicity of PTSD in a large sample of male combat veterans (N = 1,230), who were seen at the Behavioral Sciences Division of the Veterans Affairs Boston Healthcare System s National Center for posttraumatic stress disorder between 1985 and 2000. All the participants completed the Mississippi scale (Keane, Caddell,. Taylor, 1988), a 35-item measure of combat-related posttraumatic stress disorder symptoms rated on a five-point scale a subset of this sample (n = 841) was assessed with the Clinician Administered Posttraumatic Stress Disorder Scale (CAPS), an interview measure of posttraumatic stress disorder symptoms that a clinician rates on a five-point scale. According to the CAPS, 68% of the sample qualified for a posttraumatic stress disorder diagnosis. 

The author implies that a healthcare system that routinely looks... 

MEDLINE Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences http //www.nlm.nih.gov/databases/databases medline.html... 

The concept of integrating healthcare professionals expertise for the patient s best interest is not a new one for pharmacists. Speaking at a 1989 conference focusing on evolving pharmacy practice for the 21st century, Hepler and Strand reviewed the alarming extent of drug-related morbidity and mortality in the American healthcare system. They... 

Another perceived view about Western drugs is the adverse effects. Western medicine is sometimes viewed as a sledgehammer method rather than the more holistic approach using TM. The costs of Western medicine can be prohibitive as well, especially for patients in countries where there are no comprehensive healthcare systems. For example, treatment with pegylated interferon for hepatitis C or antibody for colon cancer can cost tens of thousands of dollars per year. Limitations of Western drugs in some cases, such as resistance to antibiotics, also highlight problems and pave the way for people to consider TM. See Exhibit 11.3 on how GlaxoSmithKline and... 

Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine Departments of Psychiatry and Research, Greater Los Angeles VA Healthcare System, 11301 Wilshire Blvd. Bldg 256 Suite 221, Los Angeles, CA 90073, USA asharma mednet.ucla.edu... 

Greater Los Angeles VA Healthcare System, Los Angeles, CA 90095, USA, abrody ucla.edu... 

Institute of Medicine, To Err is Human Building a Safer Healthcare System, November 1999, www.nas.org (accessed Dec. 1999). 

This chapter is written from a UK perspective and readers in coimtries outside the United Kingdom will need to make allowances for this. Some specific points may not be relevant to your country but in general, the principles apply to most healthcare systems. 

In the United States, there are several computerised healthcare systems, sometimes referred to as multipurpose databases, which have been used for post-marketing surveillance purposes. The best-known include Group Health Cooperative of Puget Sound, Kaiser-Permanente, Medicaid, Rhode Island and the Saskatchewan database in Canada. ... 

A prerequisite to the use of health economics is an acceptance that no healthcare system can possibly do all things for all people. This means recognising explicitly that some form of prioritising is necessary and unavoidable. Such recognition has been slowly emerging over the past decade or so. 

Analyses from the healthcare system perspective (e.g. Ministry or Department of Health) would include only those costs that are paid by that system. 

We live in an era in which the value of medicines can no longer be assumed and the phrase evidence based is no longer restricted to the realm of academics. The increasing financial burden on our healthcare systems has prompted decision-makers around the world to demand that the pharmaceutical industry provide proof of the value of new drugs being introduced into the market. Decision-makers in certain countries (e.g. Australia and Canada) have taken this requirement a step further by linking reimbursement approval to the provision... 

At present, healthcare systems remain a national prerogative and are subject to national rather than European controls, but operated within the broad scope of the Transparency... 

These realities of the current state of healthcare have caused healthcare policy-makers to use several methods to regulate the supply and demand of health services and thereby control the cost of those serv ices. Attempts to reduce the supply of services include a reduction in the reimbursement for services or a reduction in the number of physicians and specialists. These approaches may contain the growth of healthcare costs but a reduction in the capacity of the healthcare system also limits the patient access to services, resulting in longer waits for non-emergency services. Attempts to reduce the demand for services include ... 

Delays to the entry of services into the healthcare system, such as a separate approval process for the reimbursement of a pharmaceutical by the healthcare system after the approval of the safety, efficacy and quality of... 

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