The perception of healthcare quality of elderly in the city of Bari, South Italy

<p>Abstract</p> <p>Background</p> <p>In recent decades in Italy, as in all the industrialized nations, the proportion of elderly subjects in the total population is constantly on the increase. However the increased life expectancy is not always paralleled by a true improvement in the quality of life.</p> <p>In this context, it is essential to analyze elderly real health needs and the responses to these needs, especially in terms of healthcare, that the territorial services are perceived to offer.</p> <p>Methods</p> <p>In the period from June to September 2006 we selected randomly one General Practitioner (GP) for each district of the Bari Municipal Area and, form each GP, we randomly chose 25 patients over 65 years old (YO). We conducted phone interviews using a standard data collection questionnaire and, for each of the recruited subjects, the GP filled a data collection sheet.</p> <p>Results</p> <p>Although the mean age (73.6 years) of the population under study was quite high, the general state of health was judged good both by the G P- and by their elderly patients (>75%).</p> <p>Notably, the great majority of elderly patients considered the healthcare they receive to be satisfactory (>60%): in particular, the GP was the true point of reference for this slice of the population for strictly medical problems as well as for advice. On the contrary, the patients attributed little value to social services, which were poorly known and scarcely used (8.5%). Public hospital facilities played a central role in second level healthcare in more than 30% of cases; private facilities covered by public health insurance were also very important. As possible solutions to the problem of loneliness, 36.6% of the patients declared that they approved of nursing homes.</p> <p>Conclusion</p> <p>Decision makers need to create services supporting the key role played by General Practitioners, who are well aware that their assistance is not sufficient to satisfy the health needs of the elderly.</p

The integrated care pathway for melanoma: the Istituto Dermopatico dell'Immacolata experience in Rome

Introduction: The Integrated Care Pathway (ICP) represents a multidisciplinary outline of anticipated care, placed in an appropriate timeframe, to support patients with specific conditions or symptoms. The aim of this paper is to define the ICP for patients with melanoma referring to the "Istituto Dermopatico dell'Immacolata-IRCCS di Roma e Villa Paola" ("Center"). Methods and results: A multidisciplinary group (oncologists, dermatologists, surgeons, pathologists etc.) was defined as well as a facilitator to act as a link between all experts. The first step of ICP development was a review of current practice for patients with melanoma referring to the Center. This first step had the scope to define the multidisciplinary process map (a "picture" of the care plan) for patients with melanoma. The process map defined: i) the activities performed during delivery of care to the patients, ii) the responsibilities for these activities and iii) potential problem areas or opportunities for improvements. The process map formed the basis of the final ICP document. Conclusion: The adoption of melanoma ICP will allow the multidisciplinary group to ensure that clinical guidelines and available evidence are incorporated into everyday practice. (Oncology, HTA & Market Access

Distribution of diseases defined as limiting, by the patient and by the GP

<p><b>Copyright information:</b></p><p>Taken from "The perception of healthcare quality of elderly in the city of Bari, South Italy"</p><p>http://www.biomedcentral.com/1472-6963/7/174</p><p>BMC Health Services Research 2007;7():174-174.</p><p>Published online 24 Oct 2007</p><p>PMCID:PMC2194769.</p><p></p

Percentage distribution of recourse to laboratory, diagnostic-instrumental tests, specialist visits, physiotherapy cycles

<p><b>Copyright information:</b></p><p>Taken from "The perception of healthcare quality of elderly in the city of Bari, South Italy"</p><p>http://www.biomedcentral.com/1472-6963/7/174</p><p>BMC Health Services Research 2007;7():174-174.</p><p>Published online 24 Oct 2007</p><p>PMCID:PMC2194769.</p><p></p

Systemic photoprotection in skin cancer prevention: knowledge among dermatologists

Background: Systemic photoprotection (i.e., administration of substances such as nicotinamide, carotenoids, and vitamin D) may be important to reduce photocarcinogenesis or to support long-term protection against UV irradiation. Clinical trials showed that oral nicotinamide is effective in reducing the onset of new nonmelanoma skin cancers (NMSCs), while other oral photoprotectors failed to achieve the reduction of new melanoma or NMSC formation in humans. The aim of this study was to summarize the current state of knowledge of systemic photoprotection and to evaluate the knowledge and attitude of dermatologists regarding these treatments. Methods: The survey was conducted on a sample of dermatologists recruited according to a snowball sampling procedure. The questionnaire consisted of a first part asking for characteristics of the participant and a second part with 12 specific questions on their knowledge about systemic photoprotection, particularly their knowledge of astaxanthin, β-carotene, nicotinamide, and vitamin D3. Results: One hundred eight dermatologists answered the survey. Most of them (85.2%) stated that oral photoprotectors have a role in the prevention of skin cancer, and responses mainly mentioned nicotinamide. More than half of them (54.6%) had prescribed all the considered oral photoprotectors, but the majority of them had prescribed nicotinamide, mainly for 2 to 3 months during summer, almost invariably (n = 106) associated with topical photoprotectors. Most dermatologists (&gt;80%) were aware of scientific publications demonstrating an effect of systemic photoprotectors on NMSC. Conclusions: Most Italian dermatologists have positive views on oral photoprotection in skin cancer and are aware of the demonstrated potential of nicotinamide in the prevention of NMSCs

Art. 211 - (Pareri di precontenzioso dell'ANAC) - CODICE DEI CONTRATTI PUBBLICI. Commentario di dottrina e giurisprudenza

Art. 211 - (Pareri di precontenzioso dell'ANAC) - CODICE DEI CONTRATTI PUBBLICI. Commentario di dottrina e giurisprudenz