Influences of organizational features of healthcare settings on clinical decision making: qualitative results from a cross-national factorial experiment.

Item does not contain fulltextA proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians' explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the USA, are discussed

Evidencias produzidas por pesquisas qualitativas sobre diabetes tipo 2: revisao da literatura

Type 2 diabetes has a major impact on patients lives and the healthcare network. Given the growth in qualitative information on diabetes, it becomes important to systematize this knowledge. A meta-study on diabetes was conducted through analysis on 42 articles that were made in journals at the periodicals portal of the Coordination Office for Advancement of Higher-level Personnel (Capes). We found that the studies reviewed had a good theoretical basis, which included: care management, health-disease concepts, professional-patient relationships, professional practices and treatment compliance. The articles clearly described the methodological procedures used. The use of interviews and focal groups for data gathering predominated, and it was sought to explore different views of the individuals investigated. It was reaffirmed that it was important for health professionals and managers to implement healthcare policies, programs and models that are appropriate for the specific features of chronic illness, guided by comprehensive care and co-responsibility