Kvaliteta rada u medicini

Neke od općih definicija kvalitete su: izvrsnost, ostvarenje očekivanja ili ciljeva, odsustvo pogrešaka te prikladnost. Jedna od općih definicija kvalitete rada u medicini je stupanj do kojeg zdravstvene usluge povećavaju vjerojatnost željenih zdravstvenih ishoda kod pojedinca i populacije. Teško je odrediti mjere kojima bi se prema navedenim definicijama mogla donijeti prosudba o kvaliteti. Prema drugom pristupu konceptu kvalitete, koji prevladava u medicini, kvaliteta je višedimenzionalna. Svaka dimenzija kvalitete gledana pojedinačno daje djelomični prikaz sustava, ali u sintezi s drugim dimenzijama dobro i s dosta pojedinosti opisuje cjeloviti sustav. Dimenzije kojima se opisuje kvaliteta rada u medicini su brojne, a najčešće korištene su učinkovitost, djelotvornost, pristupačnost, dostupnost, sigurnost, pravičnost te zadovoljstvo.Definirani i mjerljivi elementi procjene kvalitete rada nazivaju se pokazatelji kvalitete rada. Odlike prihvatljivih pokazatelja kvalitete rada su valjanosti, tehnička provedivost, pouzdanost, prihvatljivost te osjetljivost na promjene. Pokazateljima kvalitete rada pridružuju se pripadajući kriteriji, navodi vezani uz pojedini akt zdravstvene skrbi, jasno definirani, tako da je moguće prosuditi je li se navedeni element skrbi u prošlosti dogodio ili ne.  

Kvaliteta rada u medicini

Neke od općih definicija kvalitete su: izvrsnost, ostvarenje očekivanja ili ciljeva, odsustvo pogrešaka te prikladnost. Jedna od općih definicija kvalitete rada u medicini je stupanj do kojeg zdravstvene usluge povećavaju vjerojatnost željenih zdravstvenih ishoda kod pojedinca i populacije. Teško je odrediti mjere kojima bi se prema navedenim definicijama mogla donijeti prosudba o kvaliteti. Prema drugom pristupu konceptu kvalitete, koji prevladava u medicini, kvaliteta je višedimenzionalna. Svaka dimenzija kvalitete gledana pojedinačno daje djelomični prikaz sustava, ali u sintezi s drugim dimenzijama dobro i s dosta pojedinosti opisuje cjeloviti sustav. Dimenzije kojima se opisuje kvaliteta rada u medicini su brojne, a najčešće korištene su učinkovitost, djelotvornost, pristupačnost, dostupnost, sigurnost, pravičnost te zadovoljstvo.Definirani i mjerljivi elementi procjene kvalitete rada nazivaju se pokazatelji kvalitete rada. Odlike prihvatljivih pokazatelja kvalitete rada su valjanosti, tehnička provedivost, pouzdanost, prihvatljivost te osjetljivost na promjene. Pokazateljima kvalitete rada pridružuju se pripadajući kriteriji, navodi vezani uz pojedini akt zdravstvene skrbi, jasno definirani, tako da je moguće prosuditi je li se navedeni element skrbi u prošlosti dogodio ili ne.  

Treća studentska konferencija o izobrazbi u javnom zdravstvu u zemljama Južne i Jugoistočne Europe

Od 10. do 12. rujna 2009. godine u Školi narodnog zdravlja „Andrija Štampar“ Medicinskog fakulteta Sveučilišta u Zagrebu održana je Treća studentska konferencija organizirana pod okriljem MetaNET projekta pod nazivom „Level of Public Health Teaching in South Eastern European Countries.“ Suorganizatori konferencije su Škola narodnog zdravlja „Andrija Štampar“ i Zavod za epidemiologiju i međunarodno javno zdravstvo Fakulteta zdravstvenih znanosti Sveučilišta u Bielefeldu (Njemačka). Na konferenciji je sudjelovalo 8 nastavnika i 27 studenata iz Albanije, Bosne i Hercegovine, Bugarske, Crne Gore, Hrvatske, Kosova, Makedonije, Njemačke, Rumunjske, Srbije i Slovenije. Glavne teme Konferencije bile su izobrazba i suradnja u području javnog zdravstva u Njemačkoj i zemljama južne i jugoistočne Europe

Distribution of Changes in Systolic Blood Pressure and Waist Circumference – Indicators for Primary Prevention

Eliminating or diminishing risk behaviors that lead to cardiovascular diseases could be achieved through primary prevention during the general practice visits. However, there is difference in effectiveness of preventive measure while there are no symptoms, and reactive response when burden of diseases start to show. We analyzed trends in gender and age- -pattern changes of systolic blood pressure and waist circumference, as a reflection of primary prevention. Results show increase of values for both indicators in both genders, through youngest and middle age groups. In the oldest group stagnation and even decrease of values is evident. These results signal possible absence of primary prevention in younger age groups and some action when symptoms occur. It is hard to distinguish weather lower values is consequence of medication or lifestyle change. The absence of primary prevention is usually missed opportunity that is charged later both to the patient and health care system

Distribution of Changes in Systolic Blood Pressure and Waist Circumference – Indicators for Primary Prevention

Eliminating or diminishing risk behaviors that lead to cardiovascular diseases could be achieved through primary prevention during the general practice visits. However, there is difference in effectiveness of preventive measure while there are no symptoms, and reactive response when burden of diseases start to show. We analyzed trends in gender and age- -pattern changes of systolic blood pressure and waist circumference, as a reflection of primary prevention. Results show increase of values for both indicators in both genders, through youngest and middle age groups. In the oldest group stagnation and even decrease of values is evident. These results signal possible absence of primary prevention in younger age groups and some action when symptoms occur. It is hard to distinguish weather lower values is consequence of medication or lifestyle change. The absence of primary prevention is usually missed opportunity that is charged later both to the patient and health care system

ENVIRONMENTAL JUSTICE AND EQUITY AS HEALTH DETERMINANTS – NEW CONCEPTS THAT SHOULD BE ADDRESSED

Autorice se osvrću na potrebu razmatranja pojmova pravednosti i pravičnosti povezanim s okolišem kao determinanti zdravlja. Jednakost u pristupu zdravstvenom sustavu automatski ne znači i jednakost u zdravlju, jer na zdravlje utječe cijeli niz determinanti izvan strogo medicinskog kuta. Nejednakosti u socioekonomskom smislu su prepoznate, ali nejednakost u odnosu na okoliš kao determinantu zdravlja treba početi promatrati u pristupu populaciji, razvoju javnozdravstvenih intervencija i razvoju zdravstvenih politika. Moderni pristup problemu ukazuje da nije dovoljno samo uklanjati posljedice sanacijom stanja u različitim sastavnicama okoliša ili smanjivati emisije, već je potrebno djelovati na sprječavanju i uvijek razmišljati o ekološkim posljedicama državnih i lokalnih politika.The article explores environmental justice and environmental equity issues. Equal access to healthcare system does not automatically grant equality in health due to the fact that health is infl uenced by an array of determinants outside the medical recourse. Socioeconomic inequalities are well recognized, but environmental inequalities need to be addressed in development of public health interventions and health policy. Modern approach to the issue of environmental justice and environmental equity indicates that it is not enough to act after, to eliminate consequences in sanitation processes, but to act in advance and always take into account environmental consequences of local and state policy

Could Determinants of PCS and MCS Serve for Public Health Intervention regarding Chronic Diseases in Croatia?

The aim of this article was to identify parameters that determinate PCS and MCS values, and analyze 5-year changes in those values according to the age, sex and geographic region. Cohort of 3229 participants was obtained from the CAHS 2003–2008. Results revealed no statistically significant differences between same age group, sex, and different region regarding PCS and MCS. When chronic conditions were in themodel difference was present, PCS beingmore influenced by all conditions but bronchial asthma. The strongest influence comes from musculoskeletal conditions; followed by weak heart. Values for PSC and MSC decreased in 2008 compared with 2003, but only in few cases decrease was statistically significant. Values of PCS and MCS are higher in men in all regions, but they show higher variability than woman. Our results support the findings that data obtained through SF-36 could be the useful for public health interventions regarding chronic diseases

Could Determinants of PCS and MCS Serve for Public Health Intervention regarding Chronic Diseases in Croatia?

The aim of this article was to identify parameters that determinate PCS and MCS values, and analyze 5-year changes in those values according to the age, sex and geographic region. Cohort of 3229 participants was obtained from the CAHS 2003–2008. Results revealed no statistically significant differences between same age group, sex, and different region regarding PCS and MCS. When chronic conditions were in themodel difference was present, PCS beingmore influenced by all conditions but bronchial asthma. The strongest influence comes from musculoskeletal conditions; followed by weak heart. Values for PSC and MSC decreased in 2008 compared with 2003, but only in few cases decrease was statistically significant. Values of PCS and MCS are higher in men in all regions, but they show higher variability than woman. Our results support the findings that data obtained through SF-36 could be the useful for public health interventions regarding chronic diseases

CHARACTERISTICS OF SELF-MEDICATION FOR PAIN RELIEF AMONG FIRST-YEAR HEALTH CARE STUDENTS IN ZAGREB, CROATIA

Background: Taking over the responsibility for one\u27s own health and active participation in eliminating the existing health problems is ever more widespread in the world. Self-medication in the form of using any kind of therapy without previous consultation with medical professionals has been ever more common among student populations in many countries. The aim of this study was to determine the attitudes about self-medication for pain relief and features of self-medication in first-year students of the University of Applied Health Studies in Zagreb. Subjects and methods: The study was conducted using an anonymous questionnaire, which was completed by 389 respondents. Results: Taking painkillers in the past year was reported by 74.6% of respondents, significantly more by female students (80.8%); 62.6% of female students used painkillers once a month versus 45.7% of male students taking analgesics once a year. Ibuprofen was preferred by female students and acetylsalicylic acid by male students. Headache was the most common indication for taking painkillers (76.6%), followed by menstrual discomforts in female students (66.2%) and toothache (28.6%). Significant sex differences were recorded in the choice of drugs, indications for self-medication, and frequency of drug use. There were no differences between study courses. Conclusions: Appropriate student education and improved information transfer between professionals and students are the key elements to ensure judicious, quality and knowledge based use of drugs among students

Association of Behavioral Cardiovascular Risk Factors with Mortality in Croatian Adult Population: the CroHort Study

This study examined individual and combined influence of smoking, physical inactivity, alcohol drinking, and unhealthy diet on total mortality. Relationship between individual and combined poor health behaviours and total mortality were examined using Cox proportional hazards regression. Out of 7490 individuals included in the study, during 5 years follow up 808 died. Adjusted hazard ratios (HRs), and 95% confidence intervals (95%CIs) for men with health behaviour scores 1, 2, 3, and 4 compared with those with score 0 were 1.67 (1.24–2.24), 2.28 (1.64–3.18), 2.24 (1.32–3.84), and 2.86 (0.77–11.70), respectively (p value for trend<0.001). Adjusted HRs (95%CIs) for women with health behaviour scores 1, 2, and 3 compared with those with score 0 were 1.17 (0.97–1.42), 1.37 (1.02–1.86), and 1.20 (0.37–3.61), respectively (p value for trend=0.04). A unit of the health behaviour score increased mortality risk equivalent to being 5.9 and 2.9 years older, for man and woman respectively