Is it possible to incorporate quality into hospital pricing systems?

Australia has recently implemented an activity - based funding system for public hospitals. Policymakers and providers are keen to ensure that the price paid for health care services stimulates improvements in quality and safety , but some remain scept ical that this can be achieved through pricing mechanisms. There are four main ways of linking quality and safety to hospital pricing in the context of activity based funding: Best-practice pricing This involves making evidenced - based decisions on what constitutes ‘best-practice’ for the treatment of a particular condition, then paying health services a set price when they provide best-practice care. Normative pricing This involves using price to influence the delivery of care (for example, providing incentives to deliver more care in the home for certain conditions or to provide day surgery options where appropriate). Structural models of pricing quality This involves linking funding to meeting accreditation standards or participating in benchmarking activities or clinical quality registries. Payment for Performance (P4P) or quality pricing This involves using financial incentives and/or disincentives to encourage providers to behave in certain ways that will improve quality and safety. This paper briefly examines the strength of the evidence for each of these pricing models. It considers both peer-reviewed research as well as non peer-reviewed material, such as program evaluations and government reports

Experimental generation and characterization of single-photon hybrid ququarts based on polarization-orbital angular momentum encoding

High-dimensional quantum states, or qudits, represent a promising resource in the quantum information field. Here we present the experimental generation of four-dimensional quantum states, or ququarts, encoded in the polarization and orbital angular momentum of a single photon. Our novel technique, based on the q-plate device, allows to prepare and measure the ququart in all five mutually unbiased bases. We report the reconstruction of the four dimensional density matrix through the tomographic procedure for different ququart states.Comment: 7 pages, 5 figure

Consideraciones para una "aletheia" del fenómeno museo

Fil: Sansoni, Andrés. Universidad Nacional de Cuyo. Facultad de Filosofía y Letra

Experimental Detection of Quantum Channels

We demonstrate experimentally the possibility of efficiently detecting properties of quantum channels and quantum gates. The optimal detection scheme is first achieved for non entanglement breaking channels of the depolarizing form and is based on the generation and detection of polarized entangled photons. We then demonstrate channel detection for non separable maps by considering the CNOT gate and employing two-photon hyperentangled states.Comment: 8 pages, 9 figure

Functional health literacy of asylum seekers and refugees. A pilot study in italy

Literature shows how some groups of populations, among which are people seeking international protection and refugees, find it difficult to access services in national health systems. Usually, asylum seekers have limited Health Literacy (HL), which makes understanding the appropriate health information difficult. The objective of this research is to consider the relationship between how people requesting international protection and refugees approach the Italian Health System to request health services and their level of Functional Health Literacy (FHL). These relationships are examined through mixed methods. Data were obtained using several tools: a self-administered questionnaire in which the subjects revealed social and demographic data and a face-to-face interview together with the S-FHL Scale fulfilment in order to identify the functional level of HL. Twenty-one subjects were interviewed in two Centers of Protection System for Asylum Seekers and Refugees (SPRAR). Results show a picture of the actual situation. Data report a problematic or insufficient FHL level. Some factors, such as gender, age and health perceptions, play a role in the FHL levels. Some racial prejudices were reported. Language barriers had the most impact on the communication gap. Nevertheless, none of the subjects were denied health services. In conclusion, although this study is a pilot, we have experienced difficulty in obtaining asylum seekers’ trust to be open about their experience. This explains the number of the sample that should be more indicated for a qualitative study. Our results are in accordance with literature for inadequate level of FHL and lack of knowledge of the Italian Health System. This study highlighted several other issues to be taken into consideration for future research on the subject

Measuring patient satisfaction with urinary incontinence treatment

Background: A number of patient satisfaction measures were trialed in a cross-sectional survey of women who had treatment for urinary incontinence (N=187). The psychometric properties of these measures were examined and a short measure for patient satisfaction was developed. Methods: Participants completed a questionnaire comprising items covering incontinence status, treatment type and three generic patient satisfaction questionnaires: the Client Satisfaction Questionnaire (CSQ-18), the Consultation Satisfaction Questionnaire (Consult SQ), and the Patient Satisfaction Index (PSI). Donabedian\u27s model postulates that satisfaction is the patient\u27s judgment on the quality of care. The seven dimensions in this model provide the conceptual framework against which the measures were reviewed. Results: The instruments were examined by their descriptive systems, internal structures and responsiveness. The items from the instruments were examined through iterative Mokken and partial credit IRT analyses against Donabedian\u27s model. Seven items were selected which formed a Short Assessment of Patient Satisfaction (SAPS) scale. Its internal psychometric properties were excellent (α = 0.86) and it provided a patient satisfaction perspective that was most consistent with Donabedian\u27s model. In summary, the internal structures of the instruments suggested that all SAPS items were responsive, but some items on the other measures were insensitive. Also, all measures were shown to be unidimensional. Tests of response bias suggested that this was present in the CSQ-18 and the PSI. Redundancy was observed in the Consult SQ, CSQ-18 and PSI. Conclusions: This study has provided evidence that patient satisfaction can be assessed validly, reliably and sensitively using the much shorter SAPS instrument. This new short measure of patient satisfaction with treatment will be a useful tool for clinicians and evaluators as the population ages

Polarization entangled state measurement on a chip

The emerging strategy to overcome the limitations of bulk quantum optics consists of taking advantage of the robustness and compactness achievable by the integrated waveguide technology. Here we report the realization of a directional coupler, fabricated by femtosecond laser waveguide writing, acting as an integrated beam splitter able to support polarization encoded qubits. This maskless and single step technique allows to realize circular transverse waveguide profiles able to support the propagation of Gaussian modes with any polarization state. Using this device, we demonstrate the quantum interference with polarization entangled states and singlet state projection.Comment: Revtex, 5+2 pages (with supplementary information), 4+1 figure