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51.
Tracy Roberts BSc MPhil RGN Stirling Bryan BSc MSc Chris Heginbotham BSc MSc MA & Alison McCallum MB ChB MSc FFPHM 《Health expectations》1999,2(4):235-244
Background Public involvement in health care decision making and priority setting in the UK is being promoted by recent policy initiatives. In 1993, the British Medical Association called for public consultation where rationing of services was to be undertaken. The approach to priority setting advocated by many health economists is the maximization of quality adjusted life years (QALYs). Typically, for a particular health care programme, the QALY calculation takes account of four features: (1) the number of patients receiving the programme, (2) the survival gain, (3) the gain in quality of life and, (4) the probability of treatment success. Only one feature, that relating to quality of life, is based upon public preferences. If the QALY is to be used as a tool for health care resource allocation at a societal level then it should incorporate broader societal preferences.
Methods This study used an interview-based survey of 91 members of the general public to explore whether the traditional QALY maximization model is a good predictor of public responses to health care priority setting choices.
Results and conclusions Many respondents did not choose consistently in line with a QALY maximization objective and were most influenced by quality of life concerns. There was little support for health care programmes that provided a prognostic improvement but left patients in relatively poor states of health. The level of respondent engagement in the survey exercise was not sensitive to the provision of supporting clinical information. 相似文献
Methods This study used an interview-based survey of 91 members of the general public to explore whether the traditional QALY maximization model is a good predictor of public responses to health care priority setting choices.
Results and conclusions Many respondents did not choose consistently in line with a QALY maximization objective and were most influenced by quality of life concerns. There was little support for health care programmes that provided a prognostic improvement but left patients in relatively poor states of health. The level of respondent engagement in the survey exercise was not sensitive to the provision of supporting clinical information. 相似文献
52.
Bernie Minard 《Journal of medical systems》1991,15(4):287-297
This article describes practical applications of the Continuous Quality Improvement (CQI) concept applied to management of the Information Services Departments of a health care institution. The article is valuable for two reasons: (1) it is valuable as a successful application of CQI in an award-winning information services division of an award-winning health care institution, and (2) since the work of the information services function is so complex, has major interdependencies with many other functions throughout the entire organization, and is driven by fast-paced change, successful use in that function can be a model for other major functions of the hospital. 相似文献
53.
Kinta Beaver PhD MRes BA DPSN RGN David Jones MD FRCS † Shabbir Susnerwala MD FRCR ‡ Olive Craven MSc RGN RM Onc.Cert § Mary Tomlinson BA RGN ¶ Gary Witham BA RGN Onc.Cert PG.Cert Karen A Luker PhD BNurs FMedSci †† 《Health expectations》2005,8(2):103-113
OBJECTIVES: To explore patient views on participation in treatment, physical care and psychological care decisions and factors that facilitate and hinder patients from making decisions. DESIGN: Qualitative study using semi-structured interviews with patients. SETTING AND PARTICIPANTS: Three NHS Trusts in the north-west of England. Theoretical sampling including 41 patients who had been treated for colorectal cancer. RESULTS: For patients, participation in the decision-making process was about being informed and feeling involved in the consultation process, whether patients actually made decisions or not. The perceived availability of treatment choices (surgery, radiotherapy, chemotherapy) was related to type of treatment. Factors that impacted on whether patients wanted to make decisions included a lack of information, a lack of medical knowledge and trust in medical expertise. Patients perceived that they could have a more participatory role in decisions related to physical and psychological care. CONCLUSION: This study has implications for health professionals aiming to implement policy guidelines that promote patient participation and shared partnerships. Patients in this study wanted to be well informed and involved in the consultation process but did not necessarily want to use the information they received to make decisions. The presentation of choices and preferences for participation may be context specific and it cannot be assumed that patients who do not want to make decisions about one aspect of their care and treatment do not want to make decisions about other aspects of their care and treatment. 相似文献
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Using action research to develop midwives’ skills to support women with perinatal mental health needs
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The perspectives of stakeholders of intellectual disability liaison nurses: a model of compassionate,person‐centred care
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60.
Patricia Leahy‐Warren PhD MSc BSc Hdip PHN RPHN RM RGN Mary Rose Day DN MA BSc Hdip PHN RPHN RM RGN Kari Glavin PhD M.Sc PHN RN MEANS Edith Roth Gjevjon PhD MSc RN MEANS Anne Kjersti Myhrene Steffenak PhD MSc PHN RN Live S. Nordhagen MSc PHN RN Hilde Egge MSc PHN RN Elizabeth Healy MSc PHN RGN 《Public health nursing (Boston, Mass.)》2018,35(4):307-316