Toward a social ethic of mental health care: Long-term therapy, short-term therapy, and managed health care.

1998 ◽  
pp. 103-120
Author(s):  
Carol Shaw Austad ◽  
Thomas C. Morgan
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Term Therapy ◽  
Social Ethic ◽  
Short Term ◽  
Managed Health Care ◽  
Short Term Therapy ◽  
Long Term Therapy

scholarly journals Ambulatory Intravenous Antibiotic Therapy in Quebec: The Hôpital Charles LeMoyne Experience in 1996

2000 ◽  
Vol 11 (suppl a) ◽  
pp. 6A-10A
Author(s):  
Laurent Delorme ◽  
Charles Frenette ◽  
Isabelle Le Corre ◽  
Julie Duchesne ◽  
Carole Delorme ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Term Therapy ◽  
Outpatient Therapy ◽  
Short Term ◽  
Intravenous Antibiotic ◽  
Therapy Program ◽  
Intravenous Antibiotic Therapy ◽  
Short Term Therapy ◽  
Long Term Therapy

From January 1, 1996 to December 31, 1996, 343 patients received outpatient intravenous antibiotic therapy at Charles LeMoyne Hospital, a 436-bed, acute care hospital in Greenfield Park, south of Montréal, Québec. The infectious diseases department saved 2660 bed-days using outpatient therapy. The mean duration of outpatient therapy was 7.76 days; 81.6% of patients were admitted to the program directly from the emergency room, or outpatient hospital clinics or private offices in the community. Hospitalized patients constituted only 18.4% of admissions to the outpatient intravenous antibiotic therapy program. Forty per cent of the surgical/medical staff participated in the program and they were able to generate a significant impact by diverting patients to outpatient therapy. Two types of patients can benefit from an outpatient intravenous antibiotic therapy program. One group of patients needs empirical short term therapy and can be switched to oral sequential therapy after two to five days of outpatient intravenous antibiotic therapy. A second group of patients needs specific long term therapy for the full duration of the antibiotic therapy. Empirical short term therapy can be managed by emergency department or hospital-based primary physicians, or medical/surgical specialists. Specific long term therapy can be managed by microbiology/infectious disease specialists or medical/surgical specialists. Hospitals that want to relieve pressure on emergency rooms and hospital bed demands should create facilities for both types of patients. Cefazolin and gentamicine/tobramycine were the most commonly used antibiotics in empirical short term therapy and in terms of number of patients treated. Ceftriaxone and vancomycin were most commonly used for long term therapy. The Drug acquisition antibiotic cost was $73,117 but constituted only 20% of the total outpatient intravenous antibiotic therapy cost. The per diem ambulatory cost was $140/patient/day.

Selective Streptokinase Fibrinolysis in Femoro-Iliac Arterial Obstruction

1986 ◽  
Vol 27 (3) ◽  
pp. 279-283 ◽  
Author(s):  
K. Sørensen ◽  
V. Hegedüs
Keyword(s):  
Low Dose ◽  
Transluminal Angioplasty ◽  
Term Therapy ◽  
High Dose ◽  
Short Term ◽  
Short Term Therapy ◽  
One Year ◽  
High Level ◽  
Long Term Therapy

Percutaneous transluminal angioplasty of iliac and femoral arteries was in 17 patients combined with selective intra-arterial streptokinase treatment. The patients were divided into two groups, one given low dose long-term therapy and the other high dose short-term therapy. The experiences obtained during an observation period of over one year revealed greater benefit from high dose short-term therapy. It seems that the major cause of complications must be attributed to the development of a high level of streptokinase antibodies during low dose long-term therapy. References

Reactions to Managed Care among Psychologists and Social Workers

1997 ◽  
Vol 80 (1) ◽  
pp. 147-154 ◽  
Author(s):  
Catherine Chambliss ◽  
Debra Pinto ◽  
Joan McGuigan
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Managed Care ◽  
Mental Health Care ◽  
Social Workers ◽  
Term Therapy ◽  
Master's Level ◽  
Care Providers ◽  
Short Term ◽  
Doctoral Level

Although the delivery system for mental health care is undergoing unprecedented changes with managed care, few empirical assessments of practitioners' responses exist. Directories of managed care providers were used to contact 139 providers of managed mental health care for an anonymous survey of experiences with case management and short-term therapy. The differential effects of managed care on the practices of doctoral-level psychologists, master's-level psychologists, and social workers were examined.

Consumerism for Neurobiological Disorders: An Assessment

1996 ◽  
Vol 12 (4) ◽  
pp. 644-656
Author(s):  
Richard E. Peschel ◽  
Enid Peschel
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Physical Nature ◽  
Outcome Data ◽  
Public Understanding ◽  
Medical Community ◽  
Treatment Programs ◽  
Equitable Treatment

AbstractConsumerism is a growing phenomenon in U.S. health care, yet its exercise is still inhibited by powerful forces within the medical community. Despite the neuroscientific framework that stresses the commonalities between mental and physical illness, consumerism is even more problematic and difficult in mental health care than in other areas of health care. People with severe mental illness and their advocates must contend with limited public understanding of neurobiological disorders, poor definitions of effective treatment, and a paucity of outcome data, especially from prospective randomized and long-term studies. The only clear way for consumerism to grow in mental health care is for its advocates to align themselves with the neuroscientific revolution and to demand that effective and equitable treatment programs be created based on the documented evidence of the physical nature of neurobiological disorders.

Clinical and Pharmacokinetic Evaluation of Long-Term Therapy With Didanosine in Children with HIV Infection

PEDIATRICS ◽  
1994 ◽  
Vol 94 (5) ◽  
pp. 724-731 ◽  
Author(s):  
Brigitta U. Mueller ◽  
Karina M. Butler ◽  
Vicki L. Stocker ◽  
Frank M. Balis ◽  
Philip A. Pizzo ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Area Under The Curve ◽  
Chronic Administration ◽  
Cd4 Count ◽  
Term Therapy ◽  
Short Term ◽  
Apparent Relationship ◽  
Term Administration ◽  
Long Term Therapy

Background. Didanosine has demonstrated promising antiviral activity and a tolerable toxicity profile in short term studies. We describe a cohort of HIV-infected children who were treated for a prolonged period of time with didanosine. Methods. Children (6 months to 18 years of age) with symptomatic HIV infection or an absolute CD4 count < 0.5 x 109 cells/L, received oral didanosine at doses between 20 mg/m2 to 180 mg/m2 every 8 hours. Clinical, immunological, and virological parameters were assessed at least every 2 months. The pharmacokinetics of didanosine were evaluated in 85 patients. Results. Previously untreated children (n = 51) and children who had received prior antiretroviral therapy (n = 52) were enrolled in the study (median time on study 22.6 months; range 2 to 48). The long-term administration of didanosine was well tolerated and no new toxicities were observed. The absolute CD4 count increased by ≥ .05 x 109 cells/L in 28 of 87 (32%) of patients after 6 months of therapy. Responses were also sustained in 41% of these children after 3 years of therapy. Children entering the study with a CD4 count >0.1 x 109 cells/L (n = 51) had a marked survival advantage (P = .00002) with an estimated survival probability after 3 years of 80% compared to 39% for children with lower CD4 counts. Although the area under the curve of didanosine increased proportionally with the dose, there was considerable interpatient variability at each dose level. There was no apparent relationship between surrogate markers of clinical outcome and plasma drug concentration. Conclusions. Didanosine was well tolerated with chronic administration, and toxicities were uncommon and usually reversible. In 41% of patients, the CD4 count increased and was maintained at the higher level even after years of treatment.

scholarly journals Exploring Perceptions of Continuity of Care Among People With Long-Term Mental Disorders in Denmark

2019 ◽  
Vol 29 (13) ◽  
pp. 1916-1929
Author(s):  
Anna P. Folker ◽  
Mette M. Kristensen ◽  
Amalie O. Kusier ◽  
Maj Britt D. Nielsen ◽  
Sigurd M. Lauridsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Continuity Of Care ◽  
Service Users ◽  
Mental Health Care System ◽  
Template Analysis ◽  
Depth Interviews

Continuity of mental health care is central to improve the treatment and rehabilitation of people with mental disorders. While most studies on continuity of care fail to take the perspectives of service users into account, the aim of this study was to explore the perceived meanings of continuity of care among people with long-term mental disorders. Fifteen service users participated in semi-structured in-depth interviews. We used template analysis to guide the analysis. The main transversal themes of continuity were “Navigating the system” and “Connecting to people and everyday life.” While the first theme related to the participants’ experiences of their interaction with the mental health care system, the latter related to their hopes and perceived opportunities for a good life as desired outcomes of mental health care. We conclude that efforts to improve continuity of mental health care should be tailored to the priorities of service users.

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