Practitioner's column: Tertiary care respiratory medicine: Is there a place for psychology in the managed care world?

1996 ◽  
Author(s):  
Bruce Bender ◽  
Keyword(s):  
Managed Care ◽  
Tertiary Care ◽  
Respiratory Medicine

ANALYSIS AND INTERPRETATION OF SPIROMETRY OF PATIENTS ATTENDING RESPIRATORY MEDICINE OPD IN A TERTIARY CARE CENTER: A RETROSPECTIVE STUDY

2021 ◽  
pp. 39-41
Author(s):  
Vidhi Jobanputra ◽  
Hafiz Deshmukh ◽  
Ashish Deshmukh ◽  
Sunil Jadhav ◽  
Shivprasad Kasat ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bronchial Asthma ◽  
Lung Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Respiratory Medicine ◽  
Smoking History ◽  
Tertiary Care Center ◽  
Operative Evaluation ◽  
History Of

OBJECTIVE: To study the various spirometry ndings and look for its association with smoking history and use of biomass fuels. METHODS: Spirometry ndings of 375 patients who attend Respiratory medicine OPD from year 2017- 2019 were studied. RESULTS: Out of 375 patients, 95 patients were diagnosed as COPD, 62 as bronchial asthma, 149 had normal spirometry and 69 had restriction. CONCLUSION: In this study we concluded that spirometry plays an intergral role in the diagnosis of bronchial asthma, COPD and restrictive lung diseases. It gives an overview of the decline of lung function with increasing age, smokers, occupational lung exposures, family history of bronchial asthma. Restrictive patterns were most commonly seen in patients who came for pre operative evaluation.

scholarly journals Prevalence of hepatitis B and C among patients admitted in respiratory medicine ward of a tertiary care hospital in Mullana, Ambala, Haryana, India

2017 ◽  
Vol 5 (4) ◽  
pp. 1546 ◽  
Author(s):  
Ankit Sharma ◽  
Sameer Singhal ◽  
Dinesh Mehta ◽  
Abinav Dagar
Keyword(s):  
Public Health ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Tertiary Care ◽  
Respiratory Medicine ◽  
World Population ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Prevalence Rates ◽  
High Prevalence

Background: Viral Hepatitis B and C have become a major public health problem. Hepatitis B affects approximately 30% of world population or about 2 billion people have serological evidence of either current or past infection. Hepatitis C virus infects approximately 3% of world population placing about 170 million people at risk of liver disease. In India, HBsAg prevalence rates among general population ranges from 0.1% to 11.7%, being 2% to 8% in most studies and seroprevalence for Hepatitis C ranges from 0.1% to 8% among general population.Methods: The study was conducted in the respiratory medicine Ward, MMIMSR in the month of August 2016. 200 patients were taken up for the study after clinical examination, necessary investigation and proper consent. Patients were tested for HBsAg antigen and HCV Tridot. Patients were put through a carefully designed questionnaire to look for possible cause of infection. Patients who came out to be positive for either Hepatitis B or C were counselled about further investigations and treatment options.Results: The prevalence rate for Hepatitis B came out to be 9% and for Hepatitis C was 5.5%. Hepatitis has become a major public health issue in India particularly in the rural areas. High prevalence rates among patients with respiratory diseases can be attributed to unsafe therapeutic injections and use of shared needles.Conclusions: There is a need to carry out larger studies to better elucidate the epidemiology of Hepatitis B and C and to identify high prevalence areas and simultaneously focus on improving public health measures to prevent disease transmission and decrease the burden of disease.

A STUDY OF PATIENT’S PROSPECTIVE ABOUT QUALITY OF DIRECTLY OBSERVED TREATMENT SERVICES (DOTS

2021 ◽  
pp. 60-61
Author(s):  
Achchhar Singh ◽  
Puneet Aggarwal ◽  
Jai Kishan
Keyword(s):  
Tertiary Care ◽  
Respiratory Medicine ◽  
Tertiary Care Centre ◽  
The Past ◽  
Treatment Services ◽  
Laboratory Facility ◽  
Directly Observed Treatment ◽  
History Of ◽  
Compliance To Treatment

Introduction--A observational study was conducted in the Department Of Respiratory Medicine in a tertiary care centre who were taking ATT under DOTS or had history of ATTconsumption in the past. Aim :Aim of the study was to 1. To see the patient's perspective of the DOTS services. 2. Behaviour of the DOTS provider,3. Facilities available at the DOTS centre. 4. Waiting period. Materials and Methods: The study was carried out among 201 patients coming to the Department of Respiratory Medicine who were on ATT under DOTS or had received ATT in the past. Demographic details and clinical ndings were noted. Data collected was entered into Excel spread sheet and quantitative data were expressed as number and percentage. Results- In our study among the 201 participants who were on ATTor had history of ATTconsumption in the past, 36.8% of the participants found the attitude of DOTS providers as supportive and helpful. A slightly higher 37.3% people had neutral opinion about it. A huge 70.6% of the participants were satised with the services at the DOTS centre. A good 56.7% of the participants were of the opinion that all their queries concerning TB were satisfactorily answered. Agood 66.7% of the participants were comfortable with the waiting time at the DOTS centre. About half (53.2%) of the participants were satised with the laboratory facility and availability of drugs. 51.7% of the participants were satised with the DOTS provider. Conclusion—. Our study analysed the various aspects of interaction of patient with the DOTS provider and DOTS centre and to judge its efciency in delivering DOTS services. Our study found that DOTS provider is very important for compliance to treatment and patient satisfaction and must for completion of the treatment and we must strengthen the services

A STUDY OF STATUS OF RETRIEVAL MECHANISM FOR PATIENTS TAKING ANTITUBERCULAR TREATMENT UNDER NTEP

2021 ◽  
pp. 47-49
Author(s):  
Jai Kishan ◽  
Achchhar Singh ◽  
Puneet Aggarwal
Keyword(s):  
Tertiary Care ◽  
Respiratory Medicine ◽  
Tertiary Care Centre ◽  
The Past ◽  
Antitubercular Treatment ◽  
The Status ◽  
History Of ◽  
Retrieval Mechanism ◽  
Lost To Follow Up

Introduction--A observational study was conducted in the Department Of Respiratory Medicine in a tertiary care centre who were taking ATT under DOTS or had history of ATTconsumption in the past. Aim :Aim of the study was to evaluate the status of a retrieval mechanism for patients who are lost to follow-up and to identify the strengths and weakness in the dispersal of medications, monitoring and follow-up of patients and status of retrieval mechanism. Materials and Methods: The study was carried out among 201 patients coming to the Department of Respiratory Medicine who were on ATTunder DOTS or had received ATTin the past. Demographic details and clinical ndings were noted. Data collected was entered into Excel spread sheet and quantitative data were expressed as number and percentage. Results- Among 201 participants 17.4% missed their doses whereas 82.6% of the participants took their medications regularly. Among the patients who missed their doses retrieval actions were taken in only 42.9%participants.Among those participants in whom retrieval actions were taken 14.3% were lost to follow up,97.14 % of the participants who missed their doses received multiple days medications. Besides this, 80% of the participants who missed their doses suffered from adverse effects of ATTduring their course of treatment. Conclusion—From this study we conclude that under NTEPmajority of patients are taking ATT regularly but regular follow-up of patients on ATT and retrieval action is not upto the mark and it should be strengthened to prevent development of DRTB and its spread in the community.

scholarly journals Outpatient prescription audit in a tertiary care hospital at Puducherry

2019 ◽  
Vol 8 (12) ◽  
pp. 2655
Author(s):  
Babu L. N. ◽  
Maharani B. ◽  
Lourdu Jafrin A. ◽  
Priyadarshini P. ◽  
Monisha P. ◽  
...  
Keyword(s):  
Health Care ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Good Health ◽  
World Health ◽  
Respiratory Medicine ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Essential Medicine List ◽  
Outpatient Prescriptions

Background: Rational use of medicines promotes good health practices and prevents inappropriate use of medicines, polypharmacy, unnecessary use of antimicrobials, injections, and also encourages use of medicines from essential medicine list and dispensing by generic names. The aim of the study was to analyze the outpatient prescriptions of a tertiary care centre by utilizing World Health Organization (WHO) core drug use prescribing indicators.Methods: A retrospective observational study was conducted in a tertiary care health setup at Puducherry, South India. Outpatient prescriptions from all the major clinical departments were analyzed using WHO prescribing indicators and they were compared with some similar studies.Results: The average number of drugs per prescription was 2.74. The percentage of prescriptions with antibiotics was 20.33% and the percentage of prescriptions with injections was 0.16%. The percentage of drugs prescribed by generic names and from essential medicine list was 83.13% and 87.9 respectively. Further antibiotic utilization was found to be higher in the department of ENT (56.67%), respiratory medicine (45%) and surgery (40%). Percentage of drugs prescribed by generic names in pediatrics and respiratory medicine were found to be 67.88% and 65.27% and percentage of drugs prescribed from essential medicine list in dermatology was 69.62%.Conclusions: Prescription pattern followed in our Institute almost adheres to the guidelines laid down by the WHO. Moreover, it is also implied that a routine audit of this type should be done in health care setups to ensure that they adhere to the WHO guidelines for better health care.

Implementation of the Community Outpatient Practice Experience in a Large Pediatric Residency Program

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 90-98
Author(s):  
Kimberlee C. Recchia ◽  
Teresa M. Petros ◽  
S. Andrew Spooner ◽  
Janet L. Cranshaw
Keyword(s):  
Managed Care ◽  
Tertiary Care ◽  
Community Practice ◽  
Publicly Funded ◽  
Community Based ◽  
Patient Age ◽  
Pediatric Residency ◽  
Health Supervision ◽  
Patient Âgé ◽  
Care Practices

Objectives. To determine the feasibility of implementing the Community Outpatient Practice Experience (COPE), a community-based continuity program, in a large, tertiary-care-oriented pediatric residency; to assess the impact of the continuity program on pediatric residents' experience; and to compare the experience in a variety of community practice settings. Settings. Continuity clinic settings included a hospital-based residents' group practice (RGP) clinic (1989 through 1991) and a community-based program in which each resident was paired with a practicing pediatrician in the community (1991 through 1993). Community practice types included publicly funded clinics (n = 9), private practices (n = 38), and managed-care practices (n = 14). In all settings, residents spent half a day per week in continuity activity. Methods. Measures of residents' experience (patient encounters, patient age distribution, and diagnostic mix) were compared in both settings and among community practice types. RGP data were derived from a patient scheduling database, and COPE data were obtained from patient encounter records submitted by each resident. Results. Residents in RGP (108.5 resident years) had 5294 encounters with 1568 patients. In COPE (102.5 resident years), 21 978 encounters with 19 235 patients occurred. COPE residents saw significantly more patients per session (6.2 vs 1.7) than residents in RGP. The mean patient age in COPE was significantly higher than RGP (5.3 vs 2.6 years). A greater proportion of encounters in RGP were for health supervision (61% vs 30%), but a greater number of health supervision encounters per resident occurred in COPE. There was a higher proportion of patients with chronic disease in RGP (38% vs 7%), but a greater number of patients with chronic disease was seen per resident in COPE. Analysis of COPE data by practice type showed fewer patient encounters per session and a younger patient age in publicly funded sites than in private- or managed-care practices. The proportion of health supervision encounters was greatest in publicly funded sites, but the greatest number of health supervision encounters per resident occurred in managed-care practices. Conclusions. We successfully integrated a large-scale community-based continuity experience into a large, tertiary-care-oriented pediatric residency program. We present COPE as an alternative to the hospital-based continuity clinic and suggest it as a model for improving residents' primary-care experience.

Management Issues: Ethics and Clinical Productivity Pressures Under Managed Care

1997 ◽  
Vol 7 (3) ◽  
pp. 8-10 ◽  
Author(s):  
Becky Sutherland-Cornett ◽  
Bernard P. Henri ◽  
Brooke Hallowell
Keyword(s):  
Managed Care ◽  
Management Issues
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