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Keywords: pancreas physiology, exocrine cells, endocrine cells, ultrastructure, metabolic syndrome, type 2 diabetes mellitus, western diet
Published in DKUM: 24.09.2024; Views: 0; Downloads: 1
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Abstract: Background Integrated care involves good coordination, networking, and communication within health care services and externally between providers and patients or informal caregivers. It affects the quality of services, is more cost-effective, and contributes to greater satisfaction among individuals and providers of integrated care. In our study, we examined the implementation and understanding of integrated care from the perspective of providers - the health care team - and gained insights into the current situation. Methods Eight focus groups were conducted with health care teams, involving a total of 48 health care professionals, including family physicians, registered nurses, practice nurses, community nurses, and registered nurses working in a health education center. Prior to conducting the focus groups, a thematic guide was developed based on the literature and contextual knowledge with the main themes of the integrated care package. The analysis was conducted using the NVivo program. Results We identified 12 main themes with 49 subthemes. Health care professionals highlighted good accessibility and the method of diagnostic screening integrated with preventive examinations as positive aspects of the current system of integrated care in Slovenia. They mentioned the good cooperation within the team, with the involvement of registered nurses and community nurses being a particular advantage. Complaints were made about the high workload and the lack of workforce. They feel that patients do not take the disease seriously enough and that patients as teachers could be useful. Conclusion Primary care teams described the importance of implementing integrated care for diabetes and hypertension patients at four levels: Patient, community, care providers, and state. Primary care teams also recognized the importance of including more professionals from different health care settings on their team.
Keywords: integrated health care system, type-2-diabetes, Hypertension, Health care team, interdisciplinary primary care, qualitative research
Published in DKUM: 19.04.2024; Views: 250; Downloads: 11
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Abstract: Background: Some chronic diseases, like diabetes type 2 and hypertension, and risk factors, such as obesity, hypercholesterolemia, and smoking, are strongly correlated with the potential development of serious health complications that can threaten a patient's life or significantly influence the quality of life, while at the same time representing an enormous economic burden. Such complications include, for example, stroke, coronary heart disease, peripheralarterial vascular disease, end-stage renal disease and congestive heart failure. Methods: For a quantitative evaluation of the mentioned patient groups, the age distribution and an estimation of the treatment expenses a dynamic mathematical model was developed, where special attention was devoted to its structure, as it should enable the sequential construction and representation of different forms of data information. The model was realized in the Matlab program package with the Simulink Toolbox. Conclusions: A dynamic mathematical model is described that enables the observation of patients (in percentage terms) with diabetes type 2 and obesity, as well as those who smoke, have hypercholesterolemia and hypertension and all possible combinations of these problems, related to their age. Taking into account the Slovenian demographic data and annual treatment expenses, we were able to quantitatively evaluate these factors, not only in Slovenia but also in other developed regions where the demographic and economic situations are similar. It is also possible to extend the model to patients with serious complications, also taking into account the population dynamics, which is the goal of the next steps in our investigation. Regarding the presented results, it is estimated that from a group of a million people, those requiring treatment for diabetes type 2 cost as much as € 19.5 millions per year, since the treatment of one patient for one year is € 355. If all the sufferers requiring such treatment were located, as a consequence of more systematic medical examinations, an additional € 16 millions would be needed. In this group of one million people, as many as 40 % are expected to develop hypercholesterolemia, of which 26 % are diagnosed and treated adequately. The annual cost for the treatment of one patient is 313, which means that for a group of a million people the costs would be € 82 millions per year. An additional € 43.5 millions would be needed if all the sufferers with hypercholesterolemia were treated. Another chronic disease is hypertension. The annual cost for treating one patient is estimated to be € 271, and so for a group of a million people the treatment costs would be € 69.5 millions. If this were extended to include so far undiscovered sufferers with this chronic disease an additional € 14.5 millions would be needed.
Keywords: modelling, simulation, diabetes type 2, obesity, smoking, hypercholesterolemia, hypertension
Published in DKUM: 28.03.2017; Views: 1144; Downloads: 121
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