Browsing by Author "Moreira, Paulo"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
- Barriers, obstacle, difficulties or challenges in development of health partnerships in community intervention projects: a systematic reviewPublication . Alves, Odete; Santos, Paula Clara; Fernandes, Lídia; Moreira, PauloEngaging communities in authentic partnerships is increasingly accepted as best practice in community intervention projects, despite the many barriers or challenges to doing so.
- Building instrument to assess user satisfaction in communicating with health professionals based on the consensus of the Delphi methodPublication . Santos, A. H.; Pimenta, Rui; Santos, Paula Clara; Moreira, PauloRecent research in user-health professionals communication have emphasized the need to develop new instruments to evaluate user satisfaction in communicating with health professionals
- Challenging healthcare-associated infections: a review of healthcare quality management issuesPublication . Baylina, Pilar; Moreira, PauloHealthcare-associated infections (HAIs) are now a worldwide problem with devastating effects, both in economic and public health impacts in the medium and long term. In reality, this healthcare management problem became frightening when we became aware of large number of cases associated with this type of infection, especially the infections caused by agents for which the existing treatment no longer works effectively. This is the case of infections associated with healthcare caused by multi-resistant microorganisms, whose line of action in therapeutic terms may be exhausted. Several factors of growth have been identified, among which are the overuse of antibiotics (by direct intake or through food), environmental conditions, and the evolution of microorganisms. This means that, all over the world, rates of high prevalence and incidence for diseases caused by HAIs agents are now new contributions to rates of mortality and morbidity. Yet, already in 1959 a report on hospital infections by Staphylococcus, published by the Central Health Services UK, identified the prevalence of Staphylococcus as a major concern. Since then, this type of infection continued to occur, in spite of a growing understanding of the necessary measures for their control. It is known that, currently, the percentage of methicillin-resistant Staphylococcus aureus (MRSA) existing in the bacterial population of S. aureus associated with HAIs varies between 1% (Netherlands and Finland) and 44% (UK and Greece). However, regardless of advances in infection control systems, the incidence of HAIs remained relatively unchanged in the last 20 years (about 10%). The situation does not get better when we analyse the problem from the cost perspective. At this point, it is known that there is a direct impact in the hospitalization costs, in diagnostics (tests, examinations, etc.), and in treatments (antibiotics, surgery, and others). A 1992 CDC study estimated costs of HAIs and already suggested that the cost of infection control programs was approximately 6% of the total costs of the infections. In a 2003 report by the United Kingdom (UK) Department of Health, entitled ‘Winning Ways: Working together to Reduce HAIs in England’, it was estimated that the cost associated with HAIs per patient bed for a year was identical to the cost of an infection control program applied to a hospital with 250 beds. On what concerns quality management system, costs with HAIs may be comprised as non-quality costs. In this sense, an estimate by the Juran Institutes, suggests that non-quality costs can be approximately one-third of direct healthcare costs, and according to Nordgren et al. inflation of related costs is, in part, due to the increased length of stay and associated increased costs with providing the extra implicit care. This article explores these issues.
- Exploring the real costs of healthcare-associated infections: an international reviewPublication . Moura, João; Baylina, Pilar; Moreira, PauloHealthcare-associated infections acquired a high degree of dissemination, being considered a serious public health problem and assumed as one of the most common adverse events associated with healthcare. They have a significant impact on health systems by increasing hospital expenses, and compromising the healthcare quality and effectiveness. Surgical site infections (SSI) are considered one of the most serious complications that can occur after an orthopaedic surgery. The aim of this study is to contribute to the development of a framework to analyse the costs of infections related to hip and knee arthroplasties. A literature review was conducted on databases, and articles published between January 2005 and April 2016 were searched. A total of 14 articles met the inclusion criteria. Costs were grouped in hospitalization and treatment dimensions. For hospitalization, the indicators were the length of stay (LOS) and/or monetary costs; For treatment, the indicators were number of surgeries and LOS, or monetary costs. We observed that LOS is the most commonly used to estimate SSI direct costs. Patients who developed hip or knee arthroplasty infections remained in hospital 2.5–3 times longer and incurred hospital costs almost three times higher, when compared with an uninfected patient.
- Healthcare-associated infections – on developing effective control systems under a renewed healthcare management debatePublication . Baylina, Pilar; Moreira, PauloThe development of control systems to sustain the level of healthcare-associated infections (HAIs) is an emerging issue for healthcare management. This is partly due to the perception that HAI became a serious negative impact factor on the performance of healthcare organizations and on related public health dimensions. Throughout the decade of 1990 a significant number of international programmes were developed to understand and to promote effective HAIs prevention and control systems: Patient Safety and the quality improvement of healthcare organizations became common concepts in healthcare management. However, regardless of advances in infection control systems, the rates of incidence of HAIs remained relatively unchanged in the last decades. The purpose of this study is to point out barriers that recent international literature has identified as factors hindering the successful development of control systems to prevent HAIs. The international debate on possible alternatives to strengthen this common healthcare management issue, benefits form one such update. A literature review was conducted in a 3-month period by two investigators. The BioMed Central, Pubmed, Emerald, and B-on databases were searched for articles published between January 2006 and September 2011. A standard form was created for data extraction. A total of 49 articles met inclusion criteria. Within the analysed articles, 26 were developed in Europe, 15 were developed in North America; 6 were developed in Asia, and 2 in Australia. Thirty (30) different barriers to effective HAIs control systems were identified. The barriers were clustered by dimensions and sub-dimensions. The largest number of barriers clustered, are associated with structures and processes and also barriers associated with healthcare management processes.