Health Essays Chronic Disease Management

Health Essays Chronic Disease Management Chronic Disease Management Chronic diseases have an effect on all countries, and the augment in their prevalence is to a great extend attributed to varying demographics, improved life expectancy, changing lifestyles, better disease management and management and a better understanding of the factors that cause poor health and disease. Laboratory, clinical and population-based research has revealed that a few risk factors are responsible for the prevalence of most chronic diseases: unhealthy diet and high energy ingestion, lack of physical activity and use of tobacco. Alcohol intake, environmental pollutants, age and hereditary factors also play a role. These risk factors are the same in men and women and across all regions in the world. The associated healthcare, financial and social burden of chronic diseases, which include diabetes mellitus, coronary heart disease, asthma, chronic obstructive airway disease, hypertension, chronic depression, osteoporosis, end stage renal failure and stroke, are progressively on the increase. In the US alone to be specific, some 125 million people now suffer from at least one chronic disease. Chronic diseases are a tremendous burden to individuals and to countries and the available traditional healthcare methods are not able to meet the requirements for preventing and reducing this burden. It is because of this problem that chronic disease management has emerged as a new approach towards caring for patients with chronic diseases. Chronic disease management in clinical circles can be defined as an elaborate, systematic, multicomponent strategy to delivering healthcare while involving all members in the population or community who suffer from similar infections. Cardiovascular disease is chronic and is the first cause of death among the elderly in all countries. This observable fact was evident even 60 years ago, as Roberts noted that diseases of the circulatory system and pneumonia were the first causes of death among the aged in Jamaica in 1950. These diseases are to some extent the sequelae of advancing age. As life expectancies are increasing the prevalence of all noncommunicable disease is also increasing. Thus, one could adopt the approach that these are an foreseeable consequence of ageing and the focus therefore has to be on simply treating them when they do occur and applying the acknowledged interventions for secondary prevention once the first disease episode has occurred. It is possible to reduce the mortality from chronic diseases in general. Some of the developed countries such as Canada, Australia and the United States have succeeded in reducing mortality by applying preventive measures. Meeting the multifaceted needs of patients with chronic diseases is the single supreme challenge facing our healthcare system in most countries today. With the increasing numbers of patients suffering from chronic diseases, it is of the essence that clinicians, healthcare administrators and health policy makers plan and ensure that the healthcare delivery system is tailored to provide care for these patients across the band of their healthcare needs. Chronic disease management has been known to be the best and most comprehensive approach for providing holistic and comprehensive care for patients with chronic illnesses. The Kaiser Permanente care triangle has frequently been used to conceptualize Chronic disease care at three main levels Supporting self-care for patients suffering from chronic disease who are at low risk of complications and hospitalization. Disease management for people who are in need of regular routine follow-up and are at high risk of chronic disease. Case management for people who have complex needs and those who are high-intensity users of unplanned less important care. Managing chronic diseases at the system level has been the focus of many latest publications.1-4 In the US, the recent Institute of Medicine Report – Crossing the Quality Chasm – focused on the need to reorganize care delivery to meet the healthcare demands of populations of patients who suffer from chronic illnesses. In October 2001, the British Medical Journal and the Western Journal of Medicine both published special issues focusing on the problem of chronic diseases and tinted how various nations are dealing with this ever rising epidemic. It is therefore timely that all nations focuses on coming up with a better program to address the needs of patients with chronic disease, on the advances in clinical and non-pharmacological management, and the challenges faced in ensuring that patients receive optimal care meeting the needs at the various stages of their disease. Programme for chronic disease management A successful chronic disease management program should be designed while considering fundamental factors that are critical to its sustainability. First of all the program should be aimed at a certain specific condition within the population suffering. Then the nest important factor concerns the availability of evidence on which its functions should be based. A good program has to keep in its consideration the existence of obstacles which may be a hindrance to its successful implementation. Adequate measures should be put in check to ensure that there is a balance between quality and the economic of the objectives of the care to be given United States In the United States chronic disease management programs, also known as chronic care management, have become extensive. They are being favored by employer groups, health-care organizations and health payers, these programs are being increasingly raising concern because very little scientific evidence is available to justify their effectiveness and economic impact. Disease management was introduced and launched in 1990 by drug companies for the purpose of helping patients to comply with various medications and also to increase their sales. This programs have developed in the private sector to become such a competitive industry that these companies contract health plans to offer comprehensive care to various groups. They are then paid a fee by the health plans to guarantee a saving. Disease management programs are wide in the private sector; they offer care and support as part of benefits and support from physicians. Some programs have been organized in such a way that the physician can receive alerts whenever the patient needs medical attention or even when the services for preventing chronic diseases are long overdue. Some use professional clinical information systems which can integrate participant’s data for instance data which concerns claims data or self reports. This can be even acquired from multiples sources. However there is only a small number of beneficiaries who suffer from chronic illness and therefore account for the unproportionate share of medical expenditure. This results in such patients receiving fragmented care from a number of site providers and to add on the insult they receive repeated and costly hospitalization. The manifestation project was endorsed by the Medicare, Medicaid,and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA). In adding together to the BIPA projects, there arenumerous of other coordinated care demonstrations approvedby Congress in the Balanced Budget Act of 1997, a capitatedDM demonstration recently initiated by the Bush administration,and an end-stage renal disease management demonstration. People are demandingto figure out ways to do disease management in the public sector that act in responseto patient-privacy concerns and that admiration the traditionalrole of the physician. Disease management programs have no effect on the state budget as they pay for administrative services while they are guaranteed by the government a savings offset in form of claims reduction. It is important to point out that even though the opportunities for cost savings and step up inhealth outcomes is great, the challenges of introducing disease management onwide scale in the Medicare program are momentous The patients increasing population is likely to bring up challenges which are not found in the private sector. France In France studies have shown a tremendous improvement in the state of health and quality of life for chronic illness patients. There has also been significant reduction in costs due to the implementation of coordinated networks for the treatment of asthma. The reduction in costs cannot be attributed to spontaneous national changes in management but rather it can be explained by the effect of the intervention program. This initiative can be said to be the first attempt towards implementation ofa disease management program in France. Italy In Italy the health system is aiming at utilizing Information technology tools to manage chronic diseases. In this country the population f over 65 years has be noted to be on the rise. What is worrying is that the number of chronic diseases also increases with this range of age. Approximately 90% of the aged people are suffering form chronic diseases and something has to be done in effect to prevent further repercussions. In the past Italian doctors have raised concern over the time that is used in treating patients with chronic diseases and therefore cam up with a resolution to use community care which such a program there is a shift from hospital based care to community based care. Such a program aims at reducing on the number of patients admitted with chronic diseases, removes patients out of hospital quicker and improving on the network for helping people with chronic diseases. This is to be done while the records are kept centrally and monitored while the services are moved to the community. In Italy there is also another program being put in place and it is called sole project as it is aiming at networking all hospitals with communities to give the citizens services. The program is also aiming at controlling flow of information so as to help the elderly patients. The idea must have been copied from the UKs pathways to telecare. Germany In German two laws were passed in the year 2001 to address the main problems in the healthcare system. Despite advance which have been made in diagnosis and treatment of diabetes, patients still experience secondary complications, The purpose of disease management program in Germany is to avoid repetition of diagnostic testing, by specialists or in hospitals thus assisting in containing the cost. In Germany chronic diseases management programs have a legal basis under which they operate. For instance in the year 2002 there was a reform law which laid down a complicated procedure for the establishment and implementation of disease management programs. These procedures included the characteristic features of a disease which qualifies to be included in the management programs. Implementation of disease management programs in Germany has been influenced by politics which is not like in the other countries. Germany has a longer experience with disease management programmes than the United States. The healthcare system in Germany has characteristics which have seen the introduction of disease management programs. This includes the free choice of the non-profit sickness funds who have to strike a balance between spending and income. There are also issues regarding to efficiency and quality on the side of those who are chronically sick The ministry of health in Germany anticipated that disease management programs will help to reorganize the fragment care for people suffering from chronic illnesses. The main challenge towards implementation of the programs regards to the defining of the minimum standards proves to be contentious and time consuming as people continue to suffer. Another challenge has been on implementing the program for Diabetes whose care requirements has been attacked by more than ten scientific societies. These scientists argue that the government and the sickness funds favored a minimal program which was created basing on studies with the highest level of evidence. Some claim that the programs were created under extreme time pressure. (R. Busse 2001) By way of the German-style DM programs the government anticipated a radicalGordian explanation to a knot of disheveled problems. While theauthentic experience with DM programs is by a long way larger and longerin the United States than in Germany, the German strategy couldbe of interest in the United States, where we have cream skimming andadverse selection having in fact blocked managed care infiltrationinto the Medicare population. One observable difference is theownership of the DM programs; in the United States they are to some extent connected with pharmaceutical companies or special DMP vendors. Whendisease management came up in Germany, analogous companies appearedon the market, with the hope for commercial triumph. Some sicknessfunds contracted them to assist them in preparing DM programs, but suchcompanies have more or less disappeared from the market The UK According to statistics in the U K lack of proper care to manage chronic diseases on a day today basis can lead to unnecessary complications and premature death. Children also suffer from chronic diseases for instance children below five years account for 15% of the cases(General household survey 2002) Self care has sometimes been ignored in the UK but it is a well proven approach to improving the situation of chronic diseases. According to data from the Department of Health’s Economic and Operational Research the effects of self care include; Reduced to visits to GP Sby over 40% for the high risk cases. Reduction in admissions to hospitals by about 50% in a Parkinson’s diseases The length of stay in hospitals for mental health problems reduce. Off work days can reduce by even more than 50% for patients suffering from arthritis Self care or management is not just an issue of providing information to the patients but it involves a range of other things to make it workable. Patients need care education regarding to self management of their sickness by helping stand what they ought to do and how to make adjustments towards their medical dosage and how and when they need healthcare. They also need quick reminders of when they should be attending to certain measures concerning their health. They need support from knowledgeable patients or even an expert in their disease and broader networks which can include attending to group practices involving the same kind of health condition. Their s uncertainty as regarding to self care however it is likely to improve in relevance because of the following: The increase of information that is availed to the patients. The ability of information technology to support self care. The possibility of having reliable and accurate home monitoring systems. The greater anticipation by many patients to be the locus of control. In the UK the main providers of care for chronic diseases are the primary care teams. They include community nurses, pharmacists, dieticians, opticians, podiatrists, and physiotherapists. Barriers for implementing disease management programs One major factor which hinders the implementation of these programs is the lack of proven after investment. This has tended to limit the health plan and interest of the disease management organization. Future of Disease management programs There is no acceptable best way to chronic disease management. Evidence that has been observed throughout the world brings out clearly that, to be successful, policy-makers should put into consideration: Providing well-built leadership and vision at the national, regional or organizational level which should oversee all that is required for the programs to succeed. They should ensure full-bodied collection of information and data-sharing among all the stakeholders in the health sector. Care should be provided based on people’s needs and an ability to identify people with different levels of need; They should also put in place measures that target key risk factors, including widespread disease prevention initiatives. Growing towards supporting self-management and empowerment of people with chronic diseases Policy brief should involving a wide range of stakeholders such as individuals, the voluntary and community sector, clinicians, private industry and public services. Future Disease management programs should be tailored to reduce the costs associated with care for people suffering from chronic illnesses. The growing costs of operations such as dialysis are still a major concern in most countries. But with the Disease management programs in place these costs are expected to decline and lead to improved care even through public health for chronic disease cases. However reducing the costs with DM programs has been successful in some areas but the drug treatment especially in diabetic cases seems to be an area where the growing costs are inevitable.

Disadvantages of Foreign Aid

An evaluation of Blackberry Company’s implementation of TQM Done by: Sanad F Jumean 1 Table of contents: _ Introduction——————————————————3 _ Continuous improvement————————————-4 _ Employee involvement—————————————-4 _ Customer focus————————————————–5 _ Conclusion——————————————————–6 _ References—————————————————â€⠀Ã¢â‚¬â€œ7 2 IntroductionBlackberry is a brand that was created by research in motion (RIM) which is a global leader in wireless innovation, the mobile industry was revolutionized with the introduction of blackberry solution in 1999, blackberry offers a variety of products and services targeting both business customers as well as individual customers, most of its products are smart phones that have the ability to send and receive push e-mails and instant massages with a high level of security , it helps its customers connect more easily with the world regardless of the place, blackberry devices can also be used as personal digital assistants, portable media players, and internet browser, the blackberry internet service is available in 91 countries around the world on over 500 mobile service operators. Blackberry’s goal and vision statement is to provide solutions for the worldwide mobile communications market, including the software that allows the BlackBerry Smartphone to p rovide mobile access to e-mail, applications, media and the Internet. Through the development of integrated hardware, software and services that support multiple wireless network standards, blackberry provides platforms and solutions for seamless access to time-sensitive information including e-mail, phone, text messaging (SMS and MMS), Internet and intranet-based applications. 3Continuous improvement: Blackberry Company listens to its customers through votes on its website, feedbacks, and surveys throughout the world. Blackberry has a policy that translates those feedbacks into their routinely two month’s software updates. Software updates include improving their current software’s that are being used by customers and adding new features that come up to the developers through customer feedback process and brainstorming of developers. Security measures are a major concern for blackberry; improvements to the software include such security measures that are most importan t to business people who operate their work on their devices.Continuous improvements in Blackberry Company is not limited to its software but also includes the body of the device, those improvements are mainly based on the previous shape of the same series of the device and reviews from users of the same series phone. Continuous improvement can also be seen in blackberry’s emphasis on continuously training their employees and making sure that they have the necessary skills and specialties to compete in the market, as well as continuously evaluating their performance and determining what needs to be improved. Employee involvement Blackberry Company have 250,000 developers throughout the world, those developers come up with different ideas about developing, improving, and producing a new product. They try to align their ideas through meetings, and then they present the conclusion of their ideas to the top management.If the top management gives the approval to the new ideas of t he developers they apply their new ideas and creations through translating these ideas into products and services. During this stage the rest of the employees receive updated e-mails during every stage of producing the new product to have an overview about the product for the sake of answering customer’s wonders. 4 Customer focus: Blackberry Company is mainly addressing business people in their device but at the same time they still focus on individuals willing to use their products or services. As previously discussed blackberry has various methods in keeping touch with their current customers and new potential markets.After evaluating the feedbacks whether positive or negative, the data gathered is then analyzed and grouped in the form of useful information and knowledge that can be used to keep their products and services up to date. Because customers are the main asset for blackberry, most of the useful information gathered is actually taken into consideration by employee s and developers and translate it effectively to their new or updated product or service. To support our earlier discussion on customer focus, blackberry has awarded an employee that has applied their strategy through engaging customers in all of its research and development process, either as source of innovation, as a part of the product testing program in the redesign of the operational process. This award is called â€Å" Blackberry customer focus award†. 5 Conclusion:It’s important for different types of organizations to continuously evaluate how well they implement TQM, taking into consideration the major effects of implementing TQM on the organization’s performance and its position in the market related to its competitors, however, although blackberry company pays considerable attention on implementing TQM properly, focusing on important factors such as employee empowerment, customer focus, and continuous improvement, it has to do more efforts in certain areas such as employee empowerment by giving its employees the chance to be part of the production process rather than just sending them updated e-mails during every stage of producing the new product or service. 6 References _ http://us. blackberry. com _ http://en. wikipedia. org/wiki/BlackBerry _ Interviews with Mr. Mike Mefleh Blackberry Product Manger- Middle east. 7

The Cold War And The Soviet Union - 1139 Words

The Cold War is a period following world war II which was marked by political conflict between former allies; the United States and the Soviet Union. It is considered â€Å"a state of conflict that stops just ever so short of direct military combat. Instead, the fighting mainly takes the form of economic competition, political maneuvers, propaganda and, at times, proxy wars between nations allied to one of the more powerful nations.† (Pelz 171). Once allies, the United States and Soviet Union experienced tense relations because of the grave differences in their political ideologies. America championed democracy of the people however; the USSR had contrasting perspective on governance and sought to impose communism within the region. Subsequent†¦show more content†¦By the 1970’s and 1980’s arms control became an urgent concern, consequently, stabilization of the superpowers became priority. The result was the â€Å"bilateral Strategic Arms Limitation Ta lks had resulted in the SALT Treaties of 1972 and 1979, both aimed at regulating the nuclear arms race between the US and the Soviet Union.† (Hanson 201) With almost fifty years of a cold war we must reflect and consider the lessons learned and how these lessons may impact foreign policies today. Let us consider that the war was proof that America’s engagement is the foundation for international stability, furthermore, the alliances forged are imperative to international security. America has proven itself to be resilient and stands firm in the face of threat. The country must never cease to improve and extend the military arm as other countries are developing their arms it is important that America continues to lead the world by enhancing its arms and continue to do extensive research that will aid in deterring other countries who might decide to go rogue and threaten the lives, existence and wellbeing of others. Let’s look at North Korea and Syria; In recent months we see that North Korea has been improving and increasing its nuclear arms. As leaders of the free world America has repeatedly cautioned and have implored North Korea to desist from unsanctioned missile launches. In early April theShow MoreRelatedThe Cold War And The Soviet Union973 Words   |  4 PagesThe Cold War was a state of economic, diplomatic, and ideological discord among nations without armed conflict. The Cold War was between the United States and the USSR because these were the two major powers after WWII. Basically, the Cold War was a series of proxy wars that had taken place back in time involving surrounding countries. 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Example Of Cole Algorithm - 706 Words

COLE algorithm is very fast, but not efficient come free; There are many famous limitations in the algorithm. Simulation accuracy for scatterers located nearby area is close to the probe surface, there is no model of shore waves and point-split function is considered to split. In addition, the use of 1-D convection is implied the pulse wave is stable during the spread of the pulse. In practice, this is not true for the promotion of a Broadband Sense depending on frequency dependent attenuation The accuracy of this convolutional model has been examined [7] by creating a physical point-scattered phantom and for the same simulation compared to the real scan compared to cola algorithms was done in field II [3]. Real ultrasound recording has†¦show more content†¦The COLE algorithm [6] is graphically portrayed in Figure 1. aims to simulate a backstroked RF signal from the target collection of 3-D point scatterers. Each scattered is one position and one dimension that controls the power Backscattered signal an RF Line is defined by its unit vectors in radial, lateral, and advanced instructions. The longest the black arrow in Fig 1 represents the whole beam, while it the small normal vector background is the direction vector. The upcoming, scatterers are projecting on the image line, and side and high distances are mapped as a weight component using an analytical expression or a lookup table. From radial distance, the closest index in the output vector determined and the weighted dimension is added to it index the speed of sound is believed to be stable, and the following formula is used to convert radial distance (R) from Time (T): The factor of two accounts for T: (R) = 2R/C0 After the two-way journey has been estimated all scatterers. The output vector is understood with pulse wave last RF Line yield. A. 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