Financial balance of home nursing care providers in the Czech Republic.

BACKGROUND: To enable people to live in old age in their own homes often requires specialised home care services. Despite the high importance of these services, the finance of home nursing care (HNC) is still under-investigated in many countries. The aim of this paper was to describe the finance of HNC in the Czech Republic. METHODS: Balancing of revenues and costs was done using structured questionnaires from the closed accounting year 2018 as a monthly average. Nonparametric Kruskal-Wallis and Wilcoxon signed ranks tests were used to test hypotheses. RESULTS: Data from 62 providers were analysed. The data included information from a total of 2297 patients and 995 employees. The average of total costs were € 17,591.7 (95% CI 14,175.3 - 21,008.1) and average of total revenues were € 17,276.5 (95% CI 13,923.5 - 20,629.5). The average cost per a patient was € 516.0 (95% CI 465.9-566.1) and the average revenues were € 500.1 (95% CI 457.0-543.3). CONCLUSIONS: The overall financial balance of HNC providers seems to be balanced in the Czech Republic. Nevertheless, insurance, although it should, did not cover all the costs. Micro- providers tended to be cheaper regarding the hours worked by nurses.

Development and performance assessment of an advanced Lucas-Kanade algorithm for dose mapping of cervical cancer external radiotherapy and brachytherapy plans.

PURPOSE: The aim of this study was to verify the possibility of summing the dose distributions of combined radiotherapeutic treatment of cervical cancer using the extended Lucas-Kanade algorithm for deformable image registration. MATERIALS AND METHODS: First, a deformable registration of planning computed tomography images for the external radiotherapy and brachytherapy treatment of 10 patients with different parameter settings of the Lucas-Kanade algorithm was performed. By evaluating the registered data using landmarks distance, root mean square error of Hounsfield units and 2D gamma analysis, the optimal parameter values were found. Next, with another group of 10 patients, the accuracy of the dose mapping of the optimized Lucas-Kanade algorithm was assessed and compared with Horn-Schunck and modified Demons algorithms using dose differences at landmarks. RESULTS: The best results of the Lucas-Kanade deformable registration were achieved for two pyramid levels in combination with a window size of 3 voxels. With this registration setting, the average landmarks distance was 2.35 mm, the RMSE was the smallest and the average gamma score reached a value of 86.7%. The mean dose difference at the landmarks after mapping the external radiotherapy and brachytherapy dose distributions was 1.33 Gy. A statistically significant difference was observed on comparing the Lucas-Kanade method with the Horn-Schunck and Demons algorithms, where after the deformable registration, the average difference in dose was 1.60 Gy (P-value: 0.0055) and 1.69 Gy (P-value: 0.0012), respectively. CONCLUSION: Lucas-Kanade deformable registration can lead to a more accurate model of dose accumulation and provide a more realistic idea of the dose distribution.

Optimal reconstruction matrix and PET image filtration for point-spread function and time-of-flight reconstruction - A phantom study.

INTRODUCTION: The aim of this study was to determine the optimal image matrix and half-width of the Gaussian filter after iterative reconstruction of the PET image with point-spread function (PSF) and time-of-flight (TOF) correction, based on measuring the recovery coefficient (RC) curves. The measured RC curves were compared to those from an older system which does not use PSF and TOF corrections. MATERIALS AND METHODS: The measurements were carried out on a NEMA IEC Body Phantom. We measured the RC curves based on SUVmax and SUVA50 in source spheres with different diameters. The change in noise level for different reconstruction parameter settings and the relation between RC curves and the administered activity were also evaluated. RESULTS: With an increasing size of image matrix and reduction in the half-width of the post-reconstruction Gaussian filter, there was a significant increase in image noise and overestimation of the SUV. The local increase in SUV, observed for certain filtrations and objects with a diameter below 13mm, was caused by PSF correction. The decrease in administered activity, while maintaining the same conditions of acquisition and reconstruction, also led to overestimation of readings of the SUV and additionally to deterioration in reproducibility. CONCLUSION: This study proposes a suitable size for the image matrix and filtering for displaying PET and SUV measurements. The benefits were demonstrated as improved image parameters for the newer instrument, these even being found using relatively strong filtration of the reconstructed images.

Analysis of planar acintigraphic images using the Li-Ma technique.

A statistics-based approach to comparison of planar scintigraphic images is introduced to provide additional information to subtraction method. The proposed procedure leads to parametric images with better noise properties allowing subsequent statistical analysis. An example of an application of the technique is given using parathyroid scintigrams. The presented technique is not intended to replace the image subtraction method but offers a tool that may help during a diagnosis-making process.