RESUMO
BACKGROUND: New regulations of the German statutory accident insurance for inpatient treatment have been introduced. The aims of the new regulations are to improve cost-effectiveness and the quality of medical care. The introduction of the injury type catalogue and the severe injuries type procedure (SAV) has led to a concentration of resources. The purpose of these innovations is an increase in the quality of treatment of patients with complex injuries. CONCLUSION: The introduction of the new regulations resulted in a centralization of medical care in order to optimize the quality of treatment of complex injuries from occupational accidents. Hence, the high demands concerning infrastructure and human resources expected of a level one university medical center are taken into account.
Assuntos
Centros Médicos Acadêmicos/legislação & jurisprudência , Centros Médicos Acadêmicos/estatística & dados numéricos , Seguro de Acidentes/legislação & jurisprudência , Programas Nacionais de Saúde/legislação & jurisprudência , Medicina do Trabalho/legislação & jurisprudência , Ferimentos e Lesões/terapia , Alemanha , Regulamentação Governamental , Humanos , Seguro de Acidentes/economia , Seguro de Acidentes/normas , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/normas , Medicina do Trabalho/economia , Medicina do Trabalho/normas , Ferimentos e Lesões/economiaRESUMO
INTRODUCTION: In many countries, a reassessment of after-hours primary care has become necessary. In particular, centralised general practitioner deputizing services (GPDS) have emerged. In this study, consumers' preferences for after-hours medical care were obtained and the use of the new GPDS was predicted. METHOD: On the basis of the Theory of Reasoned Action, a survey was developed that was used at the Free Newborn and Child health care services in Antwerp. Consumers were asked about their knowledge, experience and perceptions concerning the performance of different medical services. RESULTS: 350 questionnaires were used for analysis. 98.6% of the respondents knew about the existence of the emergency department, whereas the GPDS was known by 81.7% of the respondents. The main reasons for preferring emergency department over the other services were an easy access, good explanation by the doctor and a late due time of the payment. Respondents preferred the GPDS mainly because of an expected shorter waiting time. Experience had a strong positive influence on choosing a particular after-hours medical service. CONCLUSION: In our study, the consumers' preferences concerning after-hours medical care were assessed. The following items are crucial for choosing after-hours care: experience with the services, easy access to the service, explanation by the doctor about the illness and the treatment and waiting time.
Assuntos
Plantão Médico/normas , Comportamento de Escolha , Comportamento do Consumidor , Adulto , Bélgica , Competência Clínica , Feminino , Pesquisas sobre Atenção à Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Listas de EsperaRESUMO
A new method for measurements of pressure distributions and contact areas in joints. An innovative method is presented, allowing, for the first time, the exact determination of load-dependent pressure distributions and contact areas of joint surfaces in anatomical specimens. A thin flexible foil is inserted into the joint and adjust itself to curvatures. Upon loading, a monochromatic coloration occurs such that the optical density increases linearly with pressure. Using an electronic picture processor an analog representation of isobaric areas is obtained and evaluated, thereby integrating the areas of equal optical density. This procedure is considered to be superior to densitometric digital signal processing. For illustration, measurements of tibiofemoral-, patellafemoral- and ankle joints are shown, demonstrating the advantages and limitations of the new method.