To make the treatment approach in patients suffering a European hornet sting allergy reaction more personalized, preparing them also for possible future risks.
In Slovenia an extended retrospective ...observational cohort epidemiological study about the natural history of Hymenoptera venom sensitivity is in progress. The study is based on data from the healthcare records of the University Clinic Golnik (UCG) and data collected by a questionnaire sent to patients from May 2019 to April 2021. For a pilot study, we selected patients who were referred to UCG because of an allergic reaction to European hornet sting and had been re-stung later by a wasp (n=68). The association between severe systemic allergic reactions (SSAR) after wasp sting and potential risk factors in subjects with a history of hornet sting allergy was assessed univariately using the likelihood ratio test.
Among 68 European hornet allergic patients 27 reacted with an SSAR and 41 reacted with a mild SAR. Among 27 patients with SSAR, 4 reacted with an SSAR also to a subsequent wasp sting. Among 41 patients with a mild European hornet sting SAR nobody reacted with an SSAR to a subsequent wasp sting. The association between the severity of the wasp SAR reaction in European hornet allergic patients was statistically significant (p=0.022).
Our results suggest that patients with severe European hornet SAR should be considered for wasp venom immunotherapy or prophylactic prescription of epinephrine auto-injector as they are at risk for an SSAR also after wasp string.
Do we have the spark? Rupel, Valentina Prevolnik; Marušič, Dorijan
Zdravstveno varstvo,
06/2022, Letnik:
61, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Upgrading any system is challenging. Neglecting continuous monitoring and evaluation might impose solutions that worsen the situation. Primary orientation toward increasing productivity is the main ...reason for the tremendous decline in the accessibility of outpatient services in Slovenia since 2015, in addition to additional funds from the state budget. In the actual ‘fee-for-service’, providers are incentivised to deliver more expensive services, not first visits. Although the stakeholders are not to blame, it is high time for an orientation towards patients’ needs: a breakaway from inefficient technical solutions, an acceptance of patients as active participants in decision-making, measurement of their treatment outcomes, and the adoption of already proven advanced payment models, such as population-based payments. The journey towards value-based healthcare must start!
Slovenia is an aging society. Social security expenditures for the elderly are rising steadily, and the majority of Slovenians are firmly convinced that the state must provide elder care. This ...situation means that informal caregivers face many challenges and problems in their altruistic mission.
To explore the experiences and feelings of informal caregivers and to provide an understanding of how informal caregivers support the elderly and what challenges and difficulties they face in Slovenian society.
The study is based on qualitative semi-structured interviews with 10 caregivers. In addition to descriptive statistics, we conducted a qualitative study using the qualitative content analysis method.
We identified four themes among health caregivers' experiences with challenges and problems in providing long-term health care for the elderly. Caregivers pointed out that they are mostly left to themselves and their altruistic mission of giving informal long-term care to their elderly relatives and friends. Systemic regulation of the national public health care system is the source of many problems.
Other social systems determine and limit the position of informal caregivers in Slovenia. This qualitative study should be understood as useful stepping-stone to future research and real improvement in this area.
Heart rhythm disorders (HRD) are often present in patients visiting their family physician (FP). Dealing with their problems is not always simple, efficient and cost effective. The aim of this paper ...is to review the existing literature about the use and experience of telecardiology in patients experiencing HRD.
We conducted a review of literature in PubMed biographical databases (MeSH thesaurus), Web of Science and Cochrane, between 1995 and 2019. We included original articles in English that describe the use of telecardiology at primary and secondary healthcare levels. Exclusion criteria are those publications that discuss heart failure or observation of the activity of pacemakers or defibrillators and the age of patients under 18 years. A total of 19 papers met the inclusion criteria, thirteen of them were original scientific articles and we included them in the analysis.
Use of telemedicine can shorten the time from diagnosis to the necessary treatment (2/13), telemedicine can reduce mortality in patients with acute myocardial infarction (4/13), it can shorten the time to diagnose atrial fibrillations (4/13), it can help determine the diagnosis for patients complaining about heart rhythm disorders which were not detected on the standard ECG recording (2/13) and can also help identify cardiac causes for syncope or collapse (2/13). All studies have confirmed that the use of telecardiology significantly reduces the number of unnecessary referrals to a cardiologist or hospitalization, and shortens the time needed to treat patients with life-threatening conditions.
The use of telecardiological techniques increases the quality and safety of work in managing patients with cardiovascular disease in FP practice. Usage of telecardiologic devices can also save money and bridge the gap between the primary and secondary healthcare levels.
Objectives were to estimate the lifetime prevalence of self-reported sexually transmitted infections (STIs) and describe STIs healthcare.
Data was collected in the period 2016-2017 from a probability ...sample of the general population, 18-49 years old, at respondents' homes by a combination of face-to-face interviews and self-administration of more sensitive questions. Statistical methods for complex survey data were used to account for stratification, clustered sampling, and weighting.
Approximately every tenth sexually experienced individual reported to have had genitourinary symptoms suggestive of STIs, but only a minority of them reported to have had those respective STIs diagnosed. The proportion of sexually experienced individuals that reported to have ever been diagnosed with an STI (excluding trichomoniasis, pubic lice for men and women, and pelvic inflammatory disease, vaginal thrush, bacterial vaginosis for women) was 2.4% for men and 6.7% for women (p<0.001). Independent risk factors associated with self-reported STIs in women included at least 10 lifetime sexual partners and having been forced into sex. The majority of the last STI episodes in women were treated by gynaecologists accessible at the primary healthcare level and in men by a dermatovenerologist, after referral by a general practitioner. Approximately half of STI patients were counselled for safer sex and majority reported to have notified their sexual contacts.
Our estimates for lifetime prevalence of self-reported STIs in a probability sample of Slovenian sexually experienced men and women, 18-49 years old, indicate a substantial national burden of STIs. The results will inform national STI prevention and control policies and strategies.
The easy access to data from electronic patient records has made using this type of data in pay-for-performance systems increasingly common. General practitioners (GPs) throughout Europe oppose this ...for several reasons. Not all data can be used to derive good quality indicators and quality indicators can’t reflect the broad scope of primary care. Qualities like person-centred care and continuity are particularly difficult to measure. The indicators urge doctors and nurses to spend too much time on the registration and administration of required data. However, quality indicators can be very useful as starting points for discussions about quality in primary care, with the purpose being to initiate, stimulate and support local improvement work. This led to The European Society for Quality and Patient Safety in General Practice (EQuiP) feeling the urge to clarify the different aspects of quality indicators by updating their statement on measuring quality in Primary Care. The statement has been endorsed by the Wonca Europe Council in 2018.
Izhodišča: Informacijsko-komunikacijska tehnologija (IKT) in brezpapirno delo lahko izboljšata obstoječe delovne procese in so pomembna sestavina sodobnega osnovnega zdravstva. Namen študije je bil ...analizirati stališča zdravstvenega osebja in pacientov glede brezpapirne ambulante in najpogostejše uporabljene informacijskokomunikacijske tehnologije v slovenskem osnovnem zdravstvu.
Background: Information and communication technology (ICT) and paperless practices have been shown to improve “existing processes in the workplace” “as well as being an important component of modern ...primary healthcare”. The aim of our study was to analyse the attitudes of health-care professionals and patients with regard to paperless practice and the most frequently used information and communication technology tools in Slovenian primary healthcare.
Qualitative methodology using focus groups of 22 primary care physicians, 14 nurses and 18 patients.
The areas recognised by all participants as important for further information and communication technology development were: computer-supported decision making, accessibility and completeness of personal e-health data, emergency cases, support for chronic disease management, ICT related time savings, e-prescriptions and e-discharge letters. The most important identified barriers impeding the use of ICT were: the heavy workload of primary care physicians and nurses, health insurance reimbursement rules and duplication of work using both paper and electronic health records.
This study highlighted a number of strengths of ICT use in primary care as well as numerous areas where changes in procedures and improvement of ICT tools to support them are needed.
Izhodišča: Informacijsko-komunikacijska tehnologija (IKT) in brezpapirno delo lahko izboljšata obstoječe delovne procese in so pomembna sestavina sodobnega osnovnega zdravstva. Namen študije je bil analizirati stališča zdravstvenega osebja in pacientov glede brezpapirne ambulante in najpogostejše uporabljene informacijskokomunikacijske tehnologije v slovenskem osnovnem zdravstvu.
Kvalitativna metodologija fokusnih skupin z 22 zdravniki iz osnovnega zdravstva, s 14 ambulantnimi sestrami in z 18 bolniki.
Področja, ki so jih vsi udeleženci prepoznali kot pomembna za nadaljnji razvoj IKT, so: računalniško podprto odločanje, dostopnost in popolnost osebnih zdravstvenih podatkov, nujni primeri, podpora pri obravnavi kroničnih bolezni, prihranki časa z uporabo IKT, e-recept in e-odpustno pismo. Najpomembnejše ovire za uporabo IKT so: velike delovne obremenitve zdravnikov in sester v osnovnem zdravstvu, pravila zdravstvene zavarovalnice, podvajanje dela z uporabo papirnatih in elektronskih zdravstvenih kartotek.
Študija je poudarila številne prednosti uporabe IKT v osnovnem zdravstvu in tudi številna področja, na katerih so potrebni spremembe v procesih in izboljšanje podpornih orodij IKT.
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