[smartdoctor] Re: but managing the increasing patient demand is a crucial challenge/EIGHT EUROPEAN COUNTRIES
- From: "Dr Zrinka H. Leskovar ordinacija Vinica" <dom.zdravlja.varazdinske.zupanije14@xxxxxxxxxxx>
- To: <smartdoctor@xxxxxxxxxxxxx>
- Date: Thu, 23 Oct 2014 11:03:11 +0200
A kako je onda s pacijentima, jel njih nešto košta ako dobiju zeleni karton, a
svakako žele danas dobiti uslugu a ne pričekati svog GP?
Zrinka
From: smartdoctor-bounce@xxxxxxxxxxxxx
[mailto:smartdoctor-bounce@xxxxxxxxxxxxx] On Behalf Of itomic
Sent: Wednesday, October 22, 2014 3:52 PM
To: smartdoctor@xxxxxxxxxxxxx
Subject: [smartdoctor] Re: but managing the increasing patient demand is a
crucial challenge/EIGHT EUROPEAN COUNTRIES
oK – pročitali smo što i znamo : raste potražnja, većina nehitnih , podosta
banalnih, mnogi /SVI/se hrvu s tim problemom ( na razne načine ) ... iz
navedenog primjera GP pružaju tu skrb ( ok, imaju dispečera/trijažu, njih 40 na
hrpi dijeli tu odgovornost ) .. ali ovaj primjer pokazuje kako GP Group pruža
tu skrb - nije jasno : za koga ( samo sa svojih lista ili svakome), van
redovnog radnog vremena vrijeme pa kaže The ABM GP Out of Hours Service
operates from 6.30pm to 8am on weekdays, and all day on weekends and bank
holidays. There is one number across Swansea, Neath Port Talbot and Bridgend to
access this service: 0330 123 9180 (charged at local rates) – znači dežurstvo
tih40ak je od 18,30 do 8,00 radnim danom te ALL DAY vikendom i praznicima ... ?
Tko financira ovaj način rada, jel dobrovoljan ?
Eh sad – kako mi nemamo u grupnoj još 2-3 liječnika, kako radimo 3 SVJETSKA
STANDARDA, kako je i u nas trend porasta banalne potražnje, kako se ismijava
svaki pokušaj educiranja pacijenata o samopomoći ( Vodič je npr. dočekan na nož
– od medija i od nekih liječnika ) , kako mi teško da bi skupili 40 LOMova
spremnih da kavu popiju zajedno a da se mam ne posvade kamoli da dijele
dežurstva – OVAJ PRIMJER MI SE NE ČINI PRIMJENJIV U NAS . Ne znam kako vama
drugima...
OK idemo dalje - u Norveškoj OM radi u jednoj smjeni ( 8-15,30 ili do 17 uz
pauzu za ručak ) , hitna služba ( au pari našem Zavodu za HM) radi samo odvoz u
hitni prijam bolnica, postoji Legevakt ( nešto kao azas ?? koji radi 24 sata 7
dana u tjednu, mogu raditi svi doktori s licencom, plaća se extra i pomama je
za dobiti tamo angažman . U Legevaktu trijažiraju educirane sestre i dijele “
kartone” – crvene. žute , zelene ) .. pa kaže :
Ventetid:
Alle pasienter deles inn i hastegrader:
* Rød respons - umiddelbar hjelp
* Gul respons - vurderes ut fra alvorlighetsgrad
* Grønn respons - vurderes som ikke akutt. Du må vente på ledig kapasitet eller
blir henvist til fastlegen din.
Sykepleier på legevakten vurderer hvilken hastegrad du tilhører.
GOOGLE prevoditelj :—)
vrijeme na čekanju:
Svi bolesnici podijeljeni u prioritetnih razreda:
* Crvena odgovor - neposredna pomoć
* Žuta odgovor - procjenjuje na težini
* Zelena odgovor - ne smatra hitno. Morate pričekati za dostupnost ili iz svog
liječnika opće prakse.
Medicinska sestra kod liječnika procijeniti hitnost pripadaš.
Ovako o uslugama zdravstvenim dostupnim u Norveškoj obaviještava američka
ambasada:
http://norway.usembassy.gov/root/pdfs/physdents07.pdf
From: BARI <mailto:bari.sita@xxxxxxxxxxx>
Sent: Wednesday, October 22, 2014 11:07 AM
To: smartdoctor@xxxxxxxxxxxxx
Subject: [smartdoctor] but managing the increasing patient demand is a crucial
challenge/EIGHT EUROPEAN COUNTRIES
Out of hours primary care(rad van radnog vremena )-organiziran je na mnogo
različitih načina diljem svijeta.
Za to vrijeme zdravstvenu zaštitu širom svijeta osiguranici uglavnom
koriste(ZLORABE) za neakutna,nehitna(non life treatening) stanja.Navedene su
najčešće dijagnoze u osam zemalja EU.(na kraju)
Zaključak je da u vrijeme teških ekonomskih izazova,starenja populacije i
manjka doktora nije rješenje u sve složenijim out-of-hour organizacijama(npr
.AZAS)-VEĆ JE KRUCIJALNI IZAZOV ZA ORGANIZATORE ZZ – KAKO KONTROLIRATI
„menaging“ RASTUĆE ZAHTJEVE PACIJENATA !Eto tople vode.Pa onda slijedi
stranica na kojoj pacijent može naći sve podatke o dežurstvima GP-a ; a koja
između ostalog sadrži upute/UPOZORENJA za pacijente koja izgledaju ovako:
Ne zloupotrebljavaj hitnu službu,opis „bezveznih“stanja koja ne zahtijevaju
medicinsku skrb...itd..
P.S.GP-i sudjeluju u out-of-hours poslu-po 40-tak njih dijele
dežurstva(pacijent mora najprije nazvati dispečera/ovaj trijažira, daje savjete
za samopomoć,nepotrebitima zakazuje termine u normalno radno vrijeme GP-ja...
pa nakon svega toga liječnik potrebitima uzvraća poziv),s time da dnevno,u
redovno radon vrijeme GP-i primaju 20 -40 pacijenata i uglavnom upošljavaju
još dva do tri liječnička-bilo u grupnoj ili pojedinačnoj praksi-po
željama......A koliko smo ustanovili (usput)..ne bave se tužakanjem pacijenta
policiji-pacijent odgovara sam za sebe dok vozi i kako vozi...
Stranica za pacijente...
GP OUT of HOURS SERVICE
http://www.wales.nhs.uk/sitesplus/gallery/863/twitter-logo-small.jpghttp://www.wales.nhs.uk/sitesplus/gallery/863/facebooklogo.jpg
You can now catch up with all the latest ABM news on
<http://www.facebook.com/pages/ABM-University-Health-Board/161831273836741?ref=ts>
Facebook and Twitter <http://twitter.com/ABMhealth>
http://twitter.com/ABMhealth
CW yellow medical at nightABM GP Out of Hours ServiceGP 3
The ABM GP Out of Hours Service operates from 6.30pm to 8am on weekdays, and
all day on weekends and bank holidays. There is one number across Swansea,
Neath Port Talbot and Bridgend to access this service: 0330 123 9180 (charged
at local rates)
If you need to see a GP urgently during these times, and cannot wait until your
own surgery opens, call 0330 123 9180. You will be answered by a trained call
handler who will take some details and then a GP will call you back to assess
the patient's needs. The patient will be offered self-help advice, or an
appointment at one of the three ABM primary care centres in Morriston, Neath
Port Talbot and the Princess of Wales hospitals. Sometimes, if the GP thinks it
is necessary, a home visit may be arranged.
If you have a minor injury........
and live in Swansea, use the
<http://www.wales.nhs.uk/sitesplus/863/page/39287> Minor Injury Unit at
Singleton Hospital, which is open between 8am and 8pm every day. (After 8pm,
please use the Minor Injury Unit at Neath Port Talbot Hospital
<http://www.wales.nhs.uk/sitesplus/863/page/39451> ).
If you live in Bridgend or Neath Port Talbot please use Neath Port Talbot
Hospital Minor Injury Unit <http://www.wales.nhs.uk/sitesplus/863/page/39451>
which is open 24/7.
If you need an out of hours Dentist ring: 0845 46 47
http://www.wales.nhs.uk/sitesplus/863/page/54326
<http://www.wales.nhs.uk/sitesplus/863/page/39450> Princess of Wales Hospital
ED Don't misuse your A&E / Emergency Department (NE ZLOUPOTREBLJAVAJ SLUŽBU
HITNE POMOĆI)
CW red heartOnly use A&E / Emergency Department for serious unexpected illness
or injury
ED 4
pow emergency
Did you know that one in four patients who use the A&E Department in Morriston
Hospital and the Emergency Department in the Princess of Wales Hospital don't
actually need emergency care? This just adds to queues and makes waiting times
longer for everyone. It also doesn't make the best use of emergency staff time
or skills.
So if you have a non-urgent condition, please see your pharmacist or GP for
help, or telephone NHS Direct Wales on 0845 4647.
Did you know your pharmacist offers many more services than simply dispensing
medicines? See: <http://www.wales.nhs.uk/sitesplus/863/page/50500> Make the
most of your Community Pharmacist
Minor Illness, When Should I worry?
CW blue plasterAntibiotics are used to treat infections caused by bacteria.
Coughs, colds and sore throats are usually caused by viruses and antibiotics
have no effect on viruses.
When viruses infect your respiratory system (nose, throat and chest) they can
cause any or all of these symptoms:Sneeze
· Runny or stuffy nose
· Coughing
· Sore throat
· Sneezing
· Watery eyes
· Headache
· Body aches
· Fever
· Chills
· Tiredness
It is normal for the symptoms of a viral infection to last up to 14 days or
longer
Remember antibiotics won’t make a viral illness get better faster.
Usually viral infections just need to run their course. Normally it is best to
wait and watch and to ask your local Pharmacist for advice on how to manage the
symptoms.
When should I see the doctor? Here are some tips on when you should think about
seeing a doctor:
When to Worry about Sore Throats
The time to worry about a sore throat and to visit your doctor is if you have
any or a combination of the following:
· If you or your child has a sore throat and a temperature of 38 degrees or
above
· If you or your child has a sore throat and you can see pus in the throat
· If you or your child has a sore throat but no cough lasting more than 3
days
· If you or your child has a sore throat and swollen glands
· If you or your child has a sore throat and difficulty swallowing spit or
unable to swallow food or drink
· If you or your child has a sore throat and difficulty breathing
When to worry about coughs
The time to worry about a cough and to visit your doctor is if you have any or
a combination of the following:
· If you already have asthma or COPD
· If the cough has gone on longer than 3 weeks
· If the your baby cannot eat, sleep or drink because of coughing
· Coughing with difficulty breathing or with chest pain
· Coughing with wheezing
· Cough with a temperature of 38 degrees or above
· Coughing up blood
· Coughing up mucus that is discoloured or thicker than usual particularly
if you also have COPD
When to Worry about Ear Pain
You should visit you doctor if you or your child has ear pain, a temperature of
38 degrees or above and/or any discharge coming from the ear, which lasts more
than 2 days.
When to worry about Fever
You should visit your doctor if you or your child has a fever lasting more than
2 days and it is not improving.
In particular with children with a fever if you have measure their temperature
and
· Your child is younger than 3 months and has a fever of 38°c or higher
· Your child is 3-6months old and has a fever of 39°c or higher
· Your child is 6 months or older with a fever of 39.4° c or higher
See the doctor about any symptoms that are not getting better after 14 days
For more information particularly if you have children who are unwell you can
refer to the “when should I worry” booklet
http://www.whenshouldiworry.com/booklet-final.pdf
o
This page in Welsh/Y
Primarna zz izvan radnog vremena
Diagnostic Scope in Out-of-hours Primary Care Services in Eight European
Countries
An Observational Study
Linda AMJ Huibers, Grete Moth, Gunnar T Bondevik, Janko Kersnik, Carola A
Huber, Morten B Christensen, Rüdiger Leutgeb, Armando M Casado, Roy Remmen,
Michel Quiz: 8 Questions About Physicians Around the World
<http://www.medscape.com/viewarticle/829069>
Abstract and Introduction
Abstract
Background: In previous years, out- of-hours primary care has been organised in
large-scale organisations in many countries. This may have lowered the
threshold for many patients to present health problems at nights and during the
weekend. Comparisons of out-of-hours care between countries require
internationally comparable figures on symptoms and diagnoses, which were not
available. This study aimed to describe the symptoms and diagnoses in
out-of-hours primary care services in regions in eight European countries.
Results: The age distribution of patients showed a high consistency across
countries, while the percentage of males varied from 33.7% to 48.3%. The ICPC
categories that were used most frequently concerned: chapter A 'general and
unspecified symptoms' (mean 13.2%), chapter R 'respiratory' (mean 20.4%),
chapter L 'musculoskeletal' (mean 15.0%), chapter S 'skin' (mean 12.5%), and
chapter D 'digestive' (mean 11.6%). So, relatively high numbers of patients
presenting with infectious diseases or acute pain related syndromes. This was
largely consistent across age groups, but in some age groups chapter H ('ear
problems'), chapter L ('musculoskeletal') and chapter K ('cardiovascular') were
frequently used. Acute life-threatening problems had a low incidence.
Conclusions: This international study suggested a highly similar diagnostic
scope in out-of-hours primary care services. The incidence rates of acute
life-threatening health problems were low in all countries.
A consistent finding across countries was that the large majority of patients
presented at primary out-of-hours care settings with non-acute,
non-life-threatening health problems. Data on urgency assessment, which were
available for six countries, supported this impression. Research on
self-referring patients at A&E departments and GP cooperatives has shown
similar results.
The high proportion of non-life-threatening health problems presented poses
serious questions for policy makers, particularly in a time of economic
challenges, an ageing population, and expected shortages of health care
professionals. The trend towards larger organisations for out-of-hours care is
unlikely to be reversed, but managing the increasing patient demand is a
crucial challenge. A previous cross national survey showed that a large
diversity of organisational models for out-of-hours care exists.[11]
<javascript:newshowcontent('active','references');> International studies can
provide relevant information for policy makers in the ongoing discussion and
the reforming of the organisation of out-of-hours primary care.
* Monitoring Progress in Population Health
<http://www.medscape.com/viewarticle/819802>
* No Difference in Emergency Department Length of Stay for Patients With
Limited Proficiency in English <http://www.medscape.com/viewarticle/818825>
* Quiz: 8 Questions About Physicians Around the World
<http://www.medscape.com/viewarticle/829069>
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