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Biomedical subjects

Friedrich C Stiefel

Publications and source records attributed to Friedrich C Stiefel.

6 recordsLinked to original sources
PubMed2006

Reflections and perspectives.

Complex patients who have biopsychosocial comorbidities represent a major challenge for the current health care system. Unlike standard medical situations for which medical care can be based on an evidence-based approach, complex patients require a broader concept of care. As demonstrated throughout this issue, such an integrated approach that takes into account the concepts of case- and care complexity is not only possible, it is cost-effective. Integrated care, however, needs assessment tools and a communications-based approach that fosters exchange and collaboration between different medical disciplines and professions and patients.

Decision Support Systems, Clinical↗
PubMed2006

Case and care complexity in the medically ill.

The authors have argued that complexity in general health care is increasingly prevalent because of the increase in patients who have multimorbid conditions, and the increased professional and technical possibilities of medicine. In the increasingly complex care systems, it is necessary-specifically when treating patients in need of integrated care by several providers-that an optimal match between case and care complexity be found in order to prevent poor outcomes in this vulnerable group. The authors discussed several approaches to case complexity that can be identified in the literature. Most of them seem unsuitable for adjusting case and care complexity, and inadequate for designing multidisciplinary care. Theoretic approaches to case complexity may be of interest, but did not result in clinically meaningful information. The INTERMED, which can be considered the first empirically based instrument to link case and care complexity, is an attempt to improve care delivery and outcomes for the complex medically ill.

Cardiovascular Diseases↗
PubMed2006

Identifiers, or "red flags," of complexity and need for integrated care.

Because complex medical patients are a subgroup of the medical population and because complexity assessment involves extra effort, preselection of these patients through identifiers is necessary. There is no best identifier for complexity, and the one most suitable for the population served should be selected. This article provides a table with potential identifiers and discusses the difference between disease-oriented screening and treatment and a more generic approach such as complexity screening and complexity management.

Decision Support Systems, Clinical↗
PubMed2006

Operationalizing integrated care on a clinical level: the INTERMED project.

During the last 10 years the INTERMED method has been developed as a generic method for the assessment of bio-psychosocial health risks and health needs and for planning of integrated treatment. The INTERMED has been conceptualized to counteract divisions and fragmentation of medical care. Designed to enhance the communication between patients and the health providers as well as between different professions and disciplines, the INTERMED is a visualized, action-oriented decision-support tool. This article presents various aspects of the INTERMED, such as its relevance, description, scoring, the related patient interview and treatment planning, scientific evaluation, implementation, and support for the method.

Decision Support Systems, Clinical↗
PubMed2005

Operationalization of biopsychosocial case complexity in general health care: the INTERMED project.

OBJECTIVE: Lack of operationalization of the biopsychosocial model hinders its effective application to the increasingly prevalent problems of comorbidities in clinical presentations. Here, we describe the INTERMED, an instrument to assess biopsychosocial case complexity in general health care, and provide an overview of its psychometric evaluation. METHOD: Review and summary of our publications to date, and re-analysis of findings. RESULTS: The INTERMED has face-validity, is brief and easy to use, and several research reports support its reliability and validity. It has the capacity to detect patients at risk for poor clinical outcome and quality of life. CONCLUSIONS: The INTERMED project is relevant to various agents involved in the care process. It provides a basis for effective multidisciplinary treatment of patients with a high case complexity.

Comorbidity↗