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PubMed2002

[Assessment of hepatitis C networks].

AIMS: To assess the functioning of hepatitis networks. METHODOLOGY: A questionnaire was sent to all reference centers, to ten general hospitals and to twelve private hospitals working in hepatology. The main items included: participation and composition of networks, difficulties and positive or negative experiences, equal access to diagnostic and therapeutic means within the networks. Answers could be accompanied by personal remarks. RESULTS: The response rate was satisfactory: 75%, 70% and 100% respectively for the three groups. More than 80% of the questions were answered. Nearly all of the centers participate in a network. Two thirds of the reference centers have organized a therapeutic committee that includes private units and general hospitals. All groups actively participate in the networks. The positive experiences that were most often described were the success of training sessions especially in relation to equal access, and becoming acquainted with other participants. Most networks did not seem to be interested in screening. For reference centers the number of participating practitioners was too low. The main difficulty was felt to be overcentralization of the public hospital. Most networks are independent and meetings take place in the evening. Most responses were in favor of parity and equal access to diagnosis and therapeutic means within the networks. This only occurred in one third of the networks and if these measures were implemented it would increase network participation and effectiveness. Two thirds of the responses were also favourable to extending therapeutic trials to networks. CONCLUSION: Public and private hepatologists have similar opinions about hepatitis networks. Pooling of activities, responsibilities and means should be implemented and could improve participation in the networks.

Community Networks↗
PubMed2002

[Healthcare networks: involvement of various healthcare professionals].

Diabetes is a very representative model of chronic disease requiring a partnership between various healthcare professionals. The organisation of healthcare networks allows a global care improvement. For the "Midi-Pyrénées" area, the diabetes network associates physicians and other healthcare professionals, working in their private - practice or in clinics or hospitals. The priority of this network was to develop therapeutic patient education, outdoors and indoors. The use of a specific communication system will be unavoidable, as a basis for medical files, evaluation, and permanent updates for the network members. Current projects concern a regional organization for chronic foot ulcers care, coronary heart disease and diabetes during pregnancy. These various care domains suppose the collaboration with other regional networks.

Community Networks↗
PubMed2005

[Network to support patients with ALS in the Hyogo prefecture].

The author reports network to support patients with amyotrophic lateral sclerosis in the Hyogo prefecture. Three types of network are working, which are the network in the multidisciplinary team in the hospital, the medico-welfare network in the area and the network intra-hospitals in the prefecture. We have to establish effective network with a passion, a mission and an action.

Amyotrophic Lateral Sclerosis↗
PubMed1997

Strategic planning with multitype libraries in the community: a model with extra funding as the main goal.

Medical libraries are discovering that ongoing collaboration in fundraising with other types of community libraries is mutually beneficial. Such partnerships may lead to joint grants, increase library visibility and access to decision makers, allow participation in community information networks, and provide leverage in additional fundraising projects. These partnerships have the potential to raise the profile of libraries. The accompanying community recognition for the parent organization may create a positive image, draw patients to the health center, and position the library and institution for future success in fundraising. Within institutions, development officers may become allies, mentors, and beneficiaries of the medical librarian's efforts. For a planned approach to community outreach with extra funding as the major objective, busy medical library administrators need guidelines. Standard participative techniques were applied to strategic planning by Indianapolis libraries to help achieve successful community outreach and to write joint statements of mission, vision, goals, and objectives.

Community-Institutional Relations↗
PubMed1992

AIDS Community Demonstration Projects: implementation of volunteer networks for HIV-prevention programs--selected sites, 1991-1992.

States and cities have effectively used community-level intervention projects to reduce cigarette smoking and other risk behaviors associated with chronic disease (1-3); similar strategies have been introduced to prevent human immunodeficiency virus (HIV) infection in men who have sex with men and who identify themselves as homosexual or bisexual (4,5). Many of these projects used community volunteers to deliver interventions (2,4,5). An important concern for community-level intervention projects that rely on volunteers is the need to address the recruitment and retention of these volunteers. CDC AIDS Community Demonstration Projects have developed and maintained volunteer networks among hard-to-reach populations for HIV prevention. This report summarizes methods used by demonstration projects in five cities to develop and maintain volunteer networks during 1991-1992.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Effect of specific aspects of community social environment on the mortality of individuals diagnosed with serious illness.

The purpose of this study was to examine the prospective and contextual effects of urban community environment on mortality among Medicare beneficiaries who were 67 years old or older in 1993, lived in the city of Chicago, and were hospitalized for one of 13 serious diseases. As expected, we found that advantageous socioeconomic context helps lower mortality risk among elderly patients over and above individual demographic and health background. We also found that collective efficacy was a health-enhancing social resource whereas criminal and violent activities in the community appeared to be deleterious. Inconsistent with our hypotheses, community social network density (measured by the size of social network and frequency of social interaction) was not protective but detrimental. Moreover, social support and the civic involvement of residents in the community do not seem to affect mortality. The complex relationship between community social environment and health found in this study may suggest that community-level social interventions based on social capital/social cohesion models are not likely to achieve fruitful results without concomitant effort in the economic and health care realm, at least in terms of influences on the health of older people once they are already ill.

Acute Disease↗
PubMed1998

Health outcomes as an organisation-wide quality initiative.

Since the burgeoning of the 'health outcomes' movement there has been an ever-increasing body of literature on health outcomes policy debates, directions, frameworks and tools for implementing health outcome-directed initiatives. There is a significant gap in the literature, however, in regard to translating a comprehensive health outcomes policy into practice at a local level. This paper addresses that gap. It describes the local implementation of a comprehensive health outcomes approach which works across the continuum of care. It identifies those organisation-wide structures and processes that support successful progress, thereby providing a useful guide to other organisations wishing to institutionalise the health outcomes approach.

Community Networks↗
PubMed2002

CNOP for diffuse aggressive non-Hodgkin's lymphoma: the Nebraska lymphoma study group experience.

The purpose of this study was to evaluate the CNOP regimen (cyclophosphamide, mitoxantrone, vincristine, and prednisone) throughout a community based oncology network with a large number of elderly non-Hodgkin's lymphoma (NHL) patients. Three hundred and seventy-three previously untreated patients with diffuse aggressive NHL received the CNOP regimen administered through a community oncology network, the Nebraska Lymphoma Study Group (NLSG). The complete response rate was 60% with an overall response rate of 73%. The estimated 4-year event-free survival for patients <60years was 44%, compared to 38% for those >age 60 (p = 0.18). However, the 4-year estimated overall survival for patients <60 years was 62% compared to 44% for those >60 years (p < 0.001). Prognostic factors predictive for a poor event-free survival were male gender, stage III/IV disease, Karnofsky score <80, and elevated lactic dehydrogenase (LDH). The lymphoma specific cumulative death rate was 29% for patients <60 years compared with 33% for patients >60 years (p = 0.07). After failing CNOP the 4-year overall survival (OS) was 19%. The estimated 4-year OS for patients who failed CNOP and went on to receive high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplant (ASCT) was 64% for patients < age 60 and 48% for those >60 years (p = 0.23). In conclusion, CNOP chemotherapy administered to patients with diffuse aggressive NHL in a community oncology network produces similar result to that reported for other anthracycline based regimens reported in the literature. Patients >age 60 had a higher rate of failure due to causes other than lymphoma which accounted for a worse survival long-term. However, patients of all ages who failed CNOP and who were able to receive HDC and ASCT demonstrated long-term disease survival after the transplant.

Adolescent↗
PubMed2006

Toward a sustainable European Network for Health Technology Assessment. The EUnetHTA project.

EUnetHTA is a recently initiated EU network aiming at connecting national HTA agencies, research institutions, and health ministries to enable an effective exchange of information and to lend support to health policy decisions by the Member States. The article briefly discusses the policy background, the specific objectives, and the project structure of the network.

Biomedical Technology↗
PubMed1996

Nursing in health networks: direction and development.

The New York Organization of Nurse Executives and the American Organization of Nurse Executives held an Open Space meeting to examine issues to be addressed by nursing leaders in the development of integrated delivery systems. Participants identified issues related to the role of the RN, clarifying the value nursing adds to health care delivery, and how to articulate nursing's contribution toward patient care quality and outcomes. Action plans were developed for two major goals: operationalizing nursing across multiple settings and within multidisciplinary teams and standardizing measurement in integrated networks.

Community Networks↗
PubMed2002

Telehealth: an assessment of growth and distribution.

Telemedicine uses telecommunications technologies to deliver health care to populations located at some distance from health care providers. Telehealth is a somewhat broader term that includes non-clinical applications (such as education). This article draws on data from a nationwide survey of telehealth networks that assesses the extent and character of telemedicine activity. Although statistics point to increased utilization, the distribution of growth has been skewed toward a few applications and it is not clear that rural areas would derive substantial benefit in the absence of federal subsidy. Reported barriers to building sustainable programs often seem to reflect concerns of large hospitals and health care systems rather than constraints faced by rural organizational and individual network members. The potential role of government in addressing barriers is discussed.

Community Networks↗
PubMed2006

The influence of partnership centrality on organizational perceptions of support: a case study of the AHLN structure.

BACKGROUND: Knowledge of the structure and character of inter-organizational relationships found among health promotion organizations is a prerequisite for the development of evidence-based network-level intervention activities. The Alberta Healthy Living Network (AHLN) mapped the inter-organizational structure of its members to examine the effects of the network environment on organizational-level perceptions. This exploratory analysis examines whether network structure, specifically partnership ties among AHLN members, influences organizational perceptions of support after controlling for organizational-level attributes. METHODS: Organizational surveys were conducted with representatives from AHLN organizations as of February 2004 (n = 54). Organizational attribute and inter-organizational data on various network dimensions were collected. Organizations were classified into traditional and non-traditional categories. We examined the partnership network dimension. In- and out-degree centrality scores on partnership ties were calculated for each organization and tested against organizational perceptions of available financial support. RESULTS: Non-traditional organizations are more likely to view financial support as more readily available for their HEALTR programs and activities than traditional organizations (1.57, 95% CI: .34, 2.79). After controlling for organizational characteristics, organizations that have been frequently identified by other organizations as valuable partners in the AHLN network were found significantly more likely to perceive a higher sense of funding availability (In-degree partnership value) (.03, 95% CI: .01, .05). CONCLUSION: Organizational perceptions of a supportive environment are framed not only by organizational characteristics but also by an organization's position in an inter-organizational network. Network contexts can influence the way that organizations perceive their environment and potentially the actions that organizations may take in light of such perceptions. By developing evidence-based understandings on the influence of network contexts, the AHLN can better target the particularities of its specific health promotion network.

Alberta↗
PubMedDate not supplied

Making risk contracting work in specialty networks.

For the next several years, capitation of specialties will increasingly influence contracting arrangements. Specialists and their networks must position themselves to operate in this environment amid a shrinking market for their services and consolidation of delivery systems and accepting capitation can be a necessary step. The specialties that can quantify the costs of specific services within a defined range, and can manage appropriate utilization of those services within acceptable parameters through wellness, patient intervention and disease management techniques, are most likely to be successful in risk contracting. This article presents how to investigate risk contracting in specialty networks and what infrastructure is required for successful risk contracting.

Capitation Fee↗