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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Analysing catastrophic illness patterns in a health promoting company in Colombia].

OBJECTIVE: Identifying trends in catastrophic illness patterns as well as determinant factors of variation due to pathology and type of mandatory contribution regime in people affiliated to SaludCoop (a health promoting company forming part of Colombian's health and social security system). METHODS: Trends were analysed based on why the service was used and cost/income ratio obtained by per capita payment unit compared to actuarial reference studies. RESULTS: Intensive care unit (ICU) attention for adults and cardiovascular surgery were the pathologies leading to greater health costs 1997-1999 in the mandatory employees' insurance contribution regime. Chemotherapy and neonatal intensive care led to the greatest costs in the mandatory subsidised health insurance regime. CONCLUSIONS: The catastrophic illness patterns studied revealed the need for establishing attention models aimed at improving risk management, priority intervention in the field of prevention and epidemiological surveillance of high cost illnesses.

Catastrophic Illness↗
PubMed1979

Focusing the catastrophic illness debate.

Unlike other aspects of the American health experience, there is a current void of information on expensive illness experiences. This paper is designed to fill this void and prrsents an analysis of the incidence and cost of catastrophic illness in the United States. Catastrophic illness is defined as an illness episode for which a person incurs $5,000 or more of medical expenses in a calendar year. This information is used to provide a framework for focusing the debate about catastrophic and national health insurance.

Adolescent↗
PubMed1977

Treat decision making in catastrophic illness.

Through conceptual discussion and consideration of a case study, this paper examines how physicians respond to the availability of an innovative treatment of a serious illness. It is argued that the unusual economic environment of the delivery of catastrophic illness care works with the "social contract" in medicine to encourage the use of innovative therapies, even before their efficacy has been demonstrated and often irrespective of their costs, in striking contrast with the conventional innovation adoption process. The primary constraint on catastrophic illness treatment may well be the technology or the state of knowledge. In the case of the management of leukemias in Connecticut, decisions to use drug therapies appear to have been based on a treatment trend rather than on the inherent merits of the therapies. The trend seems to have spread from the treatment of one leukemia, which responded significantly, to the management of three other leukemias. The influence on treatment decisions of a few indiviudal varibles differed across the leukemia. For example, treatment decisions in the acute leukemias were unrelated to the patient's economic status, whereas receipt of chemotherapy for one of the chronic leukemias was significantly positively correlated with economic status.

Acute Disease↗
PubMed1992

Some superego conflicts in the analyst who has suffered a catastrophic illness.

This paper, originally part of a panel (in a somewhat different form) on life stresses of the analyst, focuses on some of the superego conflicts of the analyst who has suffered a catastrophic illness. The interplay between ego and superego functioning is examined, particularly in reference to how superego conflicts cause the ego to become subordinated to drive-related aims and to superego demands from which it would ordinarily have more autonomous distance. Some of the issues which are conflictual for analysts who have suffered a catastrophic illness and which have a tendency to be played-out in the treatment include: problems of self-esteem regulation; regressive alteration of identifications; reinstinctualization of identifications and of object relations; alterations in the ego-ideal; disruptions of other narcissistic regulatory processes; and the above mentioned subordination of ego functions, especially in regard to its synthetic, reality testing, and other autonomous capacities. Examples are presented of how these conflicts may be dynamically operative in unconsciousness, how they may enter into consciousness, and how they might be expressed in the treatment.

Aggression↗
PubMed1986

Managing the discharge crisis following catastrophic illness or injury.

Discharge from the acute care setting frequently represents a serious crisis for the catastrophically ill. Family members and the patient are expected to resume responsibility quickly for ongoing care while simultaneously coping with significant alterations in established role and behavior patterns. The dynamics of this transition are discussed and suggestions for helping the family cope with this crisis are offered.

Adaptation, Psychological↗
PubMed2001

Protecting strategies used by sufferers of catastrophic illnesses and injuries.

The purpose of this research was to describe strategies used by sufferers of catastrophic illnesses and injuries. Participants were adult men and women with a variety of serious illnesses and injuries. Qualitative research approaches to data collection and data analysis, using grounded theory methods were employed. Descriptions of the participants indicate that several strategies are used; this discussion focuses on strategies to protect themselves from further suffering. Situations where participants use protecting strategies are identified and described. The findings indicate how care-recipients try to lessen the burden on their care-givers and to protect them from the stress of the sufferer's problems.

Adaptation, Psychological↗
PubMed2003

Boosting strategies. Enhancing the self-esteem of individuals with catastrophic illnesses and injuries.

This qualitative study used grounded theory methods to determine how individuals were able to live with catastrophic illnesses and injuries. Twenty-eight participants were interviewed for stories of how they endured their circumstances. Although several strategies were used, this article describes a strategy entitled "boosting," which outlines the affected individuals' efforts to improve their self-esteem, which helped them bear their circumstances. Boosting has some relationship to social comparison theory. Implications for nurses and the importance of awareness of this communication need for patients are discussed.

Activities of Daily Living↗
PubMed1990

Catastrophic illness in the analyst and the analyst's emotional reactions to it.

The author reviews the fact that there is very little literature available on catastrophic illness in the analyst and the analyst's emotional reactions to it, compared with other topics of interest. Some of the factors suggested to account for this are exhibitionistic concerns, concerns about one's privacy (including psychic privacy), embarrassment related to countertransference, and concerns about losses of referrals if colleagues perceive the analyst to be impaired. The author then draws a distinction between the emotional life of analysts and countertransference, and discusses how and why he defines them differently. The major part of the paper then goes on to discuss two major technical questions in considerable detail: (a) whether or not to give factual information to patients about one's condition, and (b) the manner in which the material is introduced into the analysis. A number of case examples are cited. The author closes with a discussion of the question of the pros and cons of reporting on the experience immediately versus waiting for the passage of time.

Adaptation, Psychological↗
PubMedDate not supplied

Child welfare services for the catastrophically ill newborn: Part I--A confusion of responsibility.

The majority of these difficult bioethical decisions should properly be made by parents with input from physician and health care workers, utilizing the resources and guidance of infant ethics committees within the involved hospitals. The child protective service system should have the final authority, however, to assure that the decisions of the "caregivers" do not constitute abuse or neglect. This will require that the child welfare system sometimes walk the razor's edge between protecting the child's best interests and preserving, facilitating, and empowering families in these difficult circumstances. But this is an ethical dilemma the child welfare system negotiates daily, and is perhaps the reason used to justify assigning the child welfare system this responsibility. It will also require that the child welfare field have a consensus bioethical paradigm for treatment decision-making for children born with catastrophic illness. Consistent treatment decisions in the best interests of our most vulnerable children cannot be assured, or even expected, without such standardized guidelines.

Bioethical Issues↗