This systematic review identified key factors associated with telemedicine program success. However, inconsistencies in reporting represent an obstacle to establishment of successful programs in developing countries by limiting the application of previous experiences. Adhering to the guidelines suggested here may allow more quantitative assessments of effectiveness and impact for future programs.
Many challenges need to be overcome for a disinvestment initiative to be successful, and sharing particular experiences with the international community would increase the chances of positive outcomes. The present study highlights the need for publication of such experiences in LAC.
Objectives: To examine follow-up of autoantibody testing and health care utilization among patients with (sustained) celiac disease. MethOds: From the PHARMO Database Network, patients with a positive autoantibody test for deamidated gliadin peptide (anti-DGP), endomysial (EMA) or tissue transglutaminase (anti-tTG) (period 1998-2011) were classified as celiac disease patients. The first positive test served as index date. For patients with ≥ 12 months follow-up, autoantibody tests in the year after index date were assessed. Patients with a second positive test, using the same cut-off, between 6-12 months after index date were classified as 'sustained celiac disease' patients and matched 1:1 on gender, birth year and year of index date to celiac disease patients without a second positive test. For these patients, health care utilization in 2012 was determined. Results: 1,815 patients had at least one positive autoantibody test, of which anti-tTG was most common (86%). 1,724 patients had ≥ 12 months follow-up, of which 75% did not have any type of autoantibody test in the year after index date. 183 patients (11%) were classified as 'sustained celiac disease' patients. Of these, 63 were active in the database in 2012 and could be matched. The proportion of patients with at least one GP visit and/ or hospitalization in 2012 was lower among sustained celiac disease patients: 76% and 14% vs. 83% and 24% for patients without sustained celiac disease. However, the mean (±SD) number of GP visits was higher among sustained celiac disease patients (4.3 ± 7.3 vs. 3.4 ± 3.5) as was the mean (±SD) number of outpatient drug dispensings (21.6 ± 96.3 vs.10.5 ± 17.5). cOnclusiOns: This study shows limited follow-up autoantibody testing among patients with celiac disease and does not suggest higher health care utilization with sustained celiac disease. These findings are consistent with notion of patients managing the disease without engaging the health care system.
HS2 tHe imPact oF diFFerent levelS oF clinical PHarmaciSt interventionS on tHe tHeraPeutic Plan and coSt Saving
A851sam ser convertidos de forma positiva quando aplicados à pesquisa e ao treinamento de recursos humanos. Assim, as isenções podem alcançar todos os tipos de tributo (impostos, taxas, contribuições de melhoria, empréstimos compulsórios e contribuições especiais). Cada esfera de Governo (federal, estadual e municipal) legisla sobre a isenção dos tributos de sua competência. A apresentação e a análise se darão conforme Portaria nº 1.826 / 2012 que veio como uma das regulamentações da Lei 12.101/2009. Para isso o Ministério da Saúde define e divulga anualmente os temas e objetivos prioritários para a elaboração de projetos de apoio ao desenvolvimento institucional do SUS, a serem executados em um período de três anos. ResultAdos: No âmbito da avaliação e gestão em saúde, a entidade de saúde, reconhecida excelência, está apta a apresentar projetos PROADI-SUS no âmbito da Avaliação e Incorporação de Tecnologia no SUS. No triênio 2012 -2014 foram contempladas 5 instituições no programa. Vários projetos foram aprovados envolvendo um valor estimado de R$ 90.097.871,53 reais. ConClusões: O programa Proadi-SUS favorece ao SUS a construção de conhecimentos e práticas sustentáveis ao sistema de saúde, por meio de uma parceria público-privada, entre o Estado e a sociedade. Nesse triênio (2012 -2014), cerca de 3660 pessoas foram especializadas ou qualificadas em 2013 e serão concluídos até 2014, 37 estudos e 2 pesquisas. Os resultados desses projetos orientaram tomada de decisões de gestores, assim como a melhoria dos serviços prestados a sociedade com profissionais especializados e qualificados.
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