Managed care and the cystic fibrosis patient

McCoy, Karen; Stokes, Dennis C.; Dubroff, Michael; Hoffman, Anne E.; Mischler, Nicholas E.; Erickson, Sue

doi:10.1097/00063198-199711000-00007

Cited by 3 publications

(1 citation statement)

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“…Cystic fibrosis is the most common inherited fatal disease in the Caucasian population (Davis, 2001). Since 1969 (First Report on the Mortality from Cystic Fibrosis; Mc-Coy et al, 1997), survival of cystic fibrosis patients has increased markedly from 14 to 31 years (McCoy et al, 1997). This is attributed to an earlier diagnosis of the disease (Dankert-Roelse & Merelle, 2005) as well as to improvements in patient care involving multidisciplinary teams and more effective therapeutic options (Kettler, Sawyer, Winefield, & Greville, 2002).…”

Section: Introductionmentioning

confidence: 99%

Psychological Assessment of Two Adolescents with Cystic Fibrosis Awaiting Lung Transplants

Flahault¹

2010

Rorschachiana

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This paper is based on two clinical cases of adolescents suffering from cystic fibrosis who were evaluated before lung transplant by the Rorschach Comprehensive System and an interview. Clinical practice calling for the assessment with the Rorschach shows how this procedure may provide useful information for case conceptualization in a medical setting. Two clinical cases are provided and interpreted. Data show that the Rorschach allows us to explore the patients’ psychological issues as well as their defensive organizations. It provides a useful complement to the interview, especially access to depressive feelings hidden by defensive functioning. Articulation with treatment planning issues and follow-up data are also provided on the two cases.

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Section: Introductionmentioning

confidence: 99%

Psychological Assessment of Two Adolescents with Cystic Fibrosis Awaiting Lung Transplants

Flahault¹

2010

Rorschachiana

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Harmonizing care for rare diseases: How we developed the mitochondrial care network in the United States

Karaa

Goldstein

Balcells³

et al. 2019

Molecular Genetics and Metabolism

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Specialty Care Improves Outcome in Childhood Asthma

Morton¹,

Eddy²,

Yandell³

et al. 1999

Pediatric Asthma, Allergy & Immunology

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By means of a retrospective cohort analysis, we studied the impact of specialty care on health care costs and clinical outcomes in children with moderate to severe asthma. Fifteen patients with a median age of 9 ± 7 years with at least three emergency department (ED) visits and one hospital admission (HA) for asthma were identified. Patients need to be followed for at least 1 year at the Childhood Asthma Care and Education Center (CACEC) to be eligible for this study. A stepwise approach to treatment was applied according to clinical severity. Follow-up was done quarterly by the asthma management team in coordination with the primary care physician. Pulmonary function parameters, clinical outcomes, and hospital charges were compared before and after referral to the CACEC. A 67% reduction in HA rate per year (p < 0.005) and a 75 % reduction in ED utilization per year (p = 0.02) were observed. Pulmonary function tests (PFTs) showed significant improvement. The forced expiratory volume in 1 second (FEVi) increased from 63 to 80% ofthat predicted (p = 0.0006). In addition, the forced expiratory flow between 25 and 75% of the vital capacity (FEF2s_75%), a marker of small airway function, increased from 37 to 47% of the predicted values for age (p -0.03). The estimated mean hospital charges decreased by $3800 per patient per year after study enrollment. Appropriate referral to asthma specialists leads to an improved clinical outcome, decreased health care expenditures, and improved pulmonary function in children with moderate to severe asthma.

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Managed care and the cystic fibrosis patient

Cited by 3 publications

References 0 publications

Psychological Assessment of Two Adolescents with Cystic Fibrosis Awaiting Lung Transplants

Psychological Assessment of Two Adolescents with Cystic Fibrosis Awaiting Lung Transplants

Harmonizing care for rare diseases: How we developed the mitochondrial care network in the United States

Specialty Care Improves Outcome in Childhood Asthma

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