Delivery of dermatologic health care:
Gespeichert in:
Format: | Buch |
---|---|
Sprache: | English |
Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
Schriftenreihe: | Dermatologic clinics
18,2 |
Schlagworte: | |
Online-Zugang: | Inhaltsverzeichnis |
Beschreibung: | XXI S., S. 201 - 382 Ill., graph. Darst. |
Internformat
MARC
LEADER | 00000nam a2200000 cb4500 | ||
---|---|---|---|
001 | BV013163544 | ||
003 | DE-604 | ||
005 | 00000000000000.0 | ||
007 | t | ||
008 | 000519s2000 ad|| |||| 00||| eng d | ||
035 | |a (OCoLC)44072063 | ||
035 | |a (DE-599)BVBBV013163544 | ||
040 | |a DE-604 |b ger |e rakwb | ||
041 | 0 | |a eng | |
049 | |a DE-12 |a DE-578 | ||
245 | 1 | 0 | |a Delivery of dermatologic health care |c Steven R. Feldman ..., guest ed. |
264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2000 | |
300 | |a XXI S., S. 201 - 382 |b Ill., graph. Darst. | ||
336 | |b txt |2 rdacontent | ||
337 | |b n |2 rdamedia | ||
338 | |b nc |2 rdacarrier | ||
490 | 1 | |a Dermatologic clinics |v 18,2 | |
650 | 2 | |a Dermatologie | |
650 | 2 | |a Maladies de la peau | |
650 | 2 | |a Prestations des soins de santé | |
650 | 4 | |a Delivery of Health Care | |
650 | 4 | |a Dermatology | |
650 | 4 | |a Skin Diseases |x therapy | |
650 | 0 | 7 | |a Hautkrankheit |0 (DE-588)4023852-0 |2 gnd |9 rswk-swf |
650 | 0 | 7 | |a Medizinische Versorgung |0 (DE-588)4038270-9 |2 gnd |9 rswk-swf |
651 | 7 | |a USA |0 (DE-588)4078704-7 |2 gnd |9 rswk-swf | |
655 | 7 | |0 (DE-588)4143413-4 |a Aufsatzsammlung |2 gnd-content | |
689 | 0 | 0 | |a USA |0 (DE-588)4078704-7 |D g |
689 | 0 | 1 | |a Hautkrankheit |0 (DE-588)4023852-0 |D s |
689 | 0 | 2 | |a Medizinische Versorgung |0 (DE-588)4038270-9 |D s |
689 | 0 | |5 DE-604 | |
700 | 1 | |a Feldman, Steven R. |e Sonstige |4 oth | |
830 | 0 | |a Dermatologic clinics |v 18,2 |w (DE-604)BV000004924 |9 18,2 | |
856 | 4 | 2 | |m HBZ Datenaustausch |q application/pdf |u http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008968710&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |3 Inhaltsverzeichnis |
999 | |a oai:aleph.bib-bvb.de:BVB01-008968710 |
Datensatz im Suchindex
_version_ | 1804127863548411904 |
---|---|
adam_text | l)i:i IVI KY OF DERMATOLOGJC HEALTH CARE
CONTENTS
Preface xiii
Steven R. Feldman and Alan B. Fleischer, Jr
The Dermatologic Health Problem and Systems for
Delivering Health Care
Introduction: The Magnitude of Skin Disease in the
United States xv
Alan B. Fleischer, Jr, Steven R. Feldman, and Stephen R. Rapp
In 1997, there were an estimated 65.7 million skin disease visits, constitut¬
ing approximately 8.7% of all outpatient care. The treating physicians
include every type of specialty, but dermatology and family medicine
together treat 64% of such patients seen. Dermatitis accounts for over 10%
of all visits. Skin diseases have profound impact on the cost of health care,
and skin diseases affect all aspects of quality of life. Many skin diseases
have been documented to affect life quality, but none have been docu¬
mented as thoroughly as psoriasis. This introduction will provide the basis
to understand the magnitude of the effect of skin diseases in general, and
focus on the profound impact psoriasis has on patients.
Dermatology in the Developing World: Needs and Solutions 201
Terence J. Ryan
Dermatolgists, who have assets far in excess of most of the people of the
world, have the opportunity to contribute globally to the forces of social
progress. This article addresses the dermatologic needs of the developing
world and discusses how the needs of these areas, including rural areas
in the United States, should be addressed.
Economic Aspect of Health Care Systems: Advantage and
Disadvantage Incentives in Different Systems 211
G. John Chen and Steven R. Feldman
European health care delivery systems illustrate the effect of economic
incentives on health care delivery. Each country faces the issue of trying
to balance the desire for economic efficiency with comprehensive, quality
DERMATOLOGIC CLINICS
VOLUME 18 • NUMBER 2 • APRIL 2000 vii
medical care. Without careful use of economic incentives achievable with
central control, one gets to pick only two of three desired goods—high
quality, low cost, and comprehensive coverage. In the United States, the
basic approach for reimbursing hospital care has been completely restruc¬
tured by many payers for care, and payment approaches for physicians
and long term care providers also are being restructured. Financing ap¬
proaches vary from provider to provider and payer to payer, and financing
approaches will continue to evolve over time. These and other issues are
discussed in this article.
Delivery of Dermatologic Care in Different Health Care
Systems
The Primary Care Physician and the Treatment of Patients with
Skin Disorders 215
Daniel G. Federman and Robert S. Kirsner
Scientific advances have altered the nature of primary care medicine.
Primary care providers are increasingly asked to care for a broad spectrum
of common maladies, including cutaneous disease. We review studies that
have compared primary care physicians with dermatologists with respect
to the diagnosis and treatment of skin disorders. Though primary care
providers play a crucial role in the delivery of health care, the judicious
and appropriate use of dermatology consultation should be encouraged.
Role of the Dermatologist in the Delivery of Dermatologic Care 223
Steven R. Feldman and Alan B. Fleischer, Jr
Dermatology faces an uncertain future because of changes in the mecha¬
nisms of health care delivery. The Westwood Squibb Center for Dermatol¬
ogy Research was created to foster the care of patients through research
and education that supports the delivery of optimal dermatologic health
care. The center performs health care research to effect policy decisions
that impact dermatologic health care delivery. Results from a broad range
of these studies clearly demonstrate the value of dermatologists as primary
care providers for patients with skin disease. Future studies at the West¬
wood Squibb Center for Dermatology Research expand on these findings,
demonstrate the cost effectiveness of care by a dermatologist, and address
the expertise of dermatologists at management of surgical problems of
the skin.
Issues in Dermatologic Health Care Delivery in Minority
Populations 229
Amy J. McMichael and Sharon Jackson
It is well known that African Americans are at low risk for one of the
most serious diagnoses in dermatology—skin cancer. A consequence of
this lower cancer risk has been an undervaluing of the importance of
appropriate dermatologic care in this population. In fact, there are many
other skin diseases and disorders that not only cause significant morbidity
among this population but also emotional and psychological sequelae.
This article examines barriers and challenges to providing dermatologic
care among African Americans and provides recommendations and sug¬
gestions for improving care delivery in this population.
The Role of Dermatologists in the Delivery of Occupational
Dermatologic Care 235
Elizabeth F. Sherertz
This article reviews the role of dermatologists in occupational dermato¬
logic care by reviewing the types of skin diseases that may be work
CONTENTS
related, the diagnostic testing, and evidence of quality of care delivery
and outcomes provided by dermatologists.
Delivery of Dermatopathologic Health Care in the Twenty First
Century 241
Nicole Conrad, Raashid Haque, and Clay J. Cockerell
Dermatology and dermatopathology has experienced significant growth
over the last century and continues to burgeon. Upheavals as a conse¬
quence of the advent of managed care have threatened both specialties,
especially with regard to direct access and choice of consultant. The de¬
mand for dermatology and dermatopathology services continues to in¬
crease, and for patients to be served appropriately, these issues must be
addressed.
Issues in the Delivery of Dermatologic Surgery for Skin Cancer 251
Joel Cook
Skin cancer is the most common human malignancy. Given the large
number of skin cancers, cost effective treatment of cutaneous neoplasia is
important. The training and clinical experience of the dermatologist in
treating skin cancer is unsurpassed. Dermatologists are the best trained
providers in the diagnosis and management of skin cancer.
Evidence Based Medicine in Dermatology 261
Michael Bigby
Evidence based medicine (EBM) is the use of the best current evidence in
making decisions about the care of individual patients. Practicing EBM
requires five steps: formulating well built clinical questions, finding the
best evidence to answer the questions, critically appraising the evidence,
applying the evidence to specific patients, and saving the critically ap¬
praised evidence. The quality (strength) of evidence is based on a hierarchy
of evidence: results of systematic reviews of well designed clinical studies,
results of large case series, and expert opinion. Once the best evidence has
been found, the EBM approach involves critically appraising the quality
of the evidence, determining its magnitude and precision, and applying it
to the specific patient. Guidelines to critically appraise and apply evidence
are available.
Nonphysician Components of Dermatologic Health
Delivery
Patient Advocacy Groups: A Key Prescription for Dermatology 277
Tara Rolstad and Gail Zimmerman
In addition to medical care, patient education and support is important
to successful treatment of chronic dermatologic diseases. For assistance,
dermatologists and patients should turn to patient advocacy groups, which
provide educational materials, programs, support groups, and advocacy
for patients with chronic skin diseases.
The Roles of the Pharmaceutical Industry and Drug
Development in Dermatology and Dermatologic Health Care 287
David J. Airman
The interactions and relationships between the pharmaceutical industry,
the specialty of dermatology, dermatologists, and patients are complex
CONTENTS I
and interdependent. This article discusses types of drugs, drug develop¬
ment and regulatory approval process, and the idiosyncrasies of dermato
logic drug development. It also discusses the changing nature and strate¬
gies of the pharmaceutical industry and drug development and problems
they portend for dermatology. The pharmaceutical industry has important
roles in the support of research, specialty organizations, the daily practice
of the dermatologist and in the delivery of dermatologic health care.
The Emerging Role of Physician Assistants in the Delivery of
Dermatologic Health Care 297
Adele R. Clark, Joe R. Monroe, Steven R. Feldman,
Alan B. Fleischer, Jr, Debbie A. Hauser, and Martha Ann Hinds
With roots in primary care, use of the physician assistant (PA) has now
spread to many areas of medical specialty, including dermatology. Derma¬
tologic symptoms account for 14% of all PA visits, with most of these
visits taking place in a dermatologists office. Some of the duties performed
by PAs include diagnosis, evaluation and management of common derma¬
tologic conditions, preoperative and postoperative evaluations, writing
prescriptions, cryotherapy of benign lesions, intralesional injections, per¬
forming biopsies, laser therapy, and minor surgeries. This article answers
questions concerning the role of the PA and provides specific data on the
use of PAs in the care of patients with skin disease.
Regulatory Environmental Issues
Dermatology Manpower Needs 303
Jean Claude Brystryn
The future need for dermatologists is difficult to predict, as it depends on
the structure of our health care delivery system, which is still rapidly
evolving, and whose future shape is unknown. The best strategy to deal
with this unpredictable situation is to de emphasize trying to predict the
future and focus on responding as rapidly as possible to whatever changes
in dermatologic manpower needs the future may bring. From that perspec¬
tive, it is best to train fewer rather than more dermatologists, as it is much
quicker to rectify a shortage than an excess in medical manpower. Other
issues that impact on dermatologist manpower include a very rapid in¬
crease in nonphysicians taking care of skin diseases, the maldistribution
of dermatologists, the decreasing proportion of common skin diseases
treated by dermatologists, and the need to upgrade the residency training
to master the explosion in medical knowledge which has occurred, and
to gain a greater expertise in the medical and cosmetic aspects of the
specialty.
Growing Impediments to the Delivery of Dermatologic Care 313
Steven R. Feldman and Phillip M. Williford
Dermatologists provide a model for the delivery of efficient medical care.
Growing regulations consume considerable time and resources that could
otherwise be devoted to direct improvement of patient care. Because
of the limited scope of dermatology encounters, regulations and other
impediments have a disproportionally greater impact on the care of pa¬
tients with skin disease. This article discusses many of the evolving regula¬
tions that were initiated ostensibly to improve patient care but that proba¬
bly have an even greater negative impact on physicians ability to deliver
high quality dermatologic care.
CONTENTS
Organizing State Dermatologic Societies 319
Clifford Warren Lober
Each year state legislatures, boards of medicine, departments of insurance,
and other authorities promulgate laws and rules that affect the daily
practice of dermatology. It is critical that dermatologists in each state form
and maintain a strong state dermatologic society. Specific suggestions
for forming and strengthening such societies are described and available
resources are reviewed.
Current Therapy
Unusual, Innovative, and Long Forgotten Remedies 323
Stephen P. Stone
A compendium of uncommon dermatologic treatments, both medical and
surgical, are presented. This article is based on a survey of the members
of the Noah Worcester Dermatologic Society with subsequent additions,
including treatment pearls from the Internet and other contributions from
practicing dermatologists, as well as some published material. Most of the
therapies discussed in this article are based on anecdotal information.
Treatment of Common Nail Disorders 339
Antonella Tosti and Bianca Maria Piraccini
Treatment of nail diseases is not always easy, because topical treatment is
often ineffective as the nail plate is not penetrated by topical drugs and
the nail matrix is located under the proximal nail fold. The most frequent
nail disorders are nail psoriasis and onychomycosis. In these cases sys¬
temic treatment is often necessary to cure the nail changes. Systemic
treatment with steroids is mandatory for patients with nail lichen planus,
because the disease may cause definitive destruction of the nail matrix.
Environmental nail abnormalities are very frequent and include nail brit
tleness, onycholysis, and chronic paronychia. Preventive measures should
always be associated with treatment in these cases.
Establishing a Practical and Effective Psoriasis Treatment Center 349
Jerry Bagel
Running an effective psoriasis treatment center requires 1) capable photo
therapists who have received the appropriate education and training; 2) a
full range of equipment, including light boxes, hand foot units, scalp
debridement machines, and a whirlpool bath; 3) adequate space; 4) eco¬
nomic considerations, including reimbursements so patients can receive
treatment and the center can be paid; and 5) the medical expertise neces¬
sary to care for the most severe psoriatic patients. These and other issues
are discussed in this article.
Nontuberculous Mycobacterial Infections of the Skin 359
Sarah Weitzul, Phillip J. Eichhorn, and Amit G. Pandya
Nontuberculous mycobacteria are playing an increasingly important role
in human disease owing to higher prevalence of antibiotic resistance and
immunodeficiency. These organisms cause a variety of cutaneous findings
which are often misdiagnosed by the clinician. Compounding this problem
is the fact that most mycobacteria require special culture conditions, which
if not specifically requested, are frequently not used. Recognition of sus
CONTENTS
ceptible patients is imperative and is not limited to the immunocomprom
ised. Successful treatment of mycobacterial infections requires knowledge
of currently available and recommended antibiotics followed by tailoring
of the antimicrobial regimen after sensitivity testing is performed.
Index 379
Subscription Information Inside back cover
CONTENTS
|
any_adam_object | 1 |
building | Verbundindex |
bvnumber | BV013163544 |
ctrlnum | (OCoLC)44072063 (DE-599)BVBBV013163544 |
format | Book |
fullrecord | <?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01725nam a2200445 cb4500</leader><controlfield tag="001">BV013163544</controlfield><controlfield tag="003">DE-604</controlfield><controlfield tag="005">00000000000000.0</controlfield><controlfield tag="007">t</controlfield><controlfield tag="008">000519s2000 ad|| |||| 00||| eng d</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(OCoLC)44072063</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)BVBBV013163544</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-604</subfield><subfield code="b">ger</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1="0" ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="049" ind1=" " ind2=" "><subfield code="a">DE-12</subfield><subfield code="a">DE-578</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Delivery of dermatologic health care</subfield><subfield code="c">Steven R. Feldman ..., guest ed.</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="a">Philadelphia [u.a.]</subfield><subfield code="b">Saunders</subfield><subfield code="c">2000</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">XXI S., S. 201 - 382</subfield><subfield code="b">Ill., graph. Darst.</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="b">n</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="b">nc</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="490" ind1="1" ind2=" "><subfield code="a">Dermatologic clinics</subfield><subfield code="v">18,2</subfield></datafield><datafield tag="650" ind1=" " ind2="2"><subfield code="a">Dermatologie</subfield></datafield><datafield tag="650" ind1=" " ind2="2"><subfield code="a">Maladies de la peau</subfield></datafield><datafield tag="650" ind1=" " ind2="2"><subfield code="a">Prestations des soins de santé</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Delivery of Health Care</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Dermatology</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Skin Diseases</subfield><subfield code="x">therapy</subfield></datafield><datafield tag="650" ind1="0" ind2="7"><subfield code="a">Hautkrankheit</subfield><subfield code="0">(DE-588)4023852-0</subfield><subfield code="2">gnd</subfield><subfield code="9">rswk-swf</subfield></datafield><datafield tag="650" ind1="0" ind2="7"><subfield code="a">Medizinische Versorgung</subfield><subfield code="0">(DE-588)4038270-9</subfield><subfield code="2">gnd</subfield><subfield code="9">rswk-swf</subfield></datafield><datafield tag="651" ind1=" " ind2="7"><subfield code="a">USA</subfield><subfield code="0">(DE-588)4078704-7</subfield><subfield code="2">gnd</subfield><subfield code="9">rswk-swf</subfield></datafield><datafield tag="655" ind1=" " ind2="7"><subfield code="0">(DE-588)4143413-4</subfield><subfield code="a">Aufsatzsammlung</subfield><subfield code="2">gnd-content</subfield></datafield><datafield tag="689" ind1="0" ind2="0"><subfield code="a">USA</subfield><subfield code="0">(DE-588)4078704-7</subfield><subfield code="D">g</subfield></datafield><datafield tag="689" ind1="0" ind2="1"><subfield code="a">Hautkrankheit</subfield><subfield code="0">(DE-588)4023852-0</subfield><subfield code="D">s</subfield></datafield><datafield tag="689" ind1="0" ind2="2"><subfield code="a">Medizinische Versorgung</subfield><subfield code="0">(DE-588)4038270-9</subfield><subfield code="D">s</subfield></datafield><datafield tag="689" ind1="0" ind2=" "><subfield code="5">DE-604</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Feldman, Steven R.</subfield><subfield code="e">Sonstige</subfield><subfield code="4">oth</subfield></datafield><datafield tag="830" ind1=" " ind2="0"><subfield code="a">Dermatologic clinics</subfield><subfield code="v">18,2</subfield><subfield code="w">(DE-604)BV000004924</subfield><subfield code="9">18,2</subfield></datafield><datafield tag="856" ind1="4" ind2="2"><subfield code="m">HBZ Datenaustausch</subfield><subfield code="q">application/pdf</subfield><subfield code="u">http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008968710&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA</subfield><subfield code="3">Inhaltsverzeichnis</subfield></datafield><datafield tag="999" ind1=" " ind2=" "><subfield code="a">oai:aleph.bib-bvb.de:BVB01-008968710</subfield></datafield></record></collection> |
genre | (DE-588)4143413-4 Aufsatzsammlung gnd-content |
genre_facet | Aufsatzsammlung |
geographic | USA (DE-588)4078704-7 gnd |
geographic_facet | USA |
id | DE-604.BV013163544 |
illustrated | Illustrated |
indexdate | 2024-07-09T18:40:06Z |
institution | BVB |
language | English |
oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-008968710 |
oclc_num | 44072063 |
open_access_boolean | |
owner | DE-12 DE-578 |
owner_facet | DE-12 DE-578 |
physical | XXI S., S. 201 - 382 Ill., graph. Darst. |
publishDate | 2000 |
publishDateSearch | 2000 |
publishDateSort | 2000 |
publisher | Saunders |
record_format | marc |
series | Dermatologic clinics |
series2 | Dermatologic clinics |
spelling | Delivery of dermatologic health care Steven R. Feldman ..., guest ed. Philadelphia [u.a.] Saunders 2000 XXI S., S. 201 - 382 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Dermatologic clinics 18,2 Dermatologie Maladies de la peau Prestations des soins de santé Delivery of Health Care Dermatology Skin Diseases therapy Hautkrankheit (DE-588)4023852-0 gnd rswk-swf Medizinische Versorgung (DE-588)4038270-9 gnd rswk-swf USA (DE-588)4078704-7 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content USA (DE-588)4078704-7 g Hautkrankheit (DE-588)4023852-0 s Medizinische Versorgung (DE-588)4038270-9 s DE-604 Feldman, Steven R. Sonstige oth Dermatologic clinics 18,2 (DE-604)BV000004924 18,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008968710&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
spellingShingle | Delivery of dermatologic health care Dermatologic clinics Dermatologie Maladies de la peau Prestations des soins de santé Delivery of Health Care Dermatology Skin Diseases therapy Hautkrankheit (DE-588)4023852-0 gnd Medizinische Versorgung (DE-588)4038270-9 gnd |
subject_GND | (DE-588)4023852-0 (DE-588)4038270-9 (DE-588)4078704-7 (DE-588)4143413-4 |
title | Delivery of dermatologic health care |
title_auth | Delivery of dermatologic health care |
title_exact_search | Delivery of dermatologic health care |
title_full | Delivery of dermatologic health care Steven R. Feldman ..., guest ed. |
title_fullStr | Delivery of dermatologic health care Steven R. Feldman ..., guest ed. |
title_full_unstemmed | Delivery of dermatologic health care Steven R. Feldman ..., guest ed. |
title_short | Delivery of dermatologic health care |
title_sort | delivery of dermatologic health care |
topic | Dermatologie Maladies de la peau Prestations des soins de santé Delivery of Health Care Dermatology Skin Diseases therapy Hautkrankheit (DE-588)4023852-0 gnd Medizinische Versorgung (DE-588)4038270-9 gnd |
topic_facet | Dermatologie Maladies de la peau Prestations des soins de santé Delivery of Health Care Dermatology Skin Diseases therapy Hautkrankheit Medizinische Versorgung USA Aufsatzsammlung |
url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008968710&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
volume_link | (DE-604)BV000004924 |
work_keys_str_mv | AT feldmanstevenr deliveryofdermatologichealthcare |