A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain:
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Abschlussarbeit Buch |
| Sprache: | English |
| Veröffentlicht: |
2004
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| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XI, 182 S. graph. Darst. |
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Table of Content
1. Introduction 1
2. Health care, welfare and diseases pattern a challenge 9
2.1. Introduction 9
2.2. Emergence of chronic disease problems in Nepal 10
2.3. A brief history of public health and diseases 12
2.4. Complex phenomenon of human health and diseases 12
2.5. Well being: a journey from Ayurveda to the Universal Human Rights Charter 14
2.6. Health and Human Rights. 15
3. Health care provision and Us governing factors in Nepal. 17
3.1. Introduction of the geo political situation. 17
3.2. Health care delivery system 20
3.3. Health care scenario 23
3.4. Data arrangement associated with health care 25
3.5. Healthcare financing 27
3.6. Health policy of Nepal 29
3.7. Scope of public health in Nepal 30
4. Diabetes mellitus 32
4.1. An overview 32
4.2. The prevalence of diabetes type 2 in Nepal. 32
4.3. The diabetes type 2 prevalence in South East Asia 37
4.4. The trend of non contagious diseases 38
4.5. Etiologic classifications of diabetes mellitus 40
4.6. Diabetes diagnostic criteria and procedures 42
4.7. The types diabetes mellitus 45
4.8. Diabetes mellitus and its complications 47
4.8.1 Short term complications: 50
4.8.2 Intermediate term complications 50
4.8.3 Long term complications: Heart disease and stroke 50
4.9. Clinical practice guidelines .—. . 53
4.10. The prevalence of diabetes worldwide . . 55
4.11. Diabetes mellitus in Germany 57
4.12. Diabetes mellitus in the United Kingdom 58
4 1 "X ^nrinl ncnpc Is of chronic diseases 60
5. Health care policy 61
5.1. The public policy and policy process. 61
5 2 Imnnrtnnrp of hc lth Policv 62
5.3. The state of the art healthier health policy 63
v
5.4. Health care system comparison for policy learning 65
5.5. Historical background of the health care system in Germany 66
5.5.1 The social security system 67
5.5.2 Health care organization 69
5.5.3 Fundamental features of the German social insurance 69
5.5.4 In patients' care and the remuneration of physicians 74
5.6. Historical background of the United Kingdom 74
5.6.1 Historical background National Health Services (NHS) 75
5.6.2 Institutional framework of the department of health services 76
5.6.3 State run health care organisational structure 77
5.6.4 Private health care 79
5.6.5 Resource distribution 79
5.6.6 Health care financing 79
5.7. German and United Kingdom health care systems: a comparative overview 81
5.7.1 Health care system 81
5.7.2 Information and publication 81
5.7.3 Policy making 81
5.7.4 Implementing agencies of the government 82
5.7.5 Provider organisations 82
5.7.6 Individual practitioners 82
5.7.7 Provider Associations 83
5.7.8 Insurers 83
5.7.9 Education 84
5.7.10 Research 84
5.7.11 Management consulting 84
6. Public Health Informatics 86
6 1 An overview 86
6.2. An evolution in Public Health Informatics 87
6.3. Exponential growth in computer power and its usage . 89
6.4. Applications of Public Health Informatics 90
6.4.1 Data management 90
6.4.2 Improving scientific knowledge 91
6.4.3 Patient's education and service 94
6.4.4 Expert systems and knowledge discovery in medicine 95
6.5. The existing infrastructure and services in Nepal 98
6.5.1 Computerization in the government and semi government sector 99
6.6. Importance of data management in diabetes care 100
6.7. Knowledge and disease management in diabetes care 102
7. A decade's experience with health care delivery in Nepal: policy and practice 106
7 1 An ovcrvipw . 106
7.2. Health care mirror from the central hospital 109
7.3. Support in maintaining medical devices . . 114
7.4. Supporting in establish, upgrading units and professional training. .—115
7.5. A high pride institution with invisible pitfalls 116
8. Discussion 119
8.1. Diabetes is a new and young epidemiology in Nepal 119
8.2. An account of the increasing number of renal patients and renal care cost .—121
vi
8.3. An epidemiologjcal triad identifying potential drivers to increase diabetes in Nepal 124
8.4. The potential factors increasing the new cases of diabetes 127
8.4.1 Transformation of the Nepalese society towards modernity 127
8.4.2 Changing food behaviour 129
8.4.3 Reduced physical activities 132
8.4.4 Population with increasing ageing 132
8.4.5 Population movement and internal migration towards urban regions and the Terai 134
8.5. An estimation of the diabetes prevalence for the coming decades 135
8.6. Expanding globalisation and its influence on health 139
8.7. Prevention is the only available way to counteract diabetes 140
8.8. Public Health Informatics supporting diabetes management 141
8.9. Health care data management in Nepal 144
8.10. Health care data management in Nepal 145
8.11. Evidence based health care delivery system 146
8.12. Health services redesign focus on diabetes management 147
9. Recommendations 149
9.1. Creating policy to enhance better opportunities beyond health care setting 149
9.2. Creating supportive environments 150
9.3. Creating community action **.*. 150
9.4. Establishing effective self care and self management 151
9.5. Reorienting health delivery services . . 152
9.6. Creating decision support 152
9.7. Clinical information system. 153
vii
Tables
Table 1: Municipalities in Nepal 5
Table 2: Health indicators of Nepal 24
Table 3: The top ten reasons for hospitalization, FY 2055/56 (1998/99) 25
Table 4: Diabetes type 2 Prevalence in SAARC countries 37
Table 5: Type 2 diabetes in 4 South Asian Nations 38
Table 6: WHO regions except Africa, deaths from non contagious diseases 38
Table 7: Etiologic classification of diabetes mellitus (Clinical practice guidelines 2003) 41
Table 8: Values for diagnosis of diabetes mellitus and other categories of hyperglycaemia. 43
Table 9: The natural history of type 1 diabetes and spectrum of prevention opportunities 46
Table 10: Patients affected by different diabetic complications 48
Table 11: Magnitude of diabetes with sex and age group 57
Table 12: The statistics of diabetes mellitus complications in Germany 58
Table 13: The list of benefits of stationary health insurance 73
Table 14: Health indicators in Germany and Great Britain 85
Table 15: Useful search subheadings and suffixes (Greenhalgh, 1997) 93
Table 16: The Figures are based on an extensive study of the trade directories 99
Table 17: Total number of patients served during 1993 2000 110
Table 18: The number of patients dialysed at National Kidney Centre by zone 122
Table 19: Diabetes with end stage kidney failure over a decade 123
Table 20: Average daily food group consumptions of subjects 130
Table 21: Health outcome indicators by gender and regions 133
Table 22: Disparities in life expectancy 134
Table 23: Shifting of population growth structure (1981,1991 and 2001) 135
viii
Figures
Figure 1: The trend of an increasing population in urban areas of Nepal (1981 2001) 4
Figure 2: The map of Nepal 17
Figure 3: Organizational structure of the Ministry of Health 22
Figure 4: The top ten major diseases (ambulatory clinics), (1998/99) 23
Figure 5: Organogram of the Ministry of Health and professional councils 26
Figure 6: The diabetes prevalence in Nepal 33
Figure 7: The diabetes prevalence for 1995, 2000 and 2025 by continent 40
Figure 8: Disorders of glycaemia: aetiological types and clinical stages 42
Figure 9: Laboratory diagnosis and monitoring of diabetes mellitus 44
Figure 10: Cases of death among patients with diabetes mellitus 49
Figure 11: Estimated number of adults with diabetes in 1995 (in millions) 55
Figure 12: Estimated number of adults with diabetes in 2025 (in millions) 56
Figure 13: Organisational structure of the German Health care System 69
Figure 14: Organisational structure of the British National Health Services 77
Figure 15: Accessing information and consultation via the World Wide Web 92
Figure 16: Extraction of knowledge in the form of decision tree 96
Figure 17: A set up of an expert, expert system and treatment team 103
Figure 18: Archimedes: A diabetes management model 105
Figure 19: Epidemiological triad model for diabetes 125
Figure 20: Fulcrum 126
Figure 21: Diabetes projection for 2005 2025 137
Figure 22: The expanded chronic care model 148
Figure 23: Outline of guideline for policy process 154
Figure 24: The food pyramid 158
ix |
| adam_txt |
Table of Content
1. Introduction 1
2. Health care, welfare and diseases pattern a challenge 9
2.1. Introduction 9
2.2. Emergence of chronic disease problems in Nepal 10
2.3. A brief history of public health and diseases 12
2.4. Complex phenomenon of human health and diseases 12
2.5. Well being: a journey from Ayurveda to the Universal Human Rights Charter 14
2.6. Health and Human Rights. 15
3. Health care provision and Us governing factors in Nepal. 17
3.1. Introduction of the geo political situation. 17
3.2. Health care delivery system 20
3.3. Health care scenario 23
3.4. Data arrangement associated with health care 25
3.5. Healthcare financing 27
3.6. Health policy of Nepal 29
3.7. Scope of public health in Nepal 30
4. Diabetes mellitus 32
4.1. An overview 32
4.2. The prevalence of diabetes type 2 in Nepal. 32
4.3. The diabetes type 2 prevalence in South East Asia 37
4.4. The trend of non contagious diseases 38
4.5. Etiologic classifications of diabetes mellitus 40
4.6. Diabetes diagnostic criteria and procedures 42
4.7. The types diabetes mellitus 45
4.8. Diabetes mellitus and its complications 47
4.8.1 Short term complications: 50
4.8.2 Intermediate term complications 50
4.8.3 Long term complications: Heart disease and stroke 50
4.9. Clinical practice guidelines .—. . 53
4.10. The prevalence of diabetes worldwide . . 55
4.11. Diabetes mellitus in Germany 57
4.12. Diabetes mellitus in the United Kingdom 58
4 1 "X ^nrinl ncnpc Is of chronic diseases 60
5. Health care policy 61
5.1. The public policy and policy process. 61
5 2 Imnnrtnnrp of hc lth Policv 62
5.3. The state of the art healthier health policy 63
v
5.4. Health care system comparison for policy learning 65
5.5. Historical background of the health care system in Germany 66
5.5.1 The social security system 67
5.5.2 Health care organization 69
5.5.3 Fundamental features of the German social insurance 69
5.5.4 In patients' care and the remuneration of physicians 74
5.6. Historical background of the United Kingdom 74
5.6.1 Historical background National Health Services (NHS) 75
5.6.2 Institutional framework of the department of health services 76
5.6.3 State run health care organisational structure 77
5.6.4 Private health care 79
5.6.5 Resource distribution 79
5.6.6 Health care financing 79
5.7. German and United Kingdom health care systems: a comparative overview 81
5.7.1 Health care system 81
5.7.2 Information and publication 81
5.7.3 Policy making 81
5.7.4 Implementing agencies of the government 82
5.7.5 Provider organisations 82
5.7.6 Individual practitioners 82
5.7.7 Provider Associations 83
5.7.8 Insurers 83
5.7.9 Education 84
5.7.10 Research 84
5.7.11 Management consulting 84
6. Public Health Informatics 86
6 1 An overview 86
6.2. An evolution in Public Health Informatics 87
6.3. Exponential growth in computer power and its usage . 89
6.4. Applications of Public Health Informatics 90
6.4.1 Data management 90
6.4.2 Improving scientific knowledge 91
6.4.3 Patient's education and service 94
6.4.4 Expert systems and knowledge discovery in medicine 95
6.5. The existing infrastructure and services in Nepal 98
6.5.1 Computerization in the government and semi government sector 99
6.6. Importance of data management in diabetes care 100
6.7. Knowledge and disease management in diabetes care 102
7. A decade's experience with health care delivery in Nepal: policy and practice 106
7 1 An ovcrvipw . 106
7.2. Health care mirror from the central hospital 109
7.3. Support in maintaining medical devices . . 114
7.4. Supporting in establish, upgrading units and professional training. .—115
7.5. A high pride institution with invisible pitfalls 116
8. Discussion 119
8.1. Diabetes is a new and young epidemiology in Nepal 119
8.2. An account of the increasing number of renal patients and renal care cost .—121
vi
8.3. An epidemiologjcal triad identifying potential drivers to increase diabetes in Nepal 124
8.4. The potential factors increasing the new cases of diabetes 127
8.4.1 Transformation of the Nepalese society towards modernity 127
8.4.2 Changing food behaviour 129
8.4.3 Reduced physical activities 132
8.4.4 Population with increasing ageing 132
8.4.5 Population movement and internal migration towards urban regions and the Terai 134
8.5. An estimation of the diabetes prevalence for the coming decades 135
8.6. Expanding globalisation and its influence on health 139
8.7. Prevention is the only available way to counteract diabetes 140
8.8. Public Health Informatics supporting diabetes management 141
8.9. Health care data management in Nepal 144
8.10. Health care data management in Nepal 145
8.11. Evidence based health care delivery system 146
8.12. Health services redesign focus on diabetes management 147
9. Recommendations 149
9.1. Creating policy to enhance better opportunities beyond health care setting 149
9.2. Creating supportive environments 150
9.3. Creating community action **.*. 150
9.4. Establishing effective self care and self management 151
9.5. Reorienting health delivery services . . 152
9.6. Creating decision support 152
9.7. Clinical information system. 153
vii
Tables
Table 1: Municipalities in Nepal 5
Table 2: Health indicators of Nepal 24
Table 3: The top ten reasons for hospitalization, FY 2055/56 (1998/99) 25
Table 4: Diabetes type 2 Prevalence in SAARC countries 37
Table 5: Type 2 diabetes in 4 South Asian Nations 38
Table 6: WHO regions except Africa, deaths from non contagious diseases 38
Table 7: Etiologic classification of diabetes mellitus (Clinical practice guidelines 2003) 41
Table 8: Values for diagnosis of diabetes mellitus and other categories of hyperglycaemia. 43
Table 9: The natural history of type 1 diabetes and spectrum of prevention opportunities 46
Table 10: Patients affected by different diabetic complications 48
Table 11: Magnitude of diabetes with sex and age group 57
Table 12: The statistics of diabetes mellitus complications in Germany 58
Table 13: The list of benefits of stationary health insurance 73
Table 14: Health indicators in Germany and Great Britain 85
Table 15: Useful search subheadings and suffixes (Greenhalgh, 1997) 93
Table 16: The Figures are based on an extensive study of the trade directories 99
Table 17: Total number of patients served during 1993 2000 110
Table 18: The number of patients dialysed at National Kidney Centre by zone 122
Table 19: Diabetes with end stage kidney failure over a decade 123
Table 20: Average daily food group consumptions of subjects 130
Table 21: Health outcome indicators by gender and regions 133
Table 22: Disparities in life expectancy 134
Table 23: Shifting of population growth structure (1981,1991 and 2001) 135
viii
Figures
Figure 1: The trend of an increasing population in urban areas of Nepal (1981 2001) 4
Figure 2: The map of Nepal 17
Figure 3: Organizational structure of the Ministry of Health 22
Figure 4: The top ten major diseases (ambulatory clinics), (1998/99) 23
Figure 5: Organogram of the Ministry of Health and professional councils 26
Figure 6: The diabetes prevalence in Nepal 33
Figure 7: The diabetes prevalence for 1995, 2000 and 2025 by continent 40
Figure 8: Disorders of glycaemia: aetiological types and clinical stages 42
Figure 9: Laboratory diagnosis and monitoring of diabetes mellitus 44
Figure 10: Cases of death among patients with diabetes mellitus 49
Figure 11: Estimated number of adults with diabetes in 1995 (in millions) 55
Figure 12: Estimated number of adults with diabetes in 2025 (in millions) 56
Figure 13: Organisational structure of the German Health care System 69
Figure 14: Organisational structure of the British National Health Services 77
Figure 15: Accessing information and consultation via the World Wide Web 92
Figure 16: Extraction of knowledge in the form of decision tree 96
Figure 17: A set up of an expert, expert system and treatment team 103
Figure 18: Archimedes: A diabetes management model 105
Figure 19: Epidemiological triad model for diabetes 125
Figure 20: Fulcrum 126
Figure 21: Diabetes projection for 2005 2025 137
Figure 22: The expanded chronic care model 148
Figure 23: Outline of guideline for policy process 154
Figure 24: The food pyramid 158
ix |
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| genre_facet | Hochschulschrift |
| geographic | Nepal (DE-588)4041612-4 gnd |
| geographic_facet | Nepal |
| id | DE-604.BV021988722 |
| illustrated | Illustrated |
| index_date | 2024-07-02T16:10:25Z |
| indexdate | 2024-09-10T00:24:52Z |
| institution | BVB |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-015203568 |
| oclc_num | 254316519 |
| open_access_boolean | |
| owner | DE-706 DE-188 |
| owner_facet | DE-706 DE-188 |
| physical | XI, 182 S. graph. Darst. |
| publishDate | 2004 |
| publishDateSearch | 2004 |
| publishDateSort | 2004 |
| record_format | marc |
| spelling | Dulal, Ram Krishna 1965- Verfasser (DE-588)129938270 aut A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain by Ram Krishna Dulal 2004 XI, 182 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier Bremen, Univ., Diss., 2004 Diabetes mellitus Typ 2 (DE-588)1194598587 gnd rswk-swf Gesundheitsförderung (DE-588)4294611-6 gnd rswk-swf Gesundheitsfürsorge (DE-588)4136585-9 gnd rswk-swf Diabetiker (DE-588)4194876-2 gnd rswk-swf Medizinische Versorgung (DE-588)4038270-9 gnd rswk-swf Nepal (DE-588)4041612-4 gnd rswk-swf (DE-588)4113937-9 Hochschulschrift gnd-content Nepal (DE-588)4041612-4 g DE-604 Medizinische Versorgung (DE-588)4038270-9 s Diabetes mellitus Typ 2 (DE-588)1194598587 s Gesundheitsfürsorge (DE-588)4136585-9 s Diabetiker (DE-588)4194876-2 s Gesundheitsförderung (DE-588)4294611-6 s DE-188 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015203568&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Dulal, Ram Krishna 1965- A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain Diabetes mellitus Typ 2 (DE-588)1194598587 gnd Gesundheitsförderung (DE-588)4294611-6 gnd Gesundheitsfürsorge (DE-588)4136585-9 gnd Diabetiker (DE-588)4194876-2 gnd Medizinische Versorgung (DE-588)4038270-9 gnd |
| subject_GND | (DE-588)1194598587 (DE-588)4294611-6 (DE-588)4136585-9 (DE-588)4194876-2 (DE-588)4038270-9 (DE-588)4041612-4 (DE-588)4113937-9 |
| title | A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain |
| title_auth | A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain |
| title_exact_search | A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain |
| title_exact_search_txtP | A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain |
| title_full | A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain by Ram Krishna Dulal |
| title_fullStr | A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain by Ram Krishna Dulal |
| title_full_unstemmed | A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain by Ram Krishna Dulal |
| title_short | A perspective health care model for Nepal to reduce burden of diabetes mellitus through policy appraisal of Germany and Great Britain |
| title_sort | a perspective health care model for nepal to reduce burden of diabetes mellitus through policy appraisal of germany and great britain |
| topic | Diabetes mellitus Typ 2 (DE-588)1194598587 gnd Gesundheitsförderung (DE-588)4294611-6 gnd Gesundheitsfürsorge (DE-588)4136585-9 gnd Diabetiker (DE-588)4194876-2 gnd Medizinische Versorgung (DE-588)4038270-9 gnd |
| topic_facet | Diabetes mellitus Typ 2 Gesundheitsförderung Gesundheitsfürsorge Diabetiker Medizinische Versorgung Nepal Hochschulschrift |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015203568&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| work_keys_str_mv | AT dulalramkrishna aperspectivehealthcaremodelfornepaltoreduceburdenofdiabetesmellitusthroughpolicyappraisalofgermanyandgreatbritain |