Department of Health and Children Statement of Strategy 2005 - 2007

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Actualités en hépatologie : nouveautés en médecine 2007 [Highlights in hepatology]

Cette revue évoque principalement les nouveautés dans le traitement de l'hépatite B chronique, les problèmes de résistance qui émergent et les recommandations internationales pour le suivi du patient. Sont également discutées la prophylaxie postexposition de l'hépatite A, la durée de traitement des hépatites C chroniques, la vaccination contre l'hépatite E, ainsi qu'une étude contrôlée qui a évalué l'efficacité de la pioglitazone dans la stéatohépatite non alcoolique. Des études utiles pour la pratique clinique concernant l'hépatite alcoolique, les effets secondaires hépatiques du paracétamol à dose thérapeutique et la révision des critères diagnostiques et de la prise en charge du syndrome hépato-rénal sont également discutés. This review highlights new treatment options in chronic hepatitis B, issues related to antiviral resistance and current recommendations for the monitoring of patients on treatment. We also discuss post-exposure prophylaxis of hepatitis A, treatment duration in chronic hepatitis C and recent studies exploring vaccination against hepatitis E and pioglitazone for nonalcoholic steatohepatitis. Finally, we will briefly comment new findings in alcoholic hepatitis as well as acetaminophen hepatotoxicity and summarize revised criteria for the diagnosis and management of hepatorenal syndrome

Quality Customer Service Action Plan 2005 - 2007

Quality Customer Service Action Plan 2005 – 2007 Quality Customer Action Plan

Vom Finanz- zum Wissenschaftsbetrug : Methode, den Irrungen in der medizinischen Literatur beizukommen [From financial to scientific fraud : Methods to detect discrepancies in the medical literature].

Fraud is as old as Mankind. There are an enormous number of historical documents which show the interaction between truth and untruth; therefore it is not really surprising that the prevalence of publication discrepancies is increasing. More surprising is that new cases especially in the medical field generate such a huge astonishment. In financial mathematics a statistical tool for detection of fraud is known which uses the knowledge of Newcomb and Benford regarding the distribution of natural numbers. This distribution is not equal and lower numbers are more likely to be detected compared to higher ones. In this investigation all numbers contained in the blinded abstracts of the 2009 annual meeting of the Swiss Society of Anesthesia and Resuscitation (SGAR) were recorded and analyzed regarding the distribution. A manipulated abstract was also included in the investigation. The χ(2)-test was used to determine statistical differences between expected and observed counts of numbers. There was also a faked abstract integrated in the investigation. A p<0.05 was considered significant. The distribution of the 1,800 numbers in the 77 submitted abstracts followed Benford's law. The manipulated abstract was detected by statistical means (difference in expected versus observed p<0.05). Statistics cannot prove whether the content is true or not but can give some serious hints to look into the details in such conspicuous material. These are the first results of a test for the distribution of numbers presented in medical research.

Financial impact of introducing the Swiss-DRG reimbursement system on potentially avoidable readmissions at a university hospital.

QUESTION UNDER STUDY: Thirty-day readmissions can be classified as potentially avoidable (PARs) or not avoidable (NARs) by following a specific algorithm (SQLape®). We wanted to assess the financial impact of the Swiss-DRG system, which regroups some readmissions occurring within 18 days after discharge within the initial hospital stay, on PARs at our hospital. METHODS: First, PARs were identified from all hospitalisations recorded in 2011 at our university hospital. Second, 2012 Swiss-DRG readmission rules were applied, regrouped readmissions (RR) were identified, and their financial impact computed. Third, RRs were classified as potentially avoidable (PARRs), not avoidable (NARRs), and others causes (OCRRs). Characteristics of PARR patients and stays were retrieved, and the financial impact of PARRS was computed. RESULTS: A total of 36,777 hospitalisations were recorded in 2011, of which 3,140 were considered as readmissions (8.5%): 1,470 PARs (46.8%) and 1,733 NARs (53.2%). The 2012 Swiss-DRG rules would have resulted in 910 RRs (2.5% of hospitalisations, 29% of readmissions): 395 PARRs (43% of RR), 181 NARRs (20%), and 334 OCRRs (37%). Loss in reimbursement would have amounted to CHF 3.157 million (0.6% of total reimbursement). As many as 95% of the 395 PARR patients lived at home. In total, 28% of PARRs occurred within 3 days after discharge, and 58% lasted less than 5 days; 79% of the patients were discharged home again. Loss in reimbursement would amount to CHF 1.771 million. CONCLUSION: PARs represent a sizeable number of 30-day readmissions, as do PARRs of 18-day RRs in the 2012 Swiss DRG system. They should be the focus of attention, as the PARRs represent an avoidable loss in reimbursement.

Framework for Corporate and Financial Governance for Regulatory Bodies under the aegis of the Department of Health and Children

The document should be read as supplementary to existing requirements as set out both in statute â?" particularly legislation specific to your organisation, the Health Acts 1947-2004, Ombudsman Act, 1980, Data Protection Acts 1988 & 2003, Freedom of Information Acts 1997-2003, Ethics in Public Office Acts 1995 & 2001, Ombudsman for Children Act, 2002 and the Comptroller and Auditor General (Amendment) Act, 1993 – and in Government approved guidelines, including the Code of Practice for the Governance of State Bodies (2001), Public Financial Procedures, The Role and Responsibilities of Accounting Officers (2003) and Risk Management Guidance for Government Departments and Offices (2004). Read the report (PDF, 1.4mb)  

Framework for Corporate and Financial Governance for Agencies funded by the Department of Health and Children

Corporate governance is the system by which organisations direct and control their functions and relate to their stakeholders in order to manage their business, achieve their mission and objectives and meet the necessary standards of accountability, integrity and propriety. It is a key element in improving efficiency and accountability as well as enhancing openness and transparency. A significant element of the Governmentâ?Ts programme for health service reform is the strengthening of governance and accountability arrangements across the health system. Read the Report (PDF, 1mb)

Health in Ireland, Key Trends 2007

This booklet provides an overview of selected key trends in health in Ireland in recent years. Tables and graphs are presented which summarise information on demographics, on health status and on health care in order to give a quick reference guide in major areas of health and health services. The past decade has been a time of rapid change in many aspects of life in Ireland. The evidence presented in this booklet reflects this period of change with respect to health. Download document here

Annual Output Statement 2007 For Health Group of Votes

Annual Output Statement 2007 For Health Group of Votes The overall aim of this Vote Group is to provide health and personal social services to improve the health and well being of the people of Ireland in a manner that promotes better health for everyone, fair access, responsive and appropriate care delivery and high performance. The money voted goes to the of Health and Children (Vote 39), the Health Service Executive (Vote 40), and the Office of the Minister for Children (Vote 41). Click here to download PDF 92kb

Obstetric analgesia and anesthesia in Switzerland in 2007

Introduction: The last twenty years has witnessed important changes in the field of obstetric analgesia and anesthesia. In 2007, we conducted a survey to obtain information regarding the clinical practice of obstetric anesthesia in our country. The main objective was to ascertain whether recent developments in obstetric anesthesia had been adequately implemented into current clinical practice. Methodology: A confidential questionnaire was sent to 391 identified wiss obstetric anesthetists. The questionnaire included 58 questions on 5 main topics: activity and organization of the obstetric unit, practice of labor analgesia, practice of anesthesia for caesarean section, prevention of aspiration syndrome, and pain treatment after cesarean section. Results: The response rate was 80% (311/391). 66% of the surveyed anesthetists worked in intermediate size obstetric units (500-1500 deliveries per year). An anesthetist was on site 24/24 hours in only 53% of the obstetric units. Epidural labor analgesia with low dose local anesthetics combined with opioids was used by 87% but only 30% used patient controlled epidural analgesia (PCEA). Spinal anesthesia was the first choice for elective and urgent cesarean section for 95% of the responders. Adequate prevention of aspiration syndrome was prescribed by 78%. After cesarean section, a multimodal analgesic regimen was prescribed by 74%. Conclusion: When comparing these results with those of the two previous Swiss surveys [1, 2], it clearly appears that Swiss obstetric anesthetists have progressively adapted their practice to current clinical recommendations. But this survey also revealed some insufficiencies: 1. Of the public health system: a. Insufficient number of obstetric anesthetists on site 24 hours/24. b. Lack of budget in some hospitals to purchase PCEA pumps. 2. Of individual medical practice: a. Frequent excessive dosage of hyperbaric bupivacaine during spinal anesthesia for cesarean section. b. Frequent use of cristalloid preload before spinal anesthesia for cesarean section. c. Frequent systematic use of opioids when inducing general anesthesia for cesarean section. d. Fentanyl as the first choice opioid during induction of general anesthesia for severe preeclampsia. In the future, wider and more systematic information campaigns by the mean of the Swiss Association of Obstetric Anesthesia (SAOA) should be able to correct these points.

Code of Practice on Fluoridation of Drinking Water 2007

Code of Practice on Fluoridation of Drinking Water 2007 Fluoridation of drinking water, the main aim of which is the prevention and control of dental caries (dental decay), commenced in Ireland in 1964 after the introduction of the Health (Fluoridation of Water Supplies) Act 1960. The Act provides that health authorities shall arrange for the fluoridation of public piped water supplies. The Act also provides that sanitary (local) authorities may act as the agents of health authorities in fluoridating public piped water supplies. Currently approximately 73% of the population receives fluoridated water from public water supplies. Click here to download PDF 195kb

Department of Health and Children Consolidated Salary Scales effective from June 2007

Department of Health and Children Consolidated Salary Scales effective from June 2007 For the 1st worksheet, the pay-scales for grades read across. The current rate (1/06/07), 2% (2.5% if earning less than â,¬20,859 per annum) Towards 2016 and one historical rate are shown for the 1st worksheet. The grades within each section are displayed in the same order as in previous Pay Scales. Click here to download PDF 173kb

Department of Health and Children Corporate Business Plan 2007

Department of Health and Children Corporate Business Plan 2007 This document sets out the broad business and role of the Department of Health and Children, and provides information on the Departmentâ?Ts Key Objectives and corresponding Key Performance Indicators for 2007. Click here to download PDF 223kb