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ABSTRACT: AIM AND PURPOSE: Estimation of hematological laboratory effectiveness usage in family medicine, by an assessment of appropriate testing indications and efficiency of testing interpretation.
For each patient who was sent to hematological testing, physicians fulfilled the questionnaire. Data gathered was used for computation of diagnostic technology operational characteristics: sensitivity, specificity, predictive values, clinical effectiveness, diagnostic odds ratio and error odds ratio. The data were served for interpretation assessment of testing results. For assessment of indications for hematological testing accuracy setting we used: the number needles (unwanted) testing according to operating diagnosis, number of confirmed operating diagnosis, and number of cases in which testing influence to therapy selection or health improving.
The results have shown sensitivity value of 0.88, specificity value of 0.97, positive predictive value of 0.98, and negative predictive value of 0.85. Effectiveness of diagnostic technology was 0.92, diagnostic odds ratio was 238 and error odds ratio was 0.2. Unwanted haematological testing has noted in 37.3% cases, but pre-test diagnosis had confirmed in 51.8% cases. The testing contribution to improving health status of patients was noted in 57.8% of cases.
The results have shown high level of accuracy, effectiveness and diagnostic odds ratio. However, poor assessment of testing indications has shown poor contribution to improving of patient health status.
Medical Archives 02/2007; 61(4):215-7.
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ABSTRACT: Pharmacoeconomics is young rapidly developing science that uses economic, clinical and epidemiologic methods. It studies adequate use of therapeutics giving guidelines towards rational utilization of the resources in health care. Pharmacoeconomics indentifies estimates and compares costs and clinical outcomes of different strategies giving the best solution: optimal cost/benefit ratio. These studies can be used to estimate existing programs and plan the new ones. The aim of this paper was to carry out pharmacoeconomic study on the non-steroid anti-inflamatory drugs (NSAID) use in canton Tuzla, to compare costs of medication with highly selective cyclooxygenase 2 (COX-2) inhibitors and nonselective NSAIDs and to calculate medication costs of the bleeding from upper parts of gastrointestinal tract. Study covers period from January to April 2004. Meta-analysis of selected clinical studies on safe and efficiency of NSAIDs was simultaneously conducted. Our results show that hospital treatment costs of the high-risk patients group significantly exceeds their potential medication costs with highly selective COX-2 inhibitors. Simultaneous use of non-selective NSAIDs with antacids has justification only in the low-risk group with mild gastrointestinal disturbances.
Medical Archives 02/2005; 59(5):317-20.
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ABSTRACT: Research of satisfaction of patients in the area of primary health care (PHC) and especially criteria how to choose best methodology and the relevant variables guided to the situation where activities were focused on description of the basic structure and processes of health care rather than on identification of needs for services and on result based assessment and satisfaction of patients with provided service. To give advantage to any of methodologies is inexplicable problem and depend of factors beyond of health service control.
Aim of this paper is to review existing measurements of healthcare for ones who intend to use measurements of quality of healthcare for clinical and research purposes and to recommend criteria how to choose adequate methodology and relevant variables for assessment of quality of primary healthcare.
For our study we used experience of the Cathedra for Medical Informatics, Medical faculty, University of Sarajevo with emphasis on research of quality of PHC. We selected over 3,000 users of PHC (patients-adults) in PHC units in ten cantons of Federation of Bosnia and Herzegovina.
Statistically significant results we got when we crossed general attitude of patients about quality of healthcare with the following variables: place where patient receive healthcare, consultation with patients about patients' rights and life styles. We have not got statistically significant results when we crossed the following variables with general attitude of patients: distance from place of living to place where patients get healthcare, examination schedule in the units of PHC, continuity of healthcare, organization of field service and possibility to choose physician or nurse.
Very often researchers create their own methods of measurement instead to carry out systematic review of existing ones to enable them to find appropriate one. In this paper we recommended guidelines for finding the most appropriate methods of health measurement using experience of the Cathedra for Medical Informatics, Medical faculty in Sarajevo.
Medical Archives 02/2005; 59(1):23-6.
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ABSTRACT: The objective of the research were consolidate the correlation the greatest values ALT and AST, and the recovery from hepatitis infection. To the group of 237 adolescents, male sex of 18, 19 and 20 years is measured the activity of ALT and AST. The examinees are questionnaired to the recovery from hepatitis infection. Had to the significant increased values AST, and only mildly increased values in relation to the upper referent values.
Medical Archives 02/2004; 58(1 Suppl 1):5-6.
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ABSTRACT: The objective of research were consolidate the correlation the greatest values ALT and AST, and consummation alcohol. To the group of 302 adolescents, male sex of 18, 19 and 20 years is measured the activity of ALT and AST. The examines are questionned to the consummation of alcohol. Had to the significant increased values AST, and only mildly increased values in relation to the upper referent values.
Medical Archives 02/2004; 58(1):3-4.
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ABSTRACT: In Medical Informatics medical documentation and evidention are most probably the key areas. Also, in primary health care it is very important and part of daily activity of medical staff. Bosnia and Herzegovina is trying to be close to developed countries and to modernize and computerize current systems of documentation and to cross over from manual and semi manual methods to computerized medical data analysis. The most of European countries have developed standards and classification systems in primary health care for collecting, examination, analysis and interpretation of medical data assessed. One of possibilities as well as dilemma, which data carrier should be used for storage and manipulation of patient data in primary health care, is use of electronic medical record. Most of the South East European countries use chip or smart card and some of countries in neighborhood (Italy) choose laser card as patient data carrier. Both technologies have the advantages and disadvantages what was comprehensively colaborated by the authors in this paper, with intention to help experts who make decisions in this segment to create and to correctly influence on improvement of quality, correctness and accuracy of medical documentation in primary health care.
Medical Archives 02/2004; 58(1 Suppl 2):134-7.
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ABSTRACT: Pharmacoeconomics is application of economical principles in health and pharmaceutical care sector. This is comparative analysis of treatment e.i. therapeutic alternatives (drugs), which takes into consideration both their costs and their health repercussions. Cost-benefit analysis (CBA) has been used where effectiveness of cost was calculated by calculating the sum of costs for urinary infections treatment which include the cost of examinations, the costs of therapy with ciprofloxacin and norfloksacin, other costs associated with treatment and total benefit for both of treatments. CBA of costs are pointing out that it is economically justified to prescribe both drugs, ciprofloxacin and norfloksacin, due the costs-benefit are the quite equal for both.
Medical Archives 02/2003; 57(5-6):285-9.
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ABSTRACT: The objective of this study to consolidate the correlation between BMI with the values of ALT and AST of the healthy adolescents in age of 18, 19 and 20 years. To the group of 237 examinees of the healthy adolescents is determined BMI, and is measured the activity of ALT and AST. In the sample of the examinees we had 22% examinees had the increased BMI > or = 25. The examinees who had the increased BMI (> or = 25), had the significant increased values ALT, and only mildly increased values AST in relation to the upper referent values. On the basis of the simple linear regression was confirmed the positive correlation between the of body mass indexes and activities ALT i AST.
Medical Archives 01/2003; 57(5-6):267-8.
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ABSTRACT: Internet, is the greatest world net by by means of which nowadays the planet communicates, rapidly goes forward. The last years of the university in USA the commonly develop the more progressive concept of the net (Internet 2), thanks to the constant growing technologies, with the goal to answer the needs of the scientific and the educational institutions, but also the commercial institutions and the organizations. Almost the there is no more significant institution in the world which has not developed their web pages and data bases with the most actual contents available to the wider circle of the users. In this paper we have given the section of the most actual web pages. However, Internet is not immune to those users who are not benevolent and who have developed the different tools in the goal of the destroying or unabling of the normal use of all the Internet conveniences. The authors is considering the protection problem and the data security which get distributed by Internet.
Medical Archives 02/2002; 56(1):51-5.
