T he present health care environment conflicts with the values in· ternalized by many clinicians Patient care seems to be subordinated to a set of rules governing the length of hos· pitalization. The decision makers in health care seem to take a clerical rather than a clinical perspective. As one frustrated clinician exclaimed, "Forget TLC; it's DRGs that count." Although the feelings in this t...

Introduction Over the past four to five years, the focus in casemix-based payment systems in the United States has shifted more and more towards "value-based-purchasing" and "payfor-performance" measures. The reporting of pre-set quality indicators is now fundamentally in place for both the inpatient prospective-payment system, based on Medicare-Severity Diagnosis Related Groups (MS-DRGs), and,...

Introduction Healthcare systems in the early 1970s, the so called 'golden age' of the welfare state, came much closer to what we characterize as distinct ideal types: the Private Insurance System, the Social Insurance System and the National Health Service (NHS). During the past decades, as a consequence of problem pressure caused, for example, by globalization and demographic change, healthcar...

A reduction in the supply of retrogradely transported NGF has been proposed as a possible signal for the axotomy response in dorsal root ganglion (DRG) neurons. Components of the axotomy response that have previously been well characterized in axotomized DRG cells include changes in cytoskeletal gene expression and changes in the expression of neurotransmitters/neuromodulators such as substance...

Peripheral nerve injury induces inflammation and oxidative stress, which are the most significant causes of the neuronal death. Alpha Lipoic acid (ɑ-LA) as a potent antioxidant and anti-inflammatory agent may counteract the oxidative stress and inflammatory response. This study was designed to investigate the protective effect of ɑ-LA on neuronal cell death in L4 dorsal root ganglion (L4-DRG) i...