BACKGROUND Integrated delivery methods in healthcare systems have been proposed to confront the increasing complexity in general health care. INTERMED is an empirically derived, observer-rated instrument to measure case complexity. It was intended as a visualized, action-oriented decision-support tool for the early assessment of bio-psychosocial health risks and health needs. This study aims to...

The proportion of low-income nonelderly adults covered by Medicaid varies widely by state. We sought to determine whether broader state Medicaid coverage, defined as the proportion of each state's low-income nonelderly adult population covered by Medicaid, associates with lower state-level incidence of ESRD and greater access to care. The main outcomes were incidence of ESRD and five indicators...

In April 2006, the Scottish Liver Transplant Unit became the first NHS transplant unit in the UK to offer adult Living Donor Liver Transplantation (LDLT). However, within the first 21 months of its availability, no patients on the transplant waiting list had pursued this treatment option. A qualitative interview study was devised to elicit the views of patients and their families with regards t...

Background: Renal transplant candidates are frequently declined access to transplantation secondary to obesity and poor functional status. To maintain candidacy on the transplant waiting list, these patients are often required to lose significant weight. Substantial weight loss commonly produces a panniculus, generating a transplant site at high-risk for wound complications, blocking access to ...

The variability in deceased organ donation registries worldwide has received little attention. We considered all operating registries, where individual wishes about organ donation were recorded in a computerized database. We included registries which recorded an individual's decision to be a donor (donor registry), and registries which only recorded an individual's objection (non-donor registry...

BACKGROUND Transplantation is the treatment of choice for people with severe organ failure. However, demand substantially exceeds supply of suitable organs; consequently many people wait months, or years to receive an organ. Reasons for the chronic shortage of deceased organ donations are unclear; there appears to be no lack of 'in principle' public support for organ donation. METHODS/DESIGN ...

In 1996 the EUROTRANSPLANT organisation, which currently includes the member-states Austria, Belgium, Germany, Luxemburg, the Netherlands and Slovenia, changed its policy of renal donor organ allocation to the new algorithm ETKAS (Eurotransplant Kidney Allocation System). Its main goal was to shorten the average and maximum waiting time, adjust for rare HLA phenotypes and homozygosities, achiev...

OBJECTIVES To describe the relatives' experiences of information and support while heart or lung transplant candidates were waiting for a transplantation. METHODOLOGY/DESIGN The critical incident technique was used. Incidents were collected via interviews with 18 relatives (28-73 years old) of heart or lung transplant patients within four weeks of the patients being accepted onto the transpla...

INTRODUCTION Waiting times for kidney transplant are long in Singapore. Healthrelated quality of life (HRQoL) of patients might be affected as a result of the stress of the long wait and the uncertainty of being called to undergo a surgical operation. This study aimed to measure the HRQoL of patients on the kidney transplant waiting list and to identify factors which could impact on the HRQoL s...