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Economic crises, such as the economic crisis of 2008, are related to several issues, including decreases in disposable income and increases in unemployment. At the individual level, decreasing disposable income, unemployment, and loss of insurance coverage have detrimental effects on the ability to seek affordable, quality, and accessible healthcare. At the population level, they have adverse effects on physical and psychological health and on overall well-being. From a healthcare services perspective, economic crises challenge the ability to provide quality, affordable healthcare services that meet the needs and expectations of the population. In the same vein, the economic consequences of the COVID-19 crisis include decreases in income, increases in unemployment, financial uncertainty, declines in living conditions, and pressures exerted on healthcare systems. On the other hand, several non-COVID-19 health-related effects are tied to the pandemic. In this sense, this book attempts to highlight the influences of economic crises on individuals, the world economy, and healthcare. Although the range of challenges attributed to economic crises is quite broad, the collection of articles in this book investigates topics that focus on the global economic crisis of 2008 as well as the one induced by the COVID-19 pandemic. In an environment of negative economic development, these kinds of issues should be highlighted, and potential solutions should be investigated.
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Patientbehandling på sygehuse sker i et højt specialiseret tempo, hvor flere patienter modtager kompliceret pleje og behandling, som ofte fortsætter i kommunerne efter udskrivelsen. Efter strukturreformen skal aftaler om infektionshygiejnisk bistand fra sygehus til kommune indskrives i sundhedsaftaler. Formål: Formålet med studiet var at udforske og analysere samarbejde på tværs af sektorer, og få en øget forståelse for fænomenet tværsektorielt samarbejde i relation til patient/borger med behov for ydelser, hvori der indgår infektionshygiejnisk bistand. Metode: Studiet er et kvalitativt multiple casestudie, hvor empirien hentes via semistrukturerede interviews. Teorigrundlaget er perspektivet på tværsektorielt samarbejde, eksempler på modeller for samarbejde, og styrker og svagheder i samarbejde. Resultat: Studiet viste, at motiverende faktorer for tværsektorielt samarbejde i praksis var: fokus på organisering og struktur i organisationerne, at arbejde sammen i netværk, bevidsthed om klare kommunikationsveje og fokus på faglighed og kompetencer i forhold til infektionshygiejne. Struktureret samarbejde mellem kommune og sygehus med oprettelse af hygiejneorganisation mellem sektorer, gav adgang til ekspertviden, tryghed hos plejepersonalet og motivere til at arbejde med infektionshygiejne som indsatsområde. Konklusion: Nosokomielle infektioner hos patienter og borgere i sektorovergange, kan sandsynligvis forebygges ved dels at tilføre viden om infektionshygiejne til personale på alle niveauer i organisationerne, og dels ved at indgå et formelt samarbejde mellem kommune og sygehus omkring etablering af en tværsektoriel hygiejneorganisation. Today, patient care in hospitals is highly specialised and undertaken at high speed. Many patients receive complex treatment and care, which often continues in the primary-care sector after the patient is discharged. Structural reform of the health care sector requires infection control measures in intersectoral health agreements. Aim: This study aimed to investigate and analyse intersectoral collaboration and gain better understanding of collaboration across health sectors in relation to the treatment and care of patients requiring treatment and care for infection control. Method: This is a qualitative, multiple-case study, wherein semi-structured interviews form the basis of the empirical knowledge. The theory underpinning the study is the perspective on intersectoral collaboration, examples of models of collaboration, and the strengths and weaknesses of collaboration. Results: The findings showed that the motivational factors for intersectoral collaboration include focus on organisational structure and organisation, collaboration through networks, awareness of the importance of clear communication, and focus on the relationship between professional competencies and infection hygiene. Structured collaboration with the establishment of an actual infection control organisation resulted in access to expert knowledge, security among personnel, and motivation to work with infection control as an area of focus. Conclusion: Patient transference of nosocomial infections from one health sector to another likely can be prevented by increasing workers' knowledge of infection control in all sectors, and by formalised collaboration across health sectors to establish an intersectoral, infection control organization.
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"Dans un essai stimulant, Michel Bass décrypte les tenants et les aboutissants de la pensée managériale appliquée aux établissements médico-sociaux comme les EHPAD. Il en analyse les outils et les méthodes (théories, lois, projets, procédures, protocoles, organisation, gouvernance, évaluation ...) et montre que leur finalité est davantage le profit et la rentabilité qu'une réelle amélioration du service rendu aux usagers. Cette inversion des fins et des moyens, imposant une organisation verticalisée, produit nombre d'effets délétères sur les bénéficiaires et les personnels. En effet, ceux-ci sont contraints par des fonctionnements qui leur déplaisent mais qu'ils ont bien du mal à décoder. Ainsi, le management, en tant que « fiction qui transforme la réalité qu'elle est censée observer », empêche de réfléchir à ce qu'il se passe concrètement dans les établissements médico-sociaux. Heureusement subsistent des zones d'activités où les professionnels peuvent se réapproprier leur liberté d'action : cet ouvrage s'attache à décrire les méthodologies qui les rendraient à nouveau possibles.".
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