Journal of Nursing Theory and Practice

[The annual health insurance activity of the physiotherapy procedures related to definition in outpatient care]

MOLICS Bálint, ÁGOSTON István, ENDREI Dóra, ÉLIÁS Zsuzsanna, KRÁNICZ János, SCHMIDT Béla, BONCZ Imre

DECEMBER 10, 2012

Journal of Nursing Theory and Practice - 2012;25(06)

[Aim of the study: The aim of the study is mapping the extent, prevalence, specialty distribution of physiotherapy procedures in out-patient care and the health insurance expense on provisions. Methodology and sample: The data concerning the number of cases were requested from the Healthcare Strategic Research Institute, Healthcare Detailed Data Base according to the data of National Health Insurance Fund (OEP). Paragraph J17 in Book of Rules on the application of the code list of out-patient activities provided the OENO activity list with the scores, number of cases in 2008, and we obtained the financing expense/year from the 1.46 FT/point score. Results: The total number of cases of 151 physiotherapy activities /year were 24.748.877. The 20 most prevalent procedures accounted for 72.56% (17.958.097) of the total number of cases. The procedures performed by physiotherapists, masseurs, conducters and physiotherapy assisstants accounted for 7.339.446.299 Fts financed by OEP in 2008. Among the BNO main groups, most interventions occured in musculoskeletal and connective tissue diseases. Conclusions: According to results OEP financed 7,339 billion FTs on physiotherapy treatment in out-patient care, mostly in procedures of musculoskeletal disorders in 2008.]

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Journal of Nursing Theory and Practice

[Providing ambulance paramedics with more in-depth knowledge relating to the on-site treatment of acute cardiac asthma ]

MOSKOLA Vladimír, HORNYÁK István

[Aim of the study: The authors sought an answer to the questions arising in the course of on-site emergency care, in relation to the treatment of acute cardiac asthma: What is the ratio of men and women developing the disease? How frequently is supplementary, symptomatic treatment applied in the course of on-site emergency care? What is the distribution of the incidence of acute cardiac asthma by age group and time of day? Methodology and sample: The descriptive, retrospective research was conducted at the Nyíregyháza ambulance station of the North Plain Regional Ambulance Service. In the period lasting from 1 January 2006 to 31 December 2007, a total of 13 511 incident sheets were reviewed, from among which a total of 130 were subjected to a more detailed examination, on the strength of the diagnoses of acute cardiac asthma and pulmonary oedema. The data was collated using Microsoft Excel, and the processing of the results thus obtained took place using descriptive statistical methods (frequency, correlative coefficient). Results: With regard to acute cardiac asthma, 51% of the cases took place in the early hours, while 40% occurred in the evening. The remaining cases can be placed in the mid-morning and afternoon periods, which together represented only 9% of all the cases. Of the 130 patients studied, 68 were women and 62 were men. Supplementary treatment was given on-site in the form of Cerucal in 17 cases, and with Theospirex in 13% of cases. Conclusions: The incidence of the disease is increasing from year to year. The rise in the incidence of acute cardiac asthma has been especially notable among the 71-81 age group. In terms of the time of day, acute cardiac asthma tends to occur in the early hours and in the evening. Over the age of sixty incidence increases significantly in both sexes; however, age is not a significant factor in the effectiveness of the treatment. ]

Journal of Nursing Theory and Practice

[A Bridge between the Hungarian and Slovakian nursing - In Memoriam doc. PhDr. Alžbeta Hanzlíková, PhD (1935-2012)]

BETLEHEM József

Journal of Nursing Theory and Practice

[congratulations]

Journal of Nursing Theory and Practice

[Mirror Shards]

ROZSOS Erzsébet

[The author is a nursing ethicist, who reviews the past 18 years of this professional and draws comparisons with a status report published in 1994 by two leading bioethicists, Dr. Béla Blasszauer and Dr. Tibor Jakab. The comparison deals with the issues of the overall situation of nurses, salaries, working conditions, the system of “gratitude payments” (as a phenomenon specific to Hungary), the problems associated with conflicting instructions from doctors, nurses’ lack of autonomy, the lack of recognition, the untenable ratio of patients to nurses, the explicit and implicit divisions among nurses, the unconscionable and frequently changing statutory provisions, the problems related to providing information, the tolerance of a lack of healthcare, the absence of advocacy, and the emerging phenomenon of nurse emigration. It can be inferred from the analysis that if the professional does not succeed in autonomously taking control of its own future, it could lose the moral foundation and status that it has earned in the course of its history.]

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LAM Extra for General Practicioners

[PAIN MANAGEMENT IN RHEUMATOLOGY]

NAGY Katalin

[Pain is the most common symptom in rheumatology, which can be of mechanical or inflammatory origin, acute and chronic, nociceptive, neuropathic and psychogenic. Pain can be relieved by analgesics, nonsteroidal anti-inflammatory drugs, opioids, adjuvants and special drugs depending on the etiology, for example a gout attack can be stopped by colchicine. For pain relief, we use therapeutic guidelines of the World Health Organization (WHO), which recommends the use of analgesics, NSAIDs and adjuvants as the first step, weaker opioids as the second, and strong opioids as the third step. In rheumatology, the first step's drugs are generally used. If possible, NSAIDs should be administered briefly, potentially combined with analgesics and muscle relaxants. If pain management is insufficient, tramadol should be given. Pain relief in rheumatology also include the use of local and intraarticular injections, physiotherapy, TENS and balneotherapy. Complex therapies that combine the above mentioned methods is often more effective than the use of medications only.]

Journal of Nursing Theory and Practice

[The place and role of physiotherapy in total joint replacement surgery patients improve their quality of life]

TAMÁS Judit, FULLÉR Noémi

[Aim of the research: The objective of investigation was to survey the efficiency of the rehabilitation of the patients operated with complete knee endoprosthesis (TKR) nursed in the Rehabilitation Centre and whether the bath course with the applied complex physiotherapy and the spring water of induce any change in the life quality of the patients and whether the efficiency of the physiotherapy can be measured. Research and sampling methods: prospective, quantitative, describing research, with non-random, convenience sampling method. 50 TEP-operated patients have filled in the self-filling questionnaires and participated in the examination of the walking time. The examination was performed between 03/01/2013-12/01/2013 in the Musculoskeletal Rehabilitation Centre of the Gunaras. The patients have filled in the WOMAC, SF-36, BDI, questionnaire compiled by us. Additionally we have measured the walking speed on flat ground and during climbing stairs. The patients have taken a bath in 36C spa for 3 weeks, 7-times a week for 20 minutes and 5-times a week they have received electrotherapy, physiotherapy and hydrotherapy. Results: The majority of the participants of the investigation belonged to the age group of 71-75. The patients avail themselves of the treatments regularly, once or twice a year, which are evaluated by women as more efficient than by men (p <0,001). After the treatments the extent of depression has significantly reduced (p <0,001). There was a significant improvement in the walking speed (p < 0,001), in the SF-36 (TF, PCS) dimensions and we have detected a significant relation between physical and mental health (p <0,001). The movement range of the patients has significantly improved (WOMAC, p=0,001). Between the result of the SF-36 and WOMAC questionnaires we have found also a significant relation (p=0,001), with the improvement of the physical function the life quality has also improved. Conclusions: The results have shown, that the application of the spring water and physiotherapy have proven as efficient treatment in the life quality improvement of the patients operated with complete knee prosthesis. ]

Clinical Neuroscience

[Health insurance aspects of physiotherapeutic care of neurology disorders in outpatient care]

BÁLINT BONCZ, IMRE LEIDECKER, ELEONÓRA Cs. HORVÁTH, ZOLTÁN SEBESTYÉN, ANDOR KRÁNICZ, JÁNOS KOMOLY, SÁMUEL DÓCZI, TAMÁS OLÁH

[Background and purpose – The aim of our study is to analyse the ambulatory rehabilitation care of patients with neurological disorders in the field of physiotherapy. Methods – Data derive from the database of the Hungarian National Health Insurance Fund Administration (year 2009). The analyses covered patients with diagnosis „G00–G99 Diseases of the nervous system” according to the International Classification of Diseases and underwent physiotherapy treatment. Results – In 2009 altogether 190986 patients with neurological disorders received physiotherapy treatment in outpatient care, representing 1331675 cases and got 388.215 million Hungarian Forint health insurance reimbursement. The number of patients with nerve, nerve root and plexus disorders was 39 patients/10 000 population for males and 66 patients/10000 population for females. The number of patients with cerebral palsy and other paralytic syndromes was 49 patients/10000 population for males and 35 patients/10000 population for females. The number of patients with episodic and paroxysmal disorders was 33 patients/10000 population for males and 52 patients/10000 population for females. Conclusion – In the outpatient physiotherapy care the utilization indicators of females were higher in nerve, nerve root and plexus disorders and episodic and paroxysmal disorders, while in cerebral palsy and other paralytic syndromes the utilization of male was higher. There are important age and gender inequalities in the utilization of physiotherapy care of patients with neurological disorders.]

Lege Artis Medicinae

[Nutritional status, realizing sarcopenia and the importance of prehabilitation in surgical departments]

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LAM KID

[Pain management in rheumatology]

NAGY Katalin

[Pain is the most common symptom in rheumatology, which can be of mechanical or inflammatory origin, acute and chronic, nociceptive, neuropathic and psychogenic. Pain can be relieved by analgesics, nonsteroidal anti-inflammatory drugs, opioids, adjuvants and special drugs depending on the etiology, for example a gout attack can be stopped by colchicine. For pain relief, we use therapeutic guidelines of the World Health Organization (WHO), which recommends the use of analgesics, NSAIDs and adjuvants as the first step, weaker opioids as the second, and strong opioids as the third step. In rheumatology, the first step's drugs are generally used. If possible, NSAIDs should be administered briefly, potentially combined with analgesics and muscle relaxants. If pain management is insufficient, tramadol should be given. Pain relief in rheumatology also include the use of local and intraarticular injections, physiotherapy, TENS and balneotherapy. Complex therapies that combine the above mentioned methods is often more effective than the use of medications only.]