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Kostensensible Leitlinien

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ISBN: 9783954664580 Year: Pages: 209 DOI: 10.32745/9783954664580-2 Language: German
Publisher: MWV Medizinisch Wissenschaftliche Verlagsgesellschaft
Subject: Public Health
Added to DOAB on : 2020-07-08 00:00:46
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"Medical innovations and demographic change will further exacerbate the financial situation in the German healthcare system in the coming years. The evidence-based allocation of the limited funds available will therefore become increasingly important. From an ethical perspective, allocation decisions should be based on clearly defined procedures and criteria. So far, however, there are no concrete approaches on how this explicit performance control can be implemented in practice. The book provides an overview of the results of the interdisciplinary research association ""Allocation"", which for the first time examined the possibilities and limits of explicit performance management in two selected practical areas (interventional cardiology and intensive care medicine). Two exemplary cost-sensitive guidelines have been developed that enable an evidence-based balance between efficiency and justice. The legal requirements for such an explicit benefit management in statutory health insurance were examined in detail. Healthcare professionals and patients were asked for their assessments of the strengths and weaknesses of the cost-sensitive guidelines."

Wound Care

ISBN: 9783038420446 9783038420453 Year: Volume: 1 Pages: 192 Language: English
Publisher: MDPI - Multidisciplinary Digital Publishing Institute
Added to DOAB on : 2015-10-22 06:51:13
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Wounds and the many associated problems have challenged health care providers for centuries and today, despite the wealth of knowledge available, neither the incidence nor prevalence of wounds is reducing. Furthermore, in view of our changing demographic profile and the projected increase in the older population it is likely that wound management will become an ever increasing burden to the individual, health care services and society as a whole. The annual incidence of wounds in the EU-27 is approximately 4 million, and between 25% and 50% of acute hospital beds are occupied by patients with a wound, with up to 60% of these representing non-healing wounds (infected surgical wounds, pressure ulcers, leg/foot ulcers) The increasing prevalence and incidence of non-wounds healing is closely linked with quality of care and, as such, these rising figures reduce society’s confidence in the health service’s ability to deliver care that is timely, appropriate and effective. Thus, for those involved in this specialist area of clinical practice, the fundamental goal is to improve clinical outcomes, reduce the burden of wounds and improve health related quality of life.In this Special Issue “Wound Care” in Healthcare, we invited submission of manuscripts exploring contemporary issues in wound care. By devoting a special issue to wound care, we endeavoured to provide readers with a comprehensive reference source, outlining key areas of interest in this important aspect of clinical practice. The response to the call for manuscripts was fantastic and, as a result, we were able to include both original qualitative and quantitative research papers in addition to review papers, thereby providing readers with a wealth of valuable information pertinent to wound care.

Design and Engineering of Microreactor and Smart-Scaled Flow Processes

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ISBN: 9783038420385 9783038420392 Year: Pages: 252 DOI: 10.3390/books978-3-03842-039-2 Language: English
Publisher: MDPI - Multidisciplinary Digital Publishing Institute
Added to DOAB on : 2015-10-22 07:00:06
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Microreactors are small devices with sub-millimeter internals which have superb mass and heat transfer. Initially, they were used for reactions with very high demands on the latter, e.g. very exothermic reactions, gas-liquid reactions with interfacial transport issues, reactions with very fast kinetics which demands even faster mixing, and more. In this way, the processing window was opened widely and, also due to the minute volumes only present in the reaction zone, safe processing under otherwise hazardous conditions was enabled. This includes processing of reactions which are prone to thermal runaway and in the explosive regime. Scale-up of promising reactions and products which was hindered with conventional technology is now possible using the new equipment. This has widened the process development possibilities in chemical industry.In the last years, micro process technology was not only used for the very problematic synthetic issues which formerly had a dead-end position in industry’s process development. Rather, the scope of chemical reactions to be processed in microreactors was considerably widened by exploring new process conditions with regard to temperature, pressure, concentration, solvents, and more. This is commonly referred to as flow chemistry. This allowed to reduce the processing time-scale for many reactions to the minute range or even below which fits well to the residence times of microreactors. In addition, the process integration of several reactions in one flow to a multi-step synthesis has opened a new door in molecular diversity as well as system and process complexity. The same holds for the combination of reactions and separations in micro-flow. To achieve throughputs relevant for industrial production, smart scale-out to milli-flow units has established and supplemented the num­bering-up concept (parallelization of microchannels/-reactors operated under equal conditions).New innovations and enabling technologies need anyhow evaluation and benchmarking with conventional technology on the full-system level. Yet, microreactor technology has in the last years deepened so much into process intensification on a holistic scale that the focus increasingly is given towards the process dimension—to process design and automation, real-case applications, cost analysis, life-cycle assessment, and more. The impact on cost competitiveness and sustainability becomes well assessed.Facing this very recent scientific achievement, the special issue “Design and Engineering of Microreactor and Smart-Scaled Flow Processes” of the journal Processes aims to cover recent advances in the development of microreactor and smart-scaled flow processes towards the process level — in the sense as given above.

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