Articles: patients.
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Research findings indicate cost savings associated with home care hospices, while hospital-based hospices can be as expensive as conventional care. Based on National Hospice Study data, this article identifies the characteristics of patients admitted to hospital-based and home care hospices in those areas of the country where a choice of hospice model was possible. Multivariate logistic regression indicates that the significant discriminating factors between the two patient populations relate to the availability of supportive care at home and the severity of nursing care problems at the time of hospice entry. Reinforcing selected pre-existing differences, an examination of prehospice had longer episodes of care than was the case for home care hospice patients.
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Although we have efficacious treatment for hypertension many patients do not take their medication or even follow through with their physician visits, thereby negating potential benefits. Detecting patients who do not take their medications is as important as diagnosing and treating the hypertension itself. This paper outlines methods of detecting and 'treating' non-compliance and discusses the role of the physician/patient relationship in compliance.
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The stress of acute, severe illness penetrates the patient's intrapsychic defenses to varying depths. The physician who deals with the resulting regressive behavior must identify and strengthen the overwhelmed defenses. Management includes the judicious use of drugs, accurate interpretation of the patient's behavior, and acceptance of the patient. The physician's countertransferential feelings can be helped by the understanding of a trusted colleague.