Provider networks and primary-care signups: do they restrict the use of medical services?

2009 ◽  
Vol 18 (12) ◽  
pp. 1361-1380 ◽  
Author(s):  
Partha Deb ◽  
Pravin K. Trivedi
Author(s):  
Penelope Strauss ◽  
Sam Winter ◽  
Zoe Waters ◽  
Dani Wright Toussaint ◽  
Vanessa Watson ◽  
...  

1984 ◽  
Vol 15 (3) ◽  
pp. 353-361 ◽  
Author(s):  
Simon H. Budman ◽  
Annette Demby ◽  
Michael L. Feldstein

CJEM ◽  
2015 ◽  
Vol 18 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Judah Goldstein ◽  
Jennifer McVey ◽  
Stacy Ackroyd-Stolarz

AbstractCaring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step.


1983 ◽  
Vol 17 (3) ◽  
pp. 129-137 ◽  
Author(s):  
Judith H. Hibbard ◽  
Clyde R. Pope

2007 ◽  
Vol 22 ◽  
pp. S270-S271
Author(s):  
A. De Cos Milas ◽  
V. Gomez Macias ◽  
M.L. Catalina Zamora

2019 ◽  
Author(s):  
Andrea Elena Neculau ◽  
Liliana Rogozea ◽  
Daniela Popa ◽  
Ioana Atudorei ◽  
Florin Leasu ◽  
...  

Abstract Background Patients’ expectations and needs for healthcare services are changing. These changes are correlated with changes in disease profiles, a higher prevalence of chronic diseases, the introduction of new and innovative treatments and health technologies, and the emergence of new social and economic contexts. National health reports on Romania show that decisions in healthcare planning are not correlated with the health needs of the population. At the same time, this report shows a high degree of unmet healthcare needs of the Romanian population (related to cost, distance and waiting times), especially for low-income populations. The objective of the study was to identify the unmet needs of the population in relation to primary care medical services in the context of actual health regulations through a pilot study in a representative county in Romania. Methods The study is survey-based, and part of a health needs assessment programme commissioned by the District Health Authority to the university. A questionnaire with 21 items was designed to gather information about the structures, processes and outcomes of primary care from the perspective of the population. A total of 877 questionnaires were returned and validated. The data were analysed with SPSS version 25. Results Access to primary care was considered to be good by most of the population. Most of the settlements have a family doctor, and 80.5% can schedule an appointment on the same or the following day. Most basic medical services are provided, except for out-of-hours primary care services and cervical cancer screening. The family doctors are considered to be a reliable health resource. Conclusions Despite limitations in the practice of family medicine in Romania and therefore a narrow spectrum of services offered by primary care in general, the level of contentment of the population with this healthcare resource is still high. Barriers to access are related to the lack of some essential services, especially preventive and out-of-hours services. Unmet needs are presumably not recognised by patients due to a lack of medical culture. Further research is needed to clarify this conclusion. Key words: unmet health needs, primary care, Romania


2000 ◽  
Vol 17 (5) ◽  
pp. 450-450
Author(s):  
Andrew Bailey

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