ESTABLISHMENT OF A COMPREHENSIVE CARE PROGRAM (CCP) AS A COMPLEMENT TO FERTILITY EVALUATION/TREATMENT TO IDENTIFY CO-MORBIDITIES, MAXIMIZE AWARENESS AND IMPROVE OVERALL HEALTH, FERTILITY AND OBSTETRICAL OUTCOMES

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): National Health Fund Background. A novel comprehensive care program after acute myocardial infarction (AMI) „KOS-zawał" was implemented in Poland. It includes acute intervention, complex revascularization, implantation of cardiovascular electronic devices (in case of indications), rehabilitation or hybrid telerehabilitation (HTR) and scheduled outpatient follow-up. HTR is a unique component of this program. The purpose of the pilot study was to evaluate a feasibility, safety and patients’ acceptance of HTR as component of a novel care program after AMI and to assess mortality in a one-year follow-up. Methods The study included 55 patients (LVEF 55.6 ± 6.8%; aged 57.5 ± 10.5 years). Patients underwent a 5-week HTR based on Nordic walking, consisting of an initial stage (1 week) conducted within an outpatient center and a basic stage (4-week) home-based telerehabilitation five times weekly. HTR was telemonitored with a device adjusted to register electrocardiogram (ECG) recording and to transmit data via mobile phone network to the monitoring center. The moments of automatic ECG registration were pre-set and coordinated with exercise training. The influence on physical capacity was assessed by comparing changes in functional capacity (METs) from the beginning and the end of HTR. Patients filled in a questionnaire in order to assess their acceptance of HTR at the end of telerehabilitation. Results HTR resulted in a significant improvement in functional capacity and workload duration in exercise test (Table). Safety: there were neither deaths nor adverse events during HTR. Patients accepted HTR, including the need for interactive everyday collaboration with the monitoring center. Prognosis all patients survived in a one-year follow-up. Conclusions Hybrid telerehabilitation is a feasible, safe form of rehabilitation, well accepted by patients. There were no deaths in a one-year follow-up. Outcomes before and after HTR Before telerehabilitation After telerehabilitation P Exercise time [s] 381.5 ± 92.0 513.7 ± 120.2 <0.001 Maximal workload [MET] 7.9 ± 1.8 10.1 ± 2.3 <0.001 Heart rate rest [bpm] 68.6 ± 12.0 66.6 ± 10.9 0.123 Heart rate max effort [bpm] 119.7 ± 15.9 131.0 ± 20.1 <0.001 SBP rest [mmHg] 115.6 ± 14.8 117.7 ± 13.8 0.295 DBP rest [mmHg] 74.3 ± 9.2 76.2 ± 7.3 0.079 SBP max effort [mm Hg] 159.5 ± 25.7 170.7 ± 25.5 0.003 DBP max effort [mm Hg] 84.5 ± 9.2 87.2 ± 9.3 0.043 SBP systolic blood pressure, DBP diastolic blood pressure.

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Penny wise, pound foolish: an assessment of Canadian Hemophilia/inherited bleeding disorder comprehensive care program services and resources

Haemophilia ◽

10.1111/hae.12913 ◽

2016 ◽

Vol 22 (4) ◽

pp. 531-536 ◽

Cited By ~ 8

Author(s):

D. Page ◽

S. Crymble ◽

K. Lawday ◽

M. Long ◽

J. Stoffman ◽

...

Keyword(s):

Care Program ◽

Bleeding Disorder ◽

Comprehensive Care

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Patient and provider perceptions of a comprehensive care program for HIV-positive adults over 50 years of age: The formation of the Golden Compass HIV and aging care program in San Francisco

PLoS ONE ◽

10.1371/journal.pone.0208486 ◽

2018 ◽

Vol 13 (12) ◽

pp. e0208486 ◽

Cited By ~ 3

Author(s):

Meredith L. Greene ◽

Judy Y. Tan ◽

Sheri D. Weiser ◽

Katerina Christopoulos ◽

Mary Shiels ◽

...

Keyword(s):

San Francisco ◽

Care Program ◽

Comprehensive Care ◽

Hiv Positive ◽

Provider Perceptions ◽

Hiv Positive Adults

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Hard-to-reach families in a comprehensive care program

JAMA ◽

10.1001/jama.201.11.801 ◽

1967 ◽

Vol 201 (11) ◽

pp. 801-806 ◽

Cited By ~ 3

Author(s):

M. K. White

Keyword(s):

Care Program ◽

Comprehensive Care

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PMS2 SUCCESSFUL IMPLEMENTATION OF A COMPREHENSIVE CARE PROGRAM IN RHEUMATOID ARTHRITIS WITH SIGNIFICANT COST-SAVINGS FOR THE HEALTH SYSTEM

Value in Health Regional Issues ◽

10.1016/j.vhri.2019.08.295 ◽

2019 ◽

Vol 19 ◽

pp. S51

Author(s):

P. Santos-Moreno ◽

D. Buitrago-Garcia ◽

L. Villarreal ◽

M. Cabrera ◽

N.J. Alvis-Zakzuk

Keyword(s):

Rheumatoid Arthritis ◽

Health System ◽

Cost Savings ◽

Care Program ◽

Comprehensive Care ◽

Successful Implementation ◽

Significant Cost

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A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol

F1000Research ◽

10.12688/f1000research.7040.1 ◽

2015 ◽

Vol 4 ◽

pp. 872 ◽

Cited By ~ 4

Author(s):

Lufei Young ◽

Kathleen Healey ◽

Mary Charlton ◽

Kendra Schmid ◽

Rana Zabad ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Intervention Group ◽

Care Program ◽

Comprehensive Care ◽

Care Model ◽

Patient Centered ◽

Home Based ◽

Comprehensive Care Model

Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden. Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease.Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention. Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems. Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If successful, it will have far-reaching implications in research, education and practice in terms of providing high quality but affordable care to population living with severe complex, disabling conditions.

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Comprehensive Care Services for the Young Child who is Visually Impaired

Journal of Visual Impairment & Blindness ◽

10.1177/0145482x7506900501 ◽

1975 ◽

Vol 69 (5) ◽

pp. 193-200

Author(s):

Pauline M. Moor

Keyword(s):

Social Services ◽

Visually Impaired ◽

Care Program ◽

Comprehensive Care ◽

Model Program ◽

Pilot Projects ◽

Impaired Child ◽

Community Agencies ◽

Care Services ◽

Healthy Growth

The preschool visually impaired child and his family are in need of a variety of services in areas such as health and medicine, psychological and social services, and education. The purpose of a program of comprehensive care is to ensure the provision of all services that are needed at each stage of a child's development to promote healthy growth and functioning. This can be achieved only through a willingness on the part of all community agencies to work together. A case coordinator from one of the agencies accepts responsibility for making sure that child and family are put in touch with all necessary services and that everyone involved has the same treatment objectives. Part I of this report deals with comprehensive care as a concept and describes a theoretical model program. Part II is concerned with two pilot projects, one in rural New Hampshire and the other in urban Minnesota, that show how existing resources can be used in developing a comprehensive care program. It is hoped that programs of comprehensive care will be used not only with the visually impaired but with other groups as well.

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