scholarly journals Addressing the New Normal in Health Care Using an Interprofessional Model of Care Coordination

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 325-325
Author(s):  
Sam Cotton ◽  
Anna Faul ◽  
Pamela Yankeelov

Abstract There has been significant discourse surrounding the widespread system failures within healthcare during COVID-19. Older, frailer, and poorer persons across the United States have been the most impacted by the pandemic. Given this, our FlourishCare team, received funding through the COVID Cares Act, as part of our Geriatric Workforce Enhancement Program (GWEP) grant, to create innovative programming for individuals that were the most impacted by the pandemic. Remote patient monitoring (RPM) is one intervention been shown as an effective way to assist persons in managing their conditions. Patients from our Optimal Aging Clinic were identified as struggling with hypertension, diabetes and/or COPD. Interprofessional teams of nursing and social work learners were assigned to work with patients. The kits contain all of the necessary technology and a virtual app platform that allows a patient to check their heart rate, blood pressure, oxygen levels, and glucose levels. This information was then disseminated to the team coordinating the patient’s care. The sample was mostly female (88%), African American (64%) and retired (70%). The mean age was 60 (SD=4), and 40% had less than a high school diploma. After 3 months in the program, we saw a significant improvement across all determinants of health, with a particular overall change in access to health services and individual health behaviors. This study showed the importance of providing patients with access to technology and the support of an interprofessional team can improve patient outcomes, lead to improvements in individual health behaviors and improve health literacy.

PEDIATRICS ◽  
1977 ◽  
Vol 59 (3) ◽  
pp. 323-324
Author(s):  
Robert D. Burnett ◽  
Mary Kaye Willian ◽  
Richard W. Olmsted

In the 1960s, predictions were made that the United States faced a "physician shortage."1,2 On the basis of these predictions, federal legislation subsidized the establishment of new medical schools and the expansion of those in existence. From 1968 to 1974, the number of medical school graduates rose from 7,973 to 11,613.3 Nevertheless, problems of availability of, and access to, health services remain. Mere increase in number of physicians is not the solution to the problem of health care delivery in the United States; in fact, there is concern that we now face an oversupply of physicians.4 The recently published Carnegie report recommends that only "one" new medical school be established.5


2020 ◽  
Vol 21 ◽  
Author(s):  
Valeria Marina Valle ◽  
Wilma Laura Gandoy Vázquez ◽  
Karla Angélica Valenzuela Moreno

The 2010 Affordable Care Act (ACA) improved access to healthcare in the United States. However, immigrants —especially those undocumented— still faced difficulties, which have increased during the Trump administration. In order to bring access to health services to its nationals, the Mexican government has implemented the Health Windows Program (Ventanillas de Salud, or VDS). The article reviews changes in the U.S. healthcare system from the ACA to date, and assesses the role of VDS. The methodology is qualitative, consisting of a literature review, interviews with community leaders and Mexican government officials, and questionnaires sent to four VDS: Arizona, Florida, Idaho and Texas. Results show that VDS provide reliable and affordable access to basic healthcare services, and detection of chronic and non-communicable diseases, especially within undocumented immigrants. Public policy recommendations are offered based on these findings. Limitations of the study include the data collected, which is non-representative of all VDS.


HPHR Journal ◽  
2014 ◽  
Vol 2014 (2) ◽  
Author(s):  
Brad Stulberg

Over the past four decades, the United States has faced steadily rising rates of obesity and associated chronic conditions. Many of these chronic conditions are rooted in nutrition and physical activity behaviors, and are often referred to as lifestyle diseases. Historically, the prevention of lifestyle diseases has focused on changes in individual behavior and personal choices, and personal responsibilities. However, a growing body of research has demonstrated the strong influence of physical and social surroundings on individuals’ actions.


2017 ◽  
Vol 6 (4) ◽  
pp. 329-334
Author(s):  
Royal E. Wohl ◽  
Park Lockwood ◽  
Kathy Ure

Chronic disease is a leading cause of morbidity and mortality in the United States. One-half of U.S. adults have at least one chronic disease condition and 25% have multiple chronic conditions that can lead to a restriction in an ability to do basic daily living activities. Low-income adults have a high incidence of chronic disease that increases with aging due to ongoing psychological stress, higher risk exposure, less healthy living conditions, and limited access to health services. Community-based wellness programs, in collaboration with academic institutions, can serve this population by providing access to health services, quality educational and activity-based experiences, and continual assessment and support. Using a multidisciplinary approach, the expertise of numerous faculty, students, and staff can be used to help mitigate a myriad of health conditions presented by this population. This article shares one university’s creation, development, and delivery of an on-campus, multidisciplinary community wellness program for low-income adults.


2020 ◽  
Vol 26 (4) ◽  
pp. 2344-2361 ◽  
Author(s):  
Edimara Luciano ◽  
M Adam Mahmood ◽  
Parand Mansouri Rad

Telemedicine has recently garnered more attention from healthcare professionals because it provides access to health services to patients in rural areas while making patient healthcare information more vulnerable to security breaches. The objective of this research is to identify factors that play a critical role in possible adoption of telemedicine in the United States and Brazil. A model with eight hypotheses was used to establish a research framework. A survey was conducted involving healthcare professionals in the aforementioned countries. The results show that telemedicine adoption is influenced by policies and culture in both countries and influenced by security and privacy in the United States. It can be inferred from the research that perceptions of the American and Brazilian healthcare professionals are similar in telemedicine issues covered in this research. These healthcare professionals, however, disagree on how patients’ privacy should be preserved in the two countries.


2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
James H. Price ◽  
Jagdish Khubchandani ◽  
Molly McKinney ◽  
Robert Braun

Racial/ethnic minorities are 1.5 to 2.0 times more likely than whites to have most of the major chronic diseases. Chronic diseases are also more common in the poor than the nonpoor and this association is frequently mediated by race/ethnicity. Specifically, children are disproportionately affected by racial/ethnic health disparities. Between 1960 and 2005 the percentage of children with a chronic disease in the United States almost quadrupled with racial/ethnic minority youth having higher likelihood for these diseases. The most common major chronic diseases of youth in the United States are asthma, diabetes mellitus, obesity, hypertension, dental disease, attention-deficit/hyperactivity disorder, mental illness, cancers, sickle-cell anemia, cystic fibrosis, and a variety of genetic and other birth defects. This review will focus on the psychosocial rather than biological factors that play important roles in the etiology and subsequent solutions to these health disparities because they should be avoidable and they are inherently unjust. Finally, this review examines access to health services by focusing on health insurance and dental insurance coverage and access to school health services.


2020 ◽  
Vol 14 ◽  
Author(s):  
Alef Diogo da Silva Santana ◽  
Marcos Soares de Lima ◽  
Jefferson Wildes da Silva Moura ◽  
Isabel Cristina Sibalde Vanderley ◽  
Ednaldo Cavalcante de Araújo

Objetivo: analisar as dificuldades de acesso aos serviços de saúde pelas pessoas LGBT. Método: trata-se de um estudo bibliográfico, descritivo, do tipo revisão integrativa da literatura. Realizou-se a busca em janeiro de 2019 nas bases de dados: MEDLINE, Web of Science e SCOPUS. Pesquisaram-se artigos com delimitação atemporal. Avaliaram-se os artigos segundo o critério AHRQ e sua elegibilidade pelo CASP. Analisaram-se os dados no software IRAMUTEQ a partir da Classificação Hierárquica Descendente. Resultados: destaca-se que a amostra final foi composta por dez artigos, entre eles, 70% encontraram-se disponíveis na SCOPUS; 10%, na Web of Science e 20%, na MEDLINE. Notou-se que, referente à nacionalidade dos estudos, 10% foram da Alemanha; 10%, do Brasil; 10%, da Argentina; 20%, do Canadá; 20%, da África do Sul e 30%, dos Estados Unidos da América. Verificou-se que os anos de publicação dos estudos foram entre 2013 e 2018. Conclusão: evidencia-se que o acesso aos serviços de saúde pela população LGBT é permeado por constrangimentos e preconceitos. Ressalta-se que a exclusão, desamparo, omissão e indiferença ao acesso são sentimentos expressados por este público, mesmo existindo políticas públicas específicas. Descritores: Serviços de Saúde; Minorias Sexuais e de Gênero; Acesso aos Serviços de Saúde; Enfermagem; Vulnerabilidade em Saúde; Política Pública.AbstractObjective: to analyze the difficulties of access to health services by LGBT people. Method: this is a descriptive bibliographic study of the integrative literature review type. The search was performed in January 2019 in the databases: MEDLINE, Web of Science and SCOPUS. We searched for articles with timeless delimitation. The articles were evaluated according to the AHRQ criteria and their eligibility by CASP. Data was analyzed in the IRAMUTEQ software from the Descending Hierarchical Classification. Results: it is noteworthy that the final sample consisted of ten articles, among them, 70% were available at SCOPUS; 10% on Web of Science and 20% on MEDLINE. Regarding the nationality of the studies, 10% were from Germany; 10% from Brazil; 10% from Argentina; 20% from Canada; 20% from South Africa and 30% from the United States of America. It was found that the years of publication of the studies were between 2013 and 2018. Conclusion: it is evident that access to health services by the LGBT population is permeated by constraints and prejudices. It is emphasized that exclusion, helplessness, omission and indifference to access are feelings expressed by this public, even though there are specific public policies. Descriptors: Health Services; Sexual and Gender Minorities; Health Services Accessibility; Nursing; Health Vulnerability; Public Policy.ResumenObjetivo: analizar las dificultades de acceso a los servicios de salud por parte de las personas LGBT. Método: este es un estudio bibliográfico descriptivo del tipo revisión integradora de literatura. La búsqueda se realizó en enero de 2019 en las bases de datos MEDLINE, Web of Science y SCOPUS. Buscamos artículos con delimitación atemporal. Los artículos fueron evaluados de acuerdo con los criterios AHRQ y su elegibilidad por CASP. Los datos se analizaron en el software IRAMUTEQ de la Clasificación Jerárquica Descendente. Resultados: cabe destacar que la muestra final consistió en 10 artículos, entre ellos, 70% estaban disponibles en SCOPUS, 10% en Web of Science y 20% en Medline. Con respecto a la nacionalidad de los estudios, el 10% provino de Alemania, el 10% de Brasil, el 10% de Argentina, el 20% de Canadá, el 20% de Sudáfrica y el 30% de los Estados Unidos de América. Se descubrió que los años de publicación de los estudios fueron entre 2013 y 2018. Conclusión: es evidente que el acceso a los servicios de salud por parte de la población LGBT está impregnado de restricciones y prejuicios. Es de destacar que la exclusión, la impotencia, la omisión y la indiferencia al acceso son sentimientos expresados por este público, a pesar de que existen políticas públicas específicas. Descriptores: Servicios de Salud; Minorías Sexuales y de Género; Accesibilidad a los Servicios de Salud; Enfermería; Vulnerabilidad en Salud; Política Pública.


1970 ◽  
Vol 1 (1) ◽  
pp. 44-49
Author(s):  
Beatriz Bertolaccini Martínez ◽  
Fernanda Marcelino Da Silva ◽  
Vinícius Tavares Veiga ◽  
Rodrigo Pereira Custódio ◽  
José Vítor Da Silva

Introdução: A pobreza influencia na evolução dos pacientes com doenças crônicas, porque contribui para o seu agravamento e dificulta o acesso à assistência médica. O objetivo deste trabalho foi avaliar os aspectos relacionados à desigualdade social de pacientes em hemodiálise. Métodos: Estudo transversal com 123 pacientes em hemodiálise no Hospital Samuel Libânio – Pouso Alegre, MG, divididos, de acordo com a classe econômica, em 3 grupos: AB (n=23), C (n=60) e DE (n=40),. Foram coletados dados sociodemográficos e econômicos, antecedentes clínicos e informações sobre o acesso a serviços de saúde. Para a análise dos resultados, foi utilizada estatística analítica e descritiva. Adotou-se p £ 0,05. Resultados: O grupo AB apresentou um menor número de pacientes jovens (4,3% em AB vs 40% em C e 25% em DE, p < 0,05), um maior número de indivíduos com mais anos de escolaridade (65,3% em AB vs 18,3% em C e 2,5% em DE; p < 0,05), predomínio de pacientes com menos de um ano em tratamento de hemodiálise (65,2% em AB vs 10% em C e 5% em DE, p < 0,05), menor número de usuários do SUS (40% em C e 25% em DE vs 4,3% em AB; p < 0,05) e maior acesso ao tratamento com nefrologista (73,9% em AB vs 46,7% em C e 52,5 em DE; p < 0,05). Conclusão: Classes economicamente desfavorecidas agregam indivíduos mais jovens, com menor escolaridade, usuários do SUS, com maior tempo em hemodiálise e pior acesso ao tratamento com nefrologista.Introduction: The poverty influence on the evolution of patients with chronic diseases because it contributes to your aggravation and hinders access to health care. Our goal was to evaluate the aspects related to social inequality on hemodialysis patients. Methods: cross-sectional study with 123 patients on hemodialysis in Samuel Libânio Hospital – Pouso Alegre, MG, divided according to the economic class, into 3 groups: AB (n = 23), C (n = 60) and DE (n = 40). Were collected socio-demographic and economic data, clinical background and information about access to health services. For analysis of the results has been used statistical analytical and descriptive. We take p £ 0,05.  Results: The AB group has fewer young patients (4,3% in AB vs 40% in C and 25% in DE, p< 0,05), a greater number of individuals with more years of schooling (65,3% in AB vs 18,3% in C and 2,5% in DE; p< 0,05), predominance of patients with less than a year on haemodialysis treatment (65,2% in AB vs 10% in C and 5% in DE, p< 0,05), smaller number of users of SUS (40% in C and 25% in DE vs 4,3% in AB; p< 0,05), greater access to treatment with nephrologist (73,9% in AB vs 46,7% in C and 52,5% in DE; p< 0,05). Conclusion: Economically disadvantaged classes bring younger patients, with less schooling, users of SUS, patients with greater time on hemodialysis and worse access to treatment with nephrologist. 


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