scholarly journals Delivery of Home and Community Based Services During a Pandemic: Unexpected Consequences

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 466-466
Author(s):  
Adeola Ayedun ◽  
Jane Straker ◽  
Traci Wilson ◽  
Amanda Brewster ◽  
Chris Rubeo ◽  
...  
Keyword(s):  
Health Care ◽  
Comparative Method ◽  
Health Care Use ◽  
Service Organizations ◽  
Community Based ◽  
Social Service Organizations ◽  
Essential Services ◽  
Constant Comparative Method ◽  
Explanatory Mixed Methods ◽  
Community Based Services

Abstract The COVID-19 pandemic required AAAs to pause essential services, serving as a catalyst for innovation. We examined such innovations as part of an explanatory mixed-methods, positive deviance study of AAA partnerships with health and social service organizations. We identified 8 AAAs with many partners serving areas with lower levels of health care use, and 3 AAAs with few partners serving areas with higher levels of health care use. We interviewed AAA and partners, (total = 123). Using the constant comparative method, we identified recurrent themes: 1) AAAs adapted to increased demand for services by developing new ways to deliver services, 2) the pandemic raised awareness of unmet needs such as social connection, 3) changes in delivery of services included embracing technology, and 4) AAAs and their partners identified resources to rapidly pivot services. AAAs and partners demonstrated resiliency to not only to sustain programs, but to innovate throughout the pandemic.

Service Provider Perspectives Regarding Knowledge Sharing Activities in Community-Based Services

2020 ◽  
Vol 39 (2) ◽  
pp. 25-39
Author(s):  
Casey Fulford ◽  
Virginie Cobigo
Keyword(s):  
Service Providers ◽  
Service Organizations ◽  
Practical Implementation ◽  
Knowledge Mobilization ◽  
Community Based ◽  
Distributed Information ◽  
Social Service Organizations ◽  
Provider Perspectives ◽  
Adults With Intellectual Disabilities ◽  
Community Based Services

Evaluation of knowledge mobilization (KM) activities in community-based mental health and social service organizations is needed. Our objective was to understand how service providers want to access and share knowledge, in order to improve KM practices to better support adults with intellectual disabilities. We distributed information about five strategies for supporting friendships; this included strategy descriptions, outcomes of strategy evaluations, and practical implementation considerations. We distributed information through a conference presentation, online presentations, and online modules. Service providers completed questionnaires and phone interviews. We present findings on their perspectives regarding the format and content of the material, which can inform future KM efforts.

scholarly journals Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services

2017 ◽  
Vol 65 (11) ◽  
pp. 2446-2451 ◽  
Author(s):  
Melissa M. Garrido ◽  
Richard M. Allman ◽  
Steven D. Pizer ◽  
James L. Rudolph ◽  
Kali S. Thomas ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Community Based ◽  
Community Based Services ◽  
Learning Health Care System ◽  
Care System

scholarly journals EFFECTIVENESS OF HOME- AND COMMUNITY-BASED SERVICES IN DECREASING HEALTH CARE EXPENDITURE IN TAIWAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S159-S159
Author(s):  
Ya-Mei Chen ◽  
Hsiao-Wei Yu ◽  
Ying-Chieh Wang
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Long Term Care ◽  
Community Based ◽  
Term Care ◽  
Care Recipients ◽  
Home Based ◽  
Number Of Visits ◽  
Community Based Services

Abstract Ideally, continuum of care involves wide-ranging health and long-term care (LTC) services. Taiwan’s National Health Insurance scheme and 10-Year Long-term Care Plan attempts to provide universal and fundamental services of continuum care. However, the accessibility of these services for care recipients remains unclear. This study aims to examine the effectiveness of continuum care in decreasing the healthcare expenditure of LTC recipients using home- and community-based services (HCBS). Data collated from the 2010–2013 Long-Term Care Service Management System (N = 77,251) were subjected to latent class analysis to identify subgroups of recipients using HCBS. Subsequently, the 1-year primary care expenditure after receiving HCBS was compared through generalized linear modeling. Three discrete HCBS subgroups were found: home-based personal care (HP), home-based health care (HH), and community-based care (CC). No difference in the number of visits to doctors and the average primary care expenses was observed between the HP and HH subgroups. However, considering physical and psychosocial confounders, care recipients in the CC subgroup recorded a higher number of visits to doctors (β = 3.05, SD = 0.25, p < 0.05) and lower primary care expenditure (β = -98.15, SD = 43.17, p = 0.02) than the other two subgroups. These findings suggest that LTC recipients in Taiwan may obtain better continuum care only for CC service recipients. Additionally, community-based LTC services may lower the cost of health expenditure after 1 year.

Communication, Respect, and Leadership: Interprofessional Collaboration in Hospitals of Rural Ontario

2014 ◽  
Vol 75 (4) ◽  
pp. 173-179 ◽  
Author(s):  
Diane Morris ◽  
June Matthews
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Comparative Method ◽  
Rural Hospitals ◽  
Interprofessional Practice ◽  
Interprofessional Teams ◽  
Northern Areas ◽  
Constant Comparative Method

Purpose: Health care professionals are expected to work collaboratively across diverse settings. In rural hospitals, these professionals face different challenges from their urban colleagues; however, little is known about interprofessional practice in these settings. Methods: Eleven health care professionals from 2 rural interprofessional teams were interviewed about collaborative practice. The data were analyzed using a constant comparative method. Results: Common themes included communication, respect, leadership, benefits of interprofessional teams, and the assets and challenges of working in small or rural hospitals. Differences between the cases were apparent in how the members conceptualized their teams, models of which were then compared with an “Ideal Interprofessional Team”. Conclusions: These results suggest that many experienced health care professionals function well in interprofessional teams; yet, they did not likely receive much education about interprofessional practice in their training. Providing interprofessional education to new practitioners may help them to establish this approach early in their careers and build on it with additional experience. Finally, these findings can be applied to address concerns that have arisen from other reports by exploring innovative ways to attract health professionals to communities in rural, remote, and northern areas, as there is a constant need for dietitians and other health care professionals in these practice settings.

scholarly journals Policy Research Challenges in Comparing Care Models for Dual-Eligible Beneficiaries

2017 ◽  
Vol 18 (2) ◽  
pp. 72-83 ◽  
Author(s):  
Janet H. Van Cleave ◽  
Brian L. Egleston ◽  
Sarah Brosch ◽  
Elizabeth Wirth ◽  
Molly Lawson ◽  
...  
Keyword(s):  
Health Care ◽  
Integrated Care ◽  
Exploratory Study ◽  
Coordinated Care ◽  
Care Model ◽  
Community Based ◽  
Research Challenges ◽  
Care Models ◽  
Dual Eligible ◽  
Community Based Services

Providing affordable, high-quality care for the 10 million persons who are dual-eligible beneficiaries of Medicare and Medicaid is an ongoing health-care policy challenge in the United States. However, the workforce and the care provided to dual-eligible beneficiaries are understudied. The purpose of this article is to provide a narrative of the challenges and lessons learned from an exploratory study in the use of clinical and administrative data to compare the workforce of two care models that deliver home- and community-based services to dual-eligible beneficiaries. The research challenges that the study team encountered were as follows: (a) comparing different care models, (b) standardizing data across care models, and (c) comparing patterns of health-care utilization. The methods used to meet these challenges included expert opinion to classify data and summative content analysis to compare and count data. Using descriptive statistics, a summary comparison of the two care models suggested that the coordinated care model workforce provided significantly greater hours of care per recipient than the integrated care model workforce. This likely represented the coordinated care model's focus on providing in-home services for one recipient, whereas the integrated care model focused on providing services in a day center with group activities. The lesson learned from this exploratory study is the need for standardized quality measures across home- and community-based services agencies to determine the workforce that best meets the needs of dual-eligible beneficiaries.

scholarly journals MEETING SOCIAL NEEDS TO IMPROVE HEALTH OUTCOMES: PARTNERSHIPS BETWEEN COMMUNITY-BASED ORGS AND HEALTH CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S499-S500
Author(s):  
Traci L Wilson ◽  
Suzanne R Kunkel ◽  
Jane Straker ◽  
Marisa Scala-Foley ◽  
Elizabeth Blair
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Social Services ◽  
Health Care Providers ◽  
Health Care Use ◽  
Social Needs ◽  
Care Providers ◽  
Community Based ◽  
Cross Sectional ◽  
Improve Health

Abstract Unmet social needs negatively affect individual and population health, and better integration of community-based supports and health systems is a promising approach to improve health outcomes and avoid unnecessary health care use. Community-based organizations (CBOs) such as Area Agencies on Aging (AAAs) and Centers for Independent Living (CILs), as providers and coordinators of social services, are well-positioned within their communities to coordinate care and provide for unmet social needs. Partnerships between CBOs and health care entities have clear potential to improve health care outcomes while also reducing expenditures. This paper will present a cross-sectional analysis of a national survey of AAAs, CILS, and other CBOs at two time points (2017: n=593; 2018: n=763) to understand the extent, type, and evolution of CBO engagement with health care providers. In addition, longitudinal analysis (n=374) shows movement at the organization level: 33% of organizations who did not have a contract at T1 but were pursuing one had achieved a contract by T2. This presentation will: describe details of the services delivered, contracting arrangements, and populations served under CBO/health care contracts, as well as challenges experienced by CBOs; examine differences by state and organizational structure; and discuss the implications of state policy on integrated care and contracting.

scholarly journals Assessing Systems of Care for US Children with Epilepsy/Seizure Disorder

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Mary Kay Kenney ◽  
Marie Mann
Keyword(s):  
Health Care ◽  
Medical Home ◽  
Seizure Disorder ◽  
Health Care Needs ◽  
Care Needs ◽  
Community Based ◽  
High Quality ◽  
Quality Health ◽  
Us Children ◽  
Community Based Services

Background. The proportion of US children with special health care needs (CSHCN) with epilepsy/seizure disorder who receive care in high-quality health service systems was examined. Methodology. We analyzed data for 40,242 CSHCN from the 2009-2010 National Survey of CSHCN and compared CSHCN with epilepsy/seizure disorder to CSHCN without epilepsy/seizure disorder. Measures included attainment rates for 6 federal quality indicators with comparisons conducted using chi square and logistic regression methods. In addition, CSHCN with epilepsy/seizure disorder were compared to CSHCN without epilepsy/seizure disorder on the basis of 14 unmet health care needs. Results. Lower attainment rates for receiving comprehensive care in a medical home and easily accessible community-based services were found for CSHCN with epilepsy/seizure disorder versus CSHCN without epilepsy/seizure disorder (medical home: 32% versus 43%; accessible community-based services: 50% versus 66%, resp.) in unadjusted analyses. Lower adjusted odds for these indicators as well as greater unmet need for specialists, dentistry, prescriptions, therapies, and mental health care were also found for CSHCN with epilepsy/seizure disorder. Conclusions. Further efforts are needed to improve attainment of high-quality health care services for CSHCN with epilepsy/seizure disorders.

scholarly journals The Trajectory of Chronic Pain: Can a Community-Based Exercise/Education Program Soften the Ride?

2010 ◽  
Vol 15 (6) ◽  
pp. 361-368 ◽  
Author(s):  
Ruth Dubin ◽  
Cheryl King-VanVlack
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Chronic Pain ◽  
Life Events ◽  
Education Program ◽  
Primary Care Physicians ◽  
Health Care Use ◽  
Self Management ◽  
Community Based ◽  
Chronic Noncancer Pain

The entire primary care record of six patients attending a community-based education/exercise self-management program for chronic noncancer pain (YMCA Pain Exercise/Education Program [Y-PEP]) was reviewed. Medical visits, consultations and hospital admissions were coded as related or unrelated to their pain diagnoses. Mood disruption, financial concerns, conflicts with employers/insurers, analgesic doses, medication side effects and major life events were also recorded. The ‘chronic pain trajectory’ resembled a roller coaster with increased health care visits at the time of initial injuries and during ‘crises’ (reinjury, conflict with insurers/employers, failed back-to-work attempts and life events). Visits decreased when conflicts were resolved. Analgesic doses increased during ‘crises’ but did not fall after resolution. After attending Y-PEP, health care use fell for four of six patients and two returned to work. Primary care physicians need to recognize the functional limitations and psychosocial complications experienced by their chronic pain patients. A program such as Y-PEP may promote active self-management strategies resulting in lowered health care use.

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