Building an Integrative Health Program

2018 ◽  
pp. 390-402
Author(s):  
Mary Jo Kreitzer
Keyword(s):  
Health Program ◽  
System Change ◽  
Cost Of Care ◽  
Organizational Goals ◽  
Integrative Health ◽  
Health Initiative ◽  
Experience Of Care ◽  
Per Capita ◽  
Integrative Therapies ◽  
Capita Cost

Aligning an integrative health initiative or program with the organization’s mission, vision, and values is critical. Implementation of integrative therapies is an effective strategy to achieve organizational goals. Understanding the needs of stakeholders and end users is a critical first step. This chapter discusses building an integrative health program in the context of organizational and system change. The emphasis is on the Triple Aim initiative, which focuses on the simultaneous pursuit of three aims: improving the health of the population, enhancing the patient experience of care (including quality, access, and reliability), and reducing the per capita cost of care. Design, implementation, and evaluation are covered.

scholarly journals Home Telehealth and The Triple Aim

2018 ◽  
Vol 1 (4) ◽  
Author(s):  
Joel J. Reich ◽  
Thomas F. Osborne
Keyword(s):  
Cost Of Care ◽  
Reimbursement Policy ◽  
Triple Aim ◽  
Experience Of Care ◽  
Integration Of Technology ◽  
Home Telehealth ◽  
Per Capita ◽  
The Individual ◽  
Effective Integration ◽  
Capita Cost

The Triple Aim is a framework developed to increase the value of healthcare through three interrelated components; improving the individual experience of care, improving the health of populations, and reducing the per capita cost of care for populations. Achieving the goals of the Triple Aim for everyone requires a fundamental change in how we deliver healthcare. A thoughtfully implemented home telehealth program has the potential to achieve these important endpoints for a large group of patients. However, its success is dependent upon numerous factors ranging from effective integration of technology and adoption to reimbursement policy.

Transforming the Healthcare Environment Through a Hospital-Based Integrative Health Initiative

2014 ◽  
pp. 68-83
Author(s):  
Arlene Horner ◽  
Ellen L. Schellinger
Keyword(s):  
Administrative Support ◽  
Building Blocks ◽  
Quality And Safety ◽  
Integrative Therapy ◽  
Integrative Health ◽  
Health Initiative ◽  
Therapy Program ◽  
Evidence Quality ◽  
Online Access ◽  
Integrative Therapies

This chapter describes the development of a hospital-based, nurse-led, integrative therapy program. Person-centered, relationship-based care is optimally sustained with solid administrative support, a robust infrastructure, and an emphasis on evidence, quality, and safety. Initial integrative therapies included aromatherapy, acupressure and guided imagery. Building blocks discussed for a healthy program include documentation in the electronic health record, easy retrieval of clinical outcomes, online access to resources, and a readiness to involve all stakeholders. Additional considerations include a focus on patient fit, common symptoms, nurse self-care, and cost effectiveness. Evaluations provided details on nurse competence and confidence.

scholarly journals Prevalence and socioeconomic burden of diabetes mellitus in South Korean adults: a population-based study using administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sung-Hee Oh ◽  
Hyemin Ku ◽  
Kang Seo Park
Keyword(s):  
South Korea ◽  
Diabetic Complications ◽  
Economic Burden ◽  
Productivity Loss ◽  
Diabetic Patients ◽  
Claims Database ◽  
South Korean ◽  
Subgroup Analyses ◽  
Per Capita ◽  
Capita Cost

Abstract Background Diabetes leads to severe complications and imposes health and financial burdens on the society. However, currently existing domestic public health studies of diabetes in South Korea mainly focus on prevalence, and data on the nationwide burden of diabetes in South Korea are lacking. The study aimed to estimate the prevalence and economic burden of diabetes imposed on the South Korean society. Methods A prevalence-based cost-of-illness study was conducted using the Korean national claims database. Adult diabetic patients were defined as those aged ≥20 years with claim records containing diagnostic codes for diabetes (E10-E14) during at least two outpatient visits or one hospitalization. Direct costs included medical costs for the diagnosis and treatment of diabetes and transportation costs. Indirect costs included productivity loss costs due to morbidity and premature death and caregivers’ costs. Subgroup analyses were conducted according to the type of diabetes, age (< 65 vs. ≥65), diabetes medication, experience of hospitalization, and presence of diabetic complications or related comorbidities. Results A total of 4,472,133 patients were diagnosed with diabetes in Korea in 2017. The average annual prevalence of diabetes was estimated at 10.7%. The diabetes-related economic burden was USD 18,293 million, with an average per capita cost of USD 4090 in 2019. Medical costs accounted for the biggest portion of the total cost (69.5%), followed by productivity loss costs (17.9%), caregivers’ costs (10.2%), and transportation costs (2.4%). According to subgroup analyses, type 2 diabetes, presence of diabetic complications or related comorbidities, diabetes medication, and hospitalization represented the biggest portion of the economic burden for diabetes. As the number of complications increased from one to three or more, the per capita cost increased from USD 3991 to USD 11,965. In inpatient settings, the per capita cost was ~ 10.8 times higher than that of outpatient settings. Conclusions South Korea has a slightly high prevalence and economic burden of diabetes. These findings highlight the need for effective strategies to manage diabetic patients and suggest that policy makers allocate more health care resources to diabetes. This is the first study on this topic, conducted using a nationally representative claims database in South Korea.

scholarly journals Cost of care of chronic non-communicable diseases in Jamaican patients: the role of obesity

2016 ◽  
Vol 17 (2) ◽  
pp. 81-95
Author(s):  
Christine M. Fray-Aiken ◽  
Rainford J. Wilks ◽  
Abdullahi O. Abdulkadri ◽  
Affette M. McCaw-Binns
Keyword(s):  
Cost Of Illness ◽  
Hospital Setting ◽  
Indirect Costs ◽  
Communicable Diseases ◽  
Cost Of Care ◽  
Total Direct Cost ◽  
Non Communicable Diseases ◽  
Female Patients ◽  
Per Capita ◽  
The Cost

OBJECTIVE: To estimate the economic cost of Chronic Non-Communicable Diseases (CNCDs) and the portion attributable to obesity among patients in Jamaica.METHODS: The cost-of-illness approach was used to estimate the cost of care in a hospital setting in Jamaica for type 2 diabetes mellitus, hypertension, coronary heart disease, stroke, gallbladder disease, breast cancer, colon cancer, osteoarthritis, and high cholesterol. Cost and service utilization data were collected from the hospital records of all patients with these diseases who visited the University Hospital of the West Indies (UHWI) during 2006. Patients were included in the study if they were between15 and 74 years of age and if female, were not pregnant during that year. Costs were categorized as direct or indirect. Direct costs included costs for prescription drugs, consultation visits (emergency and clinic visits), hospitalizations, allied health services, diagnostic and treatment procedures. Indirect costs included costs attributed to premature mortality, disability (permanent and temporary), and absenteeism. Indirect costs were discounted at 3% rate.RESULTS: The sample consisted of 554 patients (40%) males (60%) females. The economic burden of the nine diseases was estimated at US$ 5,672,618 (males 37%; females 63%) and the portion attributable to obesity amounted to US$ 1,157,173 (males 23%; females 77%). Total direct cost was estimated at US$ 3,740,377 with female patients accounting for 69.9% of this cost. Total indirect cost was estimated at US$ 1,932,241 with female patients accounting for 50.6% of this cost. The greater cost among women was not found to be statistically significant. Overall, on a per capita basis, males and females accrued similar costs-of-illness (US$ 9,451.75 vs. US$ 10,758.18).CONCLUSIONS: In a country with per capita GDP of less than US$ 5,300, a per capita annual cost of illness of US$ 10,239 for CNCDs is excessive and has detrimental implications for the health and development of Jamaica.

How Does Creative Arts Therapy Reduce Distress for Children With Cancer? A Metasynthesis of Extant Qualitative Literature

2019 ◽  
Vol 37 (2) ◽  
pp. 91-104
Author(s):  
Jennifer L. Raybin ◽  
Emily Barr ◽  
Marilyn Krajicek ◽  
Jacqueline Jones
Keyword(s):  
Research Question ◽  
Creative Arts ◽  
Qualitative Synthesis ◽  
Creative Arts Therapy ◽  
Children With Cancer ◽  
Integrative Health ◽  
Study Team ◽  
Disease Experience ◽  
Integrative Therapies

Introduction: As more children survive cancer, attention must be paid to their quality of life (QOL). Integrative therapies are an ideal modality for nurses to advocate for reducing distress and improving QOL for children with cancer. Creative arts therapy is a type of integrative health that may improve QOL in this population. Therefore, the research question was asked, “For children with cancer, what opportunities exist for creative arts therapy to reduce distress?” Method: A metasynthesis of the extant qualitative research was conducted to answer the research question. Seven qualitative studies were identified, which included 162 participants. New themes were identified through rigorous analyzation by the study team of each study as individual data. Results: Four derived analytic themes emerged through the analysis: (a) connection is established through creative expression, (b) coping is facilitated by creative arts, (c) communication is enabled by creative arts interventions, and (d) continuance (the concept of time) is experienced through creative arts. Examples of each theme with subthemes are delineated, including expressive quotes. Summary: Through this qualitative synthesis of studies with creative arts therapy, evocative opportunities to reduce the distress associated with the disease experience are revealed. Nurses are called now to promote creative arts therapy to improve the symptoms in children with cancer.

Including Health Status in Medicare??s Adjusted Average per Capita Cost Capitation Formula

Medical Care ◽  
1986 ◽  
Vol 24 (3) ◽  
pp. 259-275 ◽  
Author(s):  
J William Thomas ◽  
Richard Lichtenstein
Keyword(s):  
Health Status ◽  
Per Capita ◽  
Capita Cost

scholarly journals Organizational Readiness for Community Health Worker Workforce Integration Among Medicaid Contracted Health Plans and Provider Networks: An Arizona Case Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Samantha Sabo ◽  
Nancy Wexler ◽  
Louisa O'Meara ◽  
Heather Dreifuss ◽  
Yanitza Soto ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Health Care Professionals ◽  
Organizational Capacity ◽  
Cost Of Care ◽  
Organizational Readiness ◽  
Experience Of Care ◽  
Workforce Integration

Understanding and building organizational capacity for system change and the integration of the Community Health Worker (CHW) workforce within the health scare sector requires a supportive organizational culture among sector leaders and providers. The aim of this mixed-methods study was to assess organizational readiness for CHW workforce integration into Arizona Medicaid health systems and care teams. This collaborative effort was in direct response to emergent state and national CHW workforce policy opportunities, and the shifting health care landscape in Arizona – which merged behavior and physical health. Specifically, and in collaboration with a broad-based, statewide CHW workforce coalition, led by the CHW professional association, we assessed 245 licensed health care professionals with experience working with CHWs and 16 Medicaid-contracted health plan leadership. Our goal was to generate a baseline understanding of the knowledge, attitudes and beliefs these stakeholders held about the integration of CHWs into systems and teams. Our findings demonstrate a high level of organizational readiness and action toward integration of CHWs within the Arizona health care system and care teams. CHWs have emerged as a health care workforce able to enhance the patient experience of care, improve population health, reduce cost of care, and improve the experience of providing care among clinicians and staff.

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