Comparative review of family-professional communication: What mental health care can learn from oncology and nursing home care

AbstractBackground:This study is part of the Innovations in Data, Evidence and Applications for Persons with Neurological Conditions project to understand the strengths, preferences, and needs of persons with neurological conditions living in Canada.Objective:To estimate the prevalence and describe the sociodemographic and clinical characteristics of persons with multiple sclerosis in Canadian home care, nursing home, Complex Continuing Care hospitals, and inpatient mental health care settings.Methods:Cross-sectional study of adults aged 18 years and older with multiple sclerosis (MS; n=11,250) across Canada from 1996 through 2011 using interRAI Resident Assessment Instrument (RAI) comprehensive health assessments (RAI Minimum Data Set 2.0, RAI-Home Care, RAI-Mental Health). Comparisons were made to adults with Alzheimer’s disease and related dementias (n=260,910), other neurological conditions (n=163,578) and non-neurological conditions (n=571,567).Results:The prevalence of MS was highest in Complex Continuing Care hospitals (4125 cases per 100,000 patients), followed by home care (2020 cases per 100,000 patients), nursing homes (1424 cases per 100,000 patients), and mental health settings (138 cases per 100,000 patients). Persons with MS experienced greater impairment in the completion of activities of daily living, pain, pressure ulcers, swallowing difficulty, depression, and anxiety compared with peers within care settings. There were also significant differences between settings, particularly the degree of physical and cognitive impairment experienced by persons with MS.Conclusions:Except for mental health care settings, the prevalence of MS in community, institutional and hospital-based care settings exceeded that of the general population. These data describing the sociodemographic and clinical characteristics of persons with MS may be used to inform clinical practice and policy decisions for persons with MS across the continuum of care.

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The meaning of urgency in the allocation of scarce health care resources; a comparison between renal transplantation and psychogeriatric nursing home care

Health Policy ◽

10.1016/s0168-8510(98)00011-6 ◽

1998 ◽

Vol 44 (2) ◽

pp. 135-148 ◽

Cited By ~ 5

Author(s):

Inge Varekamp ◽

Franka J.M Meiland ◽

Aloysia M Hoos ◽

Johannes F Wendte ◽

Johanna C.J.M de Haes ◽

...

Keyword(s):

Health Care ◽

Nursing Home ◽

Renal Transplantation ◽

Home Care ◽

Nursing Home Care ◽

Health Care Resources

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Managed Care as Regulation: Functional Ethics for a Regulated Environment

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.1995.tb01362.x ◽

1995 ◽

Vol 23 (3) ◽

pp. 266-272 ◽

Cited By ~ 5

Author(s):

Sandra H. Johnson

Keyword(s):

Health Care ◽

Nursing Home ◽

Managed Care ◽

Home Care ◽

One Health ◽

Care Setting ◽

Institutional Context ◽

Health Care Setting ◽

Nursing Home Care ◽

Institutional Setting

Analysis in bioethics has relied primarily on the identification and application of general principles and on the examination of particular paradigmatic cases. Principalism and casuistry depend on an assumption of generalizability; that is, that learning and insights gained from an understanding of the principles or the case may be effectively applied to other similar situations. For the most part, the particular characteristics of the institutional setting have not played a central role in these approaches. It would appear, then, that what has been learned in the context of one health care setting is transferable, with some few adjustments, to another. The institutional context does make both a practical and a substantive difference, however, and shifting ethical analyses from one context to another has sometimes proven difficult. This has been so, for example, in the context of nursing home care.

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Strategic sorting: the role of ordeals in health care

Economics and Philosophy ◽

10.1017/s0266267120000139 ◽

2020 ◽

pp. 1-18

Author(s):

Richard Zeckhauser

Keyword(s):

Health Care ◽

Weight Loss ◽

Nursing Home ◽

Home Care ◽

Moral Hazard ◽

Waiting Time ◽

Nursing Home Care ◽

Dead Weight ◽

Health Care Resources

Abstract Ordeals are burdens placed on individuals that yield no benefits to others; hence they represent a dead-weight loss. Ordeals – the most common is waiting time – play a prominent role in rationing health care. The recipients most willing to bear them are those receiving the greatest benefit from scarce health-care resources. Health care is heavily subsidized; hence, moral hazard leads to excess use. Ordeals are intended to discourage expenditures yielding little benefit while simultaneously avoiding the undesired consequences of rationing methods such as quotas or pricing. This analysis diagnoses the economic underpinnings of ordeals. Subsidies for nursing-home care versus home care illustrate.

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