Primary Care of Long-Stay Nursing Home Residents: Approaches of Three Health Maintenance Organizations

1999 ◽  
Vol 47 (2) ◽  
pp. 131-138 ◽  
Author(s):  
David B. Reuben ◽  
John F. Schnelle ◽  
Joan L. Buchanan ◽  
Raynard S. Kington ◽  
Gail L. Zellman ◽  
...  
Keyword(s):  
Primary Care ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Health Maintenance Organizations ◽  
Health Maintenance

Ethics Case Consultation in Primary Care: Contextual Challenges for Clinical Ethicists

2009 ◽  
Vol 18 (4) ◽  
pp. 397-405 ◽  
Author(s):  
ANNE SLOWTHER
Keyword(s):  
Primary Care ◽  
Clinical Ethics ◽  
Western Europe ◽  
Ethics Consultation ◽  
Ethics Committees ◽  
The United States ◽  
Health Maintenance Organizations ◽  
Ethics Committee ◽  
Health Maintenance ◽  
Case Consultation

The development of ethics case consultation over the past 30 years, initially in North America and recently in Western Europe, has primarily taken place in the secondary or tertiary healthcare settings. The predominant model for ethics consultation, in some countries overwhelmingly so, is a hospital-based clinical ethics committee. In the United States, accreditation boards suggest the ethics committee model as a way of meeting the ethics component of the accreditation requirement for payment by Health Maintenance Organizations (HMOs), and in some European countries, there are legislatory requirements or government recommendations for hospitals to have clinical ethics committees. There is no corresponding pressure for primary care services to have ethics committees or ethics consultants to advise clinicians, patients, and families on the difficult ethical decisions that arise in clinical practice.

Effects of Depressive Syndromes on the Everyday Competence of Nursing Home Residents with Dementia

GeroPsych ◽  
2012 ◽  
Vol 25 (2) ◽  
pp. 103-109
Author(s):  
Sandra Verhülsdonk ◽  
Sabine Engel
Keyword(s):  
Primary Care ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Nursing Homes ◽  
Functional Impairment ◽  
Depressive Symptomatology ◽  
Nursing Home Residents ◽  
Cognitive Status ◽  
The Everyday ◽  
Depressive Syndromes

Depression in dementia is very common and has significant effects on the functional impairment of nursing-home residents. This study assesses depression, depression diagnosis, cognitive status, status of medication and functional status in 138 residents. Results: (1) 34.1% of the demented residents had a depressive symptomatology. (2) No diagnosis of “depression” was documented for a high percentage of depressed residents. (3) No correlation between depressive symptoms and treatment with antidepressants was present. (4) There was no correlation between the stage of dementia and the rate of depression. (5) There were significant differences in the everyday competence between depressive and nondepressive residents with dementia. The data suggest the need for an adequate diagnosis and treatment of depressive residents with dementia and underlines the need for improvement in care and treatment in primary care and nursing homes.

Israel—start-up nation

2019 ◽  
pp. 28-33
Author(s):  
Mark Britnell
Keyword(s):  
Primary Care ◽  
Health System ◽  
Patient Information ◽  
Health Maintenance Organizations ◽  
Healthcare Organization ◽  
Immigrant Workers ◽  
Mutual Aid ◽  
Health Maintenance ◽  
Non Profit ◽  
Start Up

In this chapter, Mark Britnell focuses on Israel’s healthcare system, one of the best-kept secrets in healthcare. He looks at how Israel has achieved a primary care-led health system with four health maintenance organizations (HMOs) providing citizens with both choice and comprehensive cover. Primary and community care spend first exceeded that of secondary and acute care 20 years ago, but it has taken time. Its origins can be traced back to 1911 when an orchard worker had his arm severed and 150 immigrant workers joined together to form a mutual aid healthcare organization called Clalit, a non-governmental, non-profit entity. They knew that to help themselves they had to help each other, and Clalit is now the largest HMO in Israel with 14 hospitals and more than 1,200 primary and specialized clinics. The health system of Israel is not perfect but is highly innovative—not least in its use of patient information—and deserves attention.

Use of Primary Care Teams by HMOS for Care of Long-Stay Nursing Home Residents

1999 ◽  
Vol 47 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Donna O. Farley ◽  
Gail Zellman ◽  
Joseph G. Ouslander ◽  
David B. Reuben
Keyword(s):  
Primary Care ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Primary Care Teams

Systematic Utilization of Data for Analysis of a Pediatric Emergency-Room Experience

PEDIATRICS ◽  
1975 ◽  
Vol 55 (2) ◽  
pp. 266-274
Author(s):  
George A. Lamb ◽  
Howard L. Weinberger ◽  
Herbert Schneiderman ◽  
Bruce Goldstein
Keyword(s):  
Primary Care ◽  
Emergency Room ◽  
Systematic Approach ◽  
Care Setting ◽  
Health Maintenance Organizations ◽  
Pediatric Emergency ◽  
Health Centers ◽  
Health Maintenance ◽  
Cost Of Health Care ◽  
Neighborhood Health Centers

This report describes the systematic use of emergency-room data to (1) define the experiences of a group of pediatric interns in their emergency-room rotation (especially as they relate to their role as future pediatric practitioners), (2) evaluate, supervise, and learn from their performance in this primary care setting, and (3) provide an ongoing weekly list of illnesses diagnosed in the emergency room as an epidemiological sentinel for the larger community. The future applications of this type of systematic approach, perhaps with computer technology, offer the opportunity for comparison of delivery, quality, and cost of health care between various sources of primary care (emergency-room facilities, private physicians' offices, neighborhood health centers, and health maintenance organizations).

Emerging Practice Arenas for the Consultant Pharmacist

1988 ◽  
Vol 1 (3) ◽  
pp. 202-208
Author(s):  
Lucinda L. Maine
Keyword(s):  
Home Health Care ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Health Maintenance Organizations ◽  
Inappropriate Drug ◽  
Reimbursement Mechanisms ◽  
Term Care ◽  
Health Maintenance ◽  
Consulting Services

The growth of the aged population and changing characteristics of the elderly and their caregivers require that alternatives to institutional long-term care be developed. The need for consultant pharmacy services can be hypothesized on the basis that a considerable number of these individuals have similar levels of disability as nursing home residents. The experience of consultant pharmacists in noninstitutional environments is reviewed in this article. These environments include health maintenance organizations, home health care agencies, and residential care facilities. Barriers to providing nontraditional consulting services include (1) a lack of a regulatory mandate, (2) lack of formal reimbursement mechanisms, (3) lack of an expectation for services on the part of other providers and administrators, and (4) lack of an assertive marketing posture on the part of pharmacists. Strategies for overcoming these obstacles are discussed. Increased reliance on noninstitutional settings for the long-term care of older citizens will increase the opportunities for consulting services by pharmacists who are willing to demonstrate to other providers that inappropriate drug use in these settings results in increased cost and decreased quality of care for clients.

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