Evaluating a Model of Service Integration for Older People with Complex Health Needs

2005 ◽  
Vol 4 (1-2) ◽  
pp. 34-41 ◽  
Author(s):  
Steve Bird ◽  
William Kurowski ◽  
Gillian Dickman
Keyword(s):  
Health Care ◽  
Older People ◽  
Service Integration ◽  
Evaluation Process ◽  
Target Population ◽  
Multiple Chronic Conditions ◽  
Health Care Needs ◽  
Care Needs ◽  
Community Based ◽  
Quantitative And Qualitative Methods

Background Older people with multiple chronic conditions and complex health care needs require a comprehensive, accessible and well-coordinated system of services. To address this growing problem, a consortium of acute and community-based health care organisations implemented a ‘Patients First’ model of service integration for the target population. The project evaluation utilised a combination of quantitative and qualitative methods in an action research framework. Findings The evaluation process not only demonstrated the benefits of the project to patients and the health care system, but also contributed to the identification of pivotal components in the model, aspects requiring attention and consequently their refinement. It was also a vehicle for the development of a sense of ownership amongst staff and has evolved into an integral part of the model.

Assessment of older people in the community: lessons from Britain’s ‘75-and-over checks’

1999 ◽  
Vol 9 (4) ◽  
pp. 305-316 ◽  
Author(s):  
Steve Iliffe ◽  
Mari Gould ◽  
Paul Wallace
Keyword(s):  
Health Care ◽  
Older People ◽  
General Practitioners ◽  
Unmet Need ◽  
Health Assessment ◽  
Health Care Needs ◽  
Care Needs ◽  
Contractual Obligation ◽  
Assessment Programme ◽  
The World

Research carried out in the 1950s and early 1960s indicated that there was considerable unmet need amongst older people in Britain. This work prompted research into ways of meeting the health care needs of older people, a task made more important by the aging of the population at the end of this century. This focus resulted in the introduction in 1990 of a nationwide health assessment programme for older people, as a contractual obligation for general practitioners. The programme, the first in the world, remains in force but is widely ignored. This paper describes:

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 Integrated care facilitation for older patients with complex health care needs reduces hospital demand

2007 ◽  
Vol 31 (3) ◽  
pp. 451 ◽  
Author(s):  
Stephen R Bird ◽  
William Kurowski ◽  
Gillian K Dickman ◽  
Ian Kronborg
Keyword(s):  
Health Care ◽  
Older People ◽  
Community Health ◽  
Hospital Admissions ◽  
Acute Hospital ◽  
Health Care Needs ◽  
Hospital Services ◽  
Model Of Care ◽  
Care Needs ◽  
Bed Days

Objective: The evaluation of a new model of care for older people with complex health care needs that aimed to reduce their use of acute hospital services. Method: Older people (over 55 years) with complex health care needs, who had made three or more presentations to a hospital emergency department (ED) in the previous 12 months, or who were identified by community health care agencies as being at risk of making frequent ED presentations, were recruited to the project. The participants were allocated a ?care facilitator? who provided assistance in identifying and accessing required health care services, as well as education in aspects of self management. Data for the patients who had been participants on the project for a minimum of 90 days (n = 231) were analysed for their use of acute hospital services (ED presentations, admissions and hospital bed-days) for the period 12-months pre-recruitment and postrecruitment. A similar analysis on the use of hospital services was conducted on the data of patients who were eligible and who had been offered participation, but who had declined (comparator group; n=85). Results: Post recruitment, the recruited patients displayed a 20.8% reduction in ED presentations, a 27.9% reduction in hospital admissions, and a 19.2% reduction in bed-days. By comparison, the patients who declined recruitment displayed a 5.2% increase in ED presentations, a 4.4 % reduction in hospital admissions, and a 15.3% increase in inpatient bed-days over a similar timeframe. Conclusion: A model of care that facilitates access to community health services and provides coordination between existing services reduces hospital demand.

scholarly journals A Family-Centered, Community-Based System of Services for Children and Youth With Special Health Care Needs

2007 ◽  
Vol 161 (10) ◽  
pp. 933 ◽  
Author(s):  
James M. Perrin ◽  
Diane Romm ◽  
Sheila R. Bloom ◽  
Charles J. Homer ◽  
Karen A. Kuhlthau ◽  
...  
Keyword(s):  
Health Care ◽  
Special Health Care Needs ◽  
Children And Youth ◽  
Health Care Needs ◽  
Care Needs ◽  
Community Based ◽  
Special Health Care ◽  
Family Centered ◽  
Special Health

LGBTQ Youth’s Perceptions of Primary Care

2016 ◽  
Vol 56 (5) ◽  
pp. 443-450 ◽  
Author(s):  
Barbara K. Snyder ◽  
Gail D. Burack ◽  
Anna Petrova
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Care Physicians ◽  
Emotional Health ◽  
Group Discussion ◽  
Health Care Needs ◽  
Care Needs ◽  
Community Based ◽  
Community Based Programs ◽  
Patient Provider Communication

Despite published guidelines on the need to provide comprehensive care to lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) youth, there has been limited research related to the deliverance of primary health care to this population. The goals of this study were to learn about LGBTQ youth’s experiences with their primary care physicians and to identify areas for improvement. Youth attending 1 of 5 community-based programs completed a written questionnaire and participated in a focus group discussion regarding experiences at primary care visits, including topics discussed, counselling received, and physician communication. Most of the youth did not feel their health care needs were well met. The majority acknowledged poor patient-provider communication, disrespect, and lack of discussions about important topics such as sexual and emotional health. Participants cited concerns about confidentiality and inappropriate comments as barriers to care. Youth expressed a strong desire to have physicians be more aware of their needs and concerns.

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