Unmet Behavioral Health and Social Needs of Home Healthcare Patients and Their Caregivers

2021 ◽  
pp. 108482232110028
Author(s):  
Angela M. Gerolamo ◽  
Monika Pogorzelska-Maziarz ◽  
Alexzandra Gentsch ◽  
Ashley Traczuk ◽  
TingAnn Hsiao ◽  
...  
Keyword(s):  
Behavioral Health ◽  
Integrated Care ◽  
Public Health Problem ◽  
Social Needs ◽  
Home Healthcare ◽  
Health Needs ◽  
Future Research ◽  
Structured Interviews ◽  
Care Models ◽  
Integrated Care Models

Lack of recognition and treatment of mental health disorders in the home healthcare (HHC) population has been recognized as a national public health problem. However, there is a gap in understanding the behavioral health needs of HHC patients and caregivers from the perspectives of HHC patients, caregivers, and HHC personnel. These perspectives are critical for informing an acceptable and scalable integrated care model. We conducted semi-structured interviews with HHC patients, caregivers, and HHC personnel to assess the unmet behavioral health needs of HHC patients and their caregivers. Participants were recruited from a Medicare-certified HHC agency that is part of a large health system on the east coast. We completed a total of 31 interviews between January and May 2020. Findings suggest that HHC patients have significant unmet behavioral health and social needs and their caregivers are emotionally and physically drained. Reasons that patients may not be receiving adequate behavioral health services include denial, cost, culture, lack of awareness of available resources, lack of transportation, and homebound status. While most patients discussed the emotional toll of their illness, few were connected to services. HHC personnel offered suggestions on how to meet the behavioral health needs of patients, with the primary focus on providing in-home options. Gaps in meeting the needs of the HHC population necessitate integrated care models that can effectively address the behavioral health and social needs of HHC patients and their families. Future research should develop and test patient and caregiver-directed integrated care models in the HHC setting.

Effectiveness and cost-effectiveness of integrated care models for elderly, complex patients: A narrative review. Don’t we need a value-based approach?

2018 ◽  
Vol 21 (4) ◽  
pp. 120-139 ◽  
Author(s):  
Marta Marino ◽  
Antonio G de Belvis ◽  
Maria Tanzariello ◽  
Emanuele Dotti ◽  
Sabina Bucci ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Outcomes ◽  
Integrated Care ◽  
Service Providers ◽  
Systems Of Care ◽  
Social Needs ◽  
Narrative Review ◽  
A Value ◽  
Care Models ◽  
Integrated Care Models

Introduction The management of patients with complex health and social needs is one of the main challenges for healthcare systems. Integrated care seems to respond to this issue, with collaborative working and integration efforts of the care system components professionals and service providers aimed at improving efficiency, appropriateness and person centeredness of care. We conducted a narrative review to analyse the available evidences published on effectiveness and cost-effectiveness of integrated care models targeted on the management of such elderly patients. Methods MEDLINE, Scopus and EBSCO were searched. We reported this narrative review according to the PRISMA Checklist. For studies to be included, they had to: (i) refer to integrated care models through implemented experimental or demonstration projects; (ii) focus on frail elderly ≥65 years old, with complex health and social needs, not disease-specific; (iii) evaluate effectiveness and/or cost and/or cost-effectiveness; (iv) report quantitative data (e.g. health outcomes, utilization outcomes, cost and cost-effectiveness). Results Thirty articles were included, identifying 13 integrated care models. Common features were identified in case management, geriatric assessment and multidisciplinary team. Favourable impacts on healthcare facilities utilization rates, though with mixed results on costs, were found. The development of community-based and cost-effective integrated systems of care for the elderly is possible, thanks to the cooperation across care professionals and providers, to achieving a relevant impact on healthcare and efficient resource management. The elements of success or failure are not always unique and identifiable, but the potential clearly exists for these models to be successful and generalized on a large scale. Discussion We found out a favourable impact of integrated care models/methods on health outcomes, care utilization and costs. The selected interventions are likely to be implemented at community level, focused on the patient management in terms of continuity of care. Thus, we propose a value-based framework for the evaluation of these services.

scholarly journals Evaluating integrated care for people with complex needs

2020 ◽  
Vol 26 (1) ◽  
pp. 46-53
Author(s):  
Panagiotis Kasteridis ◽  
Anne Mason ◽  
Andrew Street
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Models Of Care ◽  
Care Team ◽  
Future Research ◽  
Complex Care ◽  
Care Needs ◽  
Complex Needs ◽  
Care Models ◽  
Integrated Care Models

Objectives As part of the Vanguard programme, two integrated care models were introduced in South Somerset for people with complex care needs: the Complex Care Team and Enhanced Primary Care. We assessed their impact on a range of utilization measures and mortality. Methods We used monthly individual-level linked primary and secondary care data from April 2014 to March 2018 to assess outcomes before and after the introduction of the care models. The analysis sample included 564 Complex Care Team and 841 Enhanced Primary Care cases that met specific criteria. We employed propensity score methods to identify out-of-area control patients and difference-in-differences analysis to isolate the care models’ impact. Results We found no evidence of significantly reduced utilization in any of the Complex Care Team or Enhanced Primary Care cohorts. The death rate was significantly lower only for those in the first Enhanced Primary Care cohort. Conclusions The integrated care models did not significantly reduce utilization nor consistently reduce mortality. Future research should test longer-term outcomes associated with the new models of care and quantify their contribution in the context of broader initiatives.

scholarly journals Older Adults’ Perception of Their Needs in Tehran: A Cry for Emotional and Social Support

2016 ◽  
Vol 9 (2) ◽  
pp. 134
Author(s):  
Sima Ghasemi ◽  
Nastaran Keshavarz Mohammadi ◽  
Farahnaz Mohammadi Shahboulaghi ◽  
Ali Ramezankhani
Keyword(s):  
Social Support ◽  
Older Adult ◽  
Meaning In Life ◽  
Healthy Lifestyle ◽  
Social Needs ◽  
Health Needs ◽  
Social Health ◽  
Structured Interviews ◽  
Instrumental Social Support ◽  
Wide Range

<p><strong>INTRODUCTION: </strong>Background and purpose: Human’s longevity has increased with advances in health and better management of communicable diseases. Therefore, the number of older adult is increasing in developed and developing countries. A glimpse at studies reveals that identifying elderly’s health needs has been mainly based on the experts’ understanding, while older adult themselves have rarely expressed their own opinions. This study aimed to better understand Tehran, Iran elderly’s perception of their own health needs.</p><p><strong>METHODS: </strong>In this qualitative study, with purposeful sampling, data was collected by conducting deep semi-structured interviews with elderlies aged 60-84 years, residing at their private houses. After 19 interviews, the data achieved saturation. The content of the interviews was analyzed through content-analysis approach.<strong></strong></p><p><strong>RESULTS: </strong>Data analyses led to extracting main categories of needs in different domains. The main health needs in physical health domain included: having a healthy lifestyle, independence and safety. Regarding elders’ mental health, coping with their aging, inner tranquility; regarding their spiritual health, the need to have a meaning in life and faithfulness in religion were identified as main groups of needs. And the most important among their main social health needs were the needs for emotional and social support, social involvement and instrumental social support. <strong></strong></p><p><strong>CONCLUSION: </strong>Although, a wide range of physical, mental and social needs were raised, some were more important. Fulfilling the emotional needs in social health had the highest frequency among the needs expressed by the contributors. Following that with a notable difference were the frequencies of having a healthy lifestyle, independence and inner tranquility. This means that attempts to address elderly health needs should avoid focusing mainly or even only on disease related needs and serious attention should be paid to their emotional and social needs.</p>

scholarly journals Impact of Relaxation and Group Psycho-Education on Health Outcomes Using Integrated Care Models and Quality Improvement

2014 ◽  
Vol 04 (12) ◽  
pp. 887-896 ◽  
Author(s):  
Martha Okafor ◽  
Victor Ede ◽  
Rosemary Kinuthia ◽  
Debbie Strotz ◽  
Cathryn Marchman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Outcomes ◽  
Integrated Care ◽  
Care Models ◽  
Integrated Care Models

scholarly journals Integrated Care Models and Child Health: A Meta-analysis

PEDIATRICS ◽  
2019 ◽  
Vol 145 (1) ◽  
pp. e20183747 ◽  
Author(s):  
Ingrid Wolfe ◽  
Rose-Marie Satherley ◽  
Elizabeth Scotney ◽  
James Newham ◽  
Raghu Lingam
Keyword(s):  
Child Health ◽  
Integrated Care ◽  
Meta Analysis ◽  
Care Models ◽  
Integrated Care Models ◽  
And Child Health
Sign in / Sign up

Export Citation Format

Share Document