scholarly journals Continuity of care is associated with satisfaction with local health care services

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
E. Lautamatti ◽  
M. Sumanen ◽  
R. Raivio ◽  
K. J. Mattila
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Local Health ◽  
Care Services ◽  
Local Health Care

Part 5: Community Perception of Local Health Care Services

1991 ◽  
Vol 7 (5) ◽  
pp. 542-559 ◽  
Author(s):  
L. Gary Hart ◽  
Denise M. Lishner ◽  
Bruce A. Amundson
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Local Health ◽  
Community Perception ◽  
Care Services ◽  
Local Health Care

Mass-gathering Events: The Role of Advanced Nurse Practitioners in Reducing Referrals to Local Health Care Agencies

2016 ◽  
Vol 31 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Anthony E. Kemp
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Nurse Practitioners ◽  
Health Care Services ◽  
Local Health ◽  
Medical Team ◽  
Mass Gathering ◽  
Care Services ◽  
Local Health Care

AbstractIntroductionThe introduction of advanced practitioner roles has challenged the traditional boundaries of health care. While studies have been undertaken to understand the role of physicians in respect of mass-gathering medicine, the role of advanced nurse practitioners (ANPs) has not been investigated.ProblemDoes the presence of an ANP reduce the referral rates of patients presenting for medical care at mass-gathering events to external health care resources?MethodsA prospective observational study was undertaken to determine whether the presence of an ANP would reduce the patient referral rate to external health care services by first aiders and paramedics working within an event medical team. Patients identified as requiring referral were reviewed by an ANP as part of the on-site medical provision for four mass-gathering events in the south of England. Additionally, information was gathered identifying which patients would have been transported to hospital by ambulance compared to those actually transported following ANP review. Statistical analysis was undertaken for three key measures (referrals to all local health resources, referrals to hospital-based acute services, and transfers to hospital by ambulance).ResultsA rounded total of 842,000 people attended four mass-gathering events held over 14 days. Of these, 652 presented for medical care, many self-referring.Using a one-tailed Fisher’s Exact Test and Phi analysis, this study demonstrated statistically significant reductions in the overall referral of patients to all external health care resources (P<.001; φ=0.44), to the emergency department (ED; P<.001; φ=0.43), and a reduction in ambulance transport (P<.001; φ=0.42). Effect size analysis demonstrated a medium-sized effect evident for all of the above, which was also demonstrated in economic terms.The event medical team would have referred 105 (16.3%) of the 652 patient presentations to external health care services; 47 (7.2%) would have been transported by ambulance. In comparison, the ANP referred 23 patients (3.5%) with 11 (1.7%) being transported by ambulance. It also was noted that the first aiders and paramedics could be more selective in their referral habits that were focused primarily on the ED.ConclusionsAppropriately trained and experienced ANPs working within event medical teams have a positive impact on referral rates from mass-gathering events.KempAE. Mass-gathering events: the role of advanced nurse practitioners in reducing referrals to local health care agencies. Prehosp Disaster Med. 2016;31(1):58–63.

scholarly journals Effective Containment of a COVID-19 Subregional Outbreak in Italy Through Strict Quarantine and Rearrangement of Local Health Care Services

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Sara Tedeschi ◽  
Lorenzo Badia ◽  
Fabio Berveglieri ◽  
Rodolfo Ferrari ◽  
Simona Coladonato ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
World Health ◽  
Nasopharyngeal Swab ◽  
Local Health ◽  
Telephone Contact ◽  
Care Services ◽  
Local Health Care ◽  
Emilia Romagna Region ◽  
Health Organization

Abstract Background Since the beginning of the pandemic, the epidemiology of coronavirus disease 2019 (COVID-19) in Italy has been characterized by the occurrence of subnational outbreaks. The World Health Organization recommended building the capacity to rapidly control COVID-19 clusters of cases in order to avoid the spread of the disease. This study describes a subregional outbreak of COVID-19 that occurred in the Emilia Romagna region, Italy, and the intervention undertaken to successfully control it. Methods Cases of COVID-19 were defined by a positive reverse transcriptase polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on nasopharyngeal swab. The outbreak involved the residential area of a small town, with ~10 500 inhabitants in an area of 9 km2. After the recognition of the outbreak, local health care authorities implemented strict quarantine and a rearrangement of health care services, consisting of closure of general practitioner outpatient clinics, telephone contact with all residents, activation of health care units to visit at-home patients with symptoms consistent with COVID-19, and a dedicated Infectious Diseases ambulatory unit at the nearest hospital. Results The outbreak lasted from February 24 to April 6, 2020, involving at least 170 people with a cumulative incidence of 160 cases/10 000 inhabitants; overall, 448 inhabitants of the municipality underwent at least 1 nasopharyngeal swab to detect SARS-CoV-2 (positivity rate, 38%). Ninety-three people presented symptoms before March 11 (pre-intervention period), and 77 presented symptoms during the postintervention period (March 11–April 6). Conclusions It was possible to control this COVID-19 outbreak by prompt recognition and implementation of a targeted local intervention.

scholarly journals Continuity of care experienced by patients in a multi-institutional pancreatic care network: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. S. Hopstaken ◽  
D. van Dalen ◽  
B. M. van der Kolk ◽  
E. J. M. van Geenen ◽  
J. J. Hermans ◽  
...  
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Pancreatic Surgery ◽  
Tertiary Hospital ◽  
Tumor Board ◽  
Pancreatic Tumors ◽  
Care Network ◽  
Care Services

Abstract Background Over the past decades, health care services for pancreatic surgery were reorganized. Volume norms were applied with the result that only a limited number of expert centers perform pancreatic surgery. As a result of this centralization of pancreatic surgery, the patient journey of patients with pancreatic tumors has become multi-institutional. To illustrate, patients are referred to a center of expertise for pancreatic surgery whereas other parts of pancreatic care, such as chemotherapy, take place in local hospitals. This fragmentation of health care services could affect continuity of care (COC). The aim of this study was to assess COC perceived by patients in a pancreatic care network and investigate correlations with patient-and care-related characteristics. Methods This is a pilot study in which patients with (pre) malignant pancreatic tumors discussed in a multidisciplinary tumor board in a Dutch tertiary hospital were asked to participate. Patients were asked to fill out the Nijmegen Continuity of Care-questionnaire (NCQ) (5-point Likert scale). Additionally, their patient-and care-related data were retrieved from medical records. Correlations of NCQ score and patient-and care-related characteristics were calculated with Spearman’s correlation coefficient. Results In total, 44 patients were included (92% response rate). Pancreatic cancer was the predominant diagnosis (32%). Forty percent received a repetition of diagnostic investigations in the tertiary hospital. Mean scores for personal continuity were 3.55 ± 0.74 for GP, 3.29 ± 0.91 for the specialist and 3.43 ± 0.65 for collaboration between GPs and specialists. Overall COC was scored with a mean 3.38 ± 0.72. No significant correlations were observed between NCQ score and certain patient-or care-related characteristics. Conclusion Continuity of care perceived by patients with pancreatic tumors was scored as moderate. This outcome supports the need to improve continuity of care within multi-institutional pancreatic care networks.

scholarly journals Older multimorbid patients’ experiences on integration of services: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lilian Keene Boye ◽  
Christian Backer Mogensen ◽  
Tine Mechlenborg ◽  
Frans Boch Waldorff ◽  
Pernille Tanggaard Andersen
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Health Care Systems ◽  
Easy Access ◽  
Ageing Population ◽  
Health Providers ◽  
Care Coordinator ◽  
Care Services ◽  
Care Systems

Abstract Background Half of the older persons in high-income counties are affected with multimorbidity and the prevalence increases with older age. To cope with both the complexity of multimorbidity and the ageing population health care systems needs to adapt to the aging population and improve the coordination of long-term services. The objectives of this review were to synthezise how older people with multimorbidity experiences integrations of health care services and to identify barriers towards continuity of care when multimorbid. Methods A systematic literature search was conducted in February 2018 by in Scopus, Embase, Cinahl, and Medline using the PRISMA guidelines. Inclusion criteria: studies exploring patients’ point of view, ≥65 and multi-morbid. Quality assessment was conducted using COREQ. Thematic synthesis was done. Results Two thousand thirty studies were identified, with 75 studies eligible for full text, resulting in 9 included articles, of generally accepted quality. Integration of health care services was successful when the patients felt listened to on all the aspects of being individuals with multimorbidity and when they obtained help from a care coordinator to prioritize their appointments. However, they felt frustrated when they did not have easy access to their health providers, when they were not listened to, and when they felt they were discharged too early. These frustrations were also identified as barriers to continuity of care. Conclusions Health care systems needs to adapt to people with multimorbidity and find solutions on ways to create flexible systems that are able to help older patients with multimorbidity, meet their individual needs and their desire to be involved in decisions regarding their care. A Care coordinator may be a solution.

Resource management and budgeting in critical care

2016 ◽  
Author(s):  
Jukka Takala
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Resource Management ◽  
Resource Use ◽  
Health Care Services ◽  
Care Process ◽  
Local Health ◽  
Planning Period ◽  
Actual Structure ◽  
Local Health Care

Resource management is a core task for intensive care unit (ICU) leadership. Budgeting covers optimizing resource use, planning for future needs, and continuous monitoring of actual resource use. Short-term budgeting is operational planning, whereas mid- and long-term budgeting should focus on strategy. Resource management is an integral and continuous part of the ICU management process. Hence, the regional and local availability of health care services rarely depends on rational or objective factors alone. For budgeting purposes, the needs for intensive care for the population of the main referral area of the hospital, the actual structure of the local health care system and probable changes during the strategic planning period should be considered. The resources needed for emergency admissions is relatively constant as long as the referral population the indications for intensive care and the treatments offered do not change. The ICU is part of a multidisciplinary, horizontal care process. The amount and level of care provided in all the participating units must be considered.

Staying in the middle

Interpreting ◽  
2012 ◽  
Vol 14 (1) ◽  
pp. 1-22 ◽  
Author(s):  
Alexander Bischoff ◽  
Elisabeth Kurth ◽  
Alix Henley
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Care Systems ◽  
Public Institutions ◽  
Local Health ◽  
Host Society ◽  
Care Services ◽  
Integration Of Immigrants ◽  
Care Systems ◽  
Local Health System

In this age of migration, many societies are characterized by linguistic and cultural diversity. Public institutions, such as health care systems, face the challenge of integrating new arrivals, immigrants, refugees or asylum seekers, into the host society. The purpose of this study was to examine how interpreters see their work within the context of the integration of immigrants into the host society (Switzerland) in general, and into the local health system in particular. We investigated the roles that interpreters working in a Women’s Hospital in Switzerland take on and are aware of in their work. The interpreters described four main roles: word-for-word interpreting, intercultural explanation, building patient–provider relationships, and accompanying immigrant patients. An additional cross-cutting theme emerged: interpreters facilitating the integration of immigration. Only the first of these is generally regarded as their “official” role. The interpreters take on the additional roles as necessary during a consultation, in response to the needs of the patient and the health professionals. Further discussion is needed about whether these additional roles should be recognized and promoted as part of their work since they are important and there is no one else to take them on. Interpreters who take on the additional roles related to integration have the potential to be important actors in health care services whose patient populations that are increasingly linguistically and culturally diverse.

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