scholarly journals Assessment of Continuity of Care among Patients with Multiple Chronic Conditions in Italy

PLoS ONE ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. e0154940 ◽  
Author(s):  
Francesco Napolitano ◽  
Paola Napolitano ◽  
Luca Garofalo ◽  
Marianna Recupito ◽  
Italo F. Angelillo
Keyword(s):  
Continuity Of Care ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions

Nurses’ Experiences of Transitional Care in Multiple Chronic Conditions

2021 ◽  
pp. 108482232110021
Author(s):  
Alireza Nikbakht Nasrabadi ◽  
Leila Mardanian Dehkordi ◽  
Fariba Taleghani
Keyword(s):  
Patient Safety ◽  
Data Collection ◽  
Continuity Of Care ◽  
Chronic Conditions ◽  
Transitional Care ◽  
Major Elements ◽  
Study Data ◽  
Multiple Chronic Conditions ◽  
University Hospitals ◽  
Levels Of Care

Transitional care is a designed plan to ensure the continuity of care received by patients as they transfer between different locations or levels of care. The aim of this paper is to explore nurses’ experiences of transitional care in multiple chronic conditions. A qualitative method with a conventional content analysis approach was utilized. The study was conducted at university hospitals in 2 big cities (Isfahan and Tehran) of Iran. This study is performed from November 2018 to December 2019 using deep, semi-structured, and face-to-face interviews which are focused on nurses’ experiences of transitional care. Data collection continued until saturation was reached. Finally, 15 nurses take part in this study. Data collection and data analysis were conducted concurrently. Data were analyzed using Graneheim and Lundman’s techniques. Two main themes providing a descriptive summary of the major elements of transitional care identified: “threat to patient safety” and “Care breakdown”. Findings showed an exclusive image of unsafe transitional care which was done unplanned without appropriate delegating care to family and threat patient safety. There is still a gap in the transition from hospital to home. Nursing managers can address this issue by creating a culture of teamwork, training competent nurses by continuum education, and more supervision of nursing care. Policymakers can ensure continuity of care by developing policies and programs about transitional care.

scholarly journals Emergency Department Utilization among Underserved African American Older Adults in South Los Angeles

2019 ◽  
Vol 16 (7) ◽  
pp. 1175 ◽  
Author(s):  
Mohsen Bazargan ◽  
James Smith ◽  
Sharon Cobb ◽  
Lisa Barkley ◽  
Cheryl Wisseh ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
African American ◽  
Los Angeles ◽  
Continuity Of Care ◽  
Chronic Conditions ◽  
Male Gender ◽  
Multiple Chronic Conditions ◽  
South Los Angeles ◽  
Ed Visits

Objectives: Using the Andersen’s Behavioral Model of Health Services Use, we explored social, behavioral, and health factors that are associated with emergency department (ED) utilization among underserved African American (AA) older adults in one of the most economically disadvantaged urban areas in South Los Angeles, California. Methods: This cross-sectional study recruited a convenience sample of 609 non-institutionalized AA older adults (age ≥ 65 years) from South Los Angeles, California. Participants were interviewed for demographic factors, self-rated health, chronic medication conditions (CMCs), pain, depressive symptoms, access to care, and continuity of care. Outcomes included 1 or 2+ ED visits in the last 12 months. Polynomial regression was used for data analysis. Results: Almost 41% of participants were treated at an ED during the last 12 months. In all, 27% of participants attended an ED once and 14% two or more times. Half of those with 6+ chronic conditions reported being treated at an ED once; one quarter at least twice. Factors that predicted no ED visit were male gender (OR = 0.50, 95% CI = 0.29–0.85), higher continuity of medical care (OR = 1.55, 95% CI = 1.04–2.31), individuals with two CMCs or less (OR = 2.61 (1.03–6.59), second tertile of pain severity (OR = 2.80, 95% CI = 1.36–5.73). Factors that predicted only one ED visit were male gender (OR = 0.45, 95% CI = 0.25–0.82), higher continuity of medical care (OR = 1.39, 95% CI = 1.01–2.15) and second tertile of pain severity (OR = 2.42, 95% CI = 1.13–5.19). Conclusions: This study documented that a lack of continuity of care for individuals with multiple chronic conditions leads to a higher rate of ED presentations. The results are significant given that ED visits may contribute to health disparities among AA older adults. Future research should examine whether case management decreases ED utilization among underserved AA older adults with multiple chronic conditions and/or severe pain. To explore the generalizability of these findings, the study should be repeated in other settings.

scholarly journals Continuity of care and multiple chronic conditions impact frequent use of outpatient services

2019 ◽  
Vol 26 (1) ◽  
pp. 318-327 ◽  
Author(s):  
Chi Wang ◽  
Hsiao-Ching Kuo ◽  
Su-Fen Cheng ◽  
Jui-Lan Hung ◽  
Jia-Hui Xiong ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Chronic Conditions ◽  
Quality Care ◽  
Outpatient Service ◽  
Emergency Department Visits ◽  
Multiple Chronic Conditions ◽  
Outpatient Services ◽  
Frequent Use ◽  
Catastrophic Illness ◽  
Care Index

This study investigated the association between care continuity and chronic conditions in relation to highly frequent use of outpatient service in order to find constructive suggestions to bring efficient, high-quality care for patients with multiple chronic conditions. The National Health Insurance database was used and 333,294 patients were identified from 2007 to 2009. The continuity of care index indicates the dispersion of a patient’s ambulatory visits among providers. Multivariate logistic regression was used to estimate adjusted odds ratios with 95 percent confidence intervals. Continuity of care index was significantly associated with age, sex, urbanization level, socioeconomic status, emergency department visits, hospitalization, psychological disorders, chronic diseases, and catastrophic illness card; those with low continuity of care index were likely to use outpatient care highly frequently. Improving continuity of care is fundamental, and the best way is to advance the practice of family medicine for primary care.

Opportunities to optimize ehealth technology for patients with multiple chronic conditions

2013 ◽  
Author(s):  
Donna M. Zulman ◽  
Emily Jenchura ◽  
Danielle Cohen ◽  
Eleanor Lewis ◽  
Steven M. Asch
Keyword(s):  
Chronic Conditions ◽  
Multiple Chronic Conditions

GPS' PERCEPTION OF THE PATIENT ORIENTED INTERVENTIONS AS KEY ELEMENTS OF PATIENT CENTRED CARE FOR PEOPLE WITH MULTIMORBIDITY.pdf

2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
Chronic Conditions ◽  
Patient Centered Care ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Positive Health ◽  
Patient Centered ◽  
Effective Response ◽  
Patient Centred Care ◽  
Centered Care ◽  
Health Related

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.

scholarly journals Using Electronic Medical Records and Health Claim Data to Develop a Patient Engagement Score for Patients With Multiple Chronic Conditions: An Exploratory Study

2021 ◽  
Vol 8 ◽  
pp. 237437352098148
Author(s):  
Surachat Ngorsuraches ◽  
Semhar Michael ◽  
Nabin Poudel ◽  
Gemechis Djira ◽  
Emily Griese ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Patient Engagement ◽  
Medical Records ◽  
Chronic Conditions ◽  
Claim Data ◽  
Hospital Charges ◽  
Multiple Chronic Conditions ◽  
Health Claim ◽  
Study Objective ◽  
Health Related

The study objective was to (1) develop a statistical model that creates a novel patient engagement score (PES) from electronic medical records (EMR) and health claim data, and (2) validate this developed score using health-related outcomes and charges of patients with multiple chronic conditions (MCCs). This study used 2014-16 EMR and health claim data of patients with MCCs from Sanford Health. Patient engagement score was created based on selected patients’ engagement behaviors using Gaussian finite mixture model. The PES was validated using multiple logistic and linear regression analyses to examine the associations between the PES and health-related outcomes, and hospital charges, respectively. Patient engagement score was generated from 5095 patient records and included low, medium, and high levels of patient engagement. The PES was a significant predictor for low-density lipoprotein, emergency department visit, hemoglobin A1c, estimated glomerular filtration rate, hospitalization, and hospital charge. The PES derived from patient behaviors recorded in EMR and health claim data can potentially serve as a patient engagement measure. Further study is needed to refine and validate the newly developed score.

scholarly journals Innovative Strategies to Facilitate Patient-Centered Research in Multiple Chronic Conditions

2021 ◽  
Vol 10 (10) ◽  
pp. 2112
Author(s):  
Tullika Garg ◽  
Courtney A. Polenick ◽  
Nancy Schoenborn ◽  
Jane Jih ◽  
Alexandra Hajduk ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Clinical Care ◽  
Intervention Development ◽  
Healthcare Services ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Older Americans ◽  
Innovative Strategies ◽  
Department Of Health ◽  
Innovative Methods

Multiple chronic conditions (MCC) are one of today’s most pressing healthcare concerns, affecting 25% of all Americans and 75% of older Americans. Clinical care for individuals with MCC is often complex, condition-centric, and poorly coordinated across multiple specialties and healthcare services. There is an urgent need for innovative patient-centered research and intervention development to address the unique needs of the growing population of individuals with MCC. In this commentary, we describe innovative methods and strategies to conduct patient-centered MCC research guided by the goals and objectives in the Department of Health and Human Services MCC Strategic Framework. We describe methods to (1) increase the external validity of trials for individuals with MCC; (2) study MCC epidemiology; (3) engage clinicians, communities, and patients into MCC research; and (4) address health equity to eliminate disparities.

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