Common Chronic Health Problems

2005 ◽  
pp. 591-600
PEDIATRICS ◽  
1996 ◽  
Vol 98 (5) ◽  
pp. 952-958 ◽  
Author(s):  
Paul W. Newacheck ◽  
Ruth E. K. Stein ◽  
Deborah Klein Walker ◽  
Steven L. Gortmaker ◽  
Karen Kuhlthau ◽  
...  

Objective. Children with chronic illnesses and disabilities are increasingly enrolling in managed care arrangements. Yet, the rapid expansion of managed care has unknown consequences for children with chronic conditions and disabilities. As managed care is likely to become the predominant mode of medical practice for children with chronic health problems, information gained from a thorough assessment of existing managed care models could be helpful in indicating adjustments and modifications that could result in improved outcomes for this population. The purpose of this article is to outline a new strategy for collecting needed information on the effects of managed care on children with chronic health problems. Methods. We reviewed the literature on the effects of managed care on children with chronic conditions and disabilities. We identified key domains relevant to monitoring and evaluating managed care for this population. Results. Two research approaches can provide helpful information for assessing the effects of managed care on children with chronic conditions. First, a monitoring strategy could be pursued in which enrollment trends in managed care, enrollee perceptions of access and satisfaction with care, and other general indicators of outcomes would be tracked over time using inexpensive and rapid turnaround data sources. Second, an evaluative strategy could be pursued using experimental or quasiexperimental designs, in which outcomes across a variety of domains for children with chronic conditions in managed care are compared with: (a) outcomes for the same children before enrollment in managed care; or (b) outcomes for similar children remaining in traditional fee-for-service settings. Evaluation and monitoring strategies should focus on outcomes in a number of domains including: (1) access to care; (2) utilization of services; (3) quality of care; (4) satisfaction with care; (5) expenditures for care; (6) health outcomes; and (7) family impact. Conclusion. Assessing outcomes that result from enrollment in managed care for children with chronic health problems presents a formidable challenge. The research strategy outlined in this article presents one approach to meeting that challenge. The monitoring and evaluation strategies described here would require commitment of additional resources on the part of government, private foundations, and/or health plans. Given the paucity of existing information and the stakes for children with chronic conditions and their families, investment of added resources in a comprehensive monitoring and evaluation strategy is essential.


2012 ◽  
Vol 11 (4) ◽  
pp. 19-26
Author(s):  
John R. Mikula, MA, CTRS, CSCS, HFS ◽  
Paul Smith, BS, CTRS, HFS

This article examines the benefits of the recreation therapy intervention leisure fitness and its potential for positively affecting the health and well being of those with chronic health problems. Working within a wide variety of settings, qualified recreation therapists facilitate a leisure-fitness (LF) process to promote endurance, strength, mobility, and psycho-social well being among consumers. This article provides a practical concept design for the development and implementation of a recreation therapy LF program.


2016 ◽  
Vol 3 (4) ◽  
pp. 367-370 ◽  
Author(s):  
Sydney X.X. Hu ◽  
Wai In Lei ◽  
Ka Kei Chao ◽  
Brian J. Hall ◽  
Siu Fung Chung

2005 ◽  
Vol 2 (4) ◽  
pp. 557-565 ◽  
Author(s):  
Michael S Goldstein ◽  
E. Richard Brown ◽  
Rachel Ballard-Barbash ◽  
Hal Morgenstern ◽  
Roshan Bastani ◽  
...  

This article examines the extent and correlates of complementary and alternative medicine (CAM) use among a population-based sample of California adults that is highly diverse in terms of sociodemographic characteristics and health status. As a follow-up to a state-wide health survey of 55 428 people, 9187 respondents were interviewed by phone regarding their use of 11 different types of CAM providers, special diets, dietary supplements, mind–body interventions, self-prayer and support groups. The sample included all participants in the initial survey who reported a diagnosis of cancer, all the non-white respondents, as well as a random sample of all the white respondents. The relation of CAM use to the respondents' demographic characteristics and health status is assessed. CAM use among Californians is generally high, and the demographic factors associated with high rates of CAM use are the same in California as have been found in other studies. Those reporting a diagnosis of cancer and those who report other chronic health problems indicate a similar level of visits to CAM providers. However, those with cancer are less likely to report using special diets, and more likely to report using support groups and prayer. Health status, gender, ethnicity and education have an independent impact upon CAM use among those who are healthy as well as those who report suffering from chronic health problems, although the precise relation varies by the type of CAM used.


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