Health Care Needs of Children in the Foster Care System

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 909-918 ◽  
Author(s):  
Mark D. Simms ◽  
Howard Dubowitz ◽  
Moira A. Szilagyi
Keyword(s):  
Health Care ◽  
Foster Care ◽  
Parent Education ◽  
Continuity Of Care ◽  
Care Delivery ◽  
Well Being ◽  
The United States ◽  
Developmental Problems ◽  
Children In Foster Care ◽  
The Impact

Nearly 750 000 children are currently in foster care in the United States. Recent trends in foster care include reliance on extended family members to care for children in kinship care placements, increased efforts to reduce the length of placement, acceleration of termination of parental rights proceedings, and emphasis on adoption. It is not clear what impact welfare reform may have on the number of children who may require foster care placement. Although most children enter foster care with medical, mental health, or developmental problems, many do not receive adequate or appropriate care while in placement. Psychological and emotional problems, in particular, may worsen rather than improve. Multiple barriers to adequate health care for this population exist. Health care practitioners can help to improve the health and well-being of children in foster care by performing timely and thorough admission evaluations, providing continuity of care, and playing an active advocacy role. Potential areas for health services research include study of the impact of different models of health care delivery, the role of a medical home in providing continuity of care, the perception of the foster care experience by the child, children's adjustment to foster care, and foster parent education on health outcomes.

Direct Primary Care: A Successful Financial Model for the Clinical Practice of Lifestyle Medicine

2021 ◽  
pp. 155982762110066
Author(s):  
Amy R. Mechley
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Well Being ◽  
The United States ◽  
Fee For Service ◽  
Financial Model ◽  
Lifestyle Medicine ◽  
Direct Primary

Primary care has been shown to significantly decrease the overall cost of a population’s health care while improving the quality of each person’s well-being. Lifestyle medicine (LM) is ideally positioned to be delivered via primary care and has been shown to improve short- and long-term health outcomes of patients and populations. Direct primary care (DPC) represents a viable alternative to the fee-for-service reimbursement model. It has been shown to be economically and financially sustainable. Furthermore, it has the potential to fulfill the Quadruple Aim of health care in the United States. LM practiced in a DPC model has the potential to transform health care delivery. This article will discuss the need for health care systems change, provide an overview of the DPC model, demonstrate a basic understanding of the benefits, and review the steps needed to de-risk the investment of time, money, and resources for our future DPC providers.

Health Care of Foster Children

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 644-646 ◽  
Author(s):  
Keyword(s):  
Social Support ◽  
Health Care ◽  
Foster Care ◽  
Foster Children ◽  
Formal Education ◽  
Well Being ◽  
High Rate ◽  
Best Interests ◽  
Social Service Agencies ◽  
Developmental Problems

Children entering foster care generally have a higher than average number of health problems, and the care they receive is usually insufficient to meet their needs. These circumstances arise from the preplacement history of these children and from within the dual systems of foster care and publicly funded health care to which responsibility for their well-being is assigned. BACKGROUND Children enter foster care because their parents are unwilling or unable to provide for their physical and emotional needs. Most often, these children come from single-parent households where poverty, lack of formal education, and absence of social support contribute to inadequate and inappropriate child care. More than 80% of the children have experienced physical or sexual abuse and/or neglect. Their previous health care is likely to have been fragmented. As a consequence, foster children are likely to have unrecognized or untreated chronic disorders, a high rate of emotional and developmental problems, and impaired school performance. Placement of children into foster care is ordinarily a court-ordered process used when the application of resources by social service agencies fail to, or appear unlikely to, improve a home situation deemed detrimental to the children's well-being. Foster care is intended to be a planned temporary service designed to strengthen families and to enhance the quality of life for children. The imposed separation of children from parents is a decision intended to be based on the best interests of the children. It is to be an opportunity for families to receive the social support and counsel they require to be reconstituted.

scholarly journals Perspectives on the COVID-19 pandemic impact on cardio-oncology: results from the COVID-19 International Collaborative Network survey

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Diego Sadler ◽  
◽  
Jeanne M. DeCara ◽  
Joerg Herrmann ◽  
Anita Arnold ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
The United States ◽  
Medical Professional ◽  
Collaborative Network ◽  
Care Providers ◽  
Future Health ◽  
Professional Societies ◽  
The Impact

Abstract Background Re-allocation of resources during the COVID-19 pandemic has resulted in delays in care delivery to patients with cardiovascular disease and cancer. The ability of health care providers to provide optimal care in this setting has not been formally evaluated. Objectives To assess the impact of COVID-19 resource re-allocation on scheduling, testing, elective procedures, telemedicine access, use of new COVID-19 therapies, and providers’ opinions on healthcare policies among oncology and cardiology practitioners. Methods An electronic survey was conducted by a cardio-oncology collaborative network through regional and state chapters of the American College of Cardiology, American Society of Clinical Oncology, and the International Cardio-Oncology Society. Descriptive statistics were reported by frequency and proportion for analyses, and stratified categorically by geographic region and specialty. Results One thousand four hundred fifteen providers (43 countries) participated: 986 cardiologists, 306 oncologists, and 118 trainees/internal medicine. 63% (195/306) of oncologists vs 92% (896/976) of cardiologists reported cancellations of treatments/elective procedures (p = 0.01). 46% (442/970) of cardiologists and 25% (76/303) of oncologists modified the scope of their practice (p = < 0.001). Academic physicians (74.5%) felt better supplied with personal protective equipment (PPE) vs non-academic (74.5% vs 67.2%; p = 0.018). Telemedicine was less common in Europe 81% (74/91), and Latin America 64% (101/158), than the United States, 88% (950/1097) (p = < 0.001). 95% of all groups supported more active leadership from medical professional societies. Conclusions These results support initiatives to promote expanded coverage for telemedicine, increased access to PPE, better testing availability and involvement of medical professional societies to help with preparedness for future health care crisis.

scholarly journals The Impact of Invisibility on the Health of Migrant Farmworkers in the Southeastern United States: A Case Study from Georgia

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Kari M. Bail ◽  
Jennifer Foster ◽  
Safiya George Dalmida ◽  
Ursula Kelly ◽  
Maeve Howett ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Educational System ◽  
Subjective Experience ◽  
Social Systems ◽  
Well Being ◽  
The United States ◽  
Migrant Farmworkers ◽  
The Impact

Migrant farmworkers represent one of the most marginalized and underserved populations in the United States. Acculturation theory cannot be easily mapped onto the transnational experience of migrant farmworkers, who navigate multiple physical and cultural spaces yearly, and who are not recognized by the state they constitute, “the Citizen’s Other” (Kerber, 2009). This paper utilizes narrative analysis of a case study to illustrate, through the relationship of the narrator to migrant farmworkers and years of participant observation by the coauthors, how isolation from family and community, as well as invisibility within institutions, affect the health and well-being of migrant farmworkers in southeastern Georgia. Invisibility of farmworkers within institutions, such as health care, the educational system, social services, domestic violence shelters, and churches contribute to illness among farmworkers. The dominant American discourse surrounding immigration policy addresses the strain immigrants put on the social systems, educational system, and the health care system. Nurses who work with farmworkers are well positioned to bring the subjective experience of farmworkers to light, especially for those engaged with socially just policies. Those who contribute to the abundant agricultural produce that feeds Americans deserve the recognition upon which social integration depends.

The Changing Health Care Environment: Implications for Residency Training

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_3) ◽  
pp. 795-804 ◽  
Author(s):  
Seth Frazier ◽  
Daniel Hyman ◽  
Steven Altschuler
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Delivery System ◽  
Care Delivery ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Pediatric Care ◽  
Health Care Environment ◽  
The Impact

Throughout the United States, the growth of managed care is forcing pediatric providers (physicians and hospitals) to reconstruct and integrate the health care delivery system with a focus away from the academic center and toward the community. Managed care also is forcing new financing approaches geared toward the assumption of economic risk for patient management and utilization of services. Radical changes in pediatric training programs will be necessary to accommodate the strategic and operational changes being pursued in response to these evolving market forces. These changes, while disruptive, will strengthen the breadth and diversity of graduate medical education and will better prepare trainees for the new delivery system in which they will practice. In this article, we examine how the evolution of managed care is redefining the basic financial and organizational framework for pediatric care and the implications of this redefinition for children's hospitals and academic medical center-based pediatric programs. We draw on our experience in the greater Philadelphia market to illustrate the impact of these changes and discuss one pediatric system's response. Finally, we review the educational opportunities provided by these changes.

scholarly journals A national study of the impact of outpatient mental health services for children in long-term foster care

2010 ◽  
Vol 15 (4) ◽  
pp. 467-479 ◽  
Author(s):  
Jennifer L. Bellamy ◽  
Geetha Gopalan ◽  
Dorian E. Traube
Keyword(s):  
Mental Health ◽  
Foster Care ◽  
Mental Health Services ◽  
Health Services ◽  
The United States ◽  
Internalizing Behavior ◽  
Outpatient Mental Health ◽  
Children In Foster Care ◽  
The Impact

Despite the tremendous mental health need evidenced by children in foster care and high rates of use of mental health services among children in foster care, little is known about the impact of outpatient mental health services on the behavioral health of this population. This study utilizes data from the National Survey of Child and Adolescent Well-being (NSCAW), the first nationally representative study of child welfare in the United States. A subsample of 439 children who have experienced long-term foster care were included in this study. These data were used to estimate the impact of outpatient mental health services on the externalizing and internalizing behavior problems of children in long-term foster care. A propensity score matching model was employed to produce a robust estimate of the treatment effect. Results indicate that children who have experienced long-term foster care do not benefit from the receipt of outpatient mental health services. Study results are discussed in the context of earlier research on the quality of mental health services for children in foster care.

Revisiting the Fetal Assault Law in Tennessee: Implications and the Way Forward

2021 ◽  
pp. 152715442198999
Author(s):  
Caroline K. Darlington ◽  
Peggy A. Compton ◽  
Sadie P. Hutson
Keyword(s):  
United States ◽  
Health Care ◽  
Drug Use ◽  
Health Care Providers ◽  
Well Being ◽  
The United States ◽  
Care Providers ◽  
Opioid Use ◽  
The Impact ◽  
In Pregnancy

The rising prevalence of opioid use disorder (OUD) among those living in the United States has demanded a collaborative response from health care and policy spheres. Addressing OUD among pregnant women is especially difficult, given the controversies surrounding the medical and ethical balance between meeting maternal versus fetal/newborn needs. Most medical organizations discourage the criminalization of drug use in pregnancy due to the adverse public health outcomes of such an approach. Despite this recommendation, many states continue to use punitive law to address drug use in pregnancy. In 2014, the Fetal Assault Law in Tennessee (TN) became the first law in the United States to directly allow women to be prosecuted for drug use in pregnancy. Since its expiration in 2016, this law has been re-introduced several times to the TN legislature in support of permanent implementation. This article outlines the impact of the initial Fetal Assault Law on maternal/newborn health in TN and provides alternative immediate, short-term, and long-term health policy strategies through which health care providers and legislators can better advocate for the well-being of both mothers with OUD and their infants.

scholarly journals Improving American Healthcare Through “Clinical Lab 2.0”

2017 ◽  
Vol 4 ◽  
pp. 237428951770106 ◽  
Author(s):  
James M. Crawford ◽  
Khosrow Shotorbani ◽  
Gaurav Sharma ◽  
Michael Crossey ◽  
Tarush Kothari ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Laboratory ◽  
Care Delivery ◽  
The United States ◽  
Evidence Base ◽  
Cost Of Care ◽  
Laboratory Diagnostics ◽  
Santa Fe ◽  
Clinical Laboratories ◽  
The Impact

Project Santa Fe was established both to provide thought leadership and to help develop the evidence base for the valuation of clinical laboratory services in the next era of American healthcare. The participants in Project Santa Fe represent major regional health systems that can operationalize laboratory-driven innovations and test their valuation in diverse regional marketplaces in the United States. We provide recommendations from the inaugural March 2016 meeting of Project Santa Fe. Specifically, in the transition from volume-based to value-based health care, clinical laboratories are called upon to provide programmatic leadership in reducing total cost of care through optimization of time-to-diagnosis and time-to-effective therapeutics, optimization of care coordination, and programmatic support of wellness care, screening, and monitoring. This call to action is more than working with industry stakeholders on the basis of our expertise; it is providing leadership in creating the programs that accomplish these objectives. In so doing, clinical laboratories can be effectors in identifying patients at risk for escalation in care, closing gaps in care, and optimizing outcomes of health care innovation. We also hope that, through such activities, the evidence base will be created for the new value propositions of integrated laboratory networks. In the very simplest sense, this effort to create “Clinical Lab 2.0” will establish the impact of laboratory diagnostics on the full 100% spend in American healthcare, not just the 2.5% spend attributed to in vitro diagnostics. In so doing, our aim is to empower regional and local laboratories to thrive under new models of payment in the next era of American health care delivery.

scholarly journals The Impact of Attitudes and Behaviors on Nurse Satisfaction, Well-being, and Outcomes of Patient Care

2020 ◽  
pp. 15-17
Author(s):  
Alan H Rosenstein
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Well Being ◽  
Care Providers ◽  
Health Care Environment ◽  
Attitudes And Behaviors ◽  
And Behaviors ◽  
The Impact

Healthcare is a complex multidimensional system that depends upon effective communication and collaboration amongst all members of the health care team as the key ingredient for best patient care. In the current health care environment all health care providers are feeling the growing pressures on care delivery and the changing health dynamics which in many instances has negatively impacted their attitudes and behaviors toward medical care. Nursing is a key part of this process. In order to provide best patient care, affiliated organizations need to recognize how important staff satisfaction and engagement is to care continuity and provide the necessary resources and support to maintain staff physical, emotional, and behavioral well- being. The aim of the article is to review key literature findings to help organizations recognize the causes and consequences of stress and burnout and the importance of providing the appropriate support and resources to help nurses succeed.

scholarly journals The COVID-19 Pandemic Impact on Cardio-Oncology: Results From the COVID-19 International Collaborative Network Survey.

2020 ◽  
Author(s):  
Diego Sadler ◽  
Jeanne M. DeCara ◽  
Joerg Herrmann ◽  
Anita Arnold ◽  
Arjun K. Ghosh ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
The United States ◽  
Medical Professional ◽  
Collaborative Network ◽  
Care Providers ◽  
Future Health ◽  
Professional Societies ◽  
The Impact

Abstract BackgroundRe-allocation of resources during the COVID-19 pandemic has resulted in delays in care delivery to patients with cardiovascular disease and cancer. The ability of health care providers to provide optimal care in this setting has not been formally evaluated.ObjectivesTo assess the impact of COVID-19 resource re-allocation on scheduling, testing, elective procedures, telemedicine access, use of new COVID-19 therapies, and providers’ opinions on healthcare policies among oncology and cardiology practitioners.MethodsAn electronic survey was conducted by a cardio-oncology collaborative network through regional and state chapters of the American College of Cardiology , American Society of Clinical Oncology, and the International Cardio-Oncology Society. Descriptive statistics were reported by frequency and proportion for analyses, and stratified categorically by geographic region and specialty.Results1,415 providers (43 countries) participated: 986 cardiologists, 306 oncologists, and 118 trainees/internal medicine. 63% (195/306) of oncologists vs 92% (896/976) of cardiologists reported cancellations of treatments/elective procedures (p=0.01). 46% (442/970) of cardiologists and 25% (76/303) of oncologists modified the scope of their practice (p=<0.001). Academic physicians (74.5%) felt better supplied with personal protective equipment (PPE) vs non-academic (74.5% vs 67.2%; p=0.018). Telemedicine was less common in Europe 81% (74/91), and Latin America 64% (101/158), than the United States, 88% (950/1,097) (p=<0.001). 95% of all groups supported more active leadership from medical professional societies.ConclusionsThese results support initiatives to promote expanded coverage for telemedicine, increased access to PPE, better testing availability and involvement of medical professional societies to help with preparedness for future health care crisis.Appendix: Link to the Survey: https://www.surveymonkey.com/r/C8ZDYNW

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