Transformacion Para Salud: A Patient Navigation Model for Chronic Disease Self-management

2012 ◽  
Vol 17 (2) ◽  
Author(s):  
Christina Esperat ◽  
Debra Flores ◽  
Linda McMurry ◽  
Du Feng ◽  
Huaxin Song ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Health Care Services ◽  
Patient Navigation ◽  
Health Workers ◽  
Underserved Populations ◽  
Cost Effective ◽  
Self Management ◽  
Patient Navigator ◽  
Demonstration Program

Increased cost of chronic illnesses in United States is an urgent call to develop a cost effective approach to improve chronic disease self-management, especially among vulnerable populations. An emerging role for professionals and paraprofessionals is the patient navigator. We present an example of a conceptual framework, Transformation for Health, developed to underpin the training of certified community health workers (CHW) to deliver health care, preventive services, and health education for underserved populations to promote chronic disease self-management. Transformacion Para Salud (TPS), a patient navigation model for chronic disease self-management, was a two year demonstration program to develop a culturally sensitive intervention to facilitate patient behavior changes. Patients involved in the TPS intervention showed improvements in clinical and behavioral outcomes after twelve months of intervention. This article describes the conceptual basis and implementation of the TPS and discusses program evaluation, specific intervention outcomes, and implications for practice. Use of CHWs in the patient navigator role demonstrated a cost effective method to improve access to quality, cost-effective, primary health care services as well as to facilitate chronic disease self-management.

scholarly journals The Chronic Disease Self-Management Program: the experience of frequent users of health care services and peer leaders

2016 ◽  
Vol 33 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Catherine Hudon ◽  
Maud-Christine Chouinard ◽  
Fatoumata Diadiou ◽  
Danielle Bouliane ◽  
Mireille Lambert ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Health Care Services ◽  
Management Program ◽  
Self Management ◽  
Peer Leaders ◽  
Frequent Users ◽  
Care Services

Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review

2013 ◽  
Vol 19 (1) ◽  
pp. 14 ◽  
Author(s):  
Janny Goris ◽  
Nera Komaric ◽  
Amanda Guandalini ◽  
Daniel Francis ◽  
Ellen Hawes
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Health Workers ◽  
Linguistically Diverse ◽  
Chronic Disease Prevention ◽  
Culturally And Linguistically Diverse ◽  
Self Management ◽  
Primary Health ◽  
Multicultural Health

With a large and increasing culturally and linguistically diverse (CALD) population, the Australian health care system faces challenges in the provision of accessible culturally competent health care. Communities at higher risk of chronic disease include CALD communities. Overseas, multicultural health workers (MHWs) have been increasingly integrated in the delivery of culturally relevant primary health care to CALD communities. The objective of this systematic review was to examine the effectiveness of MHW interventions in chronic disease prevention and self-management in CALD populations with the aim to inform policy development of effective health care in CALD communities in Australia. A systematic review protocol was developed and computerised searches were conducted of multiple electronic databases from 1 January 1995 until 1 November 2010. Thirty-nine studies were identified including 31 randomised controlled trials. Many of the studies focussed on poor and underserved ethnic minorities. Several studies reported significant improvements in participants’ chronic disease prevention and self-management outcomes and meta-analyses identified a positive trend associated with MHW intervention. Australian Government policies express the need for targeted inventions for CALD communities. The broader systemic application of MHWs in Australian primary health care may provide one of the most useful targeted interventions for CALD communities.

India’s Frontline Health Workforce: Theoretical Perspectives and Operational Challenges

2016 ◽  
Vol 2 (1) ◽  
pp. 39-44
Author(s):  
Prakash Babu Kodali
Keyword(s):  
Health Care ◽  
Health Workforce ◽  
Health Workers ◽  
Underserved Populations ◽  
Cost Effective ◽  
Physician Assistants ◽  
Care Providers ◽  
Theoretical Concepts ◽  
Theoretical Perspectives ◽  
Wide Range

FHWs are among the most utilized health workforce in majority of LMIC especially in India. Effective use of the FHWs was considered instrumental in the provision of Primary health care (PHC) and the potency of FHW was recognized to be essential to achieve the targets of MDG. FHWs consists of a wide range of health workers such as CHWs, Mid-level care providers, Physician-assistants, Nurses, Doctors etc., who are most of the time the first level contact of the health system to the people, majorly engaged in provision of PHC and the services focusing on disease prevention and health promotion. Unlike the most of FHWs the CHWs are the group of FHWs whose potency is greatly explored and well documented since there conception in 1950’s as barefoot doctors in china. FHWs by itself is a wide area of research and this review does not talk much about already well known areas in frontline health workers. The review is split in to two parts with first part talking about the theoretical perspectives in-terms of FHWs and second part talks about operational challenges. First part focuses much on other theoretical concepts in FHWs such as Task-shifting, Public-health nurses and mid-level care providers etc., which are not very much known, compared to their counter parts and majority of the times ignored. The second part of the review has its emphasis on the prime operational challenges which are faced by the FHWs. By summing-up the majority of literature related to the different theoretical concepts in the area of FHW it reflects on the options available to provide efficient health care to the underserved populations and the challenges being faced while dealing with FHWs. It could be helpful in guiding the planning and implementation of sustainable, holistic and cost effective interventions to provide universal PHC.

scholarly journals Structure and Distribution of Health Care Costs across Age Groups of Patients with Multimorbidity in Lithuania

2021 ◽  
Vol 18 (5) ◽  
pp. 2767
Author(s):  
Laura Nedzinskienė ◽  
Elena Jurevičienė ◽  
Žydrūnė Visockienė ◽  
Agnė Ulytė ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Disease ◽  
National Health Insurance ◽  
Health Care Services ◽  
Age Groups ◽  
Age Group ◽  
Resource Usage ◽  
Care Services ◽  
Care Costs

Background. Patients with multimorbidity account for ever-increasing healthcare resource usage and are often summarised as big spenders. Comprehensive analysis of health care resource usage in different age groups in patients with at least two non-communicable diseases is still scarce, limiting the quality of health care management decisions, which are often backed by limited, small-scale database analysis. The health care system in Lithuania is based on mandatory social health insurance and is covered by the National Health Insurance Fund. Based on a national Health Insurance database. The study aimed to explore the distribution, change, and interrelationships of health care costs across the age groups of patients with multimorbidity, suggesting different priorities at different age groups. Method. The study identified all adults with at least one chronic disease when any health care services were used over a three-year period between 2012 and 2014. Further data analysis excluded patients with single chronic conditions and further analysed patients with multimorbidity, accounting for increasing resource usage. The costs of primary, outpatient health care services; hospitalizations; reimbursed and paid out-of-pocket medications were analysed in eight age groups starting at 18 and up to 85 years and over. Results. The study identified a total of 428,430 adults in Lithuania with at least two different chronic diseases from the 32 chronic disease list. Out of the total expenditure within the group, 51.54% of the expenses were consumed for inpatient treatment, 30.90% for reimbursed medications. Across different age groups of patients with multimorbidity in Lithuania, 60% of the total cost is attributed to the age group of 65–84 years. The share in the total spending was the highest in the 75–84 years age group amounting to 29.53% of the overall expenditure, with an increase in hospitalization and a decrease in outpatient services. A decrease in health care expenses per capita in patients with multimorbidity after 85 years of age was observed. Conclusions. The highest proportion of health care expenses in patients with multimorbidity relates to hospitalization and reimbursed medications, increasing with age, but varies through different services. The study identifies the need to personalise the care of patients with multimorbidity in the primary-outpatient setting, aiming to reduce hospitalizations with proactive disease management.

Telemedicine During A Crisis: Challenges, Opportunities & Way Forward At A Tertiary Care Hospital (Preprint)

2021 ◽  
Author(s):  
Sadia Masood ◽  
Zanaib Samad ◽  
Sarah Nadeem ◽  
Unzela Ghulam
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Successful Implementation ◽  
Care Hospital ◽  
Quality Health Care ◽  
Cross Sectional ◽  
Innovative Strategy

BACKGROUND Telemedicine is utilized to deliver health care services remotely. Recently, it is well established due to pandemics because it can help the patients get required supportive care while minimizing their hospital exposure. In the future, it will continue to be used as a convenient, cost-effective patient care modality. OBJECTIVE The objectives were to identify physicians' challenges during teleconsultations and recognize the opportunities and strengths of this modality during the pandemic in a lower-income country. METHODS This cross-sectional study was conducted in a tertiary care hospital. The self-made questionnaire was filled through an online medium and responses were recorded on a five-point Likert scale. RESULTS A total of 83 participants were enrolled in this study. Most of them were Associate professors (29.8%), Assistant professors (26.2%), the ratio of the females was (52.4%) greater than males (,47.6%). 46 (54.8%) have laid between the age group 30-40 years. Pediatricians and senior instructors faced more difficulty in using telemedicine. The ones having clinical experience of fewer than 15 years or categorized in the age of 50-60 years faced challenges while using this modality. CONCLUSIONS During the current pandemic, situation telemedicine is the only glimmer of light to provide better quality health care. Telemedicine is an innovative strategy and it is important to understand the perception of physicians about it. Incomplete and inadequate infrastructure and attitude of the physicians is the main obstacle toward successful implementation of telemedicine. Successful installation and deployment of this technology require a complete grasp of the process among physicians.

scholarly journals Community Residents’ Awareness of Family Doctor Contract Services, Signing With Family Doctor, Willingness to Use Community Health Care Centers: A Community-Based Analysis in Shenzhen, China

2020 ◽  
Author(s):  
Qingming Zheng ◽  
Lu Shi ◽  
Tiantian Pang ◽  
Willie Leung
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Health Care Services ◽  
Family Doctor ◽  
Disease Status ◽  
Care Services ◽  
Community Health Care Centers ◽  
Primary Health Care Services ◽  
Willingness To Use ◽  
The Impact

Abstract Background: Family doctor contracted services (FDCS) began in China in 2016. Shenzhen, one of the most developed cities in China, implemented a family doctor (FD) policy in 2017. The objectives of this study were to identify the impact of the awareness of the FD and signing with a FD on health care seeking behavior, as well as the impact of chronic disease status on the awareness of FDs and signing with a FD. Methods: Cross-sectional secondary data based on residents living in Luohu district was used for analysis. Linear probability models (LPM) were used to determine the relationship between willingness to use community health care centers (CHCs) and awareness of the FDCS, as well as the association between willingness to use CHCs and signing with a FD. LPM was also used to estimate the association between chronic disease status and awareness of the FDCS, as well as the association between chronic disease status and signing with a FD.Results: Among 1205 adults included in analysis, 27% of the participants knew the FDCS, 5% signed with FD, and 20% had chronic disease. Both awareness of the FDCS and signing with a FD significantly increased the probability of using CHCs. The results indicated that participants with chronic disease were more likely to be aware of the FDCS and sign with a FD.Conclusions: Consequently, this study provided evidence that awareness of FDCS and signing with a FD had positive impact on utilization of primary health care services in the at community level. Also, individuals with chronic disease tend to use FDCS. More interventions to improve awareness of FDCS can help to increase the utilization of primary health care services.

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