PACE: An Interdisciplinary Community-Based Practice Opportunity for Pharmacists

2019 ◽  
Vol 34 (7) ◽  
pp. 439-443
Author(s):  
Jamie McCarrell
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Patient Advocacy ◽  
Health Care Expenditures ◽  
The Elderly ◽  
The United States ◽  
Community Based ◽  
Care Services ◽  
Care For The Elderly ◽  
Ample Opportunity

PACE programs (Programs of All-inclusive Care for the Elderly) across the United States provide a valuable service to older adults with a significant nursing need by allowing them to remain safely living in the community for as long as possible through the provision of extensive, community-based health care services to its participants. Clinical pharmacists have previously been underutilized in PACE, but ample opportunity exists to provide meaningful pharmacy services within PACE programs. Pharmacists working in PACE programs can expect to significantly impact clinical outcomes, health care expenditures, and patient advocacy.

Looking for Better Health in All the Wrong Places: The Road to “Equality” Hits a Dead End

2012 ◽  
Vol 40 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Tom Miller
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Health Care Services ◽  
The Elderly ◽  
The Road ◽  
Care Services ◽  
Care For The Elderly ◽  
Dead End ◽  
Path Dependent

I was initially assigned the working title, “Pursuing Equality in Health Care for the Elderly Is Futile.” I prefer to think of that particular dead end of health policy as one of listening to the wrong music for too long. Hence, this article reprises and revises the title song of the early 1980s movie, Urban Cowboy, but with Johnny Lee’s original lyrics adapted as “Looking for better health [rather than either ‘love’ or ‘love of equality’] in all the wrong places.” The better goal is to achieve more progress in improving health for more people, including (but not limited to) the elderly. It need not be as futile as the pursuit of the elusive abstraction of “equality” for all — but only if we first move away from a path-dependent approach of recent times that remains too narrowly focused on statistical disparities in health care services received by particular groups.

scholarly journals Nothing but Trouble: Studies on the Effects of Reforms in Elderly Care in Sweden and Poland

2013 ◽  
Vol 6 (1) ◽  
pp. 31-60 ◽  
Author(s):  
Iwona Sobis
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Practical Implication ◽  
Elderly Care ◽  
The Elderly ◽  
Negative Effects ◽  
The Public ◽  
Care Services ◽  
Care For The Elderly ◽  
The Future

Abstract Reforms of the public sector, conducted in the spirit of NPM since the 1990s, are frequently studied by Western and Eastern scholars. The research shows national variations in how the NPM idea was translated and adapted into a country’s context and regulations. Care for the elderly is an interesting example of reforms conducted in the spirit of NPM, because it relates to welfare and health care and to the competences of provincial and local authorities in most European countries. This paper addresses the following questions: What do we know about the reforms conducted in the spirit of NPM and its practical implication within the field of care for the elderly during 1990 - 2010? What kind of knowledge about care for the elderly is still missing and should be developed in the future ? Th is paper conducts comparative research on what is known about the effects of the Swedish and the Polish reforms regarding care for the elderly. It argues that most literature points to negative effects, but also to the fact that there are still gaps in our knowledge about the effects of reforms concerning elderly care, especially regarding its organization. Hence, despite all the research done, we do not know what kind of social and health-care services for seniors represent the best practices for the future.

Prevalence and Costs of Chronic Conditions in the VA Health Care System

2003 ◽  
Vol 60 (3_suppl) ◽  
pp. 146S-167S ◽  
Author(s):  
Wei Yu ◽  
Arliene Ravelo ◽  
Todd H. Wagner ◽  
Ciaran S. Phibbs ◽  
Aman Bhandari ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Health Care Services ◽  
Health Care Expenditures ◽  
The United States ◽  
Fiscal Year ◽  
Department Of Veterans Affairs ◽  
Care Services ◽  
Average Patient ◽  
Va Health Care System

Chronic conditions are among the most common causes of death and disability in the United States. Patients with such conditions receive disproportionate amounts of health care services and therefore cost more per capita than the average patient. This study assesses the prevalence among the Department of Veterans Affairs (VA) health care users and VA expenditures (costs) of 29 common chronic conditions. The authors used regression to identify the marginal impact of these conditions on total, inpatient, outpatient, and pharmacy costs. Excluding costs of contracted medical services at non-VA facilities, total VA health care expenditures in fiscal year 1999 (FY1999) were $14.3 billion. Among the 3.4 million VA patients in FY1999, 72 percent had 1 or more of the 29 chronic conditions, and these patients accounted for 96 percent of the total costs ($13.7 billion). In addition, 35 percent (1.2 million) of VA health care users had 3 or more of the 29 chronic conditions. These individuals accounted for 73 percent of the total cost. Overall, VA health care users have more chronic diseases than the general population.

scholarly journals Timing of Home Health Care Initiation and 30-Day Rehospitalizations among Medicare Beneficiaries with Diabetes by Race and Ethnicity

2021 ◽  
Vol 18 (11) ◽  
pp. 5623
Author(s):  
Jamie M. Smith ◽  
Haiqun Lin ◽  
Charlotte Thomas-Hawkins ◽  
Jennifer Tsui ◽  
Olga F. Jarrín
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Race And Ethnicity ◽  
Health Care Services ◽  
Propensity Scores ◽  
The United States ◽  
Home Health ◽  
Medicare Beneficiaries ◽  
Timely Initiation ◽  
Care Services

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical and geographic variables, and neighborhood socioeconomic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to the patients who received home health care within the recommended first two days, the patients who received delayed services (3–7 days after discharge) had higher odds of rehospitalization (OR, 1.28; 95% CI, 1.25–1.32). Among the patients who received late services (8–14 days after discharge), the odds of rehospitalization were four times greater than among the patients receiving services within two days (OR, 4.12; 95% CI, 3.97–4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.

Revising the ERDs for the 21st Century

2021 ◽  
Vol 46 (8) ◽  
pp. 1-2
Author(s):  
John F. Brehany ◽  
Keyword(s):  
United States ◽  
Health Care ◽  
21St Century ◽  
Health Care Services ◽  
Care Delivery ◽  
The United States ◽  
Care Services ◽  
Moral Tradition ◽  
Modern Health Care ◽  
Catholic Health Care

Since their inception in 1948, The Ethical and Religious Directives for Catholic Health Care Services (ERDs) have guided Catholic health care ministries in the United States, aiding in the application of Catholic moral tradition to modern health care delivery. The ERDs have undergone two major revisions in that time, with about twenty years separating each revision. The first came in 1971 and the second came twenty-six years ago, in 1995. As such, a third major revision is due and will likely be undertaken soon.

Reaction of New Soviet Immigrants to Primary Health Care Services in Israel

1998 ◽  
Vol 28 (3) ◽  
pp. 555-574 ◽  
Author(s):  
Larissa I. Remennick ◽  
Naomi Ottenstein-Eisen
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
The Elderly ◽  
Medical Services ◽  
Structured Interviews ◽  
Cultural Aspects ◽  
Care Services ◽  
Israeli Population ◽  
Primary Health Care Services ◽  
Diverse Cultures

The post-1989 immigration wave from the former U.S.S.R. has increased the Israeli population by over 12 percent, seriously affecting the host health care system. This study draws on semi-structured interviews with the immigrants visiting outpatient clinics in the Tel-Aviv area in order to explore organizational and cultural aspects of their encounter with the Israeli medical services. While instrumental aspects of care were seen as an improvement over the Soviet standards, communication between providers and clients was seriously flawed, reflecting both a language barrier and diverse cultures of illness and cure. Many interviewees complained of the impersonal, “technical” attitude of Israeli physicians toward patients and the lack of holism in care, which they allegedly enjoyed before emigration. Some immigrant patients feel deprived of the paternalism of the Soviet medical system, complaining that Israeli providers “forego responsibility” for patients' health. A consumerist approach to medical services is also a novelty, and immigrants have to learn to be informed and assertive clients. Most problems are experienced by the elderly patients; overall, women seem to adjust to the new system better than men.

scholarly journals COMMUNITY-BASED HEALTH INSURANCE SCHEME IN A RURAL COMMUNITY OF NORTH WEST NIGERIA: A ROADMAP TO ACHIEVING UNIVERSAL HEALTH COVERAGE.

2020 ◽  
Vol 14 (2) ◽  
pp. 125-130
Author(s):  
Lawal A ◽  
◽  
Gobir AA ◽  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Health Insurance Scheme ◽  
Willingness To Participate ◽  
Insurance Scheme ◽  
Community Based ◽  
Quality Health Care ◽  
Community Based Health Insurance ◽  
Care Services

Background: Community Based Health Insurance (CBHI) scheme is aimed at reducing out of pocket spending on health care services, ensuring final risk protection to all, especially the poor and the most vulnerable, improvement of quality of health care services, access and utilization as well as the promotion of equity. Objective: This research was aimed at determining willingness to participate in a community-based health insurance scheme among rural households in Katsina State. Method: A cross-sectional descriptive study was conducted in December 2016 among households of Batagarawa LGA, Katsina State. We used a pre-tested, electronic, semi-structured interviewer-administered questionnaire to obtain data from households that were selected using a multistage sampling technique and we analyzed the data using STATA version 13. Results: Most, (28.5%) of the respondents were in the age range of 30-39 years with a mean age of 35.5 years. Males were the dominant household heads (93%). Most were married (90%). Most, (90.5%) of households were willing to pay for a community-based health insurance scheme with a median premium of 100 Naira per household member per month. Conclusions: The high proportion of households willing to pay for the scheme should inform the decision of policy makers to design and maintain Community Based Health Insurance Scheme to improve access to and utilization of quality health care services.

scholarly journals Primary health care services utilization and satisfaction among the elderly in Asir region, Saudi Arabia

2004 ◽  
Vol 10 (3) ◽  
pp. 365-371
Author(s):  
A. A. Mahfouz ◽  
A. I. Al Sharif ◽  
M. N. El Gamal ◽  
A. H. Kisha
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Elderly People ◽  
Health Care Services ◽  
Tertiary Care ◽  
The Elderly ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Long Time

Use of primary health care [PHC] services and satisfaction among elderly people [60 + years] in Asir was studied in 26 PHC centers. They visited PHC centers significantly less often than younger adults but they were referred significantly more often to secondary and tertiary care and for more laboratory tests. A r and om sample of 253 elderly people attending the centers was interviewed about accessibility, continuity, humaneness, informativeness and thoroughness of care. Overall, 79.0% were satisfied with the services provided. The leading 3 items of dissatisfaction were:not enough audiovisual means for health education [65.1%], long time spent in the centre [46.4%], and not enough specialty clinics [42.5%]

scholarly journals Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110535
Author(s):  
Nathan Wright ◽  
Marylee Scherdt ◽  
Michelle L. Aebersold ◽  
Marjorie C. McCullagh ◽  
Barbara R. Medvec ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care System ◽  
Health Care Services ◽  
Well Being ◽  
The United States ◽  
Full Time ◽  
Rural Residents ◽  
Care Services ◽  
Care System

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.

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