Erratum: Collaboration in the Time of COVID-19: Lessons for Community Shared Care Models

CAND Journal ◽  
2021 ◽  
Vol 28 (4) ◽  
pp. 18
Author(s):  
CAND Journal
Keyword(s):  
2021 ◽  
pp. 103985622110528
Author(s):  
Jeffrey C.L. Looi ◽  
Michelle Atchison ◽  
May Matias

Objective: We explore the previous research and current context regarding opportunities for shared-care partnerships between public and private psychiatric practice. Conclusions: Since the early 2000s, when there was impetus for the development of public-private psychiatric shared-care models as part of a previous National Mental Health Strategy, there has been surprisingly little research and policy development. Given an apparent exodus of psychiatrists to private practice due to current challenges facing the public health sector, it is timely to reconsider models of private and public sector shared-care that may improve the quality of public mental healthcare.


2021 ◽  
Author(s):  
Diego Pinheiro ◽  
Ryan Hartman ◽  
Jing Mai ◽  
Erick Romero ◽  
Saad Soroya ◽  
...  

Objectives: This study aimed to evaluate the impact of shared care networks on heart failure readmission rates. Background: Higher-than-expected heart failure (HF) readmissions affect half of US hospitals every year. The Hospital Reduction Readmission Program (HRRP) has reduced risk-adjusted readmissions, but it has also produced unintended consequences. Shared care models have been advocated for HF care, but the association of shared care networks with HF readmissions has never been investigated. Methods: We curated publicly available data on hospital discharges and HF excessive readmission ratios (ERRs) from hospitals in California between 2012 and 2017. Shared Care Areas (SCAs) were delineated as data-driven units of care coordination emerging from discharge networks. The localization index (LI), the proportion of patients who reside in the same SCA in which they are admitted, were calculated by year. Generalized estimating equations (GEE) were used to evaluate the association between the LI and the ERR of hospitals controlling for race/ethnicity and socioeconomics factors. Results: A total of 300 hospitals in California in a 6-yr period were included. The HF excessive readmission ratio (ERR) was negatively associated with the localization index (beta: -0.0474; 95% CI: -0.082 to -0.013). The percentage of Black residents within the SCAs was the only statistically significant covariate (beta: 0.4128; 95% CI: 0.302 to 0.524). Conclusions: Higher-than-expected HF readmissions were associated with shared care networks. Control mechanisms such as the HRRP may need to characterize and reward shared care to guide hospitals towards a more organized HF care system.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6006-6006
Author(s):  
Winson Y. Cheung ◽  
Anne Michelle Noone ◽  
Noreen Aziz ◽  
Julia Howe Rowland ◽  
Arnold L. Potosky ◽  
...  

6006 Background: There is increasing interest in developing more efficient and effective strategies for coordinating and delivering cancer and non-cancer related follow-up care to survivors. The objectives of this nationwide survey were to describe and compare US physician preferences for different cancer survivorship care models. Methods: The Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) was mailed to PCPs and oncologists in order to evaluate their views regarding physician responsibilities, knowledge levels about survivorship, and cancer follow-up testing. Using weighted univariate and multivariate models, we analyzed PCPs’ and oncologists’ preferences for different cancer survivorship care models (PCP/shared vs. oncologist vs. non-physician provider) and examined how physician attitudes towards and self-efficacy with their own skills during breast and colorectal cancer follow-up affected these preferences. Results: Of 3,434 physicians surveyed, 2,202 (64%) responded of whom 2,026 (59%) provided eligible outcomes for this study: 938 (46%) PCPs and 1,088 (54%) oncologists. In unadjusted analyses, most PCPs (51%) supported a PCP/shared care system whereas the majority of specialists (59%) strongly endorsed an oncologist-based model (p<0.001). A number of PCPs and oncologists (23% for both) preferred to involve non-physician providers. A significant proportion of cancer specialists (87%) did not feel that PCPs can take on the primary role for cancer follow-up. Many PCPs believed that they have the skills to perform breast and colorectal cancer follow-up (57%), detect recurrent cancers (74%), and offer psychosocial support (50%), but only a minority (32%) were willing to assume exclusive responsibility. In adjusted analyses, PCPs already involved with cancer surveillance (43%) were more likely to prefer a PCP/shared care system than an oncologist-based survivorship care model (OR 2.08, 95%CI 1.34-3.23, p<0.001). Conclusions: PCPs and oncologists have different preferences for models of cancer survivorship care. Prior involvement with cancer follow-up was one of the strongest predictors of PCPs' willingness to assume this responsibility.


2016 ◽  
Vol 73 (6) ◽  
pp. 327-332
Author(s):  
Claudia Gerhards ◽  
Claudia Gregoriano ◽  
Cora Moser ◽  
Thomas Dieterle ◽  
Jörg Leuppi

Zusammenfassung. Die chronisch obstruktive Lungenerkrankung (COPD) ist vor allem unter Rauchern eine weit verbreitete Krankheit in der Schweiz. Der Verlauf ist oft progredient und die chronisch kranken und oft polymorbiden Patienten sind auf funktionierende Behandlungsnetzwerke angewiesen. Gesundheitspolitisch und auch medizinisch ist mehr Netzwerkdenken gefragt und notwendig und die Erarbeitung von eines chronic care models (CCM) äusserst sinnvoll. Die Basis dafür ist das evidenz-basierte Vorgehen. In diesem Artikel werden die Guidelines zur Diagnostik und Behandlung der COPD und deren Implementierung beleuchtet. Vorwegzunehmen ist, dass bereits ein breites Behandlungsangebot besteht und viele innovative Projekte lanciert wurden, um die Behandlungsqualität der COPD zu optimieren.


2005 ◽  
Vol 33 (6) ◽  
pp. 1-82
Author(s):  
NANCY A. MELVILLE
Keyword(s):  

2003 ◽  
Vol 42 (03) ◽  
pp. 203-211 ◽  
Author(s):  
J. L. G. Dietz ◽  
A. Hasman ◽  
P. F. de Vries Robbé ◽  
H. J. Tange

Summary Objectives: Many shared-care projects feel the need for electronic patient-record (EPR) systems. In absence of practical experiences from paper record keeping, a theoretical model is the only reference for the design of these systems. In this article, we review existing models of individual clinical practice and integrate their useful elements. We then present a generic model of clinical practice that is applicable to both individual and collaborative clinical practice. Methods: We followed the principles of the conversation-for-action theory and the DEMO method. According to these principles, information can only be generated by a conversation between two actors. An actor is a role that can be played by one or more human subjects, so the model does not distinguish between inter-individual and intra-individual conversations. Results: Clinical practice has been divided into four actors: service provider, problem solver, coordinator, and worker. Each actor represents a level of clinical responsibility. Any information in the patient record is the result of a conversation between two of these actors. Connecting different conversations to one another can create a process view with meta-information about the rationale of clinical practice. Such process view can be implemented as an extension to the EPR. Conclusions: The model has the potential to cover all professional activities, but needs to be further validated. The model can serve as a theoretical basis for the design of EPR-systems for shared care, but a successful EPR-system needs more than just a theoretical model.


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