Concept: Managed care
To explore the impact of patient education on the lives of people with diabetes, including the effect on interactions with doctors and other healthcare professionals.
Despite intensive pharmacotherapy, a considerable number of patients with severe asthma have inadequate disease control. Patients with severe asthma who experience exacerbations consume significant health care resources.
Recent health system innovations provide encouraging evidence that greater coordination of medical and social services can improve health outcomes and reduce health care expenditures. This study evaluated the savings associated with a managed care organization’s call center-based social service referral program that aimed to assist participants address their social needs, such as homelessness, transportation barriers, and food insecurity. The program evaluation linked social service referral data with health care claims to analyze expenditures in 2 annual periods, before and after the first social service referral. Secondary data analysis estimated the change in mean expenditures over 2 annual periods using generalized estimating equations regression analysis with the identity link. The study compared the change in mean health care expenditures for the second year for those reporting social needs met versus the group whose needs remained unmet. By comparing the difference between the first and second year mean expenditures for both groups, the study estimated the associated savings of social services, after controlling for group differences. These results showed that the decrease in second year mean expenditures for the group of participants who reported all of their social needs met was $2443 (10%) less than the decrease in second year mean expenditures for the group who reported none of their social needs met, after controlling for group differences. Organizations that integrate medical and social services may thrive under policy initiatives that require financial accountability for the total well-being of patients.
Do-it-yourself health care technology has become a hot area, as smart devices promise to transform homes, workplaces, and cell phones into accessible sites for health monitoring and intervention. Yet claims of novelty require a decidedly short-sighted view of history.
Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low- and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low- and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria.
The International Cancer Benchmarking Partnership (ICBP) is a collaboration between 6 countries and 12 jurisdictions with similar primary care-led health services. This study investigates primary care physician (PCP) behaviour and systems that may contribute to the timeliness of investigating for cancer and subsequently, international survival differences.
Mapping of allied health service capacity for maternity and neonatal services in the southern Queensland health service district
- Australian health review : a publication of the Australian Hospital Association
- Published about 7 years ago
Objective Allied health professionals (AHPs) in maternity and neonatology services are essential for quality care and outcomes, reflected in the minimum service delivery requirements in the Queensland Health clinical services capability framework (CSCF). However, allied health (AH) capacity across the Southern Queensland Health Service Districts (SQHSD) is not known. The aim of this project was to redress this knowledge gap to inform ongoing service planning and delivery. Methods Maternity and neonatal AH clinicians in all birthing facilities in SQHSD were surveyed between October and December 2011 to investigate AHP staffing, practices and models of care. The professions surveyed included dietitians, occupational therapists, physiotherapists, psychologists, social workers and speech pathologists. Results were grouped per question, with stratification by CSCF and/or profession. Results Fifty-five valid surveys from the 16 facilities were received. All professions were represented. Gaps in maternity AH services were identified. Awareness and use of evidence-based practices were more likely to be reported where higher full-time equivalents (FTE) were allocated. Conclusion Very low staffing levels have been recorded in all Maternity and Neonatology Services AHPs in the SQHSD. Gaps exist between actual and recommended CSCF staffing standards across all levels and professions. The results indicate that profession-specific support networks for AHPs have positive effects in the spreading of information, and continued promotion, support and involvement in these profession-specific networks is suggested for all facilities. What is known about the topic? Maternity and neonatology service allied health (AH) professionals provide essential services for quality maternal and infant care and outcomes, reflected in their inclusion in several Queensland Health maternity and neonatal clinical guidelines. Queensland Health has also released a clinical services capability framework, which outlines minimum requirements for the provision of health services in Queensland public facilities, including minimum service and workforce structure. These include AH staff in the provision of key elements of care. What does the paper add? Staffing levels and description of models of care for AH professionals across the (former) Southern Queensland Health Service District is not known. This paper describes the outcome of a mapping process that provides a clear picture of AH staffing levels and service gaps, models of care in use, and models of care or resources that may be shared within the network for the professions of nutrition and dietetics, occupational therapy, physiotherapy, psychology, social work and speech pathology. What are the implications for practitioners? This profile of AH practitioners across the district provides a baseline reference that may prove useful for future planning of maternity and neonatology services in Queensland Health. Very low levels of staffing were identified and the staffing requirements outlined in the clinical services capability framework was not met at some sites. The results indicate that profession-specific support networks for AH practitioners have positive effects in the spreading of information; in addition, the continued promotion, support and involvement in these profession-specific networks are suggested for all facilities.
Continuity across inpatient and outpatient mental health care or specialisation of teams? A systematic review
- European psychiatry : the journal of the Association of European Psychiatrists
- Published over 6 years ago
A central question for the organisation of mental health care is whether the same clinicians should be responsible for a patient’s care across inpatient and outpatient settings (continuity of care) or if there should be separate teams (specialisation). Current reforms in Europe are inconsistent on which to favour, and are based on little research evidence. This review is the first systematic appraisal of the existing evidence comparing continuity of care and specialisation across inpatient and outpatient mental health care.
Abstract Interprofessional (IP) practice embraces a range of collaborations among health professionals that includes referral networks, case management and simultaneous co-management models of health care. How IP competencies are interpreted and enacted in the curriculum falls to health educators. The aim of this research was to examine health educators' interpretations of IP competencies in five health professions (chiropractic, naturopathy, osteopathy, physiotherapy and podiatry) in Australia. Semi-structured interviews were conducted with six educators. Transcripts were analysed using constant comparison to identify emergent themes. A number of interpretations of IP practice was evident (e.g. knowing professional scopes of practice and when to refer, and co-assessing and co-managing patients). Lack of resources limited IP practice enactment in the curriculum, including complementary medicine participation in IP teams.
The Affordable Care Act requires the federal government to collect and report population data on race, ethnicity, and language needs to help reduce health and health care disparities. We assessed data availability in commercial, Medicaid, and Medicare managed care plans using the Healthcare Effectiveness Data and Information Set. Data availability varied but remained largely incomplete.