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CMS chief Seema Verma wants to reshape the entitlement program that covers about 62 million people. Verma endorses "community engagement" - work or community service - as a condition for "able-bodied" people to get Medicaid coverage and accused the Obama administration of the "soft bigotry of low expectations" for opposing such a requirement.
Health care needs of individuals living in the community are increasing. To meet the rising need, unregulated care providers are providing more complex patient care. The aim of this review is to articulate the unregulated care provider role by identifying patient care activities offered by unregulated care providers in home care.
To understand and to reflect about care based on the experiences of managers, professionals and users of maternal and child health services.
With ageing of Australians, the numbers of residential aged care (RAC) residents is rising. This places a spotlight on decisions about appropriate care for this population, including hospitalisation and end-of-life (EOL) care. The aim was to study a sample of RAC residents who attended and died in hospital, to quantify measurable components of EOL care so as to describe the extent of palliative care required.
to evaluate the quality of care provided to older people with diabetes mellitus and/or hypertension in the Primary Health Care (PHC) according to the Chronic Care Model (CCM) and identify associations with care outcomes.
Here they are: Value-based care can't be done one slice at a time, new value-based models will take aim at variations in care, the patient may gain a stronger voice, the tail cold wag the dog, and value-based care will create haves and have-nots. Some predictability from the federal government would be welcome.
The predicted demographic changes internationally have implications for the nature of care that older people receive and place of care as they age. Healthcare policy now promotes the implementation of end-of-life care interventions to improve care delivery within different settings. The Gold Standards Framework in Care Homes (GSFCH) programme is one end-of-life care initiative recommended by the English Department of Health. Only a small number of care homes that start the programme complete it, which raise...
The Institute of Medicine's report, Dying in America, highlights the critical need for the widespread implementation of palliative care to improve end-of-life care. Approximately 20% of all deaths in America occur during or shortly after an intensive care unit (ICU) admission; therefore, it is important for critical care units to have systems in place to facilitate patient access to palliative care services.
German philosopher Martin Heidegger argued that humans are defined by care. The term he used, "Sorge," picks out a wide range of caring relations, including sorrow, worry, the making of arrangements, and even fending for another. Since coming to The Hastings Center, I've been struck by the genuine care definitive of its scholars' relationship to their work. Care about newborns, the elderly, and nonhuman animals. Care about doctors, nurses, and health care institutions. Care expressed in the panoply of ways ...
To learn from the experiences of innovative primary care practices that have successfully developed care teams.
Integrated palliative care is viewed as having the potential to improve service coordination, efficiency, and quality outcomes for patients and family carers. However, the majority of Canadians do not have access to regional, comprehensive, integrated palliative care. Work needs to be directed toward planning palliative care services that is integrated into the healthcare and social care system. To further this goal, it is important to have a conceptual understanding of the meaning of integrated care and it...
Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated ...
Millions of adults have gained insurance through the Affordable Care Act (ACA). However, disparities in access to care persist.
Point-of-care ultrasonography (POCUS) has recently become a useful tool that intensivists are incorporating into clinical practice. However, the incorporation of ultrasonography in critical care in developing countries is not straightforward.
To adapt the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care and to evaluate its validity and reliability.
The Veterans Choice Program (VCP) was launched in 2014 to address the growing concerns about the timeliness and quality of Veterans Health Administration (VHA) care. Given that many sex-specific health services, such as mammography and maternity care, are not routinely provided in all VHA facilities, women Veterans may disproportionately rely on VCP care. Understanding the provision and coordination of VCP care is crucial in order to ensure that care is not fragmented across the 2 health care systems.
Erratum to: How to manage a pregnant woman for emergency care, anesthesia or intensive care? Take home messages from the French Society of Anesthesiology and Intensive Care (SFAR) monothematic one-day meeting.
Research has shown that some 30% of total care needs in people with late-life depression (LLD) are unmet. It is not known to what extent patients actually don't receive any care for these needs or consider the care to be insufficient and their satisfaction with the provided care.
Patients suffering from advanced disease face different care transitions. The transition from acute to palliative care is challenging and may lead to the discontinuity of care. Family caregivers become important sources of information, as patients begin to experience difficulties in coping with emotional transition events. The Care Transition Measure was developed to evaluate care transitions as experienced by the elderly. It has never been used in palliative care. The aim of this study was to test the vali...
Neonates who require additional care, be it in a special care baby unit, neonatal intensive care unit or just on the labour ward, may need specific equipment to allow the team to care for them accurately and safely. This article outlines some of the specific types of equipment which may be needed.
Continuity of care could reduce health care consumption by patients and reduce the number of referrals to specialist care, but it is unknown if there is a difference in referral rates to specific medical specialties.
Care coordination among health care providers is essential for high-quality care and it is strongly associated with overall ratings of doctors. Care coordination may be especially important for sicker and chronically ill patients because of the multiple providers involved in their care. This study examines whether the association of care coordination with global ratings of one's personal doctor varies by number of chronic conditions and self-rated health.
The two largest providers of HIV care in the US are the Veterans Administration and Kaiser Permanente. Both organizations are significantly outperforming the general population in implementing the HIV Care Continuum, which involves 1) testing and diagnosis, 2) linkage to care, 3) retention in care, 4) initiation and continuation of antiretroviral therapy, and 5) achievement of viral suppression. Adherence to the care continuum allows people living with HIV to achieve viral suppression to levels where the vi...
Non-communicable diseases (NCDs), specifically diabetes and hypertension, are rising in high-HIV burdened countries like South Africa. How integrated HIV-care into primary health care (PHC) influences NCD care is unknown. We aimed to understand whether differences existed in NCD care (pre versus post-integration) and how changes may relate to HIV patient numbers.