Home-Based Medical Care for Older Adults


Book Description

As the population of older adults in the U.S. continues to grow, medical house calls are increasingly part of a system of comprehensive home-based care for patients who have difficulty accessing office-.based care. Clinicians who have been trained mostly in office and hospital settings must adapt their usual approaches to accommodate a wide range of environmental, social, and physical circumstances that impact home-limited patients. Ideally, a comprehensive team of clinicians proficient in multiple domains of functional, social, and medical care can work together to address potential gaps in any one clinician’s expertise. Unfortunately, such teams are still rare. This book aims to equip individual clinicians with the interdisciplinary knowledge, skills, and perspective they need to provide the best care possible with limited formal interdisciplinary support. This book offers 20 patient cases drawn from the collective experience of experts in home-based medical care from highly respected academic and clinical programs across the United States. Each case demonstrates a scenario that is frequently encountered and/or very important in home-based medical care practice. Each scenario frequently proves to be challenging for many professionals because it requires an approach or leverages aspects of care delivery that most are not trained in. Additionally, each scenario reflects an approach to care that is enhanced by interdisciplinary input. Finally, each case lends itself to a practical problem-solving approach that could be accomplished by most home-based medical care providers, even in the absence of an interdisciplinary team. Written by interdisciplinary experts in geriatric home-based care, this book serves as both an educational tool for learners in all related disciplines as well as a quick reference for experienced clinicians looking to augment their existing house call “toolbox.”




Transforming Health Care


Book Description

For decades, the manufacturing industry has employed the Toyota Production System the most powerful production method in the world to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compe




Unequal Treatment


Book Description

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.




Access to Health Care in America


Book Description

Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.




VA health care overview


Book Description




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




Healthcare Choices


Book Description

Making healthcare decisions is hard, but making the right choices has never mattered more. Healthcare Choices: 5 Steps to Getting the Care You Want and Needgives you the tools you need to choose the best medical care—for you. Archelle Georgiou, MD, explainsher CARES model, the formula she developed to help family, friends, and thousands of television viewers make smart healthcare decisions that balance the best medical options with individual preferences. Using more than 30 real-life stories and insider tips, she demonstrates how to use this step-by-step guide to access the medical information you need to evaluate your options and make well-informed choices. Whether you are addressing a life-threatening illness, self-managing a minor ailment, selecting a doctor, or buying insurance, Georgiou’s roadmap shows you how to be an active participant in your care. Her “go to” approach describes how to: Identify all treatment options for an illness, including those not mentioned by your doctor. Make treatment decisions that reflect your priorities and preferences. Find the best doctor to treat your condition. Communicate with your doctor and make shared treatment decisions. Choose the health insurance plan that’s right for you. Maintain a voice in your lifestyle as you age. Healthcare Choiceswill give you the confidence to advocate for the healthcare you want, need, and deserve.




Finding What Works in Health Care


Book Description

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.




Health Care Off the Books


Book Description

Millions of low-income African Americans in the United States lack access to health care. How do they treat their health care problems? In Health Care Off the Books, Danielle T. Raudenbush provides an answer that challenges public perceptions and prior scholarly work. Informed by three and a half years of fieldwork in a public housing development, Raudenbush shows how residents who face obstacles to health care gain access to pharmaceutical drugs, medical equipment, physician reference manuals, and insurance cards by mobilizing social networks that include not only their neighbors but also local physicians. However, membership in these social networks is not universal, and some residents are forced to turn to a robust street market to obtain medicine. For others, health problems simply go untreated. Raudenbush reconceptualizes U.S. health care as a formal-informal hybrid system and explains why many residents who do have access to health services also turn to informal strategies to treat their health problems. While the practices described in the book may at times be beneficial to people’s health, they also have the potential to do serious harm. By understanding this hybrid system, we can evaluate its effects and gain new insight into the sources of social and racial disparities in health outcomes.




Cuban Health Care


Book Description

How the Cuban health care system became the blueprint for accessible medical care around the world Quiet as it’s kept inside the United States, the Cuban revolution has achieved some phenomenal goals, reclaiming Cuba’s agriculture, advancing its literacy rate to nearly 100 percent – and remaking its medical system. Cuba has transformed its health care to the extent that this “third-world” country has been able to maintain a first-world medical system, whose health indicators surpass those of the United States at a fraction of the cost. Don Fitz combines his deep knowledge of Cuban history with his decades of on-the-ground experience in Cuba to bring us the story of how Cuba’s health care system evolved and how Cuba is tackling the daunting challenges to its revolution in this century. Fitz weaves together complex themes in Cuban history, moving the reader from one fascinating story to another. He describes how Cuba was able to create a unified system of clinics, and evolved the family doctor-nurse teams that became a model for poor countries throughout the world. How, in the 1980s and ‘90s, Cuba survived the encroachment of AIDS and increasing suffering that came with the collapse of the Soviet Union, and then went on to establish the Latin American School of Medicine, which still brings thousands of international students to the island. Deeply researched, recounted with compassion, Cuban Health Care tells a story you won’t find anywhere else, of how, in terms of caring for everyday people, Cuba’s revolution continues.