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At least 415 records · Page 23Linked to original sources
PubMed1995

Heavy users of emergency services: social construction of a policy problem.

A relatively small subgroup of emergency department (ED) patients is responsible for a disproportionate amount of ED visits and costs. This subgroup, the heavy users of ED services, is identified as a medically and socially vulnerable population. Heavy users of ED services are identified as a 'problem' in the United States that opens a 'window' on the wider social issues critical to consensus on health care reform. The problem is nested within a complex of larger, interdependent problems including access to care, lack of primary/preventive services, absent or inadequate social services, and fragmented service delivery. This article uses the literature on heavy users of ED services to argue that social constructions of the problem and articulation of solutions by different key players in health care reform are based on divergent and often conflicting premises.

Emergency Service, Hospital↗
PubMed2001

Providing seamless community health and social services.

This article reviews a variety of Government community health policies and initiatives, from the NHS and Community Care Act 1990 to the emergence of primary care groups (PGCs). The Labour administration abolished GP fundholding and has placed considerable emphasis on its commitment to partnership with the care professions. The Government is also expecting a commitment to partnership between the community care professions in order to reflect the entwined social and health-care needs of the individual requiring care in the community. The role of the district nursing service has been brought into focus with the opportunity of representation at PCG board level. Evaluating how a district nursing service may integrate with social services is therefore, and appropriate strategy for assessing whether recent policy initiatives go far enough at grass roots level in facilitating collaboration and quality community care.

Community Health Planning↗
PubMed1997

Deficient health and social services for elderly people with learning disabilities.

Elderly people with learning disabilities have greater psychiatric morbidity than younger individuals, but a previous report has suggested that the majority of the former do not receive treatment. All people with learning disabilities aged 65 years and over living in Leicestershire, England (n = 134), and a random sample of adults with learning disabilities aged between 20 and 64 years (n = 73) were assessed for psychiatric disorders and service use. Elderly people received less day care, less respite care and were less likely to have a social worker and receive input from most health services than the younger group. Chiropody was an exception. Those receiving psychiatric services did so through the learning disabilities specialist services only. Those with an additional psychiatric disorder were more likely to receive services, but results still favoured the younger group. Services were better accessed by those living in residential care. Failure to access services may relate to carers attitudes and beliefs: in learning disability settings, morbidity was attributed to 'it's just old age; in the elderly settings, morbidity was attributed to 'it's because s/he has learning disabilities'. The specialist health and social services need to take the lead in health promotion and education.

Adult↗