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At least 973 records · Page 54Linked to original sources
PubMed2006

[Pathways through the need for care in Hessen from 1999 to 2002. Results of a longitudinal study].

AIM OF STUDY: This paper looks at pathways through care for care-dependent persons (as defined by the German statutory long-term care insurance) through longitudinal and cross-sectional analysis of types of benefits and benefit levels over a period of 4 years. METHODS: The prospective cohort study with back dated recording consists of monthly data on the type and level of benefit for each care-dependent person. Cohorts of care-dependent people (n = 6.928) are followed over time to record the benefit type and level at program entry and during enrollment. Each change of benefit type or level, including exit from the program such as in the case of death is noted for a time period of 48 months. RESULTS: The 4-years longitudinal study (1999 through 2002) proves important differences between courses of long-term care in relation to benefit types. Recipients of the cash benefit remain for a longer period of time in that benefit type (28.1 %), have lower transition rates to institutional care (6.9 %) and lower mortality rates (57.3 %) in comparison to recipients of other benefit types over the course of 4 years. Only 8 % respectively 10.7 % of recipients of the combined or the service benefit have the same type of benefit after 48 months. Transition rates to institutional care for professionally cared persons are 10.1 % (combined benefit) respectively 11.8 % (service benefit). Mortality rates of other than cash benefit recipients are about 70 %. CONCLUSIONS: Further research should consider risk factors for entry into institutional care and mortality rates as well as questions regarding the prevention of care dependency and effectiveness of rehabilitation. Pathways through care should be analysed by focusing social variables like sex and chronic diseases of older people. Secondary analysis of process data from German statutory long-term care insurance program is a powerful tool for the study pathways through of long-term care.

Adolescent↗
PubMedDate not supplied

Rehabilitation nursing novices: changing the acute care mind set.

The majority of nurses entering the specialty of rehabilitation have little or no previous rehabilitation experience. Specific strategies are needed to assist new staff in developing skills and concepts congruent with rehabilitation nursing practice. This article describes a two-stage orientation process that has been effective in helping new staff members make the practice transition from acute care to rehabilitation nursing.

Attitude of Health Personnel↗
PubMed1999

Recommendations for incorporating palliative care education into the acute care hospital setting.

This article presents recommendations for improving the education of physicians about end-of-life care in the acute care hospital setting. The authors, who have a variety of backgrounds and represent several types of institutions, formulated and reached consensus on these recommendations as members of the Acute Care Hospital Working Group, one of eight working groups convened at the National Consensus Conference on Medical Education for Care Near the End of Life in May 1997. A recently published literature review on the status of palliative care education, a summary of recent research on education about end-of-life care, and expert opinion were helpful in developing the recommendations. The authors emphasize that the acute care setting offers many opportunities for education about care at the end of life. Faculty should support learners' appreciation of the importance of end-of-life care, and convey the meaning and privilege of attending to patients and families at this difficult time. Faculty should teach students and residents to provide care that embodies attention to the control of distressing physical, physiologic, and spiritual symptoms, appropriate awareness of patients' differing cultural backgrounds and their impact upon the experience of dying, excellent communication skills, the application of bioethical principles, timely referral and smooth transition to other care settings that meet patient and family goals, and the role of the interdisciplinary team in meeting the diverse needs of dying patients and their families.

Education, Medical, Continuing↗
PubMedDate not supplied

Stage managing change: supporting new patient care models.

The scope and accelerated pace of change is providing high drama in health care organizations today. The Central DuPage Hospital experience of transitioning to patient-focused care was driven by aggressive targets and tight timelines. Providing practical, adaptable change management strategies to key players ensured a well-staged transition to the new models of patient care.

Hospital Restructuring↗
PubMed1992

Status transitions and future outlook as determinants of conflict: the caregiver's and care receiver's perspective.

This study examined the effects of status transitions and future outlook on conflict from the perspective of both caregiver and care receiver. As predicted, future outlook had a powerful association with dyadic conflict. Other strong predictors of conflict for care receivers were current state of happiness and changes in the relationship over a 3-year period. For caregivers, conflict was associated with care receivers' lack of social participation with family and friends, and changes in dyadic relationship.

Aged↗
PubMed1983

The urban transition and the evolution of the medical care delivery system in America.

This essay traces the evolution of the American urban medical care delivery system and examines the implications in terms of social and spatial variations in accessibility to medical care. It is suggested that the foundations of the present medical care delivery system were laid during the urban transformation which took place in the latter part of the nineteenth century, when changes in the division of labor, specialization, the role of the family, urban transportation technology and attitudes to social protectionism interacted with changes in science, medical technology and professional organization to produce radical changes in both the settings used to provide medical care and their relative accessibility to different sub-groups of the population. The medical care delivery system is thus interpreted largely as a product of the overall dynamic of urbanization rather than of scientific discovery, medical technology and the influence of key medical practitioners and professional organizations.

Delivery of Health Care↗
PubMedDate not supplied

Transition to home from the newborn intensive care unit: applying the principles of family-centered care to the discharge process.

Increasingly newborn intensive care units (NICUs) are embracing family-centered care principles. Family-centered newborn intensive care requires that families are welcomed as partners in caregiving and decision making. Traditionally, discharge planning has been done without significant family involvement. In fact, parent participation in caregiving may still be limited until discharge is imminent. By increasing parental involvement in caregiving throughout hospitalization and working with families to facilitate the discharge process, parents may emerge from the NICU experience with increased competence and confidence in infant caregiving. This article reviews common discharge practices and processes in the NICU and offers strategies to assist nurses in integrating a family-centered approach into discharge planning.

Documentation↗
PubMed2000

Priorities in care and services for elderly people: a path without guidelines?

The growing gap between demands and resources is putting immense pressure on all government spending in Sweden. The gap is especially apparent in care and services for elderly people in light of the rapid aging of the population. The article considers the decisions and priorities concerning resource allocation in the welfare sector in general and in elderly care in particular. The aim is to describe the political and administrative setting and to provide a conceptual structure that outlines the nature of the problem. Various levels of decision making are identified and discussed in the context of political accountability. Current transitions in elderly care are described with respect to service provision, marketisation, coverage rates, and eligibility standards. Basic principles of distribution are highlighted in order to clarify some central concepts of efficiency and justice, and a number of strategies for actual prioritising are identified. The article concludes with an endorsement of more conscious decisions in resource allocation. Existing knowledge and information concerning the effects of various strategies must be utilised, and the values and assumptions used for setting priorities must be made explicit.

Aged↗
PubMed2004

Family medicine as a model of transition from academic medicine to academic health care: Estonia's experience.

This paper presents the development of academic family medicine in an environment of traditional academic medicine at the Tartu University, Estonia. The introduction of university family medicine teachers to everyday practice and practitioners to academic teaching and research helps bridge the gap between theory and practice, and it shows changed approach to academic medicine.

Academic Medical Centers↗