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Results for “Delivery of Health Care, Integrated”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 19 recordsLinked to original sources
PubMed1979

Primary care in Durham County: who gives care to whom?

The purpose of this study is to describe quantitatively the primary health care system of a defined population. The ambulatory care services of private practices and institutions in Durham County, North Carolina were sampled four times during 1975-1976 to determine the relative contributions to primary care made by specified types of practice and sources of care. All the institutions and 96 per cent of practicing physicians participated. Utilization of primary care services was analyzed by race, sex, age and health insurance status. One striking finding is the predominant role in the delivery of primary care played by the private specialists practicing in the community in contrast to the relatively small role of the university teaching hospital. Another important finding is the low proportion of blacks and Medicaid patients served by these community physicians. Thirdly, removal of legal and financial barriers has made little impact as yet on the patterns of health care delivery established before the institution of mandatory integration of health services. Since these findings have broad implications for health care delivery, this study warrants replication in other settings.

Adolescent↗
PubMed1978

Hospital-based patient education programs and the role of the hospital librarian.

This paper examines current advances in hospital-based patient education, and delineates the role of the hospital librarian in these programs. Recently, programs of planned patient education have been recognized by health care personnel and the public as being an integral part of health care delivery. Various key elements, including legislative action, the advent of audiovisual technology, and rising health care costs have contributed to the development of patient education programs in hospitals. As responsible members of the hospital organization, hospital librarians should contribute their expertise to patient education programs. They are uniquely trained with skills in providing information on other health education programs; in assembling, cataloging, and managing collections of patient education materials; and in providing documentation of their use. In order to demonstrate the full range of their skills and to contribute to patient care, education, and research, hospital librarians should actively participate in programs of planned patient education.

Cost-Benefit Analysis↗
PubMed1978

Interdisciplinary health care: part I.

The development of the Health Care delivery system has been unorganized and fragmented. A need to integrate the various health care components is essential and a discussion of interdisciplinary health teams is presented as one model to alleviate these problems. Part I will discuss the historical parameters and the philosophical components of health care. Part II will present the problems and inherent possibilities of health teams. Part III will include a review of the Interdisciplinary Health Teams course at the University of Houston, College of Optometry.

Delivery of Health Care↗
PubMed2026

Integration of ear and hearing care services in low- and middle-income health systems: a systematic review and qualitative synthesis.

Hearing loss is a global public health burden and mostly affects those living in low- and middle-income countries (LMICs). One approach to address ongoing challenges is the World Health Organization's recommendation for the integration of ear and hearing care (EHC) services into healthcare packages. However, little is known about EHC integration approaches, particularly in LMICs additionally, these approaches have not been investigated through a health systems lens. This qualitative review aimed to describe the various approaches to the EHC service integration in LMICs and to identify enabling and constraining factors. We reviewed 17 studies, with a focus on LMICs, using adaptations of the Valentijn integration and World Health Organization EHC frameworks, following the PRISMA guidelines. Our investigation showed that most integration approaches were at micro or individual level. Enabling factors for integration of EHC services were training, mentorship, collaboration, technology, inclusion of EHC in healthcare packages and investment in EHC services. Barriers were challenges with training, facilities and equipment, policy implementation and resourcing of EHC services. We further described factors influencing healthcare seeking behaviour and the use of integrated EHC services, such as access and ability to pay, referral systems and communication and awareness. This study describes the complex nature of EHC integration and ways to support integration. Key considerations are the level of integration, training to address workforce issues and factors influencing service utilisation as we work towards health system strengthening.

Humans↗
PubMed2025

Implementation of a Face-To-Face Vs Virtual Peer-Integrated Collaborative Care Intervention for Mental Health Treatment of Physical Trauma Survivors: A Qualitative Study of Lessons from the COVID-19 Pandemic.

OBJECTIVE: We assessed the impact of the COVID-19 pandemic on the implementation of a peer-integrated enhancement of integrated clinical care intervention to address the mental health needs of 450 patients undergoing treatment for a physical injury. METHODS: Qualitative data were collected by 7 clinician investigators of a randomized controlled trial acting as participant observers in a trauma care setting of a major U.S. metropolitan hospital and analyzed in collaboration with an external mixed methods specialist. RESULTS: The pandemic created or exacerbated several implementation barriers, including increased risk of infection, homelessness, hospitalizations and comorbid conditions such as fentanyl overdoses that increased demand on emergency department and Trauma Center services, imposition of safety measures to reduce risk of infection in clinical settings, transition from face-to-face to virtual interactions with study patients, shortages of specialty mental health providers, suspension of recruitment of patients into the study, scheduling calls with patients, and an increased workload for the study clinical interventionists. Peer specialists perceived the transition to virtual interactions with patients reduced their effectiveness; however, this was not reflected in assessments of patient satisfaction with services received and may have inadvertently increased adoption by Trauma Center staff. Reduction in reach of the intervention to target population was temporary. CONCLUSIONS: The COVID-19 pandemic exacerbated existing barriers and created new barriers to successfully implementing evidence-based practices in trauma care settings, resulting in an attenuation of their effectiveness. However, the shift from face-to-face to virtual services delivery may have actually led to improved implementation outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03569878. Registered June 15, 2018.

Humans↗
PubMed1979

Genetic counseling in primary obstetric care.

Of all health professionals the obstetrician is by far the best-equipped to integrate genetic counseling into health care delivery. As with most aspects of the practice of medicine, genetic information increases daily. The practicing obstetrician, by learning the fundamentals of genetics, can at least delineate at-risk situations. When a new situation arises he can either consult an up-to-date article or book 185--190 or refer the patient to the local genetic counseling clinic for further appraisal. By incorporating prospective counseling and in some cases retrospective counseling into his daily practice, the obstetrician can contribute greatly to the ideals of obstetrics, namely producing healthy children for his patients.

Age Factors↗
PubMed1979

Report of integrity.

Explore the source record for details and available documents.

Delivery of Health Care↗
PubMed1978

Primary care treatment of emotional problems in an HMO.

Integrating mental health services into primary care should improve the availability, access, and delivery of psychiatric care to the whole population. Health maintenance organizations (HMOs) are settings for the development of integrated medical-mental health services. This paper reports findings of a project to evaluate a team collaborative model in an HMO. In this model, primary care clinicians carry major responsibility for emotional problems of their patients, and mental health clinicians collaborate with and support primary care clinicians as well as treat referred patients. Over a two-year study period, 15.7 per cent of all patients who visited the HMO presented a mental or emotional difficulty. When psychotropic drug prescriptions were used as an unobtrusive measure for estimating underenumeration, this prevalence figure rose to 19 per cent. Primary care clinicians treated an increasing proportion of the emotional problem demand, although this increase could not be attributed only to the establishment of the team collaborative model. Findings concerning the psychiatric problems treated and psychotropic drugs prescribed by primary care clinicians are also presented. We conclude that the primary care clinicians did assume major responsibility for emotional problem treatment when encouraged and supported through the team collaborative process and other organizational arrangements.

Affective Symptoms↗
PubMed1977

Evaluation of the quality of psychiatric care for the aged.

Older persons represent a high proportion of those receiving care in institutions because of behavioral problems; relatively few aged people are treated in mental health center and other outpatient settings. The author believes that the availability and accessibility of community services should be among the most important variables used in assessing quality of care for the aged. He encourages the establishment of new norms for the quality of services needed to restore and maintain maximum physical, psychological, and social integrity.

Aged↗
PubMed1977

Sociocultural barriers to medical care among Mexican Americans in Texas: a summary report of research conducted by the Southwest Medical Sociology Ad Hoc Committee.

This paper summarizes research findings from members of the Southwest Medical Sociology Ad Hoc Committee concerning sociocultural barriers to medical care among Mexican Americans in Texas. Committee members individually, or in two-person groups, studied a number of factors concerning Mexican-American medical care in Texas such as: 1) mortality, morbidity, and other health status indicators; 2) health manpower and educational needs; 3) political factors impeding economical health care; 4) alienation, familism, and their relationship to utilization of the health services; 5) language and communication barriers; and 6) folk medicine. Findings include documentation that structural alienation of Mexican-Americans from mainstream Anglo-American middle-class society is carried over into their relation with utilization of the health care delivery system; that their emphasis on familism works alternatively to encourage and discourage their seeking access to health care; the language differences serve to perpetuate certain cultural differences that are inimical to health care delivery; and that curanderismo can be seen as complementing other types of health care. The report concludes with a number of recommendations for accomplishing cultural integration that will lead to better care for this segment of the health population.

Communication↗
PubMed1978

CEO: an agent of planned change.

CEOs are evolving from traditional administrative roles to accept the mandate of today's health care delivery system--the mandate that administrators take broad social views and be innovators in dealing with medical developments and in changing services to meet changing demands. CEOs must have or develop the skills to integrate available resources for coping with the forces impinging on the modern hospital.

Delivery of Health Care↗
PubMed1978

The future for mental health in primary health care programs.

Our largely separate mental health system has developed in relationship to a health care system oriented toward specialization and solo practice. Now the health care system is moving in the direction of primary care and group and organizational practice. New forms of mental health delivery are needed to maximize the potential of these new health care programs for mental health services. The author describes these new integrated programs which bring mental health providers into the primary health care programs for direct services as well as consultation. Issues discussed include mutual roles, changes in services, the referral process, and provider relationships. The advantages of such integrated programs include decreased stigma, increased prevention through earlier detection and referral, increased family orientation, greater coordination of care, and less duplication.

Attitude of Health Personnel↗