Availability Of Outpatient Care Research Articles

Factors Associated with the Receipt of Follow-Up Care Among Medicare Beneficiaries Discharged from Inpatient Psychiatric Facilities.

This study examined the extent to which facility characteristics, discharge practices, and the availability of outpatient mental health care are associated with receiving follow-up care within 7days of discharge from an inpatient psychiatric facility among Medicare beneficiaries. The study merged 2018 National Mental Health Services Survey data with 2018 Inpatient Psychiatric Facility Quality Reporting program data representing 1147 inpatient psychiatric facilities. Results from logistic regression analyses indicated that inpatient facilities operated by private for-profit organizations and public agencies had lower odds of achieving high performance on a measure that assessed if Medicare beneficiaries received follow-up care within 7days of discharge relative to private nonprofit facilities; follow-up rates were inversely associated with the proportion of involuntarily committed patients at the facility. Follow-up rates were not associated with other facility characteristics, discharge practices, the availability of outpatient care at the location of the inpatient facility, or the density of outpatient mental health providers in the community. Improving follow-up care for Medicare beneficiaries could target for-profit and public hospitals and those that serve a high proportion of individuals involuntarily committed to inpatient care.

ОЦЕНКА РОДИТЕЛЯМИ МЕДИЦИНСКОЙ ПОМОЩИ ИХ ДЕТЯМ С БРОНХИАЛЬНОЙ АСТМОЙ, ИМЕЮЩИМ КОМОРБИДНУЮ ПАТОЛОГИЮ

Currently, there is a steady increase in the number of children suffering from two or more diseases simultaneously occurring. In this regard, the assessment by parents of the medical care received by children with concomitant diseases is highly relevant. Aim. The aim of the study is to study the satisfaction of parents with medical care provided to patients with bronchial asthma and children with comorbid pathology. Material and methods. On the basis of the regional children’s clinical hospital, a selective sociological study was carried out, in which 368 parents of children aged 7 to 14 years old, patients with bronchial asthma with concomitant pathology, took part. Study design: single-center, non-randomized, uncontrolled study. Results and discussion. In the opinion of only 36.4% of the parents surveyed, inpatient medical care provided to their children is always available. The availability of outpatient care was positively assessed by only 29.5% of the respondents. In this case, the main reasons for dissatisfaction were called insufficient provision of the specified specialists and a long wait for the day of admission. The majority (81.8%) of the respondents would like to receive consultations from specialists of other profiles, taking into account concomitant diseases, when the child is in the pulmonary department of the hospital. At the same time, according to almost every second parent, the level of consultation of various specialists is higher in hospitals than in children’s polyclinics. Among the respondents, 69.3% considered themselves sufficiently informed on the issues of bronchial asthma in children. However, the results of the survey showed that only 69% of parents always follow medical recommendations. Conclusion. The presence of concomitant pathology in childhood, including with such a fairly common chronic disease such as bronchial asthma, requires special medical and organizational approaches to treatment. At the same time, it is necessary to take into account the opinion of the legal representatives of children on the availability and quality of medical care provided.

The satisfaction of parents with ambulatory polyclinic care of children in conditions of the region

To identify the most effective areas of out-patient care of children, an in-depth sociological study was carried out in the Kabardino-Balkaria Republic. The questionnaire allowed to get answers on satisfaction of parents with the quality, volume and availability of out-patient care, as well as to study the social status of respondents. The survey included 495 mothers aged of 18-45 years. Out of them, 70.0% had 1-2 children, 30.0% had 3 or more children. The orientation of the majority of families to the birth of 1-2 children formed one of the lowest in the republics of the North Caucasus total fertility rate of 1.61. The results of the study of parental satisfaction with the level of medical care of children in out-patient settings established that the main problem is sufficiently correlated with the data of similar studies in different regions of Russia. According to the data obtained, 61.0% of the respondents were satisfied with the overall health care in the clinic, and only 12.0% of the respondents were fully satisfied. At the same time, a quarter of the respondents expressed their dissatisfaction with various aspects of medical care. The main reasons for dissatisfaction are the low level of examination, organizational issues that need to be addressed, a significant workload of doctors, often the lack of doctors of narrow specialties. According to parents opinion, the clinic is lacking continuity in the work and dynamic monitoring of a sick child, as well as awareness of patients about the ongoing therapeutic and preventive measures. The low efficiency of preventive work is established. The dissatisfaction with the availability and quality of medical care of children is the basis for the necessary measures to improve functioning of the children's clinic, including introduction of new and effective organizational and medical technologies, improvement of material and technical equipment, improvement of the professionalism of medical personnel. The prerequisite for the success of the clinic is also compliance with ethical principles in Pediatrics. The results obtained on the basis of the analysis of the parents' opinion are valuable for development of the perspective programs of development and improvement of primary health care of children in the Republic of Kabardino-Balkaria.

The factors influencing utilization of hospital services by adult sickle cell disease patients: a systematic review protocol

The factors influencing utilization of hospital services by adult sickle cell disease patients: a systematic review protocol

The factors influencing utilization of hospital services by adult sickle cell disease patients: a systematic review protocol.

REVIEW QUESTION / OBJECTIVE The research question is: what are the modifiable and non-modifiable factors that influence the utilization of hospital services by adult sickle cell disease patients? The objective of this systematic review is to determine what modifiable and non-modifiable factors influence utilization of hospital services by adult sickle cell disease patients. INCLUSION CRITERIA Types of participants The review will consider studies that include adult Sickle cell disease patients of both sexes who have utilized hospital services. The review will include adult Sickle cell disease patients who have visited emergency department s, been admitted to the hospital from the emergency department s or been admitted directly to the hospital from the community. This review will include adult Sickle cell disease patients who have utilized hospital services for acute or emergent care. The review will exclude participants who have utilized hospital services for elective treatments in order to determine factors that may be exclusive to the use of hospital services for acute care. Types of intervention(s)/phenomena of interest This review will consider studies that explore factors that influence utilization of hospital services (such as the frequency of emergency department visits and inpatient admissions among adult Sickle cell disease patients, and the risk of high utilization of hospital services). The factors will include non-modifiable (age, sex, ethnicity, Sickle cell disease genotype) and modifiable factors, such as socioeconomic (education, income, insurance status, availability of outpatient care), psychological (anxiety, depression, perceived optimism, perceived discrimination) and disease-related factors (Hgb level, presence of complications, presence TRUNCATED AT 250 WORDS

Availability of outpatient care from psychiatrists: a simulated-patient study in three U.S. cities.

The study examined availability of psychiatrists for outpatient appointments in three U.S. cities. Posing as patients, investigators called 360 psychiatrists listed in a major insurer's database in Boston, Houston, and Chicago (N=120 per city) and attempted to make appointments. Callers claimed to have Blue Cross Blue Shield or Medicare or said they would pay out of pocket (N=120 per payer type, divided evenly across cities). In round 1 of calling, investigators were able to reach 119 of the 360 psychiatrists (33%). Of 216 unanswered calls, 36% were returned. After two calling rounds, appointments were made with 93 psychiatrists (26%). Significant differences were noted between cities but not between payer type. Obtaining outpatient appointments with psychiatrists in three cities was difficult, irrespective of payer. RESULTS suggest that expanding insurance coverage alone may do little to improve access to psychiatrists-or worse, expansion might further overwhelm the capacity of available services.