Responsive Care Services Research Articles

Research of Public-Private-Partnership (PPP) Model in Elderly Care Service in the Accelerated Rate of Aging in China

China urgently needs to grow the senior care business and raise the standard of elderly care services in response to the major problem of population aging. Currently, the government provides universal old services and depends on financial support. However, with government revenue continuing to decline, it is not possible for the government to provide elderly care services on its own. The cutting-edge model of government-social capital cooperation (Public-Private Partnership (PPP) for short) was applied. The government started actively guiding social capital into the field of elderly care services in order to optimize the social financing mechanism and relieve the pressure on the government, and the cutting-edge model of government-social capital cooperation was applied.

Preparedness and Capacity of Indian Palliative Care Services to Respond to the COVID-19 Pandemic: An Online Rapid Assessment Survey.

Background:COVID-19 has been causing a high burden of suffering for patients and families. There is limited evidence on the preparedness of Indian palliative care services for the pandemic.Aim:This study aimed to assess the preparedness and capacity of Indian palliative care services in response to the COVID-19 pandemic.Methods:A cross-sectional online survey was developed based on prior evidence and international health regulations. It was emailed to the Indian Palliative Care Association members and investigators' professional networks in India. One participant per palliative care service was requested. Descriptive analysis was used.Results:Representatives of 78 palliative care services completed the survey. Three in four services had COVID-19 case definition and adapted their protocols for infection control (75%). About half of the services (55%) reported concerns about achieving appropriate hand hygiene in the community. More than half of the services (59%) had capacity to train nonspecialists for symptom control and psychological support. About half of the services reported that they had plans to redeploy staff (56%) and resources (53%) in the case of outbreaks. Two-fifths of the services used paper records to store an updated contact list of staff (40%) and did not have designated focal contacts for information update (40%). Staff anxiety related to personal infection risk and family care was relatively high (median score = 7 on a 1–10 scale).Conclusion:We recommend the following resource allocation to enable palliative care services to support the Indian health system in delivering essential care in this and future pandemics: (1) infection control, especially in the community; (2) training using existing clinical protocols to strengthen palliative care across the health system; and (3) redeployment plans.

A rapid mobilization of ‘virtual’ primary care services in response to COVID-19 at Veterans Health Administration

A rapid mobilization of ‘virtual’ primary care services in response to COVID-19 at Veterans Health Administration

Elderly Care: A Study on Community Care Services in Sleman, DIY, Indonesia.

Elderly care services are important to provide in response to the rapid growth of the elderly population. In developing countries like Indonesia, the speed of growth of the elderly population does not simultaneously occur, so the needs for care services vary. This study discusses the emergence of home care services in response to the increase in elderly population. By taking the case of community home care services in Sleman, this study found the pattern and process of the emergence of local initiatives in home care services. This study also revealed an important factor affecting the implementation of community home care services, that is, leadership.

Future Directions in Disseminating Research Findings to Urban Alaska Native People.

Southcentral Foundation (SCF), a tribal health organization based in Anchorage, Alaska, operates and plans health care services in response to the priorities and tribal values of Alaska Native and American Indian (AN/AI) people, including traditional concepts of wellness, reciprocity, and working in relationship. In an effort to better incorporate AN/AI priorities and values in research dissemination, the SCF Research Department hosted the Alaska Native Health Research Forum (Forum) in May 2016. In this paper, we describe the communication strategies used by the SCF Public Relations Department, which were shared with Forum attendees, describe attendee recommendations for researchers to consider and implement, and then discuss future directions for dissemination. Lessons learned through the Forum were 1) customer-owners are interested in learning more about research, 2) dissemination should be done throughout all stages of projects using a variety of media channels, and 3) SCF Research Department dissemination should continue to shape health care.

Patient Mobility for Elective Secondary Health Care Services in Response to Patient Choice Policies: A Systematic Review.

Our review establishes the empirical evidence for patient mobility for elective secondary care services in countries that allow patients to choose their health care provider. PubMed and Embase were searched for relevant articles between 1990 and 2015. Of 5,994 titles/abstracts reviewed, 26 studies were included. The studies used three main methodological models to establish mobility. Variation in the extent of patient mobility was observed across the studies. Mobility was positively associated with lower waiting times, indicators of better service quality, and access to advanced technology. It was negatively associated with advanced age or lower socioeconomic backgrounds. From a policy perspective we demonstrate that a significant proportion of patients are prepared to travel beyond their nearest provider for elective services. As a consequence, some providers are likely to be “winners” and others “losers,” which could result in overall decreased provider capacity or inefficient utilization of existing services. Equity also remains a key concern.

Nurse Practitioners and Men's Primary Health Care.

Though life expectancy sex differences are decreasing in many Western countries, men experience higher mortality rates at all ages. Men are often reluctant to seek medical care because health help-seeking is strongly linked to femininity, male weakness, and vulnerability. Many men are also more likely to access emergency care services in response to injury and/or severe pain instead of engaging primary health care (PHC) services. Nurse practitioners are well positioned to increase men’s engagement with PHC to waylay the pressure on emergency services and advance the well-being of men. This article demonstrates how nurse practitioners can work with men in PHC settings to optimize men’s self-health and illness prevention and management. Four recommendations are discussed: (1) leveling the hierarchies, (2) talking it through, (3) seeing diversity within patterns, and (4) augmenting face-to-face PHC services. In terms of leveling the hierarchies nurse practitioners can engage men in effectual health decision making. Within the interactions detailed in the talking it through section are strategies for connecting with male patients and mapping their progress. In terms of seeing diversity within patterns and drawing on the plurality of masculinities, nurse practitioners are encouraged to adapt a variety of age sensitive assessment tools to better intervene and guide men’s self-health efforts. Examples of community and web based men’s health resources are shared in the augmenting face-to-face PHC services section to guide the work of nurse practitioners. Overall, the information and recommendations shared in this article can proactively direct the efforts of nurse practitioners working with men.

A Declaration of Healthy Dependence: The Case of Home Care

Aging populations have become a major concern in the developed world and are expected to require novel care strategies. Public policies, health-care regimes and technology developers alike stress the need for a more individualized care to meet the increased demand for care services in response to demographic change. Increasingly, care services are offered to individuals with diseases and or disabilities in their homes by means of Personalized Health-Monitoring (PHM) technologies. PHM-based home care is typically portrayed as the key to a cost-effective future care that better can accommodate the needs of an aging population and promote care recipients' independence. In light of the emerging technology-based home care, this article sets forth to investigate the significance and implications of a strong emphasis on independence in relation to this novel care form. Notions of independence as used by care planners, care providers and technology developers are examined in relation to ICT-based home care and the reasonableness of independence as an aim for future health-care is critically discussed. In conclusion, the need for a shift from a strong emphasis on independence to a right to healthy dependence is advocated.

Drug Abuse-Related Emergency Calls: A Metropolis-Wide Study

Drug abuse is an important sociomedical problem in large metropolitan areas. Drug addicts represent a group with particularities, since they hesitate to seek medical care and often refuse hospitalization. Therefore, there is a scarcity of data on drug abuse-related calls. The burden imposed by such calls on emergency health services has not been evaluated in detail. The objectives of this study are to: (1) assess the profile of drug abuse-related calls in a large European metropolis, including the spatiotemporal distribution, as well as the frequency and variability of cancellations; and (2) evaluate the mobilization of emergency prehospital care services in response to the calls. In 2005, the Hellenic National Centre for Emergency Care received 5,836 emergency drug abuse-related calls pertaining to the metropolitan area of Athens, Greece. The analysis focused on: (1) spatiotemporal features of calls/cases; (2) step-by-step cancellation rates in the mobilization of ambulances or other means (mobile intensive care units, specially equipped motorcycles, and super-mini city cars); and (3) response time of the mobilized means. Pearson's chi-square, goodness-of-fit chi-square, and the Kruskal-Wallis tests were used as appropriate. Drug abuse-related calls represented 2% of all emergency calls. Only one-third of these cases were transported to the Accident and Emergency Departments of area hospitals. A total of 9% of the calls were cancelled before transportation arrived; another 20% of victims could not be found when authorities arrived on-scene, and 36% of patients refused transport to the hospital. The cancellation rate is significantly higher in the evening and at night, as well as in summer and autumn. The major burden is imposed on the municipality of Athens (67% of all calls). Drug abuse-related calls represent a significant load for emergency medical services in metropolitan Athens. However, a relatively small percentage of the drug addicts finally are transported to the hospital. Appropriately equipped motorcycles seem to be an effective means for the prehospital management of drug-abuse cases.

Expanding ICU facilities in an epidemic: recommendations based on experience from the SARS epidemic in Hong Kong and Singapore

Epidemics have the potential to severely strain intensive care resources and may require an increase in intensive care capability. Few intensivists have direct experience of rapidly expanding intensive care services in response to an epidemic. This contribution presents the recommendations of an expert group from Hong Kong and Singapore who had direct experience of expanding intensive care services in response to the epidemic of severe acute respiratory syndrome. These recommendations cover training, infection control, staffing, communication and ethical issues. The issue of what equipment to purchase is not addressed. Early preparations should include fit testing of negative pressure respirators, training of reserve staff, sourcing of material for physical modifications to the ICU, development of infection control policies and training programmes, and discussion of triage and quarantine issues.

How state-funded home care programs respond to changes in Medicare home health care: resource allocation decisions on the front line.

To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N = 2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics.