Coordination Of Medical Services Research Articles

Coordination of Care to Meet the Quadruple Aim

Coordination of medical services is not a novel framework for reducing healthcare costs while improving patient outcomes and experiences. Nevertheless, this goal has been found to be difficult to enact in practice. The implementation of effective care coordination faces a myriad of challenges: monitoring, sharing, and responding promptly to changes in a patient’s health status; ensuring clear and transparent communication with patients and caregivers; and addressing social determinants of health. As the adult population of the United States continues to get older, the number of patients with multiple chronic conditions is expected to increase drastically, providing a greater imperative for effective care coordination within the medical infrastructure.

CARE PARTNERS’ ENGAGEMENT IN PREVENTING FALLS FOR COMMUNITY-DWELLING OLDER PEOPLE WITH DEMENTIA

Abstract Care partners adopt various behaviors to manage fall risk for community-dwelling older people with dementia (cd-OPWD). It is unknown if these behaviors reduce falls for cd-OPWD at different levels of fall risk. We linked the data from the 2015 and 2016 National Health and Aging Trends Study (NHATS) and the 2015 National Study of Caregiving (NSOC) (cd-OPWD n=365, 89% aged 75+) to explore this question. The outcome was no fall, one fall, and multiple falls in 2016. We used the same variable in 2015 to indicate fall risk at baseline. We identified 28 items from NSOC to represent dementia care partners’ fall risk management (FRM) behaviors based on existing literature and expert review. Using exploratory factor analysis, we identified five categories of FRM behaviors: mobility and safety assistance, health management, accommodations, medical services coordination, and social services coordination. We performed multinomial logistic regression to investigate associations between care partners’ FRM behaviors in 2015 and cd-OPWD’ falls in 2016 stratified by cd-OPWD’s history of falls in 2015, adjusting for selected covariates. For cd-OPWD who had no fall in 2015, mobility and safety assistance was associated with a higher risk of having one fall in 2016; for those who had one fall in 2015, medical services coordination was associated with a lower risk of multiple falls; for those who had multiple falls in 2015, social services coordination was associated with a lower risk of multiple falls. Future research may target care partners’ different FRM behaviors based on cd-OPWD’s history of falls.

ONCOLOGICAL SERVICE PROVISION WITHIN THE MEDICAL CARE GUARANTEE PACKAGE OF THE NATIONAL HEALTH SERVICE "TREATMENT AND FOLLOW-UP OF ADULTS AND CHILDREN WITH HEMATOLOGICAL AND ONCOHEMATOLOGICAL DISEASES IN OUTPATIENT AND IN-PATIENT SETTINGS"

Introduction. The approaches to the criteria for assigning a treated case/interaction to oncology packages and the principles of their payment introduced by the National Health Service need to be improved in order to prevent the introduction of inadequate tariffs, in particular, failure to provide services in the amount specified in the tariff or, on the contrary, double/triple funding, which can lead to a significant increase in the costs of financing oncology medical services. The aim of the study is the identification of the main defects and gaps in the existing rules of the grouper regarding the assignment of a treated case/interaction to the oncology package "Treatment and follow‑up of adults and children with hematological and oncohematological diseases in outpatient and inpatient settings" and, on this basis, developing suggestions for improving services in this direction. Materials and Methods. A descriptive-analytical study of the analysis of medical services provided in the oncology package 38 "Treatment and follow-up of adults and children with hematological and oncohematological diseases in outpatient and inpatient settings" for the first 8 months of 2022 was performed according to the data of the National Health Service of Ukraine and the normative legal acts that regulate the issue of implementing the Medical Guarantees Program. Results. The study assessed the correctness of the criteria for the entry of Electronic Medical Records into package 38 compared to the Australian coding standards and analyzed the consistency of payment according to the rate for the provided medical services to patients with oncological and oncohematological diseases within the limits of all interactions of package 38. Certain inconsistencies in the selection of diagnoses for inclusion in the list of reasons for providing medical services and the vagueness of the criteria for including a case in the package were revealed, when a specific diagnosis is a criterion for inclusion in both the 38th package and the corresponding DRG, but with different funding. It was established that 1/5 of all children within the framework of this package sought medical help in an outpatient setting only once or twice, and the list of interventions does not correspond to the package rate; among adults, there was a significant number of patients who sought medical care 1 or 2 times in an outpatient setting, and paid for these cases at the full rate. The findings indicate an urgent need for two-stage medical monitoring of all interactions established for oncological diagnoses within the framework of the therapeutic package. The first automatic monitoring should be carried out according to certain indicators with the formation of "a red list of interactions", and then doctors check these interactions, even in manual mode. Conclusions. On the basis of the results, recommendations were developed regarding changes to the Medical Guarantee Program in oncology, namely to the interactions in the package "Treatment and follow-up of adults and children with hematological and oncohematological diseases in outpatient and inpatient settings", which relate to the grounds for providing services within the framework of oncology packages and coordination of medical services provided to patients with oncohematological diseases with a tariff that will allow for proper payment of the medical services and will improve the provision of medical services.

Developing Quality Indicators for Helicopter Emergency Medical Services Coordination in Norwegian Emergency Medical Communication Centrals: A Consensus Process

ObjectiveEfforts to optimize the use, availability, and safety of helicopter emergency medical services (HEMS) is important. A lack of consistent and comprehensive flight dispatch procedures and a lack of use of safety technology are recurring safety problems. Reports after several major incidents pointed toward a possible gain by coordinating Norwegian HEMS from regional emergency medical communication centrals. Our objective was to develop and implement relevant quality indicators before such implementation in central Norway. MethodsWe recruited an expert panel of 24 persons representing Norwegian health authorities, emergency medical communication centrals, and HEMS bases and performed a 3-step e-mail–based Delphi process to develop relevant quality indicators. Each indicator was assessed according to their feasibility, rankability, actionability, and variability. To reach a consensus, a median score of 5 or more on a 6-point Likert scale in step 3 was needed. ResultsA total of 61 quality indicators were proposed. Of the 14 indicators that reached a consensus, 12 of these were considered process indicators, and 2 were bordering to outcome indicators. ConclusionWe applied a Delphi process method to develop quality indicators for HEMS coordination and flight following. An experienced and heterogeneous expert panel suggested and reached a consensus on which quality indicators should be applied.

Reperfusion times for ST elevation myocardial infarction: a prospective audit

New published guidelines recommend treatment of ST elevation myocardial infarction (STEMI) within 30 minutes of first medical contact to thrombolysis and 90 minutes to primary percutaneous coronary intervention (PCI). To determine how a tertiary care center compares to these new guidelines and to evaluate the success of measures directed to shorten delays. This was a prospectively designed audit loop using retrospective chart review. Specific time intervals were evaluated: 1) T2 (ER presentation to diagnostic EKG; 2) T ER (ER presentation to reperfusion); and 3) T AHA (first medical contact to reperfusion). Results of the initial 12-month data were conveyed to Emergency Room staff and a dedicated EKG machine was placed in the ER for the subsequent 12 months, and the results were then re-analyzed. In 2003-4, 58 patients with STEMI were identified, with 41 (70.7%) receiving reperfusion. Of those receiving thrombolysis, median T AHA was 54 [37-72] minutes, with 12.0%<30 minutes, while those receiving PCI, median T AHA was 58 [43-78] minutes, with 25.0%<90 minutes. In 2004-5, 52 patients had STEMI, with 40 (76.9%) receiving reperfusion. The percentage of patients meeting the guidelines was 14.3% for the thrombolysis group and 11.1% for the PCI group. Introduction of a dedicated EKG machine led to a strong trend towards improvement in median T2 (22 vs 10 minutes; P=0.07), but other treatment times remained unchanged. Treatment times are longer than recommended guidelines. More comprehensive strategies and improved coordination of medical services are required to shorten pre-contact and post-contact response times.

SOCIAL FUNCTIONING AS AN IMPORTANT CLINICAL TARGET DURING CARE TRANSITIONS FROM SKILLED NURSING FACILITIES

Care transitions from skilled nursing facilities (SNF) to home signify a period of medical risk for older adults. They also present opportunities for clinical interventions to reduce these risks and to enhance or maintain patients’ quality of life. A substantial body of research has been published on improving late life care transitions (CTs), including the development of standardized CT models for acute care. However, such models typically focus on improved coordination of medical services; overlook the need to address psychosocial well-being and social connectedness; and have rarely been implemented in SNFs. This poster will present a conceptual model of social functioning in older adults that draws on constructs from the World Health Organization’s World Report on Ageing and Health (2015). We propose that social functioning is a key part of overall functioning among older adults who use SNFs and is simultaneously influenced by physical, psychological, and cognitive functioning. To illustrate our model, we will present results of a qualitative study (n= 21) that describes declines in social functioning following care transitions to the community from VA SNFs. Implications for clinical practice include the need to better integrate social functioning in clinical assessments, goal setting, discharge planning, and coordination of care activities. The need for additional research on this topic will also be addressed. Our project is highly relevant to the overall conference theme “Harnessing the Power of Networks” as it presents a conceptual model and study findings related to social connectedness and social functioning in older adults who use SNFs.

Sideline Coverage of Figure Skating Events.

The sport of figure skating has evolved to include various disciplines and athletes continue to push the limits of the skills they perform, thus increasing the potential for injury in practice, as well as in competition. To provide optimal rink side coverage, health care professionals must be aware of the elements skaters perform and the injuries to be expected. Appropriate planning and coordination of medical services is required to ensure adequate and timely care of injured figure skaters. Protocols developed for local, national, and international events are available to assist in this process.

Homeward bound: patients’ perspectives on care transitions after a hospitalization

Background: Suboptimal care transitions from the hospital to home (transitions) may lead to adverse patient outcomes. As reimbursement becomes increasingly linked with clinical and patient-centered outcomes, providers have strong incentives to better manage transitions. Patients may offer key insights to better assess and improve transitions.Methods: In this qualitative study, we performed semi-structured concept elicitation interviews with patients experiencing a transition following an unplanned hospitalization in medical and surgical wards at a single academic medical center. Three analysts independently analyzed transcripts to identify themes within and outside the medical centers that influenced patients’ transition.Results: Our analyses of interview transcripts of patients (n=22) identified 4 themes related to actions of discharging medical centers and 5 themes outside of the direct purview of the discharging hospital that influence transitions. In the medical center, participants generally described positive roles for quality patient-centered care, opportunities for patient participation, comprehensive discharge education and coordination of medical services on their transitions. Outside of the medical center, participants reported that having caregiver support, social support, health literacy, adequate health insurance and accessibility to healthcare and non-healthcare resources following hospital discharge assisted their transitions.Conclusions: This qualitative study suggests that successful transitions result from actions of medical centers to engage and assist patients, as well as from patients’ access to sociodemographic and psychosocial resources. Future work on strategies to develop better patient-centered transitions and their impact on patient outcomes is warranted.

Prevalence and Correlates of Autism Spectrum Disorders in Quebec: Prévalence et corrélats des troubles du spectre de l'autisme au Québec.

To estimate the prevalence, comorbidities, and service use of people with autism spectrum disorders (ASDs) based on data from Quebec Integrated Chronic Diseases Surveillance System (QICDSS). We included all residents up to age 24 eligible for health plan coverage who were in Quebec for at least 1 day from January 1, 1996, to March 31, 2015. To be considered as having an ASD, an individual had to have had at least 1 physician claim or hospital discharge abstract from 2000 to 2015 indicating one of the following ASD diagnosis codes: ICD-9 codes 299.0 to 299.9 or their ICD-10 equivalents. The QICDSS shows that the prevalence of ASD has risen steadily over the past decade to approximately 1.2% ( n = 16,940) of children and youths aged 1 to 17 years in 2014 to 2015. The same prevalence was obtained using Ministry of Education data. Common medical comorbidities included congenital abnormalities of the nervous system, particularly in the first year of life. Psychiatric comorbidity was much more highly prevalent, especially common mental disorders like anxiety and attention-deficit/hyperactivity disorder. Children and youths with ASDs made on average 2.3 medical visits per year compared with 0.2 in the general population. Between 18 and 24 years old, the mental health needs of individuals with ASDs were met less by medical specialists and more by general practitioners. Information derived from this database could support and monitor development of better medical services coordination and shared care to meet the continuous and changing needs of patients and families over time.

CYTOLOGICAL ASPECTS OF CERVICAL CANCER SCREENING

INTRODUCTION: Romania ranks first in Europe in terms of cervical cancer mortality (10.77%), over 6 times more than the average of European Union countries. Of all cancers in women, occupies 4th place in terms of mortality rate after breast, colorectal and lung cancer. Cervical cancer is caused by persistent and common infections of the female genital tract by human papilloma virus (HPV). Currently there is no treatment for HPV, reducing the incidence of cervical cancer can be achieved through organized screening programs and anti-HPV vaccination of female patients at young age. European Union Council recommends early detection of cervical cancer through programs organized for the population, providing quality services at all levels. THE AIM of the study was the identification of determinants for squamous intraepithelial lesions and assess the importance of classical cytology in detecting cervical cancer at an early stage. MATERIAL AND METHODS: We selected a group of 405 patients with positive Babes-Papanicolaou test results from the total number of women tested during 2015 by the screening program organized at the Emergency County Hospital in Tg-Mure ș . We performed a retrospective study on the previously mentioned group of women, demographic, obstetric and medical history data were collected from FS1 screening forms belonging to the Centre Region Management Technical Assistance Unit of the active screening program for early cervical cancer. The study group included women aged 25-64, asymptomatic and without known disease in the genital area. RESULTS: The accessibility of women to Babes-Pap testing has become more visible since the implementation of organized screening program. The accessibility of women to Babes-Pap testing has become more visible since the implementation of organized screening program. In the studied group, 52.25% of the women had regular menstrual cycle and 32.5% of them were at menopause. Batch analysis of the studied group of patients showed that in case of 47.75% of the women the presence of lesions at macroscopic examination of the cervix has been identified. In 12% of the patients the presence of leucorrhea was noted and bleeding of the cervix has been described in 2% of the women. Only 0.75% of the women included in the study benefited from hormonal treatment and a percentage of 1.25% were pregnant at the time of the Babes-Pap test. Analysis of the group of women from the point of view of microbiological examination showed infection with Gardnerella vaginalis in 44% and Trichomonas co-infection in 42%. Of patients selected by interpreting the results using the Bethesda cytology method, the majority (42.25%) were classified in the cytodiagnostic ASCUS class, and a percentage of 26.75 were included in the ASC-H class. Management of intraepiteliale lesions presented in 5 cases showed investigations applying differentiated therapies and the importance of follow-up screening. CONCLUSIONS: Implementing screening of cervical cancer remains a challenge as it involves complex coordination of medical services. Urban women benefit from easier access to specialized medical services, but still a large percentage of women included in the Regional Units’ screening underwent Pap test for the first time in life.Our study identified a small percentage of high-grade squamous intraepithelial lesions, but for these women case management is essential for investigation and early treatment to stop the development of dysplasia. The major benefit of screening for cervical cancer is especially identifying these cases of high-grade dysplasia, treatment applied in time decreasing the incidence of cervical cancer Keywords : cervix, screening, cytology, dysplasia Normal 0 21 false false false RO X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi; mso-fareast-language:EN-US;}

Advanced Practice Nurse Transitional Care Model Promotes Healing in Wound Care

A smooth transition between levels of care requires collaboration and care coordination of medical services and health care providers. The result of this continuity is improved patient outcomes, improved patient satisfaction, and reduced medical errors. APNs as care coordinators have the ability to bridge the existing gap between hospitalization and home while preventing readmission.

Effect of case management on patients with type 2 diabetes mellitus: a meta-analysis

Abstract Background Case management is a term used to describe the activities performed by a physician or other health care professional to ensure the coordination of medical services required by a patient. Managed care requires the incorporation of information pertaining to patient evaluation, treatment planning, referrals, and follow-up care to ensure that payment for services is received and that care is ongoing and comprehensive. The objective of this review was to assess the efficacy of case management in patients with type 2 diabetes mellitus with respect to outcomes such as glycosylated hemoglobin (HbA 1c ), systolic blood pressure (SBP), diastolic blood pressure (DBP), and low-density lipoprotein (LDL). Methods Databases including PubMed, Embase, Web of Science, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), VIP, Wan Fang and the Chinese Biomedical Literature Database (CBM) were searched for randomized controlled trials (RCTs) dating as late as Jan, 2015. Reference sections of the included studies were also searched. Results Twelve studies, involving 11 RCTs that evaluated a total of 4000 patients, were included in this analysis. Two of the 12 studies evaluated the same RCT. Seven of the 12 studies reported HbA 1c as an outcome, and three trials reported changes in SBP, DBP and LDL levels as outcomes. The pooled results indicated that statistically significant improvements in HbA 1c (MD = −0.35, 95% CI (−0.68, −0.02), P = 0.04) and LDL levels (MD = −2.49, 95% CI (−4.04, −0.93), P = 0.002) were associated with the case management group compared with control group; however, no statistically significant differences in DBP (MD = −0.08, 95% CI (−0.68, 0.52), P = 0.8) and SBP (MD = −0.96, 95% CI (−5.77, 3.84), P = 0.69) were observed. Conclusions Case management was effective in improving HbA 1c and LDL levels in patients with type 2 diabetes mellitus. Although no statistically significant differences in DBP and SBP between the case management group and the control group were observed, further research is required to draw a conclusion about the effect of managed care on these outcomes. Based on this meta-analysis of clinical trials, we conclude that case management offers an effective clinical method for the treatment of type 2 diabetes.

Poster 127: Benefits of a Medical Assistance, Medicare, and Waiver Care Coordination Program for Persons With Disabilities

Objective: To demonstrate the benefits of an integrated care coordination model on the lives of individuals with disabilities. Design: Over the first 90 days of enrollment in the Minnesota Disability Health Options (MnDHO), members' perception of their health, and completion of health and social outcomes were assessed. Setting: MnDHO is a managed care program serving Medicaid-eligible adults, as an alternative to the fee-for-service system. MnDHO wraps Medical Assistance, Medicare, and waivers into a flexible coordinated program. Participants: 56 members were tracked through their first 90 days in the MnDHO program. Members have physical disabilities and average 9.9 chronic health conditions. Interventions: Members receive coordination of medical services, including assistance in scheduling medical appointments, transportation, and accompanied physician's visits. In addition, social services such as housing transitions, purchase of durable medical equipment, home adaptations, and coverage of individualized programs such as adaptive fitness, day programs, and equipment individualized to the member are included in the program. Main Outcome Measures: The focus of this project was to assess change in members over the first 90 days of enrollment. Healthy Days is a measure of perception of health, along with care goals met in the first 90 days. Results: For 56 enrollees, Healthy Days over the first 90 days of enrollment increased from 8.19 days per month at the beginning of the program to 11.17 days per month. This is a clinically significant increase. In the first 90 days, the most commonly met care goals were specialty physician care, arrangements for transportation, primary physician care, and provision of durable medical equipment. Conclusions: Coordination of medical and social services in this population was beneficial to their overall health.

THE ORGANIZATION AND FINANCING OF MEDICINE IN THE NEW MILLENNIUM

Medicine stands at the threshold of the twenty-first century on two and a half millennia in the traditions of our art (since the founding of his school of medicine by Hippocrates on the Isle of Cos in the Aegean Sea in the fifth century bc); one century of scientific achievement (the development of diphtheria antitoxin in 1891 and the discovery of x-rays by Wilhelm Conrad Roentgen in 1895); and one decade of economic turmoil (managed care in the 1990s). At the turn of the last century, physicians outnumbered nurses, comprising 60% of the labor force. Physicians were predominantly general practitioners. The American Board of Ophthalmology was established in 1917 as the first medical specialty board. In 1890, the patient paid the physician out of pocket or by barter in the form of poultry, produce, or the promise of some services in an agrarian economy. Notwithstanding the organization of medical services by rail and mining companies in the second half of the nineteenth century, the practice of medicine was predominantly a solo endeavor. The American Medical Association joined with organized labor (American Association for Labor Legislation) in 1916 to support health insurance, but organized medicine became increasingly hostile to compulsory national health insurance after World War I. The Committee on the Costs of Medical Care was established in 1927 by a consortium of eight private foundations. After the completion of more than two dozen research papers, most of the Committee published five recommendations in Medical Care for the American People in 1932. 1 1Medical services, both preventive and therapeutic, should be furnished largely by organized groups of physicians, dentists, nurses, pharmacists, and other associated personnel. 2All basic public health services—whether provided by governmental or nongovernmental agencies—should be available to the entire population according to its needs. 3The cost of medical care should be addressed on a group payment basis, through the use of insurance and taxation. 4Studies, evaluation, and coordination of medical services should be considered important functions for every state and local government. 5The breadth, depth, and focus of education and training for the health professions should be expanded. These recommendations would be largely implemented during the remainder of the twentieth century. Early developments in the 1930s included the beginnings of Blue Cross and Blue Shield to finance health services. The Social Security Act of 1935 included Title V to fund maternal and child health programs and Title VI to provide federal subsidies for public health services. Employer funding of health insurance can be traced to a decision of the War Labor Board in 1942. Although wages were frozen, fringe benefits would be negotiable. The subsequent decision by the Department of the Treasury that fringe benefits would not be taxable to the employer or employee brought us to an estimated annual $90 billion of government subsidy of health insurance by the end of the century. Beginning in the mid-1930s, a relentless succession of legislative proposals culminated in Medicare (Title XVIII) and Medicaid (Title XIX) of the Social Security Amendments of 1965. This movement began in the drafting of Social Security in the Roosevelt Administration and signed into law as Public Law 89–97 by President Lyndon B. Johnson in the Truman Library in Independence, Missouri, on July 30, 1965. In the 1990s, the Clinton health program sought a national restructuring and refinancing of health care. It failed for a plethora of programmatic, political, professional, and priority circumstances. With the expiration of the Clinton health care reform, the nation's health care enterprise turned, more reluctantly than enthusiastically, to the managed care sought by corporate America, primarily to control costs.

British Agencies for Adoption and Fostering in Scotland—Scottish Medical Advisers' Survey

Children in local authority care (The survey was conducted before the term ‘in care’ was replaced by ‘looked after’ on The Children (Scotland) Act coming into force in October 1996) come from backgrounds of high incidence of mental illness, substance abuse and learning difficulties and have often suffered from neglect and/or abuse. They have a high incidence of medical problems affecting both physical and mental health. The Committee of the Scottish Section of the Medical Group of British Agencies for Adoption and Fostering (BAAF) were concerned about the provision and co-ordination of medical services for children in local authority care. The aim of the survey was to identify the current and evolving practice among medical advisers across Scotland. Questionnaires were returned from 40 Medical Advisers representing each of the local authorities in Scotland. The responses highlighted a variation in the implementation of practice in clinical services provided to children in care and by whom. It confirmed that difficulties in follow-up did exist and revealed widespread confusion surrounding co-ordination of medical services, absence of procedures and ignorance of legal requirements. The study confirms that involved medical practitioners need to have a pro-active role in co-operating closely with social work colleagues to provide a well co-ordinated service of medical supervision providing a comprehensive assessment of health care needs as part of the overall child care plan.

British Agencies for Adoption and Fostering in Scotland—Scottish Medical Advisers' Survey

Children in local authority care (The survey was conducted before the term ‘in care’ was replaced by ‘looked after’ on The Children (Scotland) Act coming into force in October 1996) come from backgrounds of high incidence of mental illness, substance abuse and learning difficulties and have often suffered from neglect and/or abuse. They have a high incidence of medical problems affecting both physical and mental health. The Committee of the Scottish Section of the Medical Group of British Agencies for Adoption and Fostering (BAAF) were concerned about the provision and co-ordination of medical services for children in local authority care. The aim of the survey was to identify the current and evolving practice among medical advisers across Scotland. Questionnaires were returned from 40 Medical Advisers representing each of the local authorities in Scotland. The responses highlighted a variation in the implementation of practice in clinical services provided to children in care and by whom. It confirmed that difficulties in follow-up did exist and revealed widespread confusion surrounding co-ordination of medical services, absence of procedures and ignorance of legal requirements. The study confirms that involved medical practitioners need to have a pro-active role in co-operating closely with social work colleagues to provide a well co-ordinated service of medical supervision providing a comprehensive assessment of health care needs as part of the overall child care plan.

Medical documentation for third-party payers.

Medical documentation of patient care by physical therapy has become a requirement for reimbursement of health services paid by federal and state programs or by other third-party payers. The medical record of physical therapy must satisfy several specific requirements of third-party payers before health services can be reimbursed. The fiscal intermediaries require a precise, written statement of the patient's physical problems, treatment goals and plan, and objective information on the patient's response to treatment. The criteria reflected for third-party payment must be satisfied and evident in succinct and accurate documentation in the medical record. Medical documentation must show evidence of a prescription, medical reason for treatment, a viable discharge plan, outcome of treatment, coordination of medical services, patient instruction, and discontinuance or adaptation of services when necessary. The requirements for third-party payment based on medical documentation are discussed.

Co-ordination of Medical Services

Co-ordination of Medical Services

COORDINATION OF MEDICAL SERVICES: THE PROFESSION AND THE PUBLIC

Medical Journal of AustraliaVolume 1, Issue 23 p. 709-709 Current Comment COORDINATION OF MEDICAL SERVICES: THE PROFESSION AND THE PUBLIC First published: 01 June 1941 https://doi.org/10.5694/j.1326-5377.1941.tb108555.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue23June 1941Pages 709-709 RelatedInformation

Co-ordination of Medical Services

A DEPUTATION from the central emergency committee of the British Medical Association, including representatives of the Royal Colleges, was received on November 8 by Sir Thomas Inskip, the Minister for Co-ordination of Defence, who was accompanied by officers of the Government departments concerned. The deputation urged the establishment of machinery for the co-ordination of all medical services for the civilian population under a single body, andyfche coordination of civilian medical organizations under that of the Service Departments. It was also proposed that the machinery should be closely associated with the central emergency committee as being representative of all branches of the profession.