Articles: community-health-services.
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The site of cancer care delivery has been shown to be associated with the total cost of care. The magnitude of this effect in patients receiving expensive immuno-oncology (I-O) therapies has not been evaluated. We evaluated cost differentials between community-based and hospital-based outpatient clinics among patients receiving I-O therapies. ⋯ Treatment with I-O therapies in community practice is associated with a lower total cost of care compared with that in hospital-based outpatient practices. With the expanding indications of these agents, future research is needed.
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J Public Health Manag Pract · Feb 2019
Community Benefit Spending Among North Carolina's Tax-Exempt Hospitals After Performing Community Health Needs Assessments.
As of March 23, 2012, the Internal Revenue Service (IRS) requires tax-exempt hospitals to conduct Community Health Needs Assessment (CHNA) every 3 years to incentivize hospitals to provide programs responsive to the health needs of their communities. ⋯ The study hospitals direct most of their community benefit expenditures to patient care financial assistance (individual welfare) rather than population health improvement initiatives, with virtually no investments in community-building activities that address socioeconomic determinants of health.
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This report documents a successful intervention by a community-based naloxone distribution program in San Francisco. The program and its partner organizations, working with participants who use drugs, first identified the appearance of illicitly made fentanyl and increased outreach and naloxone distribution. Distribution of naloxone and reported use of naloxone to reverse opioid-involved overdoses increased significantly while the number of opioid-involved and fentanyl-involved overdose deaths did not. Community-based programs that provide training and naloxone to people who use drugs can serve as an early warning system for overdose risk and adaptively respond to the rapidly changing overdose risk environment.
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Comparative Study
Screening Heroin Smokers attending Community Drug Services for COPD.
Heroin smoking is associated with deprivation, early onset severe emphysema, premature morbidity and mortality, and high use of health care, but individuals engage poorly with traditional health services. ⋯ Most heroin smokers had COPD or ACO, most commonly mild to moderate disease. In high-risk areas, screening this population provides an opportunity to reduce symptoms and risk. Anchoring respiratory health screening to drug center appointments delivers high completion and satisfaction and is an appropriate model for screening other hard-to-reach populations.
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Emerg Med Australas · Feb 2019
Should freestanding emergency departments be considered in Australia?
The concept of freestanding EDs is a popular operational model of emergency care in the USA. This model has been described as an emergency physician-created innovative solution in resolving ongoing overcrowding issues in EDs. A decentralised community-based emergency care model may be a solution to meet the increasing demand for emergency and unscheduled acute care in Australia. ⋯ The aim of freestanding EDs should be to manage and discharge a cohort of patients, mainly in Australasian Triage Scale 3 and 4 categories, currently seen in hospital-based EDs. This article briefly examines the potential merits and issues if this concept is considered in Australia. It also provides an early proposed model for such EDs.