Articles: community-health-services.
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J Pain Symptom Manage · Dec 2018
Patient, Caregiver, and Taxpayer Knowledge of Palliative Care and Views on a Model of Community-Based Palliative Care.
Palliative care (PC) model delivered by two large hospices and PC providers. ⋯ Education for patients, caregivers, and community members about the roles and benefits of PC will be needed to successfully expand community-based PC.
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Previous evaluations of low-dose CT (LDCT) lung cancer screening programmes have taken very different approaches in the design of the informative trials and the methods applied to determine cost-effectiveness. Therefore, it has not been possible to determine if differences in cost-effectiveness are due to different screening approaches or the evaluation methodology. This study reports the findings of an evaluation of the first round of a community-based, LDCT screening pilot Manchester, applying previously published methodology to ensure consistency. ⋯ We found the Manchester programme to be a cost-effective use of limited NHS resources. The findings suggest that further research is now needed not as to whether LDCT screening is cost-effective but under what conditions can it improve patient health by the most while remaining cost-effective.
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Although residency programs are well situated for developing a physician workforce with knowledge, skills, and attitudes that incorporate the strengths and reflect the priorities of community organizations, few curricula explicitly do so. ⋯ We implemented two novel residency tracks that successfully placed graduates in community-based primary care settings. Integrating primary care training with experiences in community organizations can create primary care leaders and may foster collective efficacy among medical centers and community organizations.
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Bmc Health Serv Res · Nov 2018
Can high-cost spending in the community signal admission to hospital? A dynamic modeling study for urgent and elective cardiovascular patients.
Much of the research on high-cost patients in healthcare has taken a static approach to studying what is actually a dynamic process. High-cost patients often utilize services across multiple sectors along care pathways, but due to the cross-sectional nature of many study designs, we lack a clear understanding of the temporal relationship between high-cost spending in community and acute care. Studying care trajectories for high cost patients with cardiovascular disease (CVD) can shed light on the dynamic interplay between community-based and acute care along the care continuum, and provide information about signals in community care that may indicate future elective and urgent hospitalizations. ⋯ By studying the dynamic nature of patient care trajectories, we may use community-based spending patterns as signals in the system that can point to future and elective hospitalizations for CVD. These community-based spending signals may be useful for identifying opportunities for intervention along the care trajectory, particularly for urgent CVD patients for whom future hospitalizations are difficult to anticipate.
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The Johns Hopkins Community Health Partnership was created to improve care coordination across the continuum in East Baltimore, Maryland. ⋯ A care coordination model consisting of complementary bundled interventions in an urban academic environment was associated with lower spending and improved health outcomes.