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HIV/AIDS and long-term care: A state perspective

JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE 2000年第2期77卷 232-243页

作者： Hoos, D Chorost, S Chesnut, TJ New York State Dept Hlth AIDS Inst New York NY 10001 USA New York City Dept Hlth Div HIV Hlth Care Chron Care Sect AIDS Inst New York NY 10001 USA New York State Dept Hlth Informat Syst Off AIDS Inst New York NY 10001 USA

Long-term care services for people with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) were fostered in Nerv York State by passage of HIV-specific regulations that set program standards and authorized reimbursement rates sufficient to support these standards. A rapid expansion of HIV-specific capacity has occurred. Demographic and selected clinical characteristics of the populations in AIDS residential health care facilities and AIDS adult day health care programs in New York State are presented. Aspects of the service models for these two program types that have changed to meet new needs are discussed.

关键词：抗HIV药/投药和剂量抗HIV药/治疗应用日间住院医疗/利用药物疗法联合 HIV感染/药物疗法 HIV感染/护理医院慢性病/利用长期医疗/组织和管理长期医疗/利用模型组织管理纽约公共卫生管理寄托医疗设施/利用成年人女(雌)性人类男(雄)性

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Applying disease management strategies to Medicare

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MILBANK QUARTERLY 1999年第4期77卷 461-+页

作者： Tompkins, CP Bhalotra, S Trisolini, M Brandeis Univ Schneider Inst Hlth Policy Heller Grad Sch Waltham MA 02454 USA

Medicare coverage begins for many when they have already developed one or more chronic diseases, and it often pays for the latest and costliest phases. Population-based disease modeling, patient screening, and monitoring would be appropriate interventions for chronic renal disease. Patients who have not get advanced to end-stage renal disease would benefit from management of diabetes and hypertension, avoidance of nephrotoxic substances, and better preparation for dialysis. Administrative support could take the form of clinical guidelines, physician-led multidisciplinary teams, integrated delivery systems, provider and patient education, and new information technologies. Medicare reflects the long-term public perspective, and thus should further this new direction by supporting education, reimbursing for prevention efforts and allied health services, encouraging efficiency, and monitoring cost and quality outcomes.

关键词：社区卫生计划/组织和管理费用控制疾病管理预测肾功能衰竭慢性/经济学肾功能衰竭慢性/治疗长期医疗/组织和管理普查/组织和管理 Medicare/组织和管理需求估价/组织和管理诊疗准则(主题) 一级预防/组织和管理质量保证卫生保健/组织和管理美国人类

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Too ill to learn: double jeopardy in education for sick children

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JOURNAL OF THE ROYAL SOCIETY OF MEDICINE 2000年第3期93卷 114-117页

作者： Gabbay, MB Cowie, V Kerr, B Purdy, B Univ Liverpool Dept Primary Care Liverpool L69 3GB Merseyside England Royal Manchester Childrens Hosp Sch Manchester M27 4HA Lancs England Royal Manchester Childrens Hosp Reg Genet Serv Manchester M27 4HA Lancs England

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Case management: Opportunities for service providers

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Home Health Care Services Quarterly 1993年第1期14卷 5-40页

作者： Williams, Judith K. Planning at the Miami Jewish Home and Hospital for the Aged United States

The notion of using case managers to coordinate care and services to the elderly has become increasingly popular. Case management appears to be seen by some as the route to reform and rationalization of the financing and provision of services. Little systematic research can be cited in making claims for its organization, efficacy or efficiency, yet opinions in this regard abound. Research and demonstration projects provide some insights but few conclusions to support the rhetoric of case management. Case management principles are enunciated and program options flow from them. A case is made for flexibility of organization and sensibility of provision. © 1993 Taylor & Francis Group, LLC.

关键词：利害冲突卫生政策/立法和法学卫生服务研究家庭医疗保健服务/组织和管理长期医疗/组织和管理管理医疗规划/组织和管理纽约病人医疗护理计划/组织和管理病人医疗护理计划/标准规划制订/方法规划制订/标准偿还途径/组织和管理州卫生计划/立法和法学美国老年人人类

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Expansion and merger of home care agencies: Optimizing existing resources through organizational redesign

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Home Health Care Services Quarterly 1981年第3期1卷 3-36页

作者： Reif, Laura Home Health Care Services Department of Family Health Care Nursing University of California San Francisco CA 94143 United States

This article analyzes the extent to which expansion and the merger of existing home care agencies is an effective strategy for improving in-home services for persons who require long-term care. Information obtained from nine comprehensive home care providers suggests that movement to a new service structure is impeded by (1) limitations and fragmentation of existing funding sources;(2) the traditional separation between agencies that deliver medical care and those that provide health-supportive “social” services;and (3) staff’s concern about the impact that organizational changes may have on established roles, functions, relationships, and work conditions. The analysis and supporting evidence show, however, that care providers are more effective and efficient following expansion or merger. After reorganization, agencies appear to be more successful in reaching greater numbers of potential clients, in providing appropriate, well-coordinated services, and in making more effective use of existing resources. Unfortunately, inadequate funding has so constrained the development of in-home services, that expansion or merger of existing providers is, at best, an interim solution. Reorganization of the service system, under existing limitations, will achieve only marginal improvements in serivces and in the population “at risk.” Home care will emerge as a viable resource only when there is a significant expansion in funding, service benefits, and the numbers of persons eligible for a funded program of in-home assistance. © 1980 by The Haworth Press, Inc. All rights reserved.

关键词：效率家庭医疗保健服务/组织和管理长期医疗/组织和管理模型理论组织改革美国

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Long term care and home health care: A challenge to service systems

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Home Health Care Services Quarterly 1979年第1期1卷 19-73页

作者： LaVor, Judith Coverage Branch Office of Long Term Care Experimentation Health Care Financing Administration Washington DC 20201 Switzer 330 “C” Street S.W. United States

No abstract available for this article.

关键词：社区卫生服务/组织和管理卫生保健提供/组织和管理筹资政府家庭医疗保健服务/组织和管理机构间关系长期医疗/组织和管理寄托医疗设施/组织和管理美国老年人人类

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Solutions to the Problems of Chronic Disease Management in Rural Settings

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The Journal of Rural Health 1985年第1期1卷 52-59页

作者： Prate, Dennis A. Johnson, Sidney A. Sharpe, Thomas R. DENNIS A. FRATE Ph.D. is Research Associate Professor in the Research Institute of Pharmaceutical Sciences School of Pharmacy The University of Mississippi. Dr. Frate is also Principal Investigator of a five year demonstration and education research project funded by the National Heart Lung and Blood Institute under grant No. HI. 31370. Dr. Frate is a member of Sigma Xi and a Fellow of the Council of Epidemiology of the American Heart Association. He co-edited The Extended Family in Black Societies (Mouton 1978) and co-authored Medical Education in the Ambulatory Setting: An Evaluation (Springer 1982).

Recent changes in disease patterns in the Untied States from acute to chronic disorders and the maldistribution of medical manpower have disproportionately affected rural residents. Programmatic attempts to alter the medical care system in rural areas have traditionally centered on increasing the number of primary providers. In central Mississippi, two innovative alternative models of chronic disease management have been evaluated. The disease focus was high blood pressure and the two management models emphasized: (1) the use of local residents as health facilitators or health counselors, and (2) the use of self‐help groups in family and church settings. Eighteen months of outcome data indicated that the health facilitator model was controlling 80 percent of the hypertensives participating;the family‐based self‐help groups were controlling 90 percent;and, the church‐based self‐help groups were controlling 79.9 percent. These community‐based models of chronic disease management have broad implications for other geographic areas and other chronic disorders. Copyright © 1985, Wiley Blackwell. All rights reserved

关键词：慢性病社区卫生服务/组织和管理咨询长期医疗/组织和管理密西西比模型理论结果与过程评价(卫生保健) 农村卫生自助小组人类

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Financing long-term care with limited resources: Combining the resources of the public and private sectors

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Journal of Aging and Social Policy 1992年第1-2期4卷 35-50页

作者： Mahoney, Kevin J.

Under Connecticut’s recently implemented public/pri- vate partnership to finance long-term care, individuals will no longer need to impoverish themselves in order to receive Medicaid assistance. To encourage those people who can afford to buy a private long-term care insurance policy to do so, the state promises to shield one dollar in assets from Medicaid “spend-down” rules for every dollar a private policy pays out for Medicaid-covered services. This article describes the Partnership, shows how dwindling resources and budget constraints affected the development of this model, and then contrasts Connecticut’s experience with that of other states and describes what can be learned from this demonstration. © 1992 by The Haworth Press, Inc. All rights reserved.

关键词：康涅狄格保险长期医疗/经济学机构间关系长期医疗/经济学长期医疗/组织和管理 Medicaid/经济学模型组织管理私营部门公营部门美国老年人人类

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Using the long-term care information system for effective community care

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Home Health Care Services Quarterly 1981年第1期2卷 83-97页

作者： Falcone, Angela R. Department of Community Health Science Michigan State University East Lansing MI 48824 United States

Obtaining appropriate long-term care is a problem common to individuals in need, community service providers, regulatory agencies, and fiscal intermediaries. The fragmented nature of the long-term care system precludes natural linkages among service programs. The Long-Term Care Information System Assessment Process was developed and demonstrated to be a communication link among programs and agencies concerned with long-term care. The use of its common language tools for decision making and program organization leads to the provision of appropriate long-term care, efficient use of resources, and effective community care. © 1981 by The Haworth Press, Inc. All rights reserved.

关键词：卫生服务需求卫生服务研究信息系统/组织和管理长期医疗/组织和管理病人/分类美国

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The physical Environment of special care units: Needs of residents with dementia from the perspective of staff and family caregivers

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QUALITATIVE HEALTH RESEARCH 1999年第1期9卷 105-118页

作者： Morgan, DG Stewart, NJ Univ Saskatchewan Ctr Agr Med Saskatoon SK S7N 0W0 Canada Univ Saskatchewan Coll Nursing Saskatoon SK S7N 0W0 Canada

To manage the care of increasing numbers of residents with dementia, many long-term cave facilities have created special care units (SCUs) designed to meet the unique needs of this group. This article describes results of the qualitative component of a larger research project examining environment-behavior relationships in dementia care settings. Eighteen in-depth interviews were conducted with 9 staff and 9 family members of SCU residents. Thematic analysis was conducted using grounded theory techniques. Participants described residents' needs in relation to both the physical and social environments. This article focuses on the five areas of need identified by participants in relation to the physical environment: safety, homelike setting, optimal stimulation, cues, and options for privacy and social interaction.

关键词：痴呆设施的设计和建造卫生服务需求长期医疗/组织和管理生活质量社会环境老年人人类

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