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Results for “Comprehensive Health Care”

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PubMedDate not supplied

[Education of psychologists and their role in primary health care].

This paper takes as its basis the concept of comprehensive health care. The need to try out complementary approaches to health care is emphasized in order to ameliorate the effects of the epidemiological transition. The approach of Primary Health Care as a basic strategy is also presented. The importance of applying health system population approach to health care is also analyzed. A number of health care alternatives are presented in order to stabilize the health of a community. Within these alternatives the training of human resources with a focus on prevention as well as the curative approach are presented. The role that the psychologist plays within the comprehensive health care is also described. Also the authors describe an innovative training program directed to Psychologists at this stage, that integrates a Master on Public Health with emphasis in mental health with a residence program in Comprehensive Health Care as an option to contribute to replicate the alternatives of care presented in the paper. Finally, the programs and their advances are presented.

Curriculum↗
PubMed1978

The use of health services by civilian beneficiaries of the military health care system. A comparative study.

The military Health Care System provides comprehensive health care to entitled beneficiaries in a dual system consisting of hospitals and clinics at military installations, and an insurance like program (CHAMPUS) which pays for care in civilian facilities. Utilization by civilian beneficiaries was studied and compared with utilization by members of the Kaiser-Permanente Plan in Northern California, and the Non-Institutionalized Population of the United States. Hospital use rates for beneficiaries under CHAMPUS and in military facilities were calculated, and rough order of magnitude data were developed for utilization of hospitals outside of the Military Health Care System. Rates within the system were found to be lower than those of the noninstitutionalized population of the United States, partly because of utilization of hospitals outside of the Military Health Care System by entitled beneficiaries. However, rates were generally higher than those of Kaiser-Permanente (northern California) enrollees, despite the high use of hospital care by beneficiaries outside of the Military System. Systems factors impinging on hospital utilization rates are discussed. Ambulatory visit rates for beneficiaries in northern California to all types of providers were found to closely approximate those of the Kaiser-Permanente system, when all sources of care (within and outside of the system) are considered. Utilization within the Military Health Care System, however, is less than utilization by Kaiser beneficiaries. In general, civilian beneficiaries of the Military Health Care System were found not to be taking full advantage of their entitlement to health care.

Ambulatory Care↗
PubMedDate not supplied

Physicians and prepaid group practices.

Prepaid group practices (PGPs) are complex organizations that directly combine prepayment for health care with a comprehensive health care delivery system. PGPs' ability to manage their physician staffing efficiently must be placed in context with the cost and quality of their care. It seems unlikely that PGPs or their use of staff will proliferate. With increased integration of care through disease management programs and use of clinical information technology, it should be possible for the United States as a whole to come closer to achieving the care delivery goals that PGPs have set in the past.

Costs and Cost Analysis↗
PubMed2005

Financing and reimbursement of elders' oral health care: lessons from the present, opportunities for the future.

This article describes current financing and reimbursement for elders' oral health care and presents innovative options and opportunities for the future. Current health and dental care financing data from the Centers for Medicare and Medicaid Services and Agency for Health Care Research and Quality are reviewed. Existing and potential reimbursement options for the future are presented. Options for future financing and reimbursement include extending dental insurance into retirement, inclusion of oral health care into existing comprehensive health care plans, developing retiree plans for selected, well-defined (by the sponsor) groups of retirees, pre-paying dental care during employment, development of an Elders Health Insurance Program for the poor and near poor, and developing optional "Part D (for Dental)" plans within the Medicare program. Given the absence of universal oral health insurance, a mix of financing options and reimbursement schema will be required to cover the costs of oral health care and eliminate disparities in oral health access and outcomes for the growing elderly population.

Aged↗
PubMedDate not supplied

A comprehensive primary health care delivery model.

Primary health care has emerged as a key element in the health care delivery system. A well-organized system of primary care is needed to reduce the fragmented, often parallel approaches currently seen in the delivery of health care. Important aspects of primary care include not only comprehensive services and continuity of care to the individual client but health assessment and intervention to meet the community needs as a whole. A nursing model is presented for comprehensive interdisciplinary primary health care practice, education, and research. A unique aspect of this model is the partnership with the community, which is an essential component for operationalization of the model. Use of this model will provide an opportunity for cost-effective, acceptable, accessible, and holistic health care that better meets the needs of the community.

Community Health Planning↗
PubMed2003

Primary health care, selective or comprehensive, which way to go?

OBJECTIVE: To critically review the advantages and disadvantages of selective versus comprehensive Primary Health Care (PHC) approaches as a strategy towards improving health in the developing world. DATA SOURCES: Review of literature on PHC. DATA SELECTION: Relevant papers from western and developing world literature. DATA EXTRACTION: Search of Pub-Med, WHO/UNICEF reports, and relevant publications on PHC. DATA SYNTHESIS: Examination of principles behind PHC and practical experiences in PHC in the developing world. CONCLUSIONS: Selective PHC programs have improved specific aspects of health, frequently at the expense of other health sectors, but fail to address an individual's health in holistic manner, or the health infrastructure of countries. Selective PHC programs tend to focus only on a small subset of the community. Comprehensive PHC is expensive to implement, however addresses health of individuals more holistically, addresses both preventive and curative health care, and promotes health infrastructure development and community involvement, thereby providing more sustainable improvement of health in the whole community.

Comprehensive Health Care↗
PubMed1981

Assessing functional abilities of elderly outpatients.

There is an important and necessary distinction to be made between the delivery of medical services and the furnishing of comprehensive health care. Both medical service (or that which makes life possible) and comprehensive health care (or that which makes life worthwhile) directly enhance the self-esteem and functional ability of elderly patients. In programs of care for the elderly, practitioners must develop an understanding of the impact that various body systems as well as the social system have on the patient if the programs are to be effective. This study has attempted to provide a comprehensive understanding of the functional capacity of elderly patients seen in the General Medicine Outpatient Clinic at the University of Utah Medical Center, Salt Lake City. Implications drawn from this multidimensional functional assessment have led to recommendations for appropriate service delivery along with a better understanding of how the elderly function and what they need. Assessment techniques such as OARS questionnaire used in this study are invaluable in helping caregivers understand and plan for the comprehensive health care needs of the elderly. As more programs make use of data derived from assessment procedures like the one described here, the overall quality of life for the elderly should improve.

Activities of Daily Living↗
PubMed1984

The structure of health care service--so-called the worried well patients and psychosomatic medicine.

The desire of people to receive the best health care services without difficulty is an instinctive one. However, defects in public health education and the irresponsible or sometimes sensational medical information released by the mass media are causing an excessive increase in the population's demand for health care services. As a result, so-called "worried well" patients are increasing and health care institutions are crowded with such patients, who play a major role in increasing national medical spending. On the other hand, it is difficult to say that health care institutions are providing satisfactorily continuous, consecutive and comprehensive health care services. Needless to say, in dealing with worried well patients, the health care institutions should make efforts towards early detection of disease, if any, but at the same time, a psychosomatic approach should be made, considering patients as holistic people with both a mind and body. To this end, interdepartmental and interhospital liaison becomes very important. From the viewpoint of comprehensive health care services, the author presents in this paper such cases where the health care services provided are regarded as defective in terms of continuity and points out the importance of systematized health care information and systematized health care services at all health care levels from primary to tertiary.

Adult↗
PubMed1977

The social work stake in problem-oriented recording.

Pressure for adoption of Problem-Oriented Recording (POR) is coming from various sources outside of the helping professions: from commercial third-party payers who have a legitmate need to scrutinize claims for payment; from all levels of government, out of concern for cost containment and for decisions regarding the allocation of limited resources; and from consumers and others who demand quality assurance and accountability mechanisms. POR is an ecological approach that promotes the concept of comprehensive health care. As social work is concerned with both the person and his environment, with the causes and the sequelae of illness and the interrelationship of problems, this problem-oriented approach is of immense interest to the profession. The social worker in an ecologically oriented health care system immediately becomes a more significant provider of health care.

Comprehensive Health Care↗
PubMed2005

Interaction with other health team members in caring for elderly patients.

Comprehensive health care of the geriatric patient requires thoughtful communication and coordination of services. Unlike young adults, older patients are likely to be frail, have multiple chronic conditions, and experience disability. Hence they are more likely to depend on others for help and to see a variety of health professionals at different sites. This complexity demands that health care professionals consider their care not in isolation, but as part of a team. They must ensure that other members of the team are kept informed and are consulted as appropriate to ensure safe and effective care. Accomplishing this goal requires being acquainted with the usual care providers, the necessary information for sharing, and the most effective communication methods within the team.

Advance Directives↗
PubMed2006

Developments in Australian general practice 2000-2002: what did these contribute to a well functioning and comprehensive Primary Health Care System?

BACKGROUND: In recent years, national and state/territory governments have undertaken an increasing number of initiatives to strengthen general practice and improve its links with the rest of the primary health care sector. This paper reviews how far these initiatives were contributing to a well functioning and comprehensive primary health care system during the period 2000-2002, using a normative model of primary health care and data from a descriptive study to evaluate progress. RESULTS: There was a significant number of programs, at both state/territory and national level. Most focused on individual care, particularly for chronic disease, rather than population health approaches. There was little evidence of integration across programs: each tended to be based in and focus on a single jurisdiction, and build capacity chiefly within the services funded through that jurisdiction. As a result, the overall effect was patchy, with similar difficulties being noted across all jurisdictions and little gain in overall system capacity for effective primary health care. CONCLUSION: Efforts to develop more effective primary health care need a more balanced approach to reform, with a better balance across the different elements of primary health care and greater integration across programs and jurisdictions. One way ahead is to form a single funding agency, as in the UK and New Zealand, and so remove the need to work across jurisdictions and manage their competing interests. A second, perhaps less politically challenging starting point, is to create an agreed framework for primary health care within which a collective vision for primary health care can be developed, based on population health needs, and the responsibilities of different sectors services can be negotiated. Either of these approaches would be assisted by a more systematic and comprehensive program of research and evaluation for primary health care.

Journal Article↗