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Older rural Americans remain largely underserved because the majority of social service delivery systems are established in urban areas. Even with recent efforts to assess the conditions of the nation's rural elderly, there have been oversights that affect the development of policies intended to provide needed services. The author explores these problems and provides suggestions for constructive changes in policy formation.
There are few data on how HIV infection/AIDS affects social service agencies serving children and youth. We conducted a survey of 24 provincially funded agencies in the Metro Toronto area and discovered that 36 clients and 9 staff members were HIV-infected. Our data strongly suggest that these agencies were ill equipped to cope with issues surrounding HIV infection/AIDS. Inadequacy or absence of policy and procedures resulted in confusion regarding issues such as HIV testing, need to know, confidentiality, duty to warn, staff and client education, and universal precautions for infection control. In order to effectively deal with the psychosocial, legal, ethical and education needs of clients and staff, agencies must be pro-active in developing policy and procedure.
Correlates of mental health and social service utilization are examined based on Ontario Child Health Study data. Findings indicate that psychiatric disorder as a predictor of service use may be confounded by school performance and parental use of services, thus calling into question the extent to which program planning should be based on prevalence rates of child psychiatric disorder. Children from low-income families tend to make greater use of available services, suggesting that programs need to be tailored more specifically to their needs.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This article examines how the role of a physician housecall program is perceived by health and social service providers that refer their clients to the program in a Midwest suburban community. Focus groups and semi-structured interviews with those providers revealed various housecall service needs of their homebound clients. In particular, the fact that home health agencies were the largest referral source suggests that the housecall program fills the needs that are not met by the current mainstream home health services. Our findings reinforce the argument for the increased physician involvement in home care and physician housecalls.
Because persons with disabilities (PWDs) use health and social services extensively, both the United States and the United Kingdom have begun to integrate care across systems. Initiatives in these two countries are examined within the context of the reality that personal needs and use of systems differ by age and by type and severity of disability. The lessons derived from this scrutiny are presented in the form of five "laws" of integration. These laws identify three levels of integration, point to alternative roles for physicians, outline resource requirements, highlight friction from differing medical and social paradigms, and urge policy makers and administrators to consider carefully who would be most appropriately selected to design, oversee, and administer integration initiatives. Both users and caregivers must be involved in planning to ensure that all three levels of integration are attended to and that the borders between medical and other systems are clarified.
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OBJECTIVES: To find the individual and socio-family characteristics of that sector of the population which uses Primary Care Social Services (PCSS) at the Primary Care Centre (PCC) and the social problems which occasion demand. DESIGN: A retrospective descriptive study, based on checking over social work case files. SETTING: A PCC situated in Barcelona's second industrial belt, serving a population with a low socio-economic level. PARTICIPANTS: The population group under study were the users with social work files open from January 1st 1985 to July 31st 1991 (a total of 690 case histories). A representative sample of 296 was selected. MEASUREMENTS AND MAIN RESULTS: In comparison with the population of the basic Health Area, the user population of the PCSS at the PCC was predominantly women, and had an older average age, a higher proportion of divorce/separation and widowhood, and, in the labour context, higher unemployment and retirement. A high proportion of one-parent families (12.8%) was found. Analysis of the work situation showed that 50% of the workers were temporary and 75% of the unemployed received no benefit. 51% of the retired people received the minimum pension and 11% received no pension. Monthly family income, recorded for 46.5% of the cases, was 75,362 pesetas (SD 37,643). The most common problems were those related to the "HEALTH" section (61%). CONCLUSIONS: The user population of the PCSS at the PCC is, in socio-economic terms, deteriorated, a condition closely related to the development of chronic illnesses. Tackling health inequalities from Primary Care is under discussion.