Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Service delivery models”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed2003

Shared antenatal care for indigenous patients in a rural and remote community.

BACKGROUND: An increase in perinatal mortality prompted a review of services to pregnant women in remote northern and western Queensland, Australia. In order to address the needs of the indigenous population in particular, a range of service changes was implemented to improve outcomes. OBJECTIVE: This article aims to highlight the changes made in the delivery of local and regional antenatal services. DISCUSSION: Mt Isa Hospital is the supplier of obstetric services for the north and west of Queensland. Poor antenatal access rates and other service issues for Indigenous patients were identified as contributing to these poor outcomes. Consultation with Indigenous patients and health service providers prompted changes in modes of delivery of services that in the short term seem to have improved results. The models for delivery of services include primary health care clinics in remote communities. Aboriginal community controlled health services, and flying obstetrician clinics.

Continuity of Patient Care↗
PubMed2006

Enhancing palliative care delivery in a regional community in Australia.

Although access to palliative care is a fundamental right for people in Australia and is endorsed by government policy, there is often limited access to specialist palliative care services in regional, rural and remote areas. This article appraises the evidence pertaining to palliative care service delivery to inform a sustainable model of palliative care that meets the needs of a regional population on the mid-north coast of New South Wales. Expert consultation and an eclectic literature review were undertaken to develop a model of palliative care service delivery appropriate to the needs of the target population and resources of the local community. On the basis of this review, a local palliative care system that is based on a population-based approach to service planning and delivery, with formalized integrated network agreements and role delineation between specialist and generalist providers, has the greatest potential to meet the palliative care needs of this regional coastal community.

Aged↗
PubMedDate not supplied

[Models of therapy for the mentally handicapped].

This paper attempts to bring into focus the variety and implications of health care models relating to service delivery for mentally handicapped people. Five separate models are identified, each of which is found to share some common elements and features, although ultimately rooted in dissimilar conceptual and ideological frameworks. A comparison between these models is suggested, together with a brief analysis of their effects, strengths and possible weaknesses. Assumptions which underlie each of the models are presented as a means of examining the quantity and quality of health care afforded within the treatment approaches.

Behavior↗
PubMed1993

A model for integrating technology into a multi-agency community service delivery system.

This article presents the results of a 4-year project to develop and test a model for integrating technology into a multi-agency community human services delivery system. "Technology" in this sense refers to both information technology and assistive technology. The project focused on systems change rather than on the creation of comprehensive assistive technology services. Several strategies of the model were developed and tested by the project. The project developed an information/communication tier that lay on top of the existing service delivery system. The information/communication tier was provided to agencies through an electronic network and searchable database, assistive technology advice-giving software, a public awareness campaign, and professional training. The results of these strategies are used to illustrate the Community Assistive Technology Services Network (CATSN) model. The model consists of five modules: 1) client assessment and technology examination, 2) professional and client training and technical assistance, 3) information and referral and needs analysis, 4) special projects, and 5) central coordination and facilitation--the hub. This model is important given recent nationwide initiatives for using assistive technology to provide people with disabilities opportunities for maximum independence, productivity, and integration.

Community Health Services↗
PubMedDate not supplied

A new model for risk stratification and delivery of cardiovascular rehabilitation services in the long-term clinical management of patients with coronary artery disease.

This model for risk stratification includes variables that classify patients for Risk of Event similar to current models of risk stratification, as well as variables that stratify patients for Risk of Progression of Atherosclerosis by established risk factors. Categories of risk are established using accepted data from the literature for each risk factor that targets regression or plaque stabilization as the goal for Low Risk. A case-rate charging system and the proposed removal of time restrictions for length of cardiovascular rehabilitation fit neatly into the present climate for health care. Health maintenance organizations will be seeking programs that use similar models to address cost issues inherent in cardiovascular rehabilitation programs under current fee-for-service models. Improved outcomes will also be targets for these programs and case-management lends itself to disease management, thus, improved outcomes. Tracking outcomes becomes even more important to both the provider and the insurer because results drive referrals. Likewise, removal of the time restriction for cardiovascular rehabilitation allows programs to individualize care and to target risk factors that are not only most deleterious, but also where patients show readiness for change. The changing environment of health care virtually mandates change in cardiovascular rehabilitation. It is imperative that programs manage the disease process, are effective in achieving outcomes that affect both patient function and the disease process, and are cost effective. This model for risk stratification and delivery of services addresses these requirements and provides a beginning for implementing these changes in cardiovascular rehabilitation.

Coronary Artery Disease↗
PubMed1975

An adaptive social systems model of a prepaid group practice plan.

In the present study, an adaptive social systems model is developed and utilized to examine the dynamic properties of a health services delivery system. The model employs a Markov chain as a structure for analyzing the utilization of physician services both inside and outside of a prepaid plan. Four system states are defined, namely, no use, inside use, outside use, and both inside and outside use of physician services. Subscribers are considered to be in one of these states on each episode of illness. Transition probabilities are estimated from data collected from a sample of subscribers to a university health plan using a regression approach that permits a heterogeneous population to be examined within a Markovian framework. This framework is used to examine factors that account for differences in utilization patterns among individual subscribers and to examine overtime changes in the transition probabilities resulting from population shifts on specific demographic and health-related attributes. Based on the assumption that individual subscribers rather than the population as a whole follow a Markov process, the k-step transition matrix is constructed for the heterogeneous subscriber population and is used to examine the long-run effects of particular utilization patterns on the functioning of the prepaid plan.

Age Factors↗
PubMedDate not supplied

Restructuring health services delivery research: a community-based model.

As management of acute illness shifts to the community from tertiary care centres, there is a need for community-based research into the delivery of health services. One author is the coordinator of a health services delivery research unit located in a community health centre as well as the director of research in the Department of Family Medicine at McMaster University. The other author is a member of the administration of the sponsoring institution. The research unit, created in 1994, has close links with the sponsoring hospital, a research centre and the faculty of health sciences at a nearby university. Its staff has grown from 2 to 12 members, mainly as a result of grant support. Its aim is to improve the delivery of community-based health services, and to this end it conducts research in collaboration with programs at the health centre, stakeholder groups, communities and institutions. Research projects have been undertaken in clinical guidelines, women's health, mature adults' health, medication use and new technologies for screening. As an example, concern about chlamydial infections in women in the community led to research into burden of illness, diagnosis, screening methods, test technologies, validation of guidelines and provider behaviors. In the future, funding will be a major concern. The authors contend that more funding from such agencies as the Medical Research Council of Canada should flow to community-based research.

Chlamydia Infections↗
PubMed2000

Mental health services in faith communities: the role of clergy in black churches.

A small but growing literature recognizes the varied roles that clergy play in identifying and addressing mental health needs in their congregations. Although the role of the clergy in mental health services delivery has not been studied extensively, a few investigations have attempted a systematic examination of this area. This article examines the research, highlighting available information with regard to the process by which mental health needs are identified and addressed by faith communities. Areas and issues where additional information is needed also are discussed. Other topics addressed include client characteristics and factors associated with the use of ministers for personal problems, the role of ministers in mental health services delivery, factors related to the development of church-based programs and service delivery systems, and models that link churches and formal services agencies. A concluding section describes barriers to and constraints against effective partnerships between churches, formal services agencies, and the broader practice of social work.

Black or African American↗
PubMed2004

The Ontario Cardiac Rehabilitation Pilot Project.

In February 2001, the Ontario Ministry of Health and Long-Term Care announced a $9.6 million, 15-month pilot project (the Pilot) to implement and evaluate a comprehensive, multifactoral model of cardiac rehabilitation (CR) service delivery at 17 sites across Ontario. This is the second paper in a three-part, policy-related series which provides a summary of the Ontario CR Pilot model and the Pilot implementation and evaluation methodology. The aim of the present paper was to outline the goals of the Pilot, the Pilot model of care, the organizational structure that facilitated implementation of the model, and the operational procedures that were put in place to evaluate patient outcomes and the generalizability of a regional model of CR service delivery. The model was based on the findings and recommendations of the Cardiac Care Network of Ontario's 1999 Consensus Panel on Cardiac Rehabilitation and Secondary Prevention, which was described in part one of this series. An upcoming final paper will describe the outcomes of the project and its recommendations for CR health policy decisions in Ontario.

Cardiac Rehabilitation↗
PubMed1999

The mental health consumer movement: implications for rural practice.

Developing consumer-oriented programs for rural areas presents a major challenge for practitioners and policy makers. The mental health consumer movement, a successful urban creation, has yet to fully impact rural practice and be of benefit to individuals with severe and persistent mental illness. Rural mental health professionals face unique challenges and opportunities in utilizing rural strengths to foster consumer participation in the design and implementation of service delivery. The authors address the unique barriers facing rural communities and propose a self-help model as a service delivery alternative.

Attitude to Health↗
PubMedDate not supplied

The wonderful world of Disney. A look at the future of health care?

What does the future hold for health care delivery? What will prove to be the most effective model for health services delivery in the next century? These are the questions that are foremost in the minds of health policy analysts across the country. While any discussion about the future of American health care typically centers around alternative payment methodologies or emerging physician-hospital integration models, one company believes it has a unique solution and is eager to share its vision for the future. That company is none other than Disney, and Celebration Health--with its grand opening on Nov. 23, 1997--is its latest venture.

Community Health Planning↗
PubMedDate not supplied

A rehabilitation programmatic model: the clinical nurse specialist perspective.

Some facilities are adopting a new organizational model to deliver rehabilitation services: the programmatic model. The premise of this model is the delivery of completely integrated services. The programmatic model differs from the traditional service model in many aspects, including philosophy, governance, clinical practice standards, and identification of patient care goals. There are five phases involved in moving from a pure service model to a programmatic model: commitment, enmeshment, product orientation, integration, and maintenance and growth. This article describes the clinical nurse specialist role and experiences in implementing a programmatic model in a rehabilitation hospital.

Humans↗
PubMedDate not supplied

Rethinking social work service delivery.

Providence Centre is a 577-bed, multilevel, geriatric health facility located in Scarborough, Ontario. This article outlines the transition from a traditional model of social work service delivery to a specialized case referral system. It describes the review process, creation of the alternative service model, implementation strategies, evaluation measures and outcomes of the undertaking. Through these efforts, the centre succeeded in creatively redefining and restructuring its social work service delivery and resource utilization in today's tough economic climate.

Aged↗
PubMed1985

An itinerant model for delivery of clinical low vision services in a rural community.

In 1976, a premise was developed that resulted in the inception of a mobile low vision service in the State of New Hampshire. Today, the New Hampshire Association for the Blind continues to provide low vision service throughout the state using a mobile clinical van and a training staff who provide training in aid use within the home. The model has proved effective in dealing with the special needs of the low vision population in a rural area.

Community Health Services↗
PubMedDate not supplied

Using a program logic model that focuses on performance measurement to develop a program.

A program logic model is used to make a program ready for an evaluation. It diagrammatically shows the relationships between the objectives of the program, program activities, indicators, and resources. This article describes an expanded logic model that has a greater focus on measurement of program performance. The expanded logic model specifies both outcome and process indicators, whereas other logic models only show service delivery indicators. Also, this article describes how the expanded logic model was used to develop a bicycle safety program. A workgroup established program boundaries and reviewed documents early in the process of developing the logic model. The workgroup developed the logic model which was subsequently reviewed by other stakeholders. The workgroup continually assessed the plausibility of the logic model. Challenges and advantages in using the logic model are discussed.

Accidents, Traffic↗
PubMed1983

Systems planning for the 80s: the Nebraska Mental Health Desired Service System model.

In an effort to address the complex realities of mental health service delivery in the 1980s, a systems model for planning and policy making has been developed. The model, called "the Nebraska Mental Health Desired Service System," can serve as a template for future service delivery system design. The development of the model and issues attendant to it are presented. Application of the model to planning, fiscal management, system management, politics, human resources development, and services coordination is presented.

Health Planning Organizations↗