[Who is succeeding whom?--or: In-hospital nursing succeeds outpatient nursing. A current commentary on the theme: Nursing Services Insurance].
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UNLABELLED: Although rheumatoid arthritis is amongst those functional disabling diseases requiring massive help and care, there is as yet no study on how RA patients master their everyday lives, nor are there reports on how many of those patients are in need of and/or do in fact receive benefits from the German Nursing Care Insurance. METHODS: In a representative sample of considerably disabled RA patients (functional capacity < 67%) in rheumatological care it was investigated how many patients received nursing care insurance benefits and how many more would have been entitled to receive them. Standardized interviews exploring functional capacity, amount of help and care needed and help-seeking behaviour were conducted to determine which patient-related and resource-related characteristics were associated with unmet need regarding the patients entitlement to benefits of nursing care insurance. Using the relation between justified need for nursing care insurance benefits and the functional status score, a coefficient was computed by logistic regression to project the expected proportion of RA patients entitled to care insurance benefits. RESULTS: A projected 5.4% of all RA patients needed benefits from the nursing care insurance, but only 63% of those did in fact receive benefits. It was found that unmet need was almost exclusively due to the fact that patients actually eligible for insurance benefits did not apply for it, whereas unjustified rejection of applications by insurance experts made up for only a marginal proportion. CONCLUSION: Applying for nursing care insurance benefits is still not a matter of course. It must be considered that about one third of all obviously care-dependent RA patients either claim care insurance benefits too late or never do. To avoid unmet need, experts should encourage particularly those patients who are unaware of their right to ask for help.
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In recent years, physicians have increasingly looked to nonphysician practitioners (NPPs) as a resource for delivering care to patients. While historically more prevalent in primary care groups, nonphysician practitioners have expanded their presence within medical subspecialty and surgical groups as well. Along with planning for appointment scheduling, credentialing, and introducing the nonphysician provider to patients and referring physicians, the savvy practice will thoroughly review how services for a nonphysician can and should be billed. In this article, we focus our attention on basic Medicare billing parameters for physician assistants and nurse practitioners, two types of nonphysician practitioners.
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The meaning and understanding of home care is a leading factor in health care both nationally and internationally. The implementation of the law on care insurance in Germany demonstrates the understanding of home care and shows changes in health care policy. This new context of health care delivery influences the nursing profession. New challenges arise and changes in nursing perspectives are necessary. The presented study focuses on the contribution of nurses in home care situations. Its aim is to illuminate and to understand the perspective of home care nurses. Grounded Theory approach is used. Altogether, nine participants are interviewed. The results show that nurses aim at keeping care recipients in a home care situation as long as possible. In order to achieve this, the contribution of nurses are not just limited to rediscountable benefits. Voluntary interventions such as managing housework and emotional support for care recipients are also being rendered. However, these actions depend on several factors, such as the relationship between the nurse and the care recipient, the home care situation or the professional attitude of the nurse. In this context, nurses have to develop strategies to deal with these various tasks. The discussion emphasizes the legislative framework of home care in Germany as well as factors that influenced the study.
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Patients with technically complex nursing needs are being discharged home from the hospital. Home care agencies striving to meet those needs have clinical, administrative, and educational concerns. Careful planning is the key to meeting these concerns.
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Visiting nurses have provided care to people in their homes for more than a century. Although their role has changed dramatically during the past 100 years, home care nurses remain committed to the key principle of promoting health and welfare while sustaining the values of patient and the home. Patients referred for home care today have increasingly complex and extensive needs. Financial constraints imposed by the government and insurance carriers have accelerated the need for efficiency and excellence in communication, coordination of care, and management of these patients. The WOC/ET nurse practicing in home care can play an invaluable role in promoting positive patient outcomes, developing patient care policies and treatment plans, and establishing standards of care for patients receiving care for chronic wounds, ostomies, or incontinence.
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