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High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.
This easy-to-use reference helps practitioners quickly diagnose common skin disorders and determine appropriate treatment options. More than 500 fullcolor images speed diagnosis by showing the reader distinguishing characteristics of each disorder, as well as providing clear comparisons between similar looking conditions. Features of the text include fornulary tables of leading topical agents and preparations by brand name, as well as patient handouts in English and Spanish. Basic derm rologic procedures are presented in a simple, easyto-understand format, making this guide an invaluable reference for office surgery. The Second Edition features new, larger photos, more patient handouts, and new material on several disorders. Also included is an expanded basic procedures section with new and more detailed procedures and more illustrations and photos of necessary equipment.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
The World Health Organization (WHO) reported that physical activity is one of the leading risk factors for non-communicable disease deaths worldwide. Several studies have shown that physical activity can reduce the risk of conditions such as heart disease, stroke and diabetes. Furthermore, exercise has been found to be beneficial in certain mental health conditions and improving the quality of life in patients undergoing cancer treatment. However, WHO estimates that 1 in 4 adults worldwide are not physically active enough. This has led to the development of the WHO global action plan on increasing physical activity, which includes integrating physical activity into primary health care. Globally, primary care professionals are already prescribing lifestyle changes, including those aimed at increasing physical activity. Examples of this include, prescription of gym memberships and initiatives that aim to better educate physicians on the benefits of physical activity on patient health. This research topic aims to discuss: • The effectiveness of exercise/lifestyle recommendations in improving patient outcomes in primary care. • Assessing physical activity in primary care practice • The use of exercise prescription to manage neurological diseases • The uptake of patients completing a recommended exercise plan and what can be done to increase this. • The importance of communication between the patient and physician in implementing the exercise plan and how this could be improved. • Confounding factors that affect the patient in following an exercise plan/ lifestyle recommendation. • Examples of where exercise recommendations by primary health care professionals have been successfully implemented in a real world setting. • Examples of successful clinical and community collaborations with allied health professionals such as exercise physiologists
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
Real-life primary care case studies* from more than 50 primary care providers, including physician assistants, nurse practitioners, and physicians! 101 Primary Care Case Studies offers real-life patient scenarios and critical thinking exercises to help you work through a patient’s chief complaint. Through narrative case studies, you will determine how best to diagnose, treat, and manage your patient based on the history of present illness, review of systems, relevant history, and physical examination findings. This workbook will ask probing questions to help you determine differential and most likely diagnoses, diagnostic tests to order, and appropriate patient management strategies using relevant and timely references to support your decisions. The organization of each case study simulates the patient care journey from chief complaint to outcome. Serving as a virtual clinical preceptor, this workbook can be used independently or in a classroom setting. It is accompanied by a robust online student supplement that provides answers to all questions, real outcomes of the cases, and valuable personal insights from the authors on how the patient was successfully managed. Not only will this workbook help you work through patient cases clinically, it will also share important, but often overlooked, bedside manner skills needed to successfully communicate with and care for your patients. Covering conditions across all organ systems and across the lifespan, this workbook is organized by chief complaint, providing an authentic perspective on what to expect in the patient care environment. It even includes information on pathophysiology and how to use ICD-10 and CPT (E/M) codes in your documentation. The book uniquely weaves together both the science and art of medicine by including personal insights into quality and compassionate care. Key Features Provides real-life patient cases from an interprofessional author team of physician assistants, nurse practitioners, and physicians Uses a templated case study design and critical thinking exercises to help you methodically work through various patient scenarios Teaches clinical and bedside manner skills imperative for delivering quality patient care Covers patients across the lifespan, including pediatric, adolescent, adult, and geriatric populations Offers additional insight on patient education, medical and legal concerns, and interprofessional collaboration Includes a robust online student supplement with valuable insights from the authors on how they successfully managed the cases Provides instructors with a table of contents that is filterable by chief complaint, diagnosis, patient population, and organ system *Details changed to protect patient information.
A landmark work which precipitated major reforms in medical education. It recommended closing commercial schools and reducing the overall number of medical schools from 155 to 31, with the aim of raising standards. Includes frank evaluative sketches of each school based on site visits by the author.
The Future of the Nursing Workforce in the United States: Data, Trends and Implications provides a timely, comprehensive, and integrated body of data supported by rich discussion of the forces shaping the nursing workforce in the US. Using plain, jargon free language, the book identifies and describes the key changes in the current nursing workforce and provide insights about what is likely to develop in the future. The Future of the Nursing Workforce offers an in-depth discussion of specific policy options to help employers, educators, and policymakers design and implement actions aimed at strengthening the current and future RN workforce. The only book of its kind, this renowned author team presents extensive data, exhibits and tables on the nurse labor market, how the composition of the workforce is evolving, changes occurring in the work environment where nurses practice their profession, and on the publics opinion of the nursing profession.