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Among the issues confronting America is long-term care for frail, older persons and others with chronic conditions and functional limitations that limit their ability to care for themselves. Improving the Quality of Long-Term Care takes a comprehensive look at the quality of care and quality of life in long-term care, including nursing homes, home health agencies, residential care facilities, family members and a variety of others. This book describes the current state of long-term care, identifying problem areas and offering recommendations for federal and state policymakers. Who uses long-term care? How have the characteristics of this population changed over time? What paths do people follow in long term care? The committee provides the latest information on these and other key questions. This book explores strengths and limitations of available data and research literature especially for settings other than nursing homes, on methods to measure, oversee, and improve the quality of long-term care. The committee makes recommendations on setting and enforcing standards of care, strengthening the caregiving workforce, reimbursement issues, and expanding the knowledge base to guide organizational and individual caregivers in improving the quality of care.
This book offers a comprehensive overview to chronic illness care, which is the coordinated, comprehensive, and sustained response to chronic diseases and conditions by a range of health care providers, formal and informal caregivers, healthcare systems, and community-based resources. Using an ecological framework, which looks at the interdependent influences between individuals and their larger environment, this unique text examines chronic illness care at multiple levels and includes sections on the individual influences on chronic illness, the role of family and social networks, and how chronic care is provided across the spectrum of health care settings; from home to clinic to the emergency department to hospital and residential care facilities. The book describes the organizational frameworks and strategies that are needed to provide quality care for chronically ill patients, including behavioral health, care management, transitions of care, and health information technology. The book also addresses the changing workforce needs in health care, and the fiscal models and policies that will be required to meet the needs of this population, with a focus on sustaining the ongoing transformation in health care. This book acts as a major reference for practitioners and students in medicine, nursing, social work, allied health, and behavioral medicine, as well as stakeholders in public health, health policy, and population health.
First published in 1999. When human populations and their needs change, organizations responsible for their care inevitably react. With the rapidly and significantly increased demand for chronic care at mid-twentieth century, solutions deemed satisfactory in the past were entirely inadequate. Thus, community leaders and politicians began promoting several approaches to long-term care services in the two decades between 1945 and 1965, but without an adequate source of financing to establish an effective system. In contrast to acute care services and despite the need, chronic care remained unavailable and of poor quality. This study consists of six chapters: an introduction and conclusion, along with four case studies that examine in detail the development of a long-term care system in Philadelphia between 1945 and 1965.
The best-selling Chronic Illness: Impact and Intervention continues to focus on the various aspects of chronic illness that influence both patients and their families. Topics include the sociological, psychological, ethical, organizational, and financial factors, as well as individual and system outcomes. the revised Sixth Edition includes new chapters on palliative care, complementary and alternative therapies, and self-efficacy, as well as added material on culturally competent care. Intended for nurses, social workers, and rehabilitation professionals, Chronic Illness demonstrates how the h
As more people live longer, the need for quality long-term care for the elderly will increase dramatically. This volume examines the current system of nursing home regulations, and proposes an overhaul to better provide for those confined to such facilities. It determines the need for regulations, and concludes that the present regulatory system is inadequate, stating that what is needed is not more regulation, but better regulation. This long-anticipated study provides a wealth of useful background information, in-depth study, and discussion for nursing home administrators, students, and teachers in the health care field; professionals involved in caring for the elderly; and geriatric specialists.
The new edition of best-selling Chronic Illness: Impact and Intervention continues to focus on the various aspects of chronic illness that influence both patients and their families. Topics include the sociological, psychological, ethical, organizational, and financial factors, as well as individual and system outcomes. The Seventh Edition has been completely revised and updated and includes new chapters on Models of Care, Culture, Psychosocial Adjustment, Self-Care, Health Promotion, and Symptom Management. Key Features Include: * Chapter Introductions * Chapter Study Questions * Case Studies * Evidence-Based Practice Boxes * List of websites appropriate to each chapter * Individual and System Outcomes
Market forces are driving a radical restructuring of health care delivery in the United States. At the same time, more and more people are living comparatively long lives with a variety of severe chronic health conditions. Many such people are concerned about the trend toward the creation of managed care systems because their need for frequent, often complex, medical services conflicts with managed care's desires to contain costs. The fear is that people with serious chronic disorders will be excluded from or underserved by the integrated health care delivery networks now emerging. Responding to a request from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, this book reflects the results of a workshop that focused on the following questions: Does the model of managed care or an integrated delivery system influence the types of interventions provided to patients with chronic conditions and the clinical and health status outcomes resulting from those interventions? If so, are these effects quantitatively and clinically significant, as compared to the effects that other variables (e.g., income, education, ethnicity) have on patient outcomes? If the type of health care delivery system appears to be related to patient care and outcomes, can specific organizational, financial, or other variables be identified that account for the relationships? If not, what type of research should be pursued to provide the information needed about the relationship between types of health care systems and the processes and outcomes of care provided to people with serious chronic conditions?