New models of care for psychology in Canada's health services.

2012 ◽  
Vol 53 (3) ◽  
pp. 165-177
Author(s):  
Lesley A. Graff ◽  
George Kaoukis ◽  
Norah Vincent ◽  
Andrea Piotrowski ◽  
Jason Ediger
Keyword(s):  
Health Services ◽  
Models Of Care ◽  
New Models

Modelling disparities in health services utilisation for older Blacks: a quantile regression framework

2014 ◽  
Vol 35 (8) ◽  
pp. 1657-1683 ◽  
Author(s):  
ANDY SHARMA
Keyword(s):  
Health Services ◽  
Quantile Regression ◽  
Scale Effects ◽  
Ethnic Disparities ◽  
The United States ◽  
Models Of Care ◽  
Medical Intervention ◽  
Medical Provider ◽  
Absolute Deviation ◽  
The Best Approximation

ABSTRACTWith the on-going ageing of the United States population, resolving health disparities continues to be a prominent and worthwhile goal, particularly in the areas of promoting minority health and reducing racial/ethnic disparities. This analysis employs the 2004 and 2005 Household Component records from the Medical Expenditures Panel Survey, which correspond to data files H89 and H97, to examine utilisation by race across the entire distribution function; more specifically, applying the behavioural model of health services utilisation and employing a Quantile Regression (QR) framework. This is a noteworthy contribution because the conditional mean may not be the best approximation for a skewed-location distribution. In contrast, QR is robust to outliers and scale effects since the estimation minimises least absolute deviation. The sample consists of 2,525 older adults at least 65 years of age with 303 corresponding to Black and 2,222 corresponding to White. Results suggest older Blacks continue to utilise health services (i.e. office or clinic visits with a physician or medical provider) at lower levels and this is more pronounced at and below the median quantile (i.e. below the 50th cut-off). Usual source of care (USC) continues to play an important role. Beliefs surrounding the need for insurance and medical intervention are also significant and explain some of the racial disparities. Although utilisation disparities persist for older Blacks, collaborative and flexible models of care can reach this group.

New Models of Care and Support

2007 ◽  
pp. 352-356
Author(s):  
Jill F. Pattenden ◽  
Robert J. Lewin
Keyword(s):  
Models Of Care ◽  
Care And Support ◽  
New Models

Physicians’ accounts of frontline tensions when implementing pilot projects to improve primary care

2018 ◽  
Vol 32 (1) ◽  
pp. 39-55 ◽  
Author(s):  
Elizabeth Mansfield ◽  
Onil Bhattacharyya ◽  
Jennifer Christian ◽  
Gary Naglie ◽  
Vicky Steriopoulos ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Care Physicians ◽  
Pilot Project ◽  
Models Of Care ◽  
Structured Interviews ◽  
Pilot Projects ◽  
Additional Time ◽  
Content Type ◽  
The Impact

Purpose Canada’s primary care system has been described as “a culture of pilot projects” with little evidence of converting successful initiatives into funded, permanent programs or sharing project outcomes and insights across jurisdictions. Health services pilot projects are advocated as an effective strategy for identifying promising models of care and building integrated care partnerships in local settings. In the qualitative study reported here, the purpose of this paper is to investigate the strengths and challenges of this approach. Design/methodology/approach Semi-structured interviews were conducted with 34 primary care physicians who discussed their experiences as pilot project leads. Following thematic analysis methods, broad system issues were captured as well as individual project information. Findings While participants often portrayed themselves as advocates for vulnerable patients, mobilizing healthcare organizations and providers to support new models of care was discussed as challenging. Competition between local healthcare providers and initiatives could impact pilot project success. Participants also reported tensions between their clinical, project management and research roles with additional time demands and skill requirements interfering with the work of implementing and evaluating service innovations. Originality/value Study findings highlight the complexity of pilot project implementation, which encompasses physician commitment to addressing care for vulnerable populations through to the need for additional skill set requirements and the impact of local project environments. The current pilot project approach could be strengthened by including more multidisciplinary collaboration and providing infrastructure supports to enhance the design, implementation and evaluation of health services improvement initiatives.

scholarly journals Advanced practice nurses, registered nurses and medical practice assistants in new care models in Swiss primary care: a focused ethnography of their professional roles

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033929
Author(s):  
Renata Josi ◽  
Monica Bianchi
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Chronic Care ◽  
Advanced Practice Nurses ◽  
Models Of Care ◽  
Advanced Practice ◽  
Practice Nurses ◽  
New Models ◽  
Care Models ◽  
Swiss Primary Care

ObjectivesWe aimed to analyse roles and tasks of advanced practice nurses (APNs), registered nurses (RNs) without advanced practice education and medical practice assistants (MPAs) with regard to chronic care in Swiss primary care (PC). The objective of this study was to explore the potential of new care models, involving these health professionals, which could meet changing future healthcare needs.DesignAn ethnographic design comprising semi-structured interviews and non-participant observations was conducted.SettingHealth professionals who worked in 10 primary care practices in the German-speaking part of Switzerland were included in the study.ParticipantsIn total, 16 interviews were conducted with four APNs, six MPAs, two RNs and four general practitioners (GPs). Nine of the health professionals were subsequently observed in their primary care practice.ResultsAPNs and MPAs were both involved in chronic care in the PC practice. While APNs cared for older, multimorbid patients with more complex needs, MPAs were involved in counselling of younger patients with chronic disease such as type 2 diabetes. Additionally, APNs were involved in many home visits and visits in elderly peoples — and nursing homes. APNs worked with a high degree of autonomy while MPAs had worked mostly in delegation. Task division between GPs and APNs or MPAs was not clear in every case yet.ConclusionsAPNs and MPAs have a high potential to contribute to optimal care in new care models, which address needs of the elderly population. The experience from our sample may inform international health policymakers and practitioners about the tasks and responsibilities those health professionals can take over in PC when implementing new models of care. The practical experience with new models of care involving APNs and MPAs may also influence the future regulation with regard to the scope of practice of these health professionals in Switzerland.

scholarly journals Multimorbidity and oral health: need for new models of care

2020 ◽  
Vol 8 (4) ◽  
pp. e000387
Author(s):  
Balraj Gill ◽  
Andrew Harris ◽  
Christopher Tredwin ◽  
Paramjit Gill
Keyword(s):  
Oral Health ◽  
Healthcare Systems ◽  
Models Of Care ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Ageing Population ◽  
New Models ◽  
Oral Health Need ◽  
Health Need ◽  
Robust Evidence

Multimorbidity is defined as patients living with two or more chronic health conditions. The prevalence of multimorbidity is increasing, driven by the ageing population, and represents a major challenge to all healthcare systems because these patients are heavy users of services. The link with oral health is growing although there is need for further robust evidence. There is also need for new models of care to address oral health in patients with multimorbidity.

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