scholarly journals Case Management in Primary Care for Frequent Users of Health Care Services: A Realist Synthesis

2020 ◽  
Vol 18 (3) ◽  
pp. 218-226 ◽  
Author(s):  
Catherine Hudon ◽  
Maud-Christine Chouinard ◽  
Kris Aubrey-Bassler ◽  
Nazeem Muhajarine ◽  
Fred Burge ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Case Management ◽  
Health Care Services ◽  
Realist Synthesis ◽  
Frequent Users ◽  
Care Services

scholarly journals Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study

2018 ◽  
Vol 16 (3) ◽  
pp. 232-239 ◽  
Author(s):  
Catherine Hudon ◽  
Maud-Christine Chouinard ◽  
Marie-France Dubois ◽  
Pasquale Roberge ◽  
Christine Loignon ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mixed Methods ◽  
Case Management ◽  
Health Care Services ◽  
Mixed Methods Study ◽  
Frequent Users ◽  
Care Services

scholarly journals Identifying Frequent Health Care Users and Care Consumption Patterns: Process Mining of Emergency Medical Services Data

10.2196/27499 ◽  
2021 ◽  
Vol 23 (10) ◽  
pp. e27499
Author(s):  
Laura Maruster ◽  
Durk-Jouke van der Zee ◽  
Erik Buskens
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Frail Elderly ◽  
Health Care Services ◽  
Process Mining ◽  
Consumption Patterns ◽  
Care Providers ◽  
Frequent Users ◽  
Care Services ◽  
Elderly Users

Background Tracing frequent users of health care services is highly relevant to policymakers and clinicians, enabling them to avoid wasting scarce resources. Data collection on frequent users from all possible health care providers may be cumbersome due to patient privacy, competition, incompatible information systems, and the efforts involved. Objective This study explored the use of a single key source, emergency medical services (EMS) records, to trace and reveal frequent users’ health care consumption patterns. Methods A retrospective study was performed analyzing EMS calls from the province of Drenthe in the Netherlands between 2012 and 2017. Process mining was applied to identify the structure of patient routings (ie, their consecutive visits to hospitals, nursing homes, and EMS). Routings are used to identify and quantify frequent users, recognizing frail elderly users as a focal group. The structure of these routes was analyzed at the patient and group levels, aiming to gain insight into regional coordination issues and workload distributions among health care providers. Results Frail elderly users aged 70 years or more represented over 50% of frequent users, making 4 or more calls per year. Over the period of observation, their annual number and the number of calls increased from 395 to 628 and 2607 to 3615, respectively. Structural analysis based on process mining revealed two categories of frail elderly users: low-complexity patients who need dialysis, radiation therapy, or hyperbaric medicine, involving a few health care providers, and high-complexity patients for whom routings appear chaotic. Conclusions This efficient approach exploits the role of EMS as the unique regional “ferryman,” while the combined use of EMS data and process mining allows for the effective and efficient tracing of frequent users’ utilization of health care services. The approach informs regional policymakers and clinicians by quantifying and detailing frequent user consumption patterns to support subsequent policy adaptations.

Specialty Care Programme for Autism Spectrum Disorders in an Urban Population: A Case-Management Model for Health Care Delivery in an asd Population

2011 ◽  
Vol 28 (2) ◽  
pp. 102-109 ◽  
Author(s):  
M. Parellada ◽  
L. Boada ◽  
C. Moreno ◽  
C. Llorente ◽  
J. Romo ◽  
...  
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorders ◽  
Case Management ◽  
Health Care Delivery ◽  
Health Care Services ◽  
Care Delivery ◽  
Autism Spectrum ◽  
Care Programme ◽  
Care Services ◽  
Spectrum Disorders

AbstractSubjects with autism spectrum disorders (ASD) have more medical needs and more difficulties accessing health care services than the general population. Their verbal and non-verbal communication difficulties and particular behaviors, along with lack of expertise on the part of physicians and failure of the services to make adjustments, make it difficult for them to obtain an appropriate health care.PurposeTo describe a model for health care delivery in an ASD population.MethodReview of relevant literature and a discussion process with stakeholders leading to the design of a service to meet the specialty health needs of subjects of all ages with ASD for a region with a population of 6,000,000.ResultsA service was designed centred around the concepts of case management, individualization, facilitation, accompaniment, continuous training and updating, and quality management. Five hundred and thirteen patients with ASD have been seen over a period of 18 months. The programme generated 1566 psychiatric visits and 1052 visits to other specialties (mainly Nutrition, Stomatology, Neurology, and Gastroenterology) in the same period.ConclusionPersons with ASD may benefit from adjustments of health care services in order to improve their access to adequate health care at the quality level of the rest of the population.

A Model for the Management of Suicidal Behaviour in Primary Care

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
V. Voros ◽  
P. Osvath ◽  
S. Fekete
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Suicidal Behaviour ◽  
Suicide Risk ◽  
Health Care Services ◽  
Warning Signs ◽  
Health Concern ◽  
Care Services ◽  
Suicidal Patients ◽  
Primary Care Professionals

Introduction:Although suicide rates are decreasing in most European countries, suicide is still a major health concern. Despite of the fact, that the vast majority of suicidal patients contacted with health care services before the suicidal act, the doctor-patient meeting is a necessary, but sometimes not sufficient way enough to prevent suicide. Most patients, who commit or attempt suicide, are not regarded as being at high immediate risk at their final contact with health care services.Aims and methods:Based on reviewing the relevant literature and on our previous studies we developed a brief, practical, clinical guideline, which may aid general practitioners and primary care professionals to assess suicide risk and also to manage these patients.Results:We introduce a model for an integrated, regional suicide prevention strategy, which includes recognition, risk assessment and also intervention. The main steps of our model are to recognize warning signs, explore crisis situation and/or psychopathologic symptoms, assess protective and risk factors, estimate suicide risk, plan intervention strategies, and finally manage suicidal patients through the different levels of intervention.Conclusion:In the management of suicidal behaviour the complex stress-diathesis model has to be adjusted by considering biological markers (mental disorders, personality traits) and psycho-social factors (crisis, negative life events, interpersonal conflicts). Only after the assessment of these factors primary care professionals, as ‘gatekeepers’ can manage suicidal patients effectively by using adequate psychopharmacotherapeutic and psychotherapeutic facilities in the recognition, treatment and prevention of suicidal behaviour.

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