Care Needs (care + need)

Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Care Needs

  • health care need

  • Selected Abstracts

    The economic costs of dementia in Korea, 2002

    Guk-Hee Suh
    Abstract Objective To estimate the economic costs of dementia in 2002 using an economic evaluation model for dementia care. Methods Data were from the Korea National Survey of the Long-Term Care Need (LTC survey) (n,=,5058), two prospective 1-year studies [one clinical trial (n,=,234), one naturalistic community cohort study (n,=,107)], and two epidemiologic community studies for prevalence of dementia (n,=,1037,+,1481). Daily costs and proportions of different levels of institutional service provided were collected from the LTC survey. Resource use in the community included health care services, social care services, out-of-pocket purchase for self-support, caregiver time and missed work of caregiver. Costs in community were calculated based on resource utilization multiplied by the unit costs for each resource. Results Total annual costs of dementia were estimated to be over 2.4 billion US$ for 272,000 dementia sufferers. Costs in community represent 96% of the total annual costs, while costs of informal care and missed work of caregivers were 1.3 billion US$, or 55% of total annual cost. Average annual costs of full time care (FTC) and pre-FTC in community LTC were 44,121 US$ and 13,273 US$ per person, whereas cost per patient who did not need community LTC was 3986 US$. Conclusion Given that the number of dementia sufferers is projected to increase in the near future and that larger part of the costs are subsidized by the government, the economic and social costs of dementia is significant not only for dementia sufferers and their caregivers, but also for society. Copyright © 2006 John Wiley & Sons, Ltd. [source]

    Health Care Need: Three Interpretations

    abstract The argument that scarce health care resources should be distributed so that patients in ,need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need, the three interpretations provide a starting-point for further debate of what the concept means in its specific application. We discuss combined interpretations, the meaning of grading needs, and compare needs-based priority setting to social welfare maximisation. [source]

    Nurse Practitioner Practice in 2012: Meeting the Health Care Needs of Tomorrow

    Endorsed by the Fellows of the American Academy of Nurse Practioners Think Tank Committee

    Meeting the Health Care Needs of a Rural Hispanic Migrant Population With Diabetes

    Loretta Heuer PhD
    ABSTRACT: Context: There is a need for models of health care that provide accessible, culturally appropriate, quality services to the population of Hispanic migrant farmworkers at risk for or diagnosed with diabetes. Purposes: The purposes of this study were to describe the Migrant Health Service, Inc (MHSI), Diabetes Program, the conceptual model on which it is based, and 4 types of outcomes achieved over a 3-year period. Methods: Types and amounts of medical services and education were studied. Qualitative data obtained from program records and documents were analyzed to determine the nature of the program. Quantitative data were used to measure outcomes of the program. Findings: The multiplecomponent MHSI Diabetes Program is addressing economic, cultural, and language barriers experienced by the target population. The program provides a continuum of health services and education that meet American Diabetes Association (ADA) Clinical Practice Recommendations on diabetes. The program exposes regional health care professionals and university students from numerous academic disciplines to Hispanic farmworker culture. Conclusions: Evidence-based program management, patient care, and program evaluation are traits of this program, which offers accessible, culturally appropriate, quality health services and education to Hispanic farmworkers. The multicomponent program model has high potential for positively impacting the health of the target population. [source]

    An exploration of the contribution of the community nurse to rehabilitation

    Rosie Kneafsey RGN BSc
    Abstract Effective hospital and community rehabilitation services are increasingly recognised as a means of meeting the changing pattern of health and social care need. While the district or community nurse has the potential to play a central part in community rehabilitation provision, this role has received relatively scant attention in the literature. This paper describes research findings on community nurses' perceptions of their role and potential contribution to rehabilitation. As part of a wider, 2-year, qualitative investigation of the role of the nurse in rehabilitation, fieldwork was undertaken with both district and community staff nurses. This comprised focus group discussions and interviews with staff recruited as a consequence of the follow-up of patients' experiencing rehabilitation. The findings indicate that community-based nurses contributed to patient rehabilitation by making assessments, referring on to other members of the multi-professional team, advocating for and liaising with other services, helping people to adapt, teaching and motivating patients and carers, supporting and involving families, and providing technical care. A number of challenges to community-based nursing roles were apparent, including feelings of exclusion, lack of recognition, a lack of time for rehabilitation and paucity of referrals for rehabilitation. Greater clarity and recognition is needed of the community-based nursing contribution to rehabilitation, and there is a need to ensure that community nursing assessments contribute to patients' rehabilitation goals and the promotion of independent living. [source]

    Health Care Need: Three Interpretations

    abstract The argument that scarce health care resources should be distributed so that patients in ,need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need, the three interpretations provide a starting-point for further debate of what the concept means in its specific application. We discuss combined interpretations, the meaning of grading needs, and compare needs-based priority setting to social welfare maximisation. [source]

    ,If it was osteoporosis, I would have really hurt myself.' Ambiguity about osteoporosis and osteoporosis care despite a screening programme to educate fragility fracture patients

    Joanna E. M. Sale PhD
    Abstract Rationale, aims and objectives, Behaviour change models suggest that people need clear information about their susceptibility to disease and knowledge of treatment recommendations in order to change their behaviour. The purpose of this qualitative study was to examine fracture patients' understanding of osteoporosis (OP) and OP care after being screened for, and educated about, OP in a fracture clinic. Methods, We conducted five focus groups with 24 patients (18 women, six men) aged 47,80 years old who were screened for OP through an urban fracture clinic. Participants were asked about their awareness of OP and their status of bone mineral density (BMD) testing and OP treatment. Results, Twenty participants vocalized at least one expression of ambiguity regarding OP and/or treatment recommendations conveyed by the screening programme staff. Participants were ambiguous about the cause of their fracture, the BMD test process and results, and the presentation of OP. They were also ambiguous about the amount and type of medication and supplements recommended. Conclusions, Despite a standardized screening programme in which OP was addressed in fragility fracture patients, ambiguity about diagnosis, testing and treatment were described. Efforts to clarify information relayed to fracture patients about their condition and recommended care need to extend beyond the fracture clinic so that health care providers can promote long-term adherence to these recommendations. [source]

    Health-Care Policy for Korean Elderly

    Young Hee Choi
    Due to advances in medicine and economic development, the percentage of Korean elderly is increasing markedly. If preparation is not made for the coming aged society, there is a possibility that the development of the Korean nation will be hindered. The increase in the number of the elderly is increasing the social/national burden of providing medical care for the elderly. Meanwhile, with the trend toward the nuclear family, the increase of female participation in social activities, and the increase of elderly who live alone, it is difficult for nursing homes alone to solve the problem of providing support for the elderly. Long-term medical treatment and care of the elderly has become the responsibility of both the government and society. Under these conditions, the Korean policy for elderly patients can be classified broadly into home care, community care, and institutional care. In order to prepare for the aged society, deficient facilities need to be supplemented and home care and community care need to be expanded so as to increase the communities' ability to support the elderly . Homes, communities, government and the private sector should work together to provide integrated welfare and health care to the elderly. [source]

    Current practices in depression care

    Albert Yeung MD
    Abstract Despite improved awareness among the medical community concerning common mental health disorders, the high prevalence of depression in the United States remains unchanged1 and has been compounded by increasing evidence of gaps in mental health care for ethnic and racial minorities.1,2 Thus, there is a strong need for the timely creation of comprehensive educational initiatives aimed at improving the quality of care provided by mental health professionals and primary care physicians. Fundamental to this process is the examination of current treatment standards, as well as identification of practices that require improved physician education. Consistent use of appropriate screening tools, diagnostic accuracy and timeliness, continual assessment of illness severity, adherence to practice guidelines, and individualized patient care need heightened attention to improve outcomes. This article describes the most prevalent types of depression and summarizes current practices in depression care, with an emphasis on treatment standards and opportunities for improved performance. [source]

    The mouth in HIV/AIDS: markers of disease status and management challenges for the dental profession

    NW Johnson
    Abstract There are over 30 million people in the world with HIV infection and, whilst the rate of new infections is slowing, this number continues to grow. Although in Australia the overall prevalence of HIV infection in adults aged 15,49 is officially estimated at only 0.2%, representing less than 20 000 people living with HIV and AIDS, our geographical area contains populations with prevalences exceeding 10 times this. Oral health professionals must therefore practise safe, standard infection control at all times and be aware of the oral manifestations of HIV disease. These are predominantly opportunistic infections with fungi such as Candida albicans or with viruses of the herpes family, particularly herpes simplex, herpes zoster and Epstein-Barr virus infections. Warts or papillomas may arise due to human papilloma viruses , even in individuals on effective antiretroviral therapy. Rare types of fungal infection can occur, and severe bacterial infections, notably tuberculosis, are an ever-present risk. Susceptibility to periodontal breakdown is somewhat enhanced by the effects of HIV disease itself, and caries activity may increase because the patient neglects attention to diet and oral hygiene. Restorative and periodontal care need, therefore, to be maintained at a high level. Oral opportunistic infections cause much distress and the diagnosis and management of these is the responsibility of our profession. [source]

    Understanding Surge Capacity: Essential Elements

    Donna F. Barbisch RN
    As economic forces have reduced immediately available resources, the need to surge to meet patient care needs that exceed expectations has become an increasing challenge to the health care community. The potential patient care needs projected by pandemic influenza and bioterrorism catapulted medical surge to a critical capability in the list of national priorities, making it front-page news. Proposals to improve surge capacity are abundant; however, surge capacity is poorly defined and there is little evidence-based comprehensive planning. There are no validated measures of effectiveness to assess the efficacy of interventions. Before implementing programs and processes to manage surge capacity, it is imperative to validate assumptions and define the underlying components of surge. The functional components of health care and what is needed to rapidly increase capacity must be identified by all involved. Appropriate resources must be put into place to support planning factors. Using well-grounded scientific principles, the health care community can develop comprehensive programs to prioritize activities and link the necessary resources. Building seamless surge capacity will minimize loss and optimize outcomes regardless of the degree to which patient care needs exceed capability. [source]

    The well-being of gays, lesbians and bisexuals in Botswana

    V.J. Ehlers BA BSSc MA DLitt RGN RM
    The well-being of gays, lesbians and bisexuals in Botswana Aims.,To investigate the level of well-being of gays, lesbians and bisexuals (GLBs) in Botswana, how this level of well-being could be promoted and whether their health care needs were met by health care professionals. Rationale.,It is illegal to engage in same-sex activities in Botswana, punishable by imprisonment. Although Botswana's citizens have one of Africa's best health care systems, little is known about the health status, health care needs and general well-being of Botswana's GLBs. This survey attempted to uncover some of these potential health care needs, impacting on the GLBs' well-being. Design/methods.,The research framework adopted was the health and human rights approach, placing dignity before rights. A survey design, with structured questionnaires, was used. Snow-ball sampling techniques were used. Results.,Results indicated that varying degrees of distress were experienced by 64% of the GLBs in this study. The GLBs identified a need for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) education and had concerns about their general health, discrimination against them and vulnerability to violence including sexual assaults. Conclusions.,The well-being of the GLBs in Botswana was influenced by both positive internal acceptance of their sexual orientation and negative external acceptance by society. Health care professionals played insignificant roles in the promotion of GLBs' well-being, and could make greater inputs into health education efforts, and more significant contributions towards enhancing the GLBs' levels of well-being. Enhanced collaboration between health professionals and human rights activists are recommended to reduce violations of Botswana's GLBs' dignity and to improve their quality of life, including enhanced access to and utilization of health care services. [source]

    When Home Care Ends,Changes in the Physical Health of Informal Caregivers Caring for Dementia Patients: A Longitudinal Study

    Elmar Gräsel MD
    OBJECTIVES: To verify the change in health variables and parameters of health service utilization in a group of active caregivers for older persons with dementia in comparison with former caregivers who had ceased to provide home care for at least 6 months (death of the patient or institutionalized care). DESIGN: A prospective longitudinal study with 1-year follow-up. Active and former caregiver groups originated from a sample of active caregivers at baseline. SETTING: Participants were recruited mainly via advertisements placed in two magazines with large, nationwide circulation. The questionnaires were sent on request. PARTICIPANTS: Seven hundred twenty primary caregivers of dementia patients living in the community. All patients had a medical diagnosis of dementia and had a score of 20 or greater on the mental-mnestic disturbances factor of the Sandoz Clinical Assessment,Geriatric scale. Their care needs covered at least one of four activities of daily living (personal hygiene, eating, toilet use/excretion, mobility). After 12 months, 681 caregivers were reinterviewed. MEASUREMENTS: The physical complaints were assessed with the 24-item Giessen Symptom List (subscales: aching limbs, stomach complaints, heart complaints, physical exhaustion). Other key variables were the number of illnesses, number of somatic and psychotropic medications, and number of physician visits. RESULTS: Although the somatic symptoms of the active caregivers (n = 427) remained stable at a high level, they decreased significantly (24%) in the group of former caregivers (n = 121). Simultaneously, the number of visits former caregivers made to physicians almost doubled. The reason why home care was terminated (death or institutionalization) did not influence health variables or health service utilization. CONCLUSION: The physical health of former caregivers improves in the long term once they cease to provide home care. The fact that former caregivers go to the doctor much more frequently is to be interpreted as an indication that they take the time to attend to their own physical and medical needs. [source]

    Osteoporosis and the Global Competition for Health Care Resources,

    L Joseph Melton III
    Abstract Global aging superimposed on existing infectious diseases and trauma will aggravate competition for health care resources to diagnose and treat osteoporosis. Efforts to implement public health measures are needed, but the targeted approach to assessment and treatment of high-risk individuals must also be refined. Increases in the elderly population worldwide will cause a dramatic rise in osteoporotic fractures, but other age-related diseases will increase as well. Changes will be superimposed on existing public health problems (e.g., malaria, alcoholism), and these acute health care needs will take priority in some areas. Societies in most parts of the world may have to limit osteoporosis control to broad public health measures, and such efforts (e.g., calcium and vitamin D supplementation) should be supported. In these regions, clinical decision-making will generally be limited to treating patients with fractures (who presumably have already failed any public health measures in place), or in a few wealthy countries, to patients with low bone density identified by case-finding. Case-finding approaches will vary with the resources available, although unselective (mass) screening by bone densitometry is largely ineffective and unaffordable anywhere. The key to clinical decision-making on behalf of individuals will be an assessment of absolute fracture risk, and the tools needed to predict the risk of an osteoporotic fracture over the next 10 years are now being developed. These include bone density measures, but also incorporate other risk factors (e.g., fracture history, corticosteroid use), which may allow extension of fracture risk prediction to nonwhite populations and to men. Even with a universal risk prediction tool, cost-effective treatment thresholds will vary by country based on the level of fracture risk in the region and on the resources available for health care. To better compete for these resources, efforts should be made to lower the cost of osteoporosis interventions. Additionally, evidence is needed that these interventions are really effective in reducing fractures in the community. [source]

    Identifying Children with Dental Care Needs: Evaluation of a Targeted School-based Dental Screening Program

    David Locker BDS
    Abstract Objectives: It has been suggested that changes in the distribution of dental caries mean that targeting high-risk groups can maximize the cost effectiveness of dental health programs. This study aimed to assess the effectiveness of a targeted school-based dental screening program in terms of the proportion of children with dental care needs it identified. Methods: The target population was all children in junior and senior kindergarten and grades 2, 4, 6, and 8 who attended schools in four Ontario communities. The study was conducted in a random sample of 38 schools stratified according to caries risk. Universal screening was implemented in these schools. The parents of all children identified as having dental care needs were sent a short questionnaire to document the sociodemographic and family characteristics of these children. Children with needs were divided into two groups: those who would and who would not have been identified had the targeted program been implemented. The characteristics of the two groups were compared. Results: Overall, 21.0 percent of the target population were identified as needing dental care, with 7.4 percent needing urgent care. The targeted program would have identified 43.5 percent of those with dental care needs and 58.0 percent of those with urgent needs. There were substantial differences across the four communities in the proportions identified by the targeted program. Identification rates were lowest when the difference in prevalence of need between the high- and low-risk groups was small and where the low-risk group was large in relation to the high-risk group. The targeted program was more effective at identifying children from disadvantaged backgrounds. Of those with needs who lived in households receiving government income support, 59.0 percent of those with needs and 80.1 percent of those with urgent needs would be identified. Conclusions: The targeted program was most effective at identifying children with dental care needs from disadvantaged backgrounds. However, any improvements in cost effectiveness achieved by targeting must be balanced against inequities in access to public health care resources. [source]

    Comparing Frequent and Average Users of Elementary School-Based Health Centers in the Bronx, New York City

    Raymundo S. Baquiran
    ABSTRACT: This study analyzed health care utilization at three school-based health centers (SBHCs) in the Bronx, New York City, and compared characteristics of "frequent" and "average" service users. Encounter form data for visits by 2,795 students who received services at least once between September 7, 1998, and June 30, 1999, were reviewed. Demographic comparisons between clinic users and the total school population, and between "frequent" (five or more visits/year) and "average" (one to four visits/year) users were made. The two groups also were compared after primary diagnoses were classified into five general categories. Some 96% (3,469/3,614) of students were registered in the SBHCs, of whom 81% (2,795/3,469) used clinic services at least once during the school year. Clinic users did not differ from the general school population by gender, but were younger (p < 0.01). "Frequent" users were more likely than "average" users to be older (p < 0.01), but they did not differ by gender, race/ethnicity, or insurance status. "Frequent" users comprised 28% of the clinic-using population, but accounted for 72.5% of all visits. Similarly, "average" users comprised 72.4% of the clinic-using population, but accounted for 27.5% of all visits. "Frequent" users generated most visits for mental health and chronic medical conditions, while "average" users generated most visits for preventive care, acute medical care, and injuries/emergencies (p < 0.01 for all). Important challenges for elementary SBHCs include developing new approaches that meet children's needs while protecting clinic resources, like scheduling group interventions for those with on-going health care needs who require frequent use of school health services. [source]

    Achieving comprehensive critical care

    Catherine Derham
    Abstract The policy document, Comprehensive Critical Care, suggested that patients with critical care needs should expect the same standard of care wherever they are nursed, be that in a traditional critical care setting or in a general ward area. It is recognized that in order for this to occur, the developmental needs of ward nurses need to be met to enable them to care for patients with level 1 and level 2 needs. A second document, The Nursing Contribution to the Provision of Comprehensive Critical Care for Adults: A strategic Programme of Action, proposed a programme of action and outlined five priority areas to be considered to ensure the success of comprehensive critical care. Education, training and workforce development was one of the areas outlined, and thus, in response, the role of the practice development facilitator was created as a means of developing the critical care knowledge, skills and practice in ward areas. It became apparent that education and training alone were insufficient to ensure that the aims of comprehensive critical care were realized. The way in which the nurses approached and organized their work and the availability of resources had a great impact on the ability of staff to care for these patients. It is argued that achieving comprehensive critical care is complex and that a multi-dimensional approach to the implementation of policy is essential in order to realize its aims. [source]

    The development and evaluation of a measure to assess cancer survivors' unmet supportive care needs: the CaSUN (Cancer Survivors' Unmet Needs measure)

    PSYCHO-ONCOLOGY, Issue 9 2007
    K. Hodgkinson
    Abstract Background: Many cancer survivors experience ongoing morbidity over the survivorship continuum and their supportive care needs have yet to be comprehensively assessed. Methods: This study aimed to develop and empirically evaluate a self-report measure of cancer survivors' supportive care needs. In Phase I, questionnaire items were generated based upon previous qualitative research that identified both unique and shared needs in survivors and their partners; items were constructed into the Cancer Survivors' Unmet Needs measure (CaSUN). In Phase 2, the CaSUN was completed by 353 cancer survivors who had been diagnosed with cancer between 1 and 15 years earlier and were currently disease-free. Results: After modification, the CaSUN included 35 unmet need items, 6 positive change items and an open-ended question. Good acceptability, internal consistency and validity were demonstrated, although test,retest reliability was low. Maximum likelihood factor analysis identified five discrete factors: Existential Survivorship, Comprehensive Care, Information, Quality of Life and Relationships. Conclusions: Preliminary data indicates that the CaSUN meets the majority of psychometric criteria for assessment measures, although its low test,retest reliability awaits further investigation. The CaSUN will facilitate the evaluation of supportive care services and generation of service delivery recommendations for cancer survivors. Copyright © 2006 John Wiley & Sons, Ltd. [source]