Chronic Care (chronic + care)

Distribution by Scientific Domains
Medical Sciences100%

Terms modified by Chronic Care

  • chronic care facility
    		•
  • chronic care model
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    Selected Abstracts

    The Effects of Geography and Spatial Behavior on Health Care Utilization among the Residents of a Rural Region

    HEALTH SERVICES RESEARCH, Issue 1 2005
    Thomas A. Arcury
    Objective. This analysis determines the importance of geography and spatial behavior as predisposing and enabling factors in rural health care utilization, controlling for demographic, social, cultural, and health status factors. Data Sources. A survey of 1,059 adults in 12 rural Appalachian North Carolina counties. Study Design. This cross-sectional study used a three-stage sampling design stratified by county and ethnicity. Preliminary analysis of health services utilization compared weighted proportions of number of health care visits in the previous 12 months for regular check-up care, chronic care, and acute care across geographic, sociodemographic, cultural, and health variables. Multivariable logistic models identified independent correlates of health services utilization. Data Collection Methods. Respondents answered standard survey questions. They located places in which they engaged health related and normal day-to-day activities; these data were entered into a geographic information system for analysis. Principal Findings. Several geographic and spatial behavior factors, including having a driver's license, use of provided rides, and distance for regular care, were significantly related to health care utilization for regular check-up and chronic care in the bivariate analysis. In the multivariate model, having a driver's license and distance for regular care remained significant, as did several predisposing (age, gender, ethnicity), enabling (household income), and need (physical and mental health measures, number of conditions). Geographic measures, as predisposing and enabling factors, were related to regular check-up and chronic care, but not to acute care visits. Conclusions. These results show the importance of geographic and spatial behavior factors in rural health care utilization. They also indicate continuing inequity in rural health care utilization that must be addressed in public policy. [source]

    Using Nursing Interventions Classification as a Framework to Revise the Belgian Nursing Minimum Data Set

    INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2009
    Koen Van den Heede PhD
    Nursing Interventions Classification (NIC); Minimale Verpleegkundige Gegevens; ontwikkeling van consensus PURPOSE., To develop the revised Belgian nursing minimum data set (B-NMDS). METHODS., The Nursing Interventions Classification (NIC, 2nd edition) was used as a framework. Six expert nurse panels (cardiology, oncology, intensive care, pediatrics, geriatrics, chronic care) were consulted. Seventy-nine panelists completed standardized e-mail questionnaires and discussed results in face-to-face meetings. FINDINGS., We initially selected 256 of 433 NIC interventions. After panel discussions, plenary meetings, and pretesting, the revised B-NMDS (alpha version) contained 79 items covering 22 NIC classes and 196 NIC interventions. CONCLUSIONS., Consensus building promoted acceptance of the B-NMDS, while the NIC provided a good theoretical basis and guaranteed international comparability. IMPLICATIONS FOR NURSING PRACTICE., The revised B-NMDS instrument can be used to visualize nursing activities in different applications (e.g., financing, staffing allocation). DOELSTELLING., Ontwikkeling van een nieuwe versie van de Minimale Verpleegkundige Gegevens (MVG). METHODE., De Nursing Interventions Classification (NIC, 2nd editie) werd gebruikt als raamwerk. Zes experten panels (cardiologie, oncologie, intensieve zorgen, pediatrie, geriatrie, chronische zorg) werden geraadpleegd. Zeven-en-negentig panelleden vulden gestandaardiseerde e-mail vragenlijsten in en bediscussieerden de resultaten in werkgroepvergaderingen. RESULTATEN., We selecteerden initieel 256 van de 433 NIC-interventies. Na panel-discussies, plenaire vergaderingen, en pre-tests, bevatte de herziene MVG (alpha versie) 79 items uit 22 NIC klassen en 196 NIC-interventies. CONCLUSIES., Het draagvlak voor de herziene versie van MVG werd gecreëerd door het nastreven van consensus. Het gebruik van NIC vormde hierbij een geode theoretische basis en verhoogt het internationaal karakter van de nieuwe MVG. IMPLICATIES VOOR DE VERPLEEGKUNDIGE PRAKTIJK., De nieuwe MVG kan gebruikt worden om de dagelijkse verpleegkundige praktijk zichtbaar te maken in verschillende beleidsdomeinen (e.g., financiering, toewijzing personeel). [source]

    Editorial: Communication in chronic care: confronting the evidence challenge in an era of system reform

    JOURNAL OF CLINICAL NURSING, Issue 11c 2008
    Sally Thorne
    [source]

    Integrating education into primary care quality and cost improvement at an academic medical center

    THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2006
    R. Van Harrison PhD
    Abstract Introduction: In 1996 the University of Michigan Health System created the Guidelines Utilization, Implementation, Development, and Evaluation Studies (GUIDES) unit to improve the quality and cost-effectiveness of primary care for common medical problems. GUIDES's primary functions are to oversee the development of evidence-based, practical clinical guidelines for common medical conditions; measure and provide feedback on physicians' performance; and facilitate systemic changes to support appropriate care. Various methods are used to improve care, including evidence reviews, formal education, informal clinical "opinion leaders," feedback, reminders, and procedure changes. Twenty-four common medical conditions have been addressed through this process. More than 30 measures of clinical performance have been developed and reported. Methods: This case study describes a systematic, multifaceted program to improve the quality and cost-effectiveness of primary care. Results: Illustrative results for clinical performance are presented for 2 measures of chronic care, 2 measures of preventive care, and 2 measures of acute care. All 6 measures show general improvement in performance across years, with performance near or above the National Committee for Quality Assurance's 90th percentile for Health Plan Employer Data and Information Set measures. Discussion: A systematic approach involving all relevant components of a health system integrates the synthesis of information, education about the information and how to implement it, and addressing operational barriers. Benefits include a curriculum that is shared across faculty, residents, and medical students and more uniform quality of care that faculty model for physicians-in-training. [source]