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Medical Referral (medical + referral)
Selected AbstractsHealthcare Costs and Utilization of Vulnerable Elderly People Reported to Adult Protective Services for Self-NeglectJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2008(See editorial comments by Dr. Mark Lachs, pp 757) OBJECTIVES: To assess differences between diagnoses, healthcare utilization, and healthcare costs of vulnerable elderly people reported to Adult Protective Services for self-neglect and those of matched controls. DESIGN: A case-control study of 131 self-neglect cases and 131 matched controls. SETTING: All participants were patients in a public hospital geriatrics program. PARTICIPANTS: Adult Protection Services referred the self-neglect cases to an interdisciplinary geriatric medicine team. The controls were patients who used the same source of geriatric medical services and were matched on race or ethnicity, sex, and age. MEASUREMENTS: Diagnoses, healthcare utilization, and Medicare reimbursable costs were compared in cases and controls for 1 year before and 1 year after the case medical referral. RESULTS: Mental disorders were diagnosed more frequently in the self-neglect group than in the control group. Self-neglecters had lower healthcare utilization and medical costs than controls in the year before the medical referral, but utilization and costs were similar in the two groups in the year after the referral. CONCLUSION: This study provides evidence that, once self-neglecters are brought into the healthcare system, they are no more expensive than other similar patients. This result has important public policy implications and fills an important gap, because there is no published literature describing the financial effect of self-neglect on the healthcare system. [source] The Stigma of Psychological Problems in a Work Environment: Evidence From the Screening of Service Members Returning From Bosnia,JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 8 2000Thomas W. Britt The present research examined the stigma associated with psychological problems among service members returning from the United States peacekeeping mission to Bosnia. The results show that admitting a psychological problem in the military is perceived as muchmore stigmatizing than admitting a medical problem. Service members had more concerns about stigmatization and felt more uncomfortable discussing psychological problems than medical problems, and these feelings were magnified when service members were being screened with their units rather than alone. Service members also reported a lesser likelihood of following through with a psychological referral than with a medical referral. However, participants who discussed psychological issues with a therapist felt the screening was more beneficial than those who did not discuss their responses. The results address the neglected topic of the stigma associated with psychological problems in the workplace. [source] Contemporary referral of patients from community care to cardiology lack diagnostic and clinical detailINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2006S. Bodek Summary The quantity of referrals to secondary care is increasing. That the quality of medical referrals is decreasing is a common allegation yet has rarely been assessed. We report a time-limited, cross-sectional survey evaluating cardiological referral information quality. Referral letters (n = 218, excluding direct access pro formas) from GPs to the Cardiology Department at City Hospital, Birmingham, were collated and analysed over 2 months. A subset (n = 49) of these patients completed questionnaires assessing their knowledge and patient communication of the referral. Information quality was poor (length, diagnosis, expectation, prior treatment and investigation) with almost half of all letters containing only outline symptomatic complaints without diagnosis. The majority of patients referred had not been investigated or treated in any way before referral. Despite lack of understanding of the reason for referral, typically the majority of patients expressed themselves as satisfied with the process. Given most referrals are seen as appropriate, information exchange between secondary and primary care is crucial. By contrast, the standard of even basic clinical assessment communicated between primary care and secondary care was severely limited. The reason(s) why medical assessment is lacking are unclear but must be explored to give more support to primary care to complete basic medical task particularly if investment is to flow into this source. [source] | ||||||||||