OBJECTIVES Despite the increasing utilization of in-home services, the assessment of in-home services used by those that have certified levels of care needs has been limited to the actual changes in individual outcomes. The purpose of the present study was to determine factors affecting how the utilization of in-home services could have sustained and/or improved or deteriorated the care needs l...

OBJECTIVES This paper examined the potential of a new classification framework, The Spectrum of Children's Palliative Care Needs, to facilitate identification of children with palliative care needs for the purposes of minimum data set collection and population needs assessment. METHODS Health and social care professionals (n=50) in a range of paediatric palliative care settings applied The Sp...

The needs assessment process is indeed complex in the social service context. Whereas most contexts can start with a presumption of "no need," the social service context frequently must start with an assumption of "need met-->change." In addition, underlying values--the individual's, the assessor's, the society's--all play a part in the judgment process. The assumption that the involvement of a...

PROBLEM Communication with patients and families in critical care medicine (CCM) can be complex and challenging. A longitudinal curricular model integrating multiple techniques within classroom and clinical milieus may facilitate skillful communication across diverse settings. APPROACH In 2014-2015, the authors developed and implemented a curriculum for CCM fellows at the Cumming School of Me...

A review of palliative care policies and bereavement support practices in the United States, Canada, United Kingdom, Australia, and Japan demonstrated 4 challenges: questions over providing universal versus targeted support; a lack of clear evidence driving service delivery; informal or no risk assessment; and limited or no evaluation of services. Bridging the gaps between the policy and practi...

To investigate the associations between dementia, the use of long-term care (LTC) services, and the deterioration of care-needs levels of elderly persons in Japan. Using a retrospective cohort study, we analyzed 50,268 insurance beneficiaries aged 65 years and older who had utilized LTC services between 2010 and 2011 in Kyoto prefecture, Japan. Logistic regression analyses were used to identify...

PURPOSE Youth with special health care needs (YSHCN) increasingly live into adulthood, and approximately 500,000 U.S. youth transition from pediatric to adult health care systems annually. Through a systematic literature review, we sought to (1) determine adult outcomes for YSHCN who have no special transition interventions and (2) identify evidence for strategies that lead to better outcomes, ...

Patients with complex health care needs account for a high percentage of annual medical expenditures. Care management is a set of activities intended to improve patient care and reduce the need for medical services by helping patients and caregivers more effectively manage health conditions. This synthesis reviews the evidence on care management and its ability to improve patient care and reduc...