We investigated the extent to which children continuously enrolled in two mature county-organized Medicaid managed care plans for 6, 12, and 24 months received recommended well-child visits and immunizations. We also investigated whether any improvements in compliance were evident during the period 1989-92. Compliance was low for well-child visits and immunizations at the recommended ages regar...

Managed care of some kind will dominate the future of health care, but the unresolved crucial question concerns ownership of the managed care plans. An investor-owned managed care industry now holds sway, but I do not expect it to last very long. In the long run, physicians must be in charge of medical care, but they must live within budgets and be accountable to payers and to their patients. T...

This study examined relationships between workplace stress, organizational factors and use of EAP counseling services delivered by network providers in a large, privately-insured population. Claims data were linked to measures of workplace stress, focus on wellness/prevention, EAP promotion, and EAP activities for health care plan enrollees from 26 employers. The association of external environ...

BACKGROUND A large discrepancy exists between the wishes of dying patients and their actual end-of-life care. However, retrospective clinical experience suggests that early advance care planning (ACP) can markedly reduce this discrepancy. This article describes a randomized trial to evaluate the short-term clinical utility of early ACP. We also assessed the feasibility of performing a larger pr...

This article illustrates the authors' participation in the ONS Foundation-supported Breast Cancer Survivorship (BCS) Quality Measures Set pilot study at Southern Ohio Medical Center (SOMC) Cancer Center. The data collection, outcomes, and action plans based on results are described. Included are the SOMC distress tool, psychosocial assessment tool, a survivorship care plan, and a clinical vigne...

AIM The Asthma 3+ Visit Plan is an initiative to promote organised asthma care in general practice. This study aimed to identify factors associated with uptake of the plan by general practitioners, and their views on barriers and facilitators to implementation of the plan. DESIGN Postal survey sent to a random sample of GPs. PARTICIPANTS AND SETTING 315 GPs in five Divisions of General Prac...

background : schizophrenia is a debilitating psychotic disorder that affects patients’ personality, career-related and social functioning. patients stop medications after discharge or inpatient care, when they feel relatively recovered. most patients do not know that they are sick and they need medication for recovery due to lack of information and cognitive impairment, which makes them incompe...

BACKGROUND The number of people suffering from one or more chronic conditions is rising, resulting in an increase in patients with complex health care demands. Interprofessional collaboration and the use of shared care plans support the management of complex health care demands of patients with chronic illnesses. This study aims to get an overview of the scientific literature on developing inte...

Few studies have fully explored the problem of communication barriers in pediatric palliative care, particularly the detrimental effects of poor interaction between staff and families on children's health and well-being. A literature review was undertaken to expand the current body of knowledge about staff to patient communications. Articles meeting the inclusion criteria (N = 15) were systemat...

Mr K is an 89-year-old married man with a number of comorbid conditions and multiple recent falls. He was referred to the IMPACT clinic (Interprofessional Model of Practice for Aging and Complex Treatments) as his primary care physician was concerned about his declining health and the growing care giver burden on his wife. Mr K's condition was deteriorating while the complexity of his case was ...