Community development approaches to integrated health care planning and delivery has had a chequered history—both in ‘Western’ economies and developing nations. As the authors point out: ‘‘As whealthx practitioners we are aware that the rhetoric about the importance of engaging communities and building community capacity is not always matched with resources«.The re-orientation of governments an...

BACKGROUND Six million US children are uninsured, despite two-thirds being eligible for Medicaid/Children's Health Insurance Program (CHIP), and minority children are at especially high risk. The most effective way to insure uninsured children, however, is unclear. METHODS We conducted a randomized trial of the effects of parent mentors (PMs) on insuring uninsured minority children. PMs were ...

HOME HEALTH CARE HAS BEEN ONE OF THE fastest-growing sectors in the health care industry, but the prevention of occupational exposures in this setting has not received the attention it deserves. Of the more than 8 million U.S. health care workers who work in hospitals and other health care settings1, between 650,000 and 850,000 are employed in home health care.2 There are few data and no nation...

Pediatric home health care is an effective and holistic venue of treatment of children with medical complexity or developmental disabilities who otherwise may experience frequent and/or prolonged hospitalizations or who may enter chronic institutional care. Demand for pediatric home health care is increasing while the provider base is eroding, primarily because of inadequate payment or restrict...

We document a robust negative correlation in which residing in a larger family is associated with lower consumption of medical care ceteris paribus. For men, an additional household member is associated with between $659.69 and $1039.97 fewer expenditures on health care and, for women, the estimates range between $391.28 and $728.66. Using quantile regression, the magnitude of the coefficients ...

Building therapeutic nurse-patient relationships is pivotal to the provision of optimum nurse care management for geriatric home health care (HHC) patients. However, little is known about which strategies most effectively treat older adult HHC patients with concomitant depression and disability. This qualitative descriptive study was conducted in two parts to explore the issue further. The firs...

BACKGROUND Depression and diabetes cause significant burden for patients and the healthcare system and, when co-occurring, result in poorer self-care behaviors and worse glycemic control than for either condition alone. However, the clinical management of these comorbid conditions is complicated by a host of patient, provider, and system-level barriers that are especially problematic for patien...

In the patient-centered medical home, PCMH, patient care is overseen by a primary care physician leading a team of health care providers, who collaborate to optimize treatment. To facilitate interactions in PCMH, secure collaboration will be needed to: control access to information; dictate who can do what when; and promote sharing and concurrent access. This contrasts approaches such as the Na...

The U.S. healthcare system has been plagued by rising costs while achieving relatively poor-quality outcomes, and the situation continues to worsen. One solution is the patient-centered medical home (PCMH) model of primary care. This model focuses on care coordination and development of long-term physician-patient relationships that are expected to lead to better quality care and higher rates o...