Search results for ‘Subject term:"comorbidity"’ Sort:
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Standards of care for people living with HIV 2013
- Author:
- BRITISH HIV ASSOCIATION
- Publisher:
- British HIV Association
- Publication year:
- 2012
- Pagination:
- 98p.
- Place of publication:
- London
Working in partnership with care providers, professional associations, commissioners and people living with HIV, the British HIV Association has produced a set of quality standards for the care of those with HIV in the UK. Treatment outcomes of people living with HIV in the UK are said to be among the best in the world. The current concern is maintaining this standard in the light of financial pressures, new structures that are emerging within the NHS, and the new providers and commissioners that are entering the health economy. These standards are intended to provide a benchmark against which to judge the quality of HIV care. Derived from the best available evidence, the standards focus on 12 key themes that have particular relevance for delivering equitable high-quality services. The themes are; diagnostic testing; access to, and retention in, treatment and care; provision of outpatient treatment and HIV care, and access to care for complex co-morbidity; safe ARV prescribing and effective medicines management; inpatient care for people living with HIV; psychological care; sexual health and secondary HIV prevention; reproductive health; self management; service user engagement/involvement; competencies; and information for public health surveillance, commissioning, audit and research.
Depression in veterans with Parkinson's disease: frequency, co-morbidity, and healthcare utilization
- Authors:
- CHEN Peijun, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(6), June 2007, pp.543-548.
- Publisher:
- Wiley
This American study aimed to determine the frequency of depression in Parkinson's disease (PD) in routine clinical care, and to examine its association with co-morbid psychiatric and medical conditions and healthcare utilization. Depression diagnoses and healthcare utilization data for all male veterans with PD age 55 or older seen in fiscal year 2002 (n = 41,162) were analyzed using Department of Veterans Affairs (VA) national databases. Frequencies of co-morbid disorders and healthcare utilization were determined for depressed and non-depressed patients; associations with depression were examined using multivariate logistic regression models. A depression diagnosis was recorded for 18.5% of PD patients, including major depression in 3.9%. Depression decreased in frequency and severity with increasing age. In multivariate logistic regression models, depressed patients had significantly greater psychiatric and medical co-morbidity, including dementia, psychosis, stroke, congestive heart failure, diabetes, and chronic obstructive pulmonary disease than non-depressed patients. Depressed PD patients were also significantly more likely to have medical and psychiatric hospitalizations, and had more outpatient visits, than non-depressed PD patients in adjusted models. Depression in PD in non-tertiary care settings may not be as common or as severe as that seen in specialty care, though these findings also may reflect under-recognition or diagnostic imprecision. The occurrence of depression in PD is associated with greater psychiatric and medical co-morbidity, and greater healthcare utilization. These findings suggest that screening for depression in PD is important and should be embedded in a comprehensive psychiatric, neuropsychological, and medical evaluation.
Caring for older patients with complex needs: how does England compare with 11 OECD countries?
- Authors:
- KNIGHT Hannah, et al
- Publisher:
- Health Foundation
- Publication year:
- 2021
- Pagination:
- 19
- Place of publication:
- London
... with heart failure and with a comorbidity of diabetes. Based on pre-pandemic data, the analysis is further evidence that the NHS in England remains a relatively low-cost health care system. The findings support previously stated concerns that the mortality rate in England among older patients with high needs is higher than average among comparable countries. England is performing relatively well in acute (Edited publisher abstract)
A spectrum of obstacles: an inquiry into access to healthcare for autistic people
- Authors:
- CHRISTOU Emily, WESTMINSTER COMMISSION ON AUTISM
- Publisher:
- Westminster Commission on Autism
- Publication year:
- 2016
- Pagination:
- 63
- Place of publication:
- Huddersfield
Final report of the Westminster Commission on Autism into the access to health care for people with autism which was chaired by Barry Sheerman MP. The report aims to highlight what good quality, person centred healthcare, tailored to the needs of those on the autistic spectrum, can achieve and calls for equal access to quality healthcare for all on the autistic spectrum. The report follows a seven-month inquiry and a consultation of over 900 people. The Commission collected evidence through four oral evidence sessions in the Houses of Parliament and through written submissions, telephone interviews, and 863 survey response from autistic people and parent-advocates. The inquiry identified seven main obstacles that people with autism encounter when accessing health care. These were: lack of understanding; autism and co-occurring conditions; co-occurring mental health issues; diagnostic overshadowing; sensory processing and communication; isolation, avoidance and neglect; and leadership. It also highlights the need for improvement in training and commissioning. The report makes six key recommendations to help improve access, these cover: training, inspection, data collection, annual health checks, leadership and the development of resources to help people with autism access health care services. (Edited publisher abstract)
Dementia rarely travels alone: living with dementia and other conditions
- Author:
- ALL-PARTY PARLIAMENTARY GROUP ON DEMENTIA
- Publisher:
- Alzheimer's Society
- Publication year:
- 2016
- Pagination:
- 11
- Place of publication:
- London
Report of the All Party Parliamentary Group on Dementia which looks at the challenges facing people living with dementia and other conditions, the prevalence of co-morbidities, and the changes that are needed across the health and social care system to help mitigate these difficulties. The report draws on 30 evidence submissions received from a range of organisations, including voluntary organisations, the Royal colleges, practitioners, and service providers and two focus groups held by the Alzheimer’s with people with dementia and carers. The report found that despite significant progress to deliver integrated care services and support, the health and social system frequently treats conditions in isolation so that people with dementia and other health conditions receive disjointed, substandard care and treatment. It makes a number of recommendations grouped into the following themes: improved risk reduction, GP-led holistic annual reviews, new guidance for medication management, better data for joint commissioning, and regulation of care pathways as well as providers. (Edited publisher abstract)
Interrelationships among physical health, health-related, and psychosocial characteristics of persons receiving integrated care in community mental health settings
- Author:
- LEMIEUX Catherine M.
- Journal article citation:
- Journal of Social Service Research, 41(5), 2015, pp.561-583.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
... predictors of health status. Results are consistent with research on comorbidity that emphasises the multidimensionality of health. Future social work research should employ multivariate approaches to identify disparities and clarify treatment needs of diverse CMH clients (Edited publisher abstract)
Development and implementation of collaborative care for depression in HIV clinics
- Author:
- CURRAN Geoffrey M.
- Journal article citation:
- AIDS Care, 23(12), December 2011, pp.1626-1636.
- Publisher:
- Taylor and Francis
... collaborative depression care in a specialty physical health clinic setting with a population that has a high prevalence of depression and mental health comorbidity. The paper describes: the formative evaluation conducted prior to implementation; the process used to adapt the primary care collaborative care model for depression to specialty HIV clinics; and the intervention itself. Baseline assessments were
“So I just took over”: African American daughters’ caregiving for parents with heart failure
- Authors:
- THORNTON Nancy, HOPP Faith Pratt
- Journal article citation:
- Families in Society, 92(2), April 2011, pp.211-217.
- Publisher:
- The Alliance for Children and Families
... for a parent with heart failure. Analysis of in-depth interviews suggested the presence of caregiving stressors, including heart failure symptoms and comorbidity, caregiving duties, social-emotional stressors, and distrust of the health system. Coping strategies that were embraced included valuing the caregiving role, coordinating care with siblings, and spirituality. Social workers can help to reduce racial
Quality of medical care for people with and without comorbid mental illness and substance misuse: systematic review of comparative studies
- Authors:
- MITCHELL Alex J., MALONE Darren, DOEBBELING Caroline Carney
- Journal article citation:
- British Journal of Psychiatry, 194(6), June 2009, pp.491-499.
- Publisher:
- Cambridge University Press
This study aimed to investigate whether the quality of medical care received by people with mental health conditions, including substance misuse, differs from the care received by people who have no comparable mental disorder. A systematic review of studies that examined the quality of medical care in those with and without mental illness was conducted using robust critical appraisal techniques. Of 31 valid studies, 27 examined receipt of medical care in those with and without mental illness and 10 examined medical care in those with and without substance use disorder (or dual diagnosis). Nineteen of 27 and 10 of 10, respectively, suggested inferior quality of care in at least one domain. Twelve studies found no appreciable differences in care or failed to detect a difference in at least one key area. Several studies showed an increase in healthcare utilisation but without any increase in quality. Three studies found superior care for individuals with mental illness in specific subdomains. There was inadequate information concerning patient satisfaction and structural differences in healthcare delivery. There was also inadequate separation of delivery of care from uptake in care on which to base causal explanations. Despite similar or more frequent medical contacts, there are often disparities in the physical healthcare delivered to those with psychiatric illness although the magnitude of this effect varies considerably.
The impact of payment reforms on the quality and utilisation of healthcare for patients with multimorbidity: a systematic review
- Authors:
- REMERS Toine E. P., et al
- Journal article citation:
- International Journal of Integrated Care, 22(1), 2022, p.10. Online only
- Publisher:
- International Foundation for Integrated Care
Inadequate treatment of multimorbidity is recognised as a major determinant of the effectiveness of healthcare and also of its inappropriate expenditures. However, current payment systems target, primarily, the treatment of single diseases, thus hindering integrated delivery of care for patients with multimorbidity (PwM). This review aims to assess the effects of targeted reforms of payment systems which could help attain a higher quality of care and reduce unnecessary healthcare utilisation. In June 2020, a search of Medline and EMBASE revealed 13 relevant articles. The most common payment models were the use of bundled payments (n = 4) and diagnosis-related group payments (n = 4). Except for an increase in hospital admissions (n = 3), no outcome showed unambiguous significant effects across more than one study. The two studies which focused explicitly on PwM showed a significant decrease in 30-day hospital readmissions. This, however, was not maintained after 60 days in one study. No general conclusion could be drawn on the effects of targeted payment reforms for PwM. The findings suggest that reforms should be combined with more multifaceted healthcare delivery to address the complex patterns of healthcare use effectively. Thorough evaluations of targeted payment reforms are needed urgently to contribute to the body of evidence required. (Edited publisher abstract)