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Ageism and age discrimination in primary and community health care in the United Kingdom: a review from the literature
- Author:
- CLARK Angela
- Publisher:
- Centre for Policy on Ageing
- Publication year:
- 2009
- Pagination:
- 90p., bibliog.
- Place of publication:
- London
The Department of Health (DH) commissioned the Centre for Policy on Ageing (CPA) to identify possible evidence of age discrimination in policy and practice in primary health care in the UK through a literature review. The remit for the review of primary care services was to signpost areas where negative discrimination may be occurring for service commissioners and providers to use as a starting point in reviewing and revising their practice. Topics include: ageist attitudes; NSF for older people; access to GP services; evidence of ageism and age discrimination in GP practice; treatment and quality of care; GP referrals; preventative strategies; frail older people and multimorbidity; GP performance contract; NICE guidelines and the use of QALYS; focus of the NHS. This is one of four reviews of ageism and age discrimination in health and social care.
Combining extra care housing with health care services at Barton Mews
- Author:
- EVANS Simon
- Publisher:
- Care Services Improvement Partnership. Housing Learning and Improvement Network
- Publication year:
- 2008
- Pagination:
- 6p.
- Place of publication:
- London
This case study describes Barton Mews, a private development in partnership with a Primary Care Trust that provides extra care housing with a community hospital and GP practice. This approach of private engagement with extra care housing is currently relatively uncommon but is likely to become more prevalent as a way of meeting demand, particularly in the light of the projected increase in home ownership among older people. The case study outlines the facilities and highlights key learning points.
Physician and nurse practitioner perceptions of social worker and community health worker roles in primary care practices caring for frail elders: insights for social work
- Authors:
- BERRETT-ABEBE Julie, et al
- Journal article citation:
- Social Work in Health Care, 59(1), 2020, pp.46-60.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Social workers (SW) and community health workers (CHW) have emerged as key workforce personnel in efforts to care for elders in the U.S. However, little is known about the presence and roles of SW and CHW in primary care practices. This paper presents findings from a nationally representative survey of geriatrics and primary care practices. Physician and nurse practitioner clinicians were randomly selected within practices, stratifying by practice staffing and presence/absence of geriatric clinicians; the final sample for this analysis included 341 practices. Key findings include: reported challenges in meeting the social service needs of elders, underutilization of SW, and fuller utilization of social work competencies in practices in which both SW and CHW were present. These findings offer a unique perspective of SW on interprofessional teams and have implications for the future of the profession. (Edited publisher abstract)
'It's not just the word care, it’s the meaning of the word...(they) actually care': caregivers' perceptions of home-based primary care in Toronto, Ontario
- Authors:
- SMITH-CARRIER Tracy, et al
- Journal article citation:
- Ageing and Society, 38(10), 2018, pp.2019-2040.
- Publisher:
- Cambridge University Press
The frail and homebound older adult populations currently experience difficulties accessing primary care in the medical office. Given this fundamental access to care problem, and the questionable care quality that arises when navigating a labyrinthine health-care system, these populations have typically been subject to inadequate primary care. To meet their needs better, growing research stresses the importance of providing comprehensive home-based primary care (HBPC), delivered by an inter-professional team of health-care providers. Family care-givers typically provide the majority of care within the home, yet their perceptions of HBPC remain under-researched. The purpose of this study was to explore unpaid care-givers' perceptions of and experiences with HBPC programmes in Toronto, Canada. The research conducted qualitative inductive content analysis, using analytic procedures informed by grounded theory, to discover a number of themes regarding unpaid care-givers' understandings of HBPC. Findings suggest that, compared to the standard office-based care model, HBPC may better support unpaid care-givers, providing them assistance with system navigation and offering them the peace of mind that they are not alone, but have someone to call should the need arise. The implications of this research suggest that HBPC could be a model to help mitigate the discontinuities in care that patients with comorbid chronic conditions and their attendant unpaid care-givers experience when accessing fragmented health, home and social care systems. (Edited publisher abstract)
What's the alternative?
- Author:
- HOLDEN John
- Journal article citation:
- Health Service Journal, 27.9.12, 2012, pp.32-33.
- Publisher:
- Emap Healthcare
Eldercare is an innovative model of delivering primary care services for housebound and vulnerable patients, most of whom are over 65. The service provides specialist GP services patients where they live (either at home or in residential care), and helps to reduce health inequalities and delivering greater choice in services. By improving access to primary care services Eldercare has reduced hospital admissions by 40 percent and reduced length of stay by 80 per cent overall. This has resulted in both improved levels of care and cost savings. The service is owned and run by three local Liverpool University training practices.
Take your partners
- Author:
- DAVIS Rowenna
- Journal article citation:
- Community Care, 10.04.08, 2008, pp.14-16.
- Publisher:
- Reed Business Information
The Excellence Network is Community Care's new honours programme which recognises innovative practice. This article profiles six teams that judges felt demonstrated excellence in partnership working. The teams are: The Bridge Substance Misuse Service in Birmingham; Gateway in Poole, which aims to bridge the gap between social and mental health services; East Cambridgeshire Children's Team; Aberdeenshire Autism Service; the Reprovisioning Project Team in Melrose, Scotland which developed a new community based service to meet the needs of former nursing home residents with physical and complex disabilities; and the Meadows Centre for Excellence which joins social care rehabilitation, primary care trust intermediate care and voluntary sector services to provide seamless support for people over 50 in Stoke on Trent.
Outcomes of community-based screening for depression and suicide prevention among Japanese elders
- Authors:
- OYAMA Hirofumi, et al
- Journal article citation:
- Gerontologist, 46(6), December 2006, pp.821-826.
- Publisher:
- Oxford University Press
This study evaluates outcomes of a community-based program to prevent suicide among elderly individuals aged 65 and older. The study used a quasi-experimental design with intervention and referent municipalities. The program included a 7-year implementation of depression screening with follow-up by general practitioners and a 10-year implementation of public education conducted in Yasuzuka (population 4,940; elderly suicide rate for women, 275/100,000; for men, 323/100,000). Changes in the risk of completing suicide before and after the 10-year implementation by the incidence-rate ratio (IRR) were estimated. The results found risk for women in the intervention area was reduced by 64%, whereas there was no significant change in the risk for men in the intervention area and either men or women in the referent municipalities. A ratio of the IRR for women aged 65 to 74 in the intervention area to that in its prefecture was estimated at 0.23, showing that the risk reduction was greater than the secular trend. It is concluded that the management of depression by use of community resources involving public health and primary care physicians is effective in the prevention of suicide for elderly women but uncertain for men.
Team performance and risk-adjusted health outcomes in the program of all-inclusive care for the elderly (PACE)
- Authors:
- MUKAMEL Dana B., et al
- Journal article citation:
- Gerontologist, 46(2), April 2006, pp.227-237.
- Publisher:
- Oxford University Press
The Program of All-Inclusive Care for the Elderly (PACE) is a community-based program providing primary, acute, and long-term care to frail elderly individuals in the United States. A central component of the PACE model is the interdisciplinary care team, which includes both professionals and non-professionals. This study examined the association between the team's overall performance and the risk-adjusted health outcomes of program enrolees. The study included interdisciplinary teams in 26 PACE programs and 3,401 individuals enrolled in them. The researchers combined information about individuals' health, functional, and mental status from DataPACE with an overall measure of team performance. Multivariate regression techniques were used to test the hypothesis that better team performance is associated with better risk-adjusted health outcomes: survival and short-term (within 3 months of enrolment) and long-term (within 12 months of enrolment) improvements in functional status and in urinary incontinence. Results found that team performance was significantly associated with better functional outcomes (both short and long term) and with better long-term urinary incontinence outcomes. There was no significant association with survival. This study provides empirical evidence for the relationship between team performance and patient outcomes in long-term care. It suggests that PACE programs can improve patient outcomes by improving the functioning of care teams.
Just for us: an academic medical center-community partnership to maintain the health of frail low-income senior population
- Authors:
- YAGGY Susan D., et al
- Journal article citation:
- Gerontologist, 46(2), April 2006, pp.271-276.
- Publisher:
- Oxford University Press
To promote health and maintain independence, Just for Us provides financially sustainable, in-home, integrated care to medically fragile, low-income seniors and disabled adults living in subsidized housing in the United States. The program provides primary care, care management, and mental health services delivered in patient's homes by a multidisciplinary, multiagency team. After 2 years of operation, Just for Us is serving nearly 300 individuals in 10 buildings. The program is demonstrating improvement in individual indices of health. Medicaid expenditures for enrolees are shifting from ambulances and hospital services to pharmacy, personal care, and outpatient visits. The program is not breaking even, but it is moving toward that goal. The program's success is based on a partnership involving an academic medical center, a community health center, county social and mental health agencies, and a city housing authority to coordinate and leverage services.
Designing services for older people: lessons for practitioners
- Author:
- -
- Journal article citation:
- Community Practitioner, 73(8), August 2000, pp.716-718.
- Publisher:
- Community Practitioners' and Health Visitors' Association
This third article in the assessment of older people in the community series looks at community oriented primary care (COPC) methodology and introduces phase I of the primary care for older people programme, which applies the COPC model to innovative primary care for the elderly.