medical home model

Introduction This study aims to examine the disparities in the place of death for patients due to thyroid neoplasms and understand the mortality trends. The study also aims to assess the influence of factors like age, gender, geography, and race, thus allowing for the assessment and improvement of end-of-life and palliative care. Methodology The study analyzes thyroid cancer mortality trends from 1999 to 2020 using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database, taking into consideration locations of death, medical facilities, home and hospice care, and others...

OBJECTIVE: To understand the health status of older adults living alone in China and analyze the influencing factors, so as to provide reference for improving the health status of older adults living alone. METHODS: Based on CGSS data from China General Social Survey (2017), the influencing factors of health status of older adults living alone were analyzed by unconditional Logistic regression, and the R software was used to develop a nomogram for predicting the risk of self-assessed unhealthy adverse outcomes...

BACKGROUND: Obesity adversely impacts outcomes of total hip arthroplasty (THA), leading surgeons to impose body mass index cutoffs for patient eligibility and encourage preoperative weight loss. This study aimed to determine if preoperative weight loss impacts outcomes of THA in the general patient population and if it mitigates poor outcomes in obese patients. METHODS: Patients who underwent THA from 2013-2020 were identified in the National Surgical Quality Improvement Program (NSQIP) database...

BACKGROUND: Artificial nail modelling systems (ANMS) pose a significant risk for nail stylists and their clients regarding acrylate sensitization, which might jeopardize the use of acrylate-containing medical devices. OBJECTIVES: To evaluate the frequency of artificial nail practices among female healthcare workers (HCWs) compared with controls and assess ANMS-related side effects. METHODS: In this comparative, cross-sectional, single-centre study, a face-to-face interview with 200 female HCWs and 200 age-matched female dermatology patients (controls) was conducted regarding the use of ANMS between March and November 2023...

Calls to leverage routinely collected data to inform health system improvements have been made. Misalignment between home care services and client needs can result in poor client, caregiver, and system outcomes. To inform development of an integrated model of community-based home care, grounded in a holistic definition of health, comprehensive clinical profiles were created using Ontario, Canada home care assessment data. Retrospective, cross-sectional analyses of 2017-2018 Resident Assessment Instrument Home Care (RAI-HC) assessments (n = 162,523) were completed to group home care clients by service needs and generate comprehensive profiles of each group's dominant medical, functional, cognitive, and psychosocial care needs...

BACKGROUND: Despite being the gold-standard method for objectively assessing sleep, polysomnography (PSG) faces several limitations as it is expensive, time-consuming, and labor-intensive; requires various equipment and technical expertise; and is impractical for long-term or in-home use. Consumer wrist-worn wearables are able to monitor sleep parameters and thus could be used as an alternative for PSG. Consequently, wearables gained immense popularity over the past few years, but their accuracy has been a major concern...

This study aimed to: (1) validate a natural language processing (NLP) system developed for the home health care setting to identify signs and symptoms of Alzheimer's disease and related dementias (ADRD) documented in clinicians' free-text notes; (2) determine whether signs and symptoms detected via NLP help to identify patients at risk of a new ADRD diagnosis within four years after admission. This study applied NLP to a longitudinal dataset including medical record and Medicare claims data for 56,652 home health care patients and Cox proportional hazard models to the subset of 24,874 patients admitted without an ADRD diagnosis...

The risk of pressure ulcers in stroke patients is a significant concern, impacting their recovery and quality of life. This systematic review and meta-analysis investigate the prevalence and risk factors of pressure ulcers in stroke patients, comparing those in healthcare facilities with those in home-based or non-clinical environments. The study aims to elucidate how different care settings affect the development of pressure ulcers, serving as a crucial indicator of patient care quality and management across diverse healthcare contexts...

BACKGROUND: Favorable neighborhood-level social determinants of health (SDoH) are associated with lower cardiovascular disease risk. Less is known about their influence on cardioprotective behaviors. We evaluated the associations between neighborhood-level SDoH and cardioprotective behaviors among church members in Louisiana. METHODS: Participants were surveyed between November 2021 to February 2022, and were asked about health behaviors, aspects of their neighborhood, and home address (to link to census tract and corresponding social deprivation index [SDI] data)...

This paper examines the long-standing and severe public health crisis, the opioid epidemic in the United States, which has been worsening since the mid-1990s. In contrast to previous research, it investigates the broader impacts of this epidemic, particularly on family members and healthcare systems. Using a comprehensive dataset spanning from 1998 to 2010, the study analyzes opioid use at the three-digit ZIP code level, utilizing data from the Drug Enforcement Agency (DEA) and individual-level data from the Health and Retirement Study (HRS) in a two-way fixed effect model...

BACKGROUND: Kaiser Permanente Southern California began offering a 4-week supplemental benefit of home-delivered meals to Medicare Advantage members after discharge from a hospitalization for heart failure and other medical conditions in 2021. The purpose of this study is to explore the associations between socioeconomic disadvantage and food insecurity with patient uptake of and satisfaction with the meals. METHODS: Data for this cross-sectional study were drawn from survey and electronic medical record data for members referred for the meals benefit (n = 6169) and linked to a hospitalization encounter (n = 2254) between January and December 2021...

BACKGROUND: People with intellectual and developmental disabilities (IDD) were disproportionately affected by the COVID-19 pandemic. Predicting COVID-19 infection has been difficult. OBJECTIVE: We sought to address two research questions in this study: 1) to assess the overall utility of a machine learning model to predict COVID-19 diagnosis for people with IDD, and 2) to determine the primary predictors of COVID-19 diagnosis in a random sample of Home and Community Based Services users in one state...

INTRODUCTION: Discussions comparing the components and virtues of models of integrated behavioral health (IBH), that is, collaborative care management and primary care behavioral health, have been ongoing. In this conceptual article, we recommend shifting the focus to a broader set of components we have found essential to serve the needs of our patients, and hopefully the broader aims of dissemination and implementation of IBH. METHOD: We detail our 20-year experience including the personnel, program components, challenges, successes, and plans for the future that will meet our patients' behavioral health needs and serve primary care...

Based on the vulnerability-stress model and coping theory, this study of 1920 people in Scotland investigated how sex, age, occupational factors, anxiety, depression and maladaptive coping behaviours are associated with cardiovascular health. Structural equation modelling and serial Sobel mediation tests were conducted. Anxiety was associated with past arrhythmia, whereas depression was associated with past heart attacks, stroke and angina. Females reported more anxiety, past arrhythmia, confectionary and alcohol consumption, whereas males had more heart attacks...

INTRODUCTION: Pharmacists are often not recognised as a core part of palliative care teams, despite their ideal placement to assist with the burden of medication management. OBJECTIVE: This study explored the role of pharmacists working in the rural palliative care team, in the home-based setting. DESIGN: Health care professionals working with palliative care patients in rural South Australia participated in semi-structured interviews. Data were analysed using thematic analysis...

Lower extremity exercises are considered a standard and necessary treatment for rehabilitation and a well-rounded fitness routine, which builds strength, flexibility, and balance. The efficacy of rehabilitation programs hinges on meticulous monitoring of both adherence to home exercise routines and the quality of performance. However, in a home environment, patients often tend to inaccurately report the number of exercises performed and overlook the correctness of their rehabilitation motions, lacking quantifiable and systematic standards, thus impeding the recovery process...

A policy of aging in place should be accompanied by physical and social environments that support healthy aging. This article describes how a property development company in Hong Kong sought to elicit the views of older people and their caregivers towards elderly services through a market research company, using questionnaire surveys followed by focus groups. Over 80% of all participants rated healthy dietary habits and exercise, maintaining mental and spiritual health, and maintaining a generally healthy lifestyle as important...

BACKGROUND: SARS-CoV-2 vaccines are effective in reducing hospitalization, COVID-19 symptoms, and COVID-19 mortality for nursing home (NH) residents. We sought to compare the accuracy of various machine learning models, examine changes to model performance, and identify resident characteristics that have the strongest associations with 30-day COVID-19 mortality, before and after vaccine availability. METHODS: We conducted a population-based retrospective cohort study analyzing data from all NH facilities across Ontario, Canada...

OBJECTIVE: This study aimed to explore the direct and indirect effects of social frailty on functional state trajectories mediated by subjective cognitive function in older adults. DESIGN: Longitudinal study. SETTING AND PARTICIPANTS: Overall, 514 adults aged ≥65 years living in a suburban area of central Japan were included in this study. METHODS: Five-item social frailty index (going out, visiting, feeling helpful, living alone, and talking to others), subjective cognitive function from the Kihon Checklist, and instrumental activities of daily living disability...

Adjuvant and neoadjuvant therapy of early breast cancer reduces the risk of relapse and breast cancer mortality. Treatment modalities include chemotherapy, endocrine therapy, human epidermal growth factor receptor 2-targeted agents, bisphosphonates, immunotherapy, cyclin-dependent kinase inhibitors 4/6- and poly-ADP-ribose polymerase inhibitors. All cases are reviewed at multidisciplinary breast cancer tumour boards. An individualized risk stratification model is applied in this review to optimize the risk-benefit ratio for each patient, and shared decision-making is an integrated part of (neo)adjuvant therapy...