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medical-legal partnership

Marsha Regenstein, Jennifer Trott, Alanna Williamson, Joanna Theiss
The US health care system needs effective tools to address complex social and environmental issues that perpetuate health inequities, such as food insecurity, education and employment barriers, and substandard housing conditions. The medical-legal partnership is a collaborative intervention that embeds civil legal aid professionals in health care settings to address seemingly intractable social problems that contribute to poor health outcomes and health disparities. More than three hundred health care organizations are home to medical-legal partnerships...
March 2018: Health Affairs
Caroline J Wick, Jeannette Y Wick
Medical providers know that there are some conditions they can't treat because the condition is caused or exacerbated by social conditions and are known as "social determinants of health." ThIs classic example-a patient has asthma, lives in a moldor cockroach-infested apartment, has no resources to move, and has a landlord who refuses to clean or exterminate bugs- exemplifies why patients need legal advocates to improve their health. This article discusses medical-legal partnerships (MLPs), models in which medical providers refer patients to attorneys to represent them to resolve such problems...
February 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Linda Diem Tran, Haiyong Xu, Francisca Azocar, Susan L Ettner
OBJECTIVE: This study examined specialty behavioral health treatment patterns among employer-insured adults in same- and different-gender domestic partnerships and marriages. METHODS: The study used behavioral health service claims (2008-2013) from Optum to estimate gender-stratified penetration rates of behavioral health service use by couple type and partnership status among partnered adults ages 18-64 (N=12,727,292 person-years) and levels of use among those with any use (conditional analyses)...
February 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Faisal S Malik, Joyce P Yi-Frazier, Craig E Taplin, Christian L Roth, Kathryn B Whitlock, Waylon Howard, Catherine Pihoker
Purpose The purpose of this study was to examine the feasibility and efficacy of the Diabetes Community Care Ambassador (DCCA) Program, a novel medical-legal community intervention designed to support high-risk youth with type 1 diabetes. Methods Study eligibility criteria: ages 3-19 years, A1C ≥8.5% (≥69 mmol/mol) and/or recent diabetic ketoacidosis hospitalization, type 1 diabetes duration ≥1 year, and English- or Spanish-speaking. Eighty-nine youth and their caregivers participated in the 9- to 12-month intervention, which included diabetes education and support through 3 home visits, 1 to 2 school visits, and phone support from a lay health worker, as well as legal support from a medical-legal partnership attorney...
January 1, 2018: Diabetes Educator
Jack Tsai, Margaret Middleton, Jennifer Villegas, Cindy Johnson, Randye Retkin, Alison Seidman, Scott Sherman, Robert A Rosenheck
Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5...
December 2017: Health Affairs
Avik Chatterjee, Marvin So, Spencer Dunleavy, Emily Oken
BACKGROUND: We assessed whether and how health care organizations serving homeless pediatric patients meet recommendations issued by the American Academy of Pediatrics (AAP). METHODS: We conducted a web-based survey of Health Care for the Homeless (HCH) Program grantees serving children. RESULTS: Of 169 grantees, 77 (46%) responded. All organizations reported connecting patients to specialty services. Nearly all reported screening for homelessness (90%), facilitating Medicaid enrollment (90%), connecting patients to benefits (94%), addressing underlying causes of homelessness (83%), assisting with transportation (83%), and knowing about the causes of homelessness (76%)...
2017: Journal of Health Care for the Poor and Underserved
Andrew D Pinto, Gary Bloch
PROBLEM ADDRESSED: Family physicians have long understood that social factors influence the health of individuals and communities; however, most primary care organizations have yet to develop the capacity to specifically address these social determinants of health (SDOH). OBJECTIVE OF PROGRAM: To support SDOH interventions and foster an organizational culture in which addressing SDOH is considered part of high-quality primary care. PROGRAM DESCRIPTION: An academic family health team in Toronto, Ont, established a committee comprising a diverse group of health professionals focused on the SDOH...
November 2017: Canadian Family Physician Médecin de Famille Canadien
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
Joshua R Vest, Shaun J Grannis, Dawn P Haut, Paul K Halverson, Nir Menachemi
INTRODUCTION: Increasingly, health care providers are adopting population health management approaches that address the social determinants of health (SDH). However, effectively identifying patients needing services that address a SDH in primary care settings is challenging. The purpose of the current study is to explore how various data sources can identify adult primary care patients that are in need of services that address SDH. METHODS: A cross-sectional study described patients in need of SDH services offered by a safety-net hospital's federally qualified health center clinics...
November 2017: International Journal of Medical Informatics
Thomas D'Hooghe
The pharmaceutical and device industry has greatly contributed to diagnostic and therapeutic approaches in reproductive medicine in a very highly regulated environment, ensuring that development and manufacturing follow the highest standards. In spite of these achievements, collaboration between industry and physicians/academia is often presented in a negative context. However, today more than ever, partnership between industry and academia is needed to shorten the timeline between innovation and application, and to achieve faster access to better diagnostics, drugs and devices for the benefit of patients and society, based on complementary knowledge, skills and expertise...
August 1, 2017: Human Reproduction
Wei J Chen, Shang-Chi Wu, Wen-Ing Tsay, Yen-Tyng Chen, Po-Chang Hsiao, Ya-Hui Yu, Te-Tien Ting, Chuan-Yu Chen, Yu-Kang Tu, Jiun-Hau Huang, Hao-Jan Yang, Chung-Yi Li, Carol Strong, Cheng-Fang Yen, Chia-Feng Yen, Jui Hsu
BACKGROUND: This study examined variation between users of 'club' and 'hard' drugs in Taiwan in terms of prevalence of use and demographics and psychosocial characteristics. METHODS: Data were derived from a survey of 17,837 Taiwanese civilians, aged 12-64 years, using stratified, multi-stage, random sampling. Participants completed a computer-assisted self-interview on tablet computers which covered use of legal substances, sedatives/hypnotics and prescription analgesics; use of illicit drugs/inhalants, risky sexual experiences; expectations of drugs; and psychological distress...
October 2017: International Journal on Drug Policy
Joy Probyn, Joanne Greenhalgh, Janet Holt, Dwayne Conway, Felicity Astin
OBJECTIVE: Informed consent is central to ethical medical practice, but little is known about how the process takes place in clinical practice. Percutaneous coronary intervention (PCI) is a common revascularisation procedure. Studies report that patients overestimate benefits, forget the risks and are unaware of alternative treatments. The aim of this study was to describe PCI patients' and cardiologists' experiences of the informed consent process in acute care settings. DESIGN/SETTING/PARTICIPANTS: A qualitative study with a maximum variation sample of elective and acute PCI patients and cardiologists taking their consent, recruited from a district general hospital and tertiary centre...
June 24, 2017: BMJ Open
Lia Ilona Losonczy, Dennis Hsieh, Michael Wang, Christopher Hahn, Tarak Trivedi, Marcela Rodriguez, Jahan Fahimi, Harrison Alter
OBJECTIVES: Patients commonly come to the emergency department (ED) with social needs. To address this, we created the Highland Health Advocates (HHA), an ED-based help desk and medical-legal partnership using undergraduate volunteers to help patients navigate public resources and provide onsite legal and social work referrals. We were able to provide these services in English and Spanish. We aimed to determine the social needs of the patients who presented to our ED and the potential impact of the programme in resolving those needs and connecting them to a 'medical home' (defined as a consistent, primary source of medical care such as a primary care doctor or clinic)...
June 22, 2017: Emergency Medicine Journal: EMJ
Martin Härter, Jörg Dirmaier, Isabelle Scholl, Norbert Donner-Banzhoff, Marie-Luise Dierks, Wolfgang Eich, Hardy Müller, David Klemperer, Klaus Koch, Christiane Bieber
The main focus of the paper is on the description of the development and current state of research and implementation of patient-centered care (PCC) and shared decision-making (SDM) after fifteen years of substantial advances in health policy and health services research. What is the current state of SDM in health policy? The "Law on Patients' Rights" from 2013 standardizes all rights and responsibilities within the framework of medical treatment for German citizens and legal residents. This comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on a clinician-patient-partnership...
May 22, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Jack Tsai, Elizabeth Goggin
The Veterans Service Unit (VSU) in Connecticut is one of several all-veterans prison units that are being created throughout the United States. This study examined the characteristics, needs, and experiences of veterans on the Connecticut VSU. This study utilized data from a quality improvement survey that was completed by 87 of the 110 veterans on the Connecticut VSU (79% response rate). The majority of veterans on the VSU were white, aged 41-56, never married, and had an honorable or general military discharge making them potentially eligible for Veterans Affairs (VA) healthcare upon release...
October 2017: Evaluation and Program Planning
Sari L Reisner, Amaya G Perez-Brumer, Sarah A McLean, Javier R Lama, Alfonso Silva-Santisteban, Leyla Huerta, Jorge Sanchez, Jesse L Clark, Matthew J Mimiaga, Kenneth H Mayer
Transgender women (TW) represent a vulnerable population at increased risk for HIV infection in Peru. A mixed-methods study with 48 TW and 19 healthcare professionals was conducted between January and February 2015 to explore barriers and facilitators to implementing a model of care that integrates HIV services with gender-affirmative medical care (i.e., hormone therapy) in Lima, Peru. Perceived acceptability of the integrated care model was high among TW and healthcare professionals alike. Barriers included stigma, lack of provider training or Peruvian guidelines regarding optimal TW care, and service delivery obstacles (e...
December 2017: AIDS and Behavior
M d'Elbée, M Baumevieille, C Dumartin
BACKGROUND: In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement...
June 2017: Revue D'épidémiologie et de Santé Publique
Edward G Paul, Mallory Curran, Elizabeth Tobin Tyler
Medical-legal partnerships (MLPs) embed civil legal services lawyers into health care settings and interprofessional health care teams delivering care to low-income or otherwise vulnerable patients and communities. MLPs present the opportunity to instill in residents a practical understanding of the social determinants of health and provide them with concrete tools to address them. MLP training helps residents develop structural competency and build the skills necessary to address barriers to health at the patient, institutional, and population levels...
March 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Tamara Fetters, Ghazaleh Samandari, Patrick Djemo, Bellington Vwallika, Stephen Mupeta
BACKGROUND: Although abortion is technically legal in Zambia, the reality is far more complicated. This study describes the process and results of galvanizing access to medical abortion where abortion has been legal for many years, but provision severely limited. It highlights the challenges and successes of scaling up abortion care using implementation science to document 2 years of implementation. METHODS: An intervention between the Ministry of Health, University Teaching Hospital and the international organization Ipas, was established to introduce medical abortion and to address the lack of understanding and implementation of the country's abortion law...
February 16, 2017: Reproductive Health
William N Elwood, Veronica L Irvin, Qiankun Sun, Nancy Breen
PURPOSE: This study explored the utility of the California Health Interview Survey (CHIS) to compare health-related outcomes among gay men, lesbians, and heterosexuals who reported being in a legally recognized partnership. METHODS: We regressed sexual identity and marriage/legally recognized partnership status on seven different outcomes related to health insurance coverage, medical services access and use, and general health and well-being using CHIS data collected between 2009 and 2013...
April 2017: LGBT Health
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