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1 – 10 of over 9000In March this year the European Coalition for Community Living published Wasted Time, Wasted Money, Wasted Lives… A Wasted Opportunity? This reported on how the current use of…
Abstract
In March this year the European Coalition for Community Living published Wasted Time, Wasted Money, Wasted Lives… A Wasted Opportunity? This reported on how the current use of European Union Structural Funds perpetuates the social exclusion of disabled people in central and eastern Europe by failing to support the transition from institutional care to community‐based alternatives. This paper summarises its key findings and recommendations.
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Liqun Xiang, Ann T.W. Yu, Yongtao Tan, Xuezhu Shan and QiPing Shen
This study aims to identify senior citizens’ requirements related to “embedded retirement facilities (ERFs)”, which are small-scale, multi-functional and community-based care…
Abstract
Purpose
This study aims to identify senior citizens’ requirements related to “embedded retirement facilities (ERFs)”, which are small-scale, multi-functional and community-based care facilities for senior citizens in mainland China, and to discuss whether senior citizens’ perceptions are influenced by their backgrounds.
Design/methodology/approach
A questionnaire type of research was administrated to gain senior citizens’ rankings of services that should be provided by ERFs. Non-parametric statistical models were applied to analyse the collected data.
Findings
Results reveal that health care services for senior citizens are considered the most important. Requirements regarding rehabilitation and entertainment and daily life assistance are ranked second and third, respectively. Culture-related activities are the least important. Differences in the senior citizens’ background also influence their choices.
Research limitations/implications
This research is based on a questionnaire survey completed in northeast China. Opinions from other areas of mainland China will be collected in the future study. Furthermore, the key items identified in this research, which was completed by participants from the built environment discipline, can be further elaborated by combining interdisciplinary feedback.
Practical implications
This study explores services that are supposedly provided by ERFs. Findings will provide useful perceptions from senior citizens and will enable decision makers to prioritise services for senior citizens.
Social implications
Although senior citizens are the end users of ERFs, their needs are easily overlooked. This study calls attention to their needs from ERFs, and the results are likely to serve as references for stakeholders in building improved facilities.
Originality/value
ERFs have been provided in mainland China to cater to senior citizens’ needs since 2014. However, few studies have identified senior citizens’ requirements for provided services. The survey-based results of this work will serve as references for various stakeholders in making enhanced decisions.
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Sally Jacobs, Jane Hughes, David Challis, Karen Stewart and Kate Weiner
Care management has developed in a variety of forms. This diary study explores differences in the approach taken to care management in three distinct social service settings…
Abstract
Care management has developed in a variety of forms. This diary study explores differences in the approach taken to care management in three distinct social service settings: community‐based older people's teams, hospital social work teams also for older people and community‐based teams for adults with mental health problems. Conclusions are drawn both for social care and for health services developing case management for people with long‐term conditions.
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Genevra F. Murray and Valerie A. Lewis
While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to…
Abstract
While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to this topic has grown dramatically. Reforms that promote high-quality care as well as responsibility for total cost of care have shifted focus among health care providers toward upstream determinants of health care outcomes. As a result, there has been a proliferation of activity focused on integrating and aligning social and medical care, many of which depend critically on cross-sector alliances. Despite considerable activity in this area, cross-sector alliances in health care remain largely undertheorized. Both literatures stand to gain from more attention to carefully knitting together the theoretical and management literature on alliances with the empirical, health policy and health services literature on cross-sector alliances in health care. In this chapter, we lay out what exists in the current scientific literature as well as a framework for considering much needed work in this area. We organize the literature and our commentary around the lifecycle of alliances: alliance formation, including factors prompting alliance formation, partner selection, and alliance goals; alliance maturity, including the work of these cross-sector alliances, governance, finance and contracts, staffing structure, and rewards; and critical crossroads, including alliance timelines, definitions of success, and dissolution. We also lay out critical areas for future inquiry, including better theorizing on cross-sector alliances, developing typologies of these cross-sector health care alliances, and the role of policy in cross-sector alliances.
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Frances Wilby and Cathy Chambless
This paper aims to identify the characteristics of 260 adults, 65 and over, who applied for services through an Area Agency on Aging in a western state in the United States, and…
Abstract
Purpose
This paper aims to identify the characteristics of 260 adults, 65 and over, who applied for services through an Area Agency on Aging in a western state in the United States, and to determine the conditions that resulted in referral to the state‐funded Home and Community Based Alternatives Program (Alternatives) or the Medicaid Aging Waiver (Waiver) program.
Design/methodology/approach
The study was an exploratory one utilizing quantitative data from an existing database of older adults who sought home and community based services from Mountainlands Area Agency on Aging (AAA) between January 1, 2006 and December 31, 2007.
Findings
Although most of the sample lived at or near poverty levels, results suggest that higher monthly income and living alone predict referral to the Alternatives program, whereas greater need for assistance with bathing and performing heavy housework are the primary determinants of referral to the Medicaid Waiver program.
Originality/value
This study adds to the body of knowledge concerning the characteristics of people who access home and community based services. Most people in this study, who were seeking assistance from public programs, were living at or below the US Federal Poverty Line. One home and community based program was more likely to serve people who lived with others and had cognitive impairments, and referral to a Medicaid home and community based program was more likely for people who needed assistance with bathing and heavy housework.
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Yi-Fen Wang, Ya-Hui Lee and Jing-Yi Lu
This qualitative study aims to explore the experiences of Taiwan’s community-based long-term care service stations.
Abstract
Purpose
This qualitative study aims to explore the experiences of Taiwan’s community-based long-term care service stations.
Design/methodology/approach
Semi-structured interviews were conducted with eight managers selected from stations located in the counties with the highest proportion of elderly people.
Findings
The results are as follows: the main services offered by the stations include health promotion activities, congregate meal programs, respite care and making house calls; government subsidies constitute a major proportion of the service stations’ funds, followed by user payments and external donations; the adversities encountered include frequent policy revisions, the dwellers’ reluctance to participate in the activities, manpower shortages and subpar service quality; and the effects of the stations on the community include achieving aging in place, providing more options for life after retirement, mitigating caregivers’ burden, expanding the elderly’s social networks and strengthening their health literacy.
Originality/value
The results of this research can understand the benefits and difficulties of Tier C service centers in Taiwan. Also, the practical experiences provide some suggestions for policies and training. Future studies can focus on establishing systematized training programs and standardizing the service personnel’s competence.
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Ya Luan Hsiao, Eric B. Bass, Albert W. Wu, Melissa B. Richardson, Amy Deutschendorf, Daniel J. Brotman, Michele Bellantoni, Eric E. Howell, Anita Everett, Debra Hickman, Leon Purnell, Raymond Zollinger, Carol Sylvester, Constantine G. Lyketsos, Linda Dunbar and Scott A. Berkowitz
Academic healthcare systems face great challenges in coordinating services across a continuum of care that spans hospital, community providers, home and chronic care facilities…
Abstract
Purpose
Academic healthcare systems face great challenges in coordinating services across a continuum of care that spans hospital, community providers, home and chronic care facilities. The Johns Hopkins Community Health Partnership (J-CHiP) was created to improve coordination of acute, sub-acute and ambulatory care for patients, and improve the health of high-risk patients in surrounding neighborhoods. The paper aims to discuss this issue.
Design/methodology/approach
J-CHiP targeted adults admitted to the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, patients discharged to participating skilled nursing facilities (SNFs), and high-risk Medicare and Medicaid patients receiving primary care in eight nearby outpatient sites. The primary drivers of the program were redesigned acute care delivery, seamless transitions of care and deployment of community care teams.
Findings
Acute care interventions included risk screening, multidisciplinary care planning, pharmacist-driven medication management, patient/family education, communication with next provider and care coordination protocols for common conditions. Transition interventions included post-discharge health plans, hand-offs and follow-up with primary care providers, Transition Guides, a patient access line and collaboration with SNFs. Community interventions involved forming multidisciplinary care coordination teams, integrated behavioral care and new partnerships with community-based organizations.
Originality/value
This paper offers a detailed description of the design and implementation of a complex program to improve care coordination for high-risk patients in an urban setting. The case studies feature findings from each intervention that promoted patient engagement, strengthened collaboration with community-based organizations and improved coordination of care.
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In this chapter, I develop an analysis of the institutional logics which have shaped the organizational field of public sector mental health and which provide a framework for…
Abstract
Purpose
In this chapter, I develop an analysis of the institutional logics which have shaped the organizational field of public sector mental health and which provide a framework for understanding the complexities facing policy makers, providers, researchers, and community mental health advocates.
Approach
I first assess the current state of public sector mental health care. I then describe institutional theory, which focuses our attention on the wider social values and priorities (i.e., institutional logics) which shape mental health care. In the current post-deinstitutionalization era, there are three competing institutional logics: recovery and community integration, cost containment and commodification, and increased social control over those with severe mental disorders. Each of these logics, and the conflict between them, is explicated and analyzed. I then develop a theoretical framework for understanding how conflicting institutional logics are resolved. In the concluding section of this chapter, I offer some guidance to both researchers and advocates seeking meaningful system level reform.
Research implications
Researchers studying mental health policy need to understand how competing institutional logics work to shape the political climate, economic priorities, and types of services available.
Social implications
Advocacy is critical for meaningful reform, and a fourth institutional logic – that of social justice – needs to be developed by which to evaluate policy reforms and service offerings.
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Kathleen Biebel and Jeffrey L. Geller
A system of care is a function-specific, rather than agency-specific approach defined as a “comprehensive spectrum of mental health and other necessary services which are…
Abstract
A system of care is a function-specific, rather than agency-specific approach defined as a “comprehensive spectrum of mental health and other necessary services which are organized into a coordinated network to meet the multiple and changing needs of children and adolescents with severe emotional disturbances and their families” (Stroul & Friedman, 1986). A system of care provides a mental health delivery system for children with SED with a wide array of accessible, community-based services that focus on children's individual needs, include the family in treatment planning, and provide culturally competent services. System of care services are provided by multiple child serving agencies and are collaborative and coordinated (Stroul & Friedman, 1986).
Phudit Tejativaddhana, Nalinee Nakittipha Chuakhamfoo and Man Thi Hue Vo
This paper aims to explore the aging society situation, long-term care (LTC) policy preparation, COVID-19’s impact on older people, and post-pandemic preparations in Thailand and…
Abstract
Purpose
This paper aims to explore the aging society situation, long-term care (LTC) policy preparation, COVID-19’s impact on older people, and post-pandemic preparations in Thailand and the implications for The Association of Southeast Asian Nations (ASEAN) countries.
Design/methodology/approach
Online databases from international, national, academic agencies and SCOPUS database from January 2019 to July 2021 were utilized for analysis. Relevant literature and data were selected for review.
Findings
The evidence suggests that the proportion of the aging population is increasing due to declined fertility and rising life expectancy. Current and future demand for effective healthcare in ASEAN will be better achieved with policies like the Universal Health Coverage and Primary Health Care system. While some countries, specifically Thailand, are developing and expanding their LTC policies, some concerns regarding the active aging policy remain. Most ASEAN countries are using public domain for LTC policies. However, the COVID-19 pandemic has posed a major challenge in implementing LTC and affected the vulnerable aging population in many aspects, including social protection issues in Thailand.
Originality/value
With the support from international organizations, ASEAN countries have framed several policy strategies in response to the increasing aging population, such as providing more LTC in the community. The unexpected challenges from the COVID-19 pandemic compel policymakers to consider resource allocations and community-based services. On the positive side, as the pandemic has made the vulnerable group exposed, social protection issues have been brought to the forefront of the political debate and called for an appropriate policy response.
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