Transition Of Care

This comprehensive book thoroughly addresses all aspects of health care transition of adolescents and young adults with chronic illness or disability; and includes the framework, tools and case-based examples needed to develop and evaluate a Health Care Transition (HCT) planning program that can be implemented regardless of a patient’s disease or disability. Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is a uniquely inclusive resource, incorporating youth/young adult, caregiver, and pediatric and adult provider voices and perspectives. Part I of the book opens by defining Health Care Transition, describing the urgent need for comprehensive transition planning, barriers to HCT and then offering a framework for developing and evaluating health care transition programs. Part II focuses on the anatomic and neuro-chemical changes that occur in the brain during adolescence and young adulthood, and how they affect function and behavior. Part III covers the perspectives of important participants in the HCT transition process – youth and young adults, caregivers, and both pediatric and adult providers. Each chapter in Part IV addresses a unique aspect of developing HCT programs. Part V explores various examples of successful transition from the perspective of five key participants in the transition process - patients, caregivers, pediatric providers, adult providers and third party payers. Related financial matters are covered in part VI, while Part VII explores special issues such as HCT and the medical home, international perspectives, and potential legal issues. Models of HCT programs are presented in Part VIII, utilizing an example case study. Representing perspectives from over 75 authors and more than 100 medical centers in North America and Europe, Health Care Transition: Building a Program for Adolescents and Young Adults with Chronic Illness and Disability is an ideal resource for any clinician, policy maker, caregiver, or hospitalist working with youth in transition.

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

The U.S. population of older adults is predicted to grow rapidly as "baby boomers" (those born between 1946 and 1964) begin to reach 65 years of age. Simultaneously, advancements in medical care and improved awareness of healthy lifestyles have led to longer life expectancies. The Census Bureau projects that the population of Americans 65 years of age and older will rise from approximately 40 million in 2010 to 55 million in 2020, a 36 percent increase. Furthermore, older adults are choosing to live independently in the community setting rather than residing in an institutional environment. Furthermore, the types of services needed by this population are shifting due to changes in their health issues. Older adults have historically been viewed as underweight and frail; however, over the past decade there has been an increase in the number of obese older persons. Obesity in older adults is not only associated with medical comorbidities such as diabetes; it is also a major risk factor for functional decline and homebound status. The baby boomers have a greater prevalence of obesity than any of their historic counterparts, and projections forecast an aging population with even greater chronic disease burden and disability. In light of the increasing numbers of older adults choosing to live independently rather than in nursing homes, and the important role nutrition can play in healthy aging, the Institute of Medicine (IOM) convened a public workshop to illuminate issues related to community-based delivery of nutrition services for older adults and to identify nutrition interventions and model programs. Nutrition and Healthy Aging in the Community summarizes the presentations and discussions prepared from the workshop transcript and slides. This report examines nutrition-related issues of concern experienced by older adults in the community including nutrition screening, food insecurity, sarcopenic obesity, dietary patterns for older adults, and economic issues. This report explores transitional care as individuals move from acute, subacute, or chronic care settings to the community, and provides models of transitional care in the community. This report also provides examples of successful intervention models in the community setting, and covers the discussion of research gaps in knowledge about nutrition interventions and services for older adults in the community.

Over the course of the last two decades, improved practices in child and adolescent mental healthcare have led to a decreased environment of stigma, which also led to an increased identification and treatment of mental health disorders in children and youth. Considering that treatment and outcomes are improved with early intervention, this is good news. However, the success gained in the field of child and adolescent psychiatry leads to a new challenge: transitioning from adolescent care to adult care. It has been known for some time that children, adult, and geriatric patients all have unique needs where it comes to mental healthcare, yet limited work has been done where it comes to the shifting of the lifespan. Where it comes to the child-adult transition—defined as those in their late teens and early/mid-20s—there can be multiple barriers in seeking mental healthcare that stem from age-appropriate developmental approaches as well as include systems of care needs. Apart from increasing childhood intervention, the problem is exacerbated by the changing social dynamics: more youths are attending college rather than diving straight into the workforce, but for various reasons these youths can be more dependent on their parents more than previous generations. Technology has improved the daily lives of many, but it has also created a new layer of complications in the mental health world. The quality and amount of access to care between those with a certain level of privilege and those who do not have this privilege is sharp, creating more complicating factors for people in this age range. Such societal change has unfolded so rapidly that training programs have not had an opportunity to catch up, which has created a crisis for care. Efforts to modernize the approach to this unique age group are still young, and so no resource exists for any clinicians at any phase in their career. This book aims to serve as the first concise guide to fill this gap in the literature. The book will be edited by two leading figures in transition age youth, both of whom are at institutions that have been at the forefront of this clinical work and research. This proposed mid-sized guide is therefore intended to be a collaborative effort, written primarily by child and adolescent psychiatrists, and also with adult psychiatrists. The aim is to discuss the developmental presentation of many common mental health diagnoses and topics in chapters, with each chapter containing clinically-relevant “bullet points” and/or salient features that receiving providers, who are generally, adult-trained, should keep in mind when continuing mental health treatment from the child and adolescent system. Chapters will cover a wide range of challenges that are unique to transition-age youths, including their unique developmental needs, anxiety, mood, and personality disorders at the interface of this development, trauma and adjustment disorders, special populations, and a wide range of other topics. Each chapter will begin with a clinical pearl about each topic before delving into the specifics.

This book provides insight into how the Canadian health care system is financed and organized, how it has evolved over time, and how well it performs relative to peer countries.

The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

100 complex cases illustrate how to ensure safe, effective treatment during transitions between care settings Moving a patient from one healthcare provider or setting to another—a transition of care—increases the risk of medication errors due to inadequate communication and poor coordination of care. While guideline-and evidence-based therapy is important, pharmacists must also address other patient-specific needs and possible barriers to safety, efficacy, and to adherence of therapies. Providing a deep dive into this critical topic, Transitions of Care in Pharmacy Casebook explains how to deliver and optimize complex patient care during transitions between care settings. This essential resource features 100 enlightening clinical cases that illustrate real-world practices. Organized by disease state, each case incorporates clinical knowledge, patient education, effective communication, and social issues. Transition of Care in Pharmacy Casebook includes: An insightful introduction to transitions of care practice models 100 complex clinical cases incorporating specific elements of patient care Concise coverage of various medical conditions commonly encountered in various practice settings Considerations on treating special populations, such as the elderly and homeless patients Bulleted text explaining the theory and rationale for each case Informative charts with lab findings, medication records, provider notes, and diagnostic exams

Pediatricians face many questions and challenges during patients’ transition from childhood to adulthood. Chronic diseases justify long-term medical, psychological, educational, and social management. The establishment of networks with adult endocrinologists is, therefore, very important to achieving optimal conditions for a successful transition period. In this book, leading experts discuss major public health issues such as diabetes and obesity. They also review genetic diseases, including Turner syndrome and congenital adrenal hyperplasia. All clinical cases are presented in a focused way to highlight any issues which might be discussed by the doctor with patients and family. Psychological approaches are debated as are proposals for defining specific tools to encourage autonomy during this life period. This book is a valuable tool and will be helpful in answering many questions for endocrinologists, adult and pediatric, dedicated to the long-term management of patients with chronic diseases.