Reduction in rehospitalization is an outcome measure used to evaluate home care services, especially in Outcome Based Quality Management using OASIS data; however, practitioners and managers must carefully analyze the reasons patients return to the hospital. This study examines events leading to rehospitalization of patients with CHF, whether it is possible to determine upon admission which patients are at risk, and whether the readmissions were necessary and/or preventable. Among the study's important findings are that half of the patients developed a new problem that required the rehospitalization. This and other research outcomes should be considered when analyzing adverse event reports.
Academic researchers and professionals from a hospice organization collaborated to assess physical, emotional, social, economic, and spiritual strain stemming from providing care to a terminally ill older relative among 162 family caregivers to older adults newly admitted to hospice home care. The study investigated predictors of the different types of strain, as well as cumulative strain. Hierarchical multiple regressions revealed that caregivers' age and race, hospice patients' major illnesses (particularly cancer), caregivers' appraisals of their situation, and resources were significant risk or protective factors for caregiver strain, although the predictors varied by type of strain and amount of strain. Discussion focuses on the importance of identifying family caregivers at risk of higher strain during hospice home care and implications for family caregiver interventions.
This study focuses on the current experience of Nanaimo's nonprofit family and child service organizations (N = 29) providing services on behalf of government and their adaptation to this devolution. The effects and consequences of contracting on organizational practices, accountability, and services were explored through interviews and focus groups with executive directors, board members, line staff, government representatives, and the United Way. Results show that a significant proportion of funding comes from provincial government contracts. The funding climate is uncertain, and there is considerable confusion, stress, and time involved with the contracting process. Accountability requirements are demanding and nonprofit organizations (NPOs) express concern about a shift to a business management model. Recommendations include a need for increased collaboration between NPOs, a body that speaks for the voluntary sector, and improved relationships between NPOs and government funders.
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