Comprehensive Discharge Planning for Hospitalized Elderly

Naylor, Mary D.

doi:10.1097/00006199-199005000-00007

Cited by 249 publications

(277 citation statements)

References 0 publications

Supporting

Mentioning

266

Contrasting

Unclassified

Order By: Relevance

“…FFS payment also results in "voltage drops"-that is, in underuse of services often not included on fee schedules (for example, care coordination, patient education, evisits) or for which payments are low relative to the resources required to produce them (for example, primary care and comprehensive discharge planning). 23 n Payment. Options for better aligning the payment system include expanding the list of reimbursable services to fill in the "gaps"; replacing FFS with bundled payments for patient-focused episodes; and using capitation more extensively.…”

Section: Implications For Payment and Capital Investmentmentioning

confidence: 99%

Building Organizational Capacity: A Cornerstone Of Health System Reform

Corrigan

McNeill

2009

Health Affairs

View full text Add to dashboard Cite

The U.S. health care delivery system is in need of overhaul. Care is fragmented, unsafe, and inefficient. Achieving higher levels of performance requires organizational capacity, including information technology (IT) and specialized expertise, not present in most settings. Organizational capacity is fortified through the benefits of larger scale and clinical integration. The evolution of new organizational structures will open up opportunities to redesign payment programs and invest capital toward building high-performing systems. A comprehensive policy agenda is needed to encourage growth in organizational capacity, including national priorities and goals, performance measurement and reporting, payment reform, community leadership, IT, and public education. A lt h o u g h c o m m o n pa r l an c e often refers to the U.S. health care "system," it is anything but. It comprises many uncoordinated pieces, lacks a common strategy, and seldom achieves the promise of consistently high performance seen in other sectors of the economy. Eight years ago, the Institute of Medicine's (IOM's) Crossing the Quality Chasm report called for fundamental transformation of the way in which health care is organized and delivered. The report concludes: "The current care system cannot do the job. Trying harder will not work. Changing systems of care will." 1 Although there are pockets of great innovation and hope, transformation has yet to occur.In this paper we examine the challenge of reforming the health care delivery system, and we make three points. First, stronger organizational capabilities and supports are urgently needed to achieve high levels of performance. Next, as new organizational structures evolve, they will open up opportunities to align payment and capital investment systems with value. Finally, a focused policy agenda is needed that will help cultivate these new supports and structures.

show abstract

Section: Implications For Payment and Capital Investmentmentioning

confidence: 99%

Building Organizational Capacity: A Cornerstone Of Health System Reform

Corrigan

McNeill

2009

Health Affairs

View full text Add to dashboard Cite

show abstract

“…Descriptive and clinical characteristics section The sociodemographic characteristics of the children and their families, the children's diagnoses and treatment-related characteristics, and questions about their home environments were included (12 questions) [2,6,14,27,30,31].…”

Section: Interview Questionnairementioning

confidence: 99%

“…An unplanned clinic visit/readmission was defined as unplanned hospitalization for fever, problems with nutrition, mouth ulcers, catheter problems, or any other reason. Clinic visits and hospital readmissions were recorded for experimental and control groups that occurred during the five monitoring times [20,27,30,31].…”

Section: Interview Questionnairementioning

confidence: 99%

“…Continuity of care, discharge planning, and home health care are the primary subjects in quality of health care today [30]. Ensuring continuity of care, decreasing unplanned visits to the hospital and hospitalizations, and shortening hospital length of stay can increase the level of satisfaction of the patient and patient's caregiver.…”

Section: Introductionmentioning

confidence: 99%

“…Discharge planning and home health care are the basic components in continuity of care and health promotion [31,33]. Discharge planning is not expected to solve all problems; however, it has an important role in ensuring continuity of care and in decreasing side effects associated with hospital readmissions [30,33,34]. monitoring their child's health condition, treatment regimens, progression of the illness, and for maintaining their child's physical care at home.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations