Causes and Consequences
Causes
Despite the importance of appropriate transitional care there are many barriers impeding the delivery of transitional care to all CSHCN. The main barriers preventing CSHCN are cost, a difference in provider culture, provider education, and adolescent development. The first cause of poor transitional outcomes, cost, affects those who most commonly suffer from economic social determinants of health. Those with no insurance or with gaps in coverage are less likely to receive transitional care in comparison to those with adequate insurance due to inability to pay for necessary medical care (McManus et al., 2013). The issue is additionally compounded by the fact that up to 30% of CSHCN lack insurance coverage
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When children transition from pediatric to adult health care, they experience a cultural shift, which can negatively impact their perception and follow up with their care (Callahan, Winitzer, & Keenan, 2001). In pediatric clinics, patients are reminded of follow-up appointments, and providers ensure that their patients have the appropriate resources (prescription refills, medical equipment). Conversely, adult healthcare providers have a patient-centered care approach that requires the patient to collaborate effectively with the healthcare team. This change in culture can be overwhelming to CSHCN, as it requires the patients to have a complete understanding of their conditions and be well trained in personal advocacy (Callahan, Winitzer, & Keenan, 2001). Inadequate transitional care is also caused by lack of adult provider education in childhood-onset conditions. Adult providers not adequately trained in the childhood onset conditions are less likely to accept a CSHCN due to lack of education in the care and treatment of CSHCN (Cooley, 2011). This unwillingness to accept patients hinders transitional care as it delays pediatric providers from appropriately referring and transitioning CSHCN to adult clinics (Cooley, …show more content…
As many adolescents are developmentally unable to make decisions that impact their long-term care it is up to the parents or guardians of CSHCN to make the steps in implementing appropriate transitional care (White et al., 2012). Transitional care focuses on changes in autonomy; from parents caring for CSHCN to CSHCN caring for themselves. For this to happen, parents should slowly transfer responsibility of care from themselves to their children (McDonagh, 2005). This transfer of care should focus on disease management, symptom management as well as ensuring that the patient has a working understanding of their disorder and strategies to manage and care for associated issues (McDonagh, 2005). With disease education, children must be assessed for cognitive development and understanding should be assessed (McDonagh,
Douglas, Rosenkoetter, Pacquiao, Callister, Hattar-Pollara, Lauderdale, Milstead, Nardi, & Purnell (2014) outline ten guidelines for implementing culturally competent care; knowledge of cultures, education and training in culturally competent care, critical reflection, cross-cultural communication, culturally competent practice, cultural competence in health care systems and organizations, patient advocacy and empowerment, multicultural workforce, cross-cultural leadership, and evidence-based practice and research. One specific suggestion I will incorporate is to engage in critical reflection. This is mentioned both by Douglas, et al. (2014) and Trentham, et al. (2007) as an important part of cultural competency. I will do this by looking at my own culture, beliefs, and values and examining how they affect my actions. I will use this information to better inform my day to day practice when working with patients with a different culture than my
Children’s Healthcare of Atlanta has a highly unique approach to patient care. The network of hospitals have a combined number of one hundred and fifty doctors, which is more than any other hospital in Georgia. The hospital has also been listed among the nation’s best by “Doctors in America”. In addition to
Access to healthcare provides financial stability by assuring people that they will not be financially destroyed by injury or illness. Additionally, when people can afford regular medical care they tend to avoid chronic problems and financial stress. In a study provided by the American Medical Students Association, researchers reviewed the costs and benefits of universal health care. They came to the conclusion, after reviewing other articles and statistics from multiple sources, that, “The annual cost of diminished health and shorter life spans of Americans without insurance is $65-$130 billion.” (Chua 5) This comes from people not having adequate health care and then losing their jobs because they...
In efforts to address the health care needs of an individual with MCC, health care systems benefit from using the Chronic Care Model (CCM) and Transitional Care Model (TCM) when developing a patient care plan. The CCM predicts an increase in patients with self-management skills and tracking systems, by streamlining medical care through partnerships between health systems and local community assets (Mackey, Parchman, & et al., 2012). The TCM “emphasizes recognition of patient's’ health goals, coordination and continuity of care during acute episodes of illness, and development of streamlined plan of care to prevent future hospitalizations” ("Transitional Care Model," 2014, para. 1). Both models are successful with active participation of
Approximately 1 in 5 Americans do not have medical insurance and are more likely to lack a usual source of medical care, and more likely to skip routine medical care because of the very high costs, increasing their risk for serious health conditions. For the program, increasing the access to routine medical care and medical insurance are very important steps to achieve their goal of improving America’s health. The access to health services leading health indicators are those with medical insurance and a usual primary care provider. The access to health services in a regular basis can prevent disease and disability, detect and treat health conditions, increase quality of life, decrease the probability of premature death, and increase life
Stein R.E. (2001). Challenges in Long Term Health Care for Children. Ambulatory Pediatrics. 1(5), pp. 280-288.
Integrating the framework will enable nurses to become culturally competent health care providers. First and foremost, the framework permit patients’ the opportunity to express their concerns and perception of their problem (Campinha-Bacote, 2011). Additionally, it focuses on incorporating the patients beliefs, values, and needs into the plan of care. The framework further give nurses an opportunity to better understand and evaluate their patients’ concerns. Campinha-Bacote (2011) reported that continuous encounters with culturally diverse backgrounds will lead nurses to validate, refine, or modify what they know of existing values, beliefs, and practices of a cultural group. This in turn, will develop into cultural desire, cultural awareness, and cultural knowledge. With the end result, being cultural
These differences in origin accounts for diversity in socio-cultural backgrounds and nurses must develop the knowledge and the skills to engage patients from different cultures and to understand the beliefs and the values of those cultures (Jarvis, 2012). If healthcare professionals focus only on a narrowly defined biomedical approach to the treatment of disease, they will often misunderstand their patients, miss valuable diagnostic cues, and experience higher rates of patient noncompliance with therapies. Thus, it is important for a nurse to know what sociocultural background a patient is coming from in order to deliver safe an effective
When individuals went through MHC programs the vast majority of patrons agreed to go through with it, however a lot of those individuals had no idea what the program was about or that they could deny going to it (Kim,K., Sarteschi,C.,Vaughn, M. pg 14). This is highly problematic because everyone has the right to say no to treatment and many of them were clueless about the rights they are entitled to.
Arizona Department of Health Services. (2011). Office for children with special health care needs: School nursing. Retrieved from http://www.azdhs.gov/phs/ocshcn/school_ nursing_az.htm
...ch aims at scaling up services for mental disorders for low and middle income and familiarizes children with the proper care and psychosocial assistance and medication to tens of millions of children that could be treated for depression and other mental disorders (2009).
Today, many Americans face the struggle of the daily hustle and bustle, and at times can experience this pressure to rush even in their medical appointments. Conversely, the introduction of “patient-centered care” has been pushed immensely, to ensure that patients and families feel they get the medical attention they are seeking and paying for. Unlike years past, patient centered care places the focus on the patient, as opposed to the physician.1 The Institute of Medicine (IOM) separates patient centered care into eight dimensions, including respect, emotional support, coordination of care, involvement of the family, physical comfort, continuity and transition and access to care.2
Bentancourt et al. (2005) allows asserts that there are three distinctive reasons why cultural competency is so very important for the American healthcare system. American is composed of a very diverse population, which mean healthcare providers will continual be exposed to treating individuals from various backgrounds and from various cultures; their beliefs regarding their health or healthcare may range widely. When patients have a deficiency in the English language, proper healthcare delivery becomes increasingly more difficult as they will present symptoms in the syntax of their culture and their first language. Also, research shows the communication between the patient and their provider directly correlates to their satisfaction as well as their responsiveness or willingness to follow the health provider medical instructions; this ultimately affects the patient’s health outcome (Bentancourt et al., 2005). It’s fair to say that a successful health outcome is also contingent upon the interaction of the health provider and patient. Reports generated by the Institute of Medicine (IOM) – “Crossing the Quality Chasm and Unequal Treatment, confirms that cultural competence that focuses on the care of patient through
Health insurance facilitates entry into the health care system. Uninsured people are less likely to receive medical care and more likely to have poor health. Many Americans are foregoing medical care because they cannot afford it, or are struggling to pay their medical bills. “Adults in the US are more likely to go without health care due to cost” (Schoen, Osborn, Squires, Doty, & Pierson, 2010) Many of the currently uninsured or underinsured are forced accept inferior plans with large out-of-pocket costs, or are not be able to afford coverage offered by private health insurers. This lack of adequate coverage makes it difficult for people to get the health care they need and can have a particularly serious impact on a person's health and stability.
Lipson, J.G. & Dubble, S.L. (Eds). (2007). Culture & clinical care. San Francisco, California: The Regents, University of California.