Atlas on the Primary Care of Adults with Developmental Disabilities in Ontario

Download: Atlas on the Primary Care of Adults with Developmental Disabilities in Ontario

Source: ICES

Lunsky Y, Klein-Geltink JE, Yates EA, editors. December 2013

The Issue

Ontario’s Action Plan for Health Care focuses on becoming healthier, with improved access to integrated family/primary care and a major emphasis on the provision of the right care at the right time and in the right place. These priorities are particularly relevant to individuals with developmental disabilities: research from other jurisdictions would suggest that they have higher rates of preventable diseases, greater challenges obtaining guideline-recommended primary care3 and higher associated health care costs.4 However, the health status and

health care of adults with developmental disabilities have not been well studied in Ontario, due to the absence of population-based data. The work of the Health Care Access Research and Developmental Disabilities (H-CARDD) Program is in direct response to Ontario’s call to action through addressing this data gap. The first H-CARDD project, conducted in partnership with decision makers and clinicians from the health and social services sectors, has focused on primary care.

The Study

The Atlas on the Primary Care of Adults with Developmental Disabilities in Ontario provides, for the first time in Canada, descriptive information on the health of adults with developmental disabilities in Ontario and examines the quality of their primary care relative to adults without developmental disabilities. Findings have relevance in Ontario and in other jurisdictions where there is interest in improving health care and the health status of those with developmental disabilities.

Revised ACA Repeal and Replace Bill Likely to Increase the Uninsured Rate and Health Insurance Costs for Many

House Republicans are close to agreeing on an amended version of the American Health Care Act, their proposed repeal and replacement of the Affordable Care Act. David Blumenthal, M.D., and Sara Collins say that, based on the summaries circulated by the media, the revised bill will significantly increase the numbers of uninsured Americans while raising insurance costs for many of the nation’s most vulnerable citizens. At the same time, the bill’s restructuring of the Medicaid program is likely to hurt state economies and enrollees.

Source: Revised ACA Repeal and Replace Bill Likely to Increase the Uninsured Rate and Health Insurance Costs for Many – The Commonwealth Fund

News outlets report that House Republicans are close to agreeing on an amended version of the American Health Care Act (AHCA), their proposed repeal and replacement of the Affordable Care Act (ACA). The all-important legislative language for the revised bill is not yet available, nor are Congressional Budget Office (CBO) projections of its effects on coverage and the budget, so any analyses are necessarily tentative.

Nevertheless, the summaries leaked to the media offer insight on the amended bill. If accurate, those summaries suggest that the revised AHCA will significantly increase the numbers of uninsured Americans, raise the cost of insurance for many of the nation’s most vulnerable citizens, and, as originally proposed in the AHCA, cut and reconfigure the Medicaid program. The new amendment specifically allows states to weaken consumer protections by, for example, permitting insurers to charge people with preexisting conditions higher premiums.

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CompareMaine

CompareMaine shows the average cost of common healthcare procedures at different facilities in Maine. You can also see patient experience ratings and how Maine hospitals compare on patient safety.

Source: CompareMaine

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Compare Costs of Healthcare Procedures and Quality of Care Across Maine

The Maine Health Data Organization, in collaboration with the Maine Quality Forum, is required by law to promote the transparency of healthcare cost and quality information via a publicly accessible website. The cost and quality of healthcare procedures can vary widely among providers. You have a choice in where you receive care. CompareMaine shows the average cost of common healthcare procedures at different facilities in Maine. You can also see patient experience ratings and how Maine hospitals compare on patient safety.

The cost estimates on CompareMaine are median payments. They are meant to serve as a reference point for comparison. In order to find out your actual payment, please contact your insurance company. If you do not have insurance, please contact the facility that you are interested in. When contacted directly, facilities often report their charges which may be higher than the actual payments they receive from insurance companies and patients.

Breaking Stereotypes: Spotlight on Male Family Caregivers

In the United States, family caregivers are the backbone for the delivery of supportive services for individuals with a chronic, disabling, or serious health condition. 40 percent of family caregivers of adults are men—which equates to 16 million male family caregivers in the United States.

Source: Breaking Stereotypes: Spotlight on Male Family Caregivers

They identify, arrange, and coordinate services and supports; provide emotional support; accompany their family member or friend to health provider visits; administer medications; assist with personal care (such as bathing and dressing); pay bills and deal with health insurance; and perform other vital activities to help individuals remain in their homes and communities for as long as possible.

Full Report

Although the “typical” family caregiver is a 49-year-old woman who takes care of a relative, caregivers on the whole are becoming as diverse as the American population. Men, a group traditionally not recognized for performing caregiving tasks, are rising to the challenge. These husbands, brothers, sons, sons-in-law, partners, friends, and neighbors are joining, either by choice or necessity, the army of family caregivers providing care across the country. However, there is a paucity of research that has exclusively examined the impact of caregiving within and among diverse male family caregivers. Prior studies were predominately qualitative in nature and several had methodological challenges, including small sample sizes that limited the generalizability of the findings.

Using data from the Caregiving in the U.S. 2015 survey, this Spotlight highlights male family caregivers, providing current information about the experiences and challenges facing them today.

Related Links: 

Caregiving in the United States 2015

Home Alone

Research Brief: Family Caregiver Support for People with IDD

The 2010 Family and Individual Needs for Disability Support Survey (FINDS) conducted by The Arc (2011) shows that family caregivers play a critical role in providing supports to individuals with intellectual and developmental disabilities (IDD).

Source: Research Brief: Family Caregiver Support for People with IDD | Family Support Research and Training Center

This databrief describes the kinds and amount of supports provided by families to individuals with IDD living in their family home. Caregivers provided an average of nine different kinds of support and more than half of all caregivers reported providing these supports more than 40 hours per week. More than half of caregivers in this survey reported being aged 50 or older, highlighting the critical need to start planning for a future when aging caregivers are no longer able to continue providing significant amounts of support for their family members.Click this link to download the data brief.

 

Mainstream health professionals’ stigmatising attitudes towards people with ID: a systematic review

Source: Pelleboer-Gunnink – 2017 – Journal of Intellectual Disability Research – Wiley Online Library

Abstract

Background

Equal access to mainstream healthcare services for people with intellectual disabilities (ID) still requires attention. Although recent studies suggest that health professionals hold positive attitudes towards people with ID, stigmatising attitudes may influence their efforts to serve people with ID in community healthcare practice. To stimulate inclusion in mainstream healthcare services, this systematic review focussed on barriers in attitudes of mainstream health professionals towards people with ID.

Method

Five electronic databases were systematically searched and references in full text articles were checked for studies published in the English language between January 1994 and January 2016. A social–psychological triad of cognitive, affective and behavioural dimensions of stigmatising attitudes is used to structure and discuss the results.

Results

The literature search generated 2190 records with 30 studies that passed our exclusion criteria. Studies were mostly cross-sectional and of moderate quality. With respect to stigma, a lack of familiarity with and knowledge about people with ID was found. ID was considered as a stable condition not under personal control. Moreover, mainstream health professionals had either low or high expectations of the capabilities of people with ID. Professionals reported stress, lack of confidence, fear and anxiety, a tendency to treat people with ID differently and a lack of supporting autonomy.

Conclusions

Stigmatising attitudes towards people with ID appeared to be present among mainstream health professionals. This might affect the ongoing challenges regarding inclusion in mainstream healthcare services. To facilitate inclusion in mainstream healthcare services, it is recommended to include contact and collaboration with experts-by-experience in education programs of health professionals. Future research should progress beyond descriptive accounts of stigma towards exploring relationships between cognitive, affective and behavioural dimensions as pointers for intervention. Finally, inclusion would benefit from an understanding of ‘equal’ treatment that means reasonable adjustments instead of undifferentiated treatment.

Improving diabetes care for people with ID: a qualitative study exploring the perceptions and experiences of professionals in diabetes and ID services

Source: Brown – 2017 – Journal of Intellectual Disability Research – Wiley Online Library

Abstract

Background

Globally, diabetes is increasing with concerns about the impact on outcomes, including premature death and the costs associated with managing the condition. Research indicates that adults with intellectual disabilities (ID) are two to three times more likely to develop diabetes; however, there has been limited focus on diabetes service utilisation in this population. The aim of this study is to explore the perceptions and experiences of diabetes and ID practitioners.

Methods

A series of 1:1 semi-structured interviews were undertaken in one Scottish health service area. In total, 29 qualitative interviews were conducted: 10 with diabetes practitioners from primary and secondary care, 14 from ID services and 5 from community care services regarding diabetes service provision for this population. Thematic content analysis was undertaken to identify the themes and subthemes.

Results

Three main themes were identified: (1) enabling access to services to meet diabetes-related care needs of people with ID; (2) communication and service improvements between staff, patients and across services; and (3) providing person-centred diabetes care and developing adapted resources to increase patient self-care.

Conclusions

The findings of this study have important international implications in how diabetes practitioners plan and deliver services for people with ID and other vulnerable groups with limited cognitive ability and communication skills and difficulties in self-management. The findings highlight that access to diabetes education and adapted resources is needed, and if ‘reasonable adjustments’ are made to service provision and practice, people with ID can benefit from improved healthcare. Developing joint clinics to share knowledge and resources between diabetes and ID practitioners may improve service delivery and continuity of care, and thereby diminish the costs of not providing quality care.

Primary health care for people with an ID: an exploration of consultations, problems identified, and their management in Australia

Source: Primary health care for people with an intellectual disability: an exploration of consultations, problems identified, and their management in Australia

Abstract

Background

People with an intellectual disability (ID) have more complex and different patterns of health care needs than the general population. They experience a greater burden of multi-morbidity, high levels of undetected and unmanaged health issues, and premature mortality than the general population. Primary care has a key role in the health care of people with an ID. Currently, very little is known about the consultation type and length, problems managed, and how general practitioners (GPs) manage these problems for people with an ID compared with the general population. This information would provide valuable insights into how GPs are achieving the health guidelines and facilitating people with an ID to achieve the highest attainable standard of health.

Methods

A secondary analysis of data was collected from January 2003 to December 2012 from the Bettering the Evaluation and Care of Health (BEACH) programme. Consultation type, consultation length in minutes, problem(s) managed during the consultation, medications, treatments provided, and referrals made, pre and post age–sex standardisation, at all GP encounters with people identified in the encounter record as having an ID (‘ID’ encounters, n = 690) were compared with those at ‘non-ID’ encounters (n = 970 641). Statistical significance was tested with 95% confidence intervals.

Results

This study identified significant differences in consultation types, consultation length, problem(s) managed during the consultation, medications, treatments provided, and referrals made at ‘ID’ encounters compared with ‘non-ID’ encounters. ‘ID’ encounters had more indirect encounters, longer consultations, more problems managed, but an under management of common health conditions in people with an ID. Administrative rather than medically related actions dominated clinical treatments for people at ‘ID’ encounters, and they received fewer procedural treatments, referrals to specialists, and medications compared with those at ‘non-ID’ encounters.

Conclusion

The significant differences in consultations, problems identified and managed suggest that GPs may require additional support to (1) identify and manage common medical conditions experienced by people with an ID; (2) manage the increased time required for consultations; and (3) directly consult with people with an ID. Further research is required to determine why GPs managed problems in a significantly different way for people with an ID.

 

Robert Wood Johnson Foundation Program to Increase Diversity Across Its Programming

Robert Wood Johnson Foundation
Program to Increase Diversity Across Its Programming
Deadline: May 16, 2017
Award Ceiling: $50,000
http://rwjf.ws/2ojDzXq
The Robert Wood Johnson Foundation has issued a Request for Proposals for an annual initiative to increase diversity across its research network and programming.

Now in its eleventh year, New Connections: Increasing Diversity of RWJF Programming, a career development program for early-career researchers, is designed to expand the diversity of perspectives that inform RWJF programming and introduce new researchers to the foundation to help address research and evaluation needs. Through grantmaking, mentorship, career development and networking, New Connections enhances the research capacity of its grantees and network members. The researchers in the program transcend disciplines (health, health care, social sciences, business, urban planning, architecture and engineering); work to build the case for a Culture of Health with strong qualitative and quantitative research skills; and produce and translate timely research results.

Healthy Communities: What you can do

Source: What you can do

A new survey shows 94 percent of Americans are willing to take positive action to make their community a healthier place, according to research conducted by the Aetna Foundation.

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You can play a role in creating more healthy days where you live! Don’t wait! Start the Healthiest Cities & Counties conversation in your area today:

  • POTENTIAL PARTICIPANTS: Is your community making a collaborative effort to become a healthier city or county? Join the Challenge and tell us how your city or county is creating more healthy days where you live.
  • COMMUNITY MEMBERS: Real change starts at the grassroots level, and a healthier city or county starts with you! Share information with your friends, family, peers and elected officials. Send a link to the local elected official, academic institution, business or organization in your area that has shown interest in improving the health of your community.

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