Can targeted messaging encourage PCP contact before ED visits?

Objectives: Targeted messaging that encourages consumers who are frequent users of the emergency department (ED) to contact their primary care physician in advance of an ED visit could reduce healthcare expenditures in select populations. However, such messaging has not been thoroughly evaluated. We used the input from consumers in a capitated plan to develop and test messaging designed to encourage primary care physician (PCP) contact prior to an ED visit.

Bridging troubled waters: family caregivers, transitions, and long-term care.

Families are the bedrock of long-term care, but policymakers have traditionally considered them "informal" caregivers, as they are not part of the formal paid caregiving workforce. As chronic and long-term care systems have become more complex and as more demanding tasks have been shifted to families, this view is no longer sustainable. The care transition process offers a critical opportunity to treat family caregivers as important care partners.

The New York City Palliative Care Quality Improvement Collaborative.

Background: Care for persons living with fatal chronic conditions is expensive and challenging, and can be unreliable. A quality improvement collaborative was conducted to develop capacity among health care providers in a single geographic area-New York City-to apply quality improvement methodology to palliative care services..

"This case is closed": family caregivers and the termination of home health care services for stroke patients.

Policies promoting home- and community-based services and disease management models implicitly rely on family care, still the bedrock of long-term and chronic care in the United States. The United Hospital Fund studied family caregivers of stroke and brain injury patients when home care cases were opened and closed and found that even with short-term formal services, family caregivers provided three-quarters of the care. Patients' mobility impairments and Medicaid eligibility were the main factors in determining the amount and duration of formal services.

Young adult caregivers: a first look at an unstudied population.

Objectives: We examined the prevalence, characteristics, and responsibilities of young adults aged 18 to 25 years who are caregivers for ill, elderly, or disabled family members or friends.

Methods: We analyzed 2 previously published national studies (from 1998 and 2004) of adult caregivers.

Results: Young adult caregivers make up between 12% and 18% of the total number of adult caregivers.

Next-of-kin perceptions of physician responsiveness to symptoms of hospitalized patients near death.

Many different medical providers visit critically ill patients during a hospitalization, and patients and family members may not feel any physician is truly in charge of care. This study explores whether perceiving that a physician was clearly in charge is associated with reports by surviving next of kin about the responsiveness of physicians to symptoms in hospitalized patients near the end of life. We conducted telephone interviews with surviving next of kin of adult patients (n = 1107) who died in one of five New York City teaching hospitals between April 1998 and June 1999 after a minimum 3-day inpatient stay.

When the caregiver needs care: the plight of vulnerable caregivers.

Objectives: This study examined the characteristics, activities, and challenges of high-risk informal caregivers.

Methods: Telephone interviews were conducted with a nationally representative cross-section of 1002 informal caregivers. Vulnerable caregivers with poor health or a serious health condition were compared with nonvulnerable caregivers.