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sth about chronic healthcare

泰然健康网
2025-05-20 13:53

After reading a lot of papers and comments in terms of healthcare, I think chronic healthcare is a very good direction deserved to embark on. There still exist some gaps to fill in this area. In the meantime, chronic healthcare is an increasingly hot topic in the upcoming years due to the chronic mismatch of supply and demand.

Some Keywords related to chronic healthcare: eldly care, community-based care, home care, long-term care, geriatric care etc.

1. Paper 1

Paper "An analytical framework for designing community-based care for chronic diseases" develops an analytical framework to understand and evaluate a community-based chronic care system for a specific chronic illness, and investigate the potential of alternative interventions to improve the system. This is the first study that fills the gap by identifying the patterns of care, determing the care provider characteristics and care patterns associated with optimal management of care, and proposing a tool to estimate the potential influence of various interventions on community-based care. An analytical epidemiologic model is extended by utilizing a patient flow approach, in order to model the multiple care-provider visit patterns of patients with a specific chronic illness. The patterns of care received by a group of patients are represented in compact form by means of a Markov model that is based on a disease-specific state space. This framework also reflects the case-mix biases. The framework is applied to the data of 4000+ stroke patients discharged from the acute care hospitals of Quebec to their homes.

Comments:

1. It's very significant to provide mathematical analysis for evaluation of relationship between some healthcare patterns and outcomes (including death) based on the empirical data. There still exists big gap in this area, especially for the OM thinking rather than medical or clinical level. It deserves to do some high-quality research based on Hong Kong background.

2. It is a little related to network design in graph theory where arcs represent the flow of patients/resource consumption/agent interaction, and nodes represent the care phases/facilities/providers. In addition, delivery path of patient, delivery pattern can be considered comparably.

3. Interventions are proven by simulation(with some characteristics of heuristic/policy improvement) in this paper while interventions in some papers are proven by randomized controlled trials and before-after observational studies. However, randomized controlled experiments are often not possible in healthcare settings. Specially, the paper "Impact on hospital admissions of an integrated primary care model for very frail eldly patients“ carries out with experiments based on the intervention group and the control group (benchmark) to prove that the proposed model improves the quality of care provided to very frail elderly patients by reducing unplanned hosptitalizations and improving some health parameters.

4. Patients suffering from a chronic condition often require periodic treatment.

2. Paper 2

Paper "Improving access to community-based chronic care through improved capacity allocation" studies a model of community-based health care delivery for chronic diseases in a non-profit setting.