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1.
Health Serv Res ; 54(6): 1246-1254, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31595498

RESUMEN

OBJECTIVE: To measure strategies of interorganizational collaboration among health care and social service organizations that serve older adults. STUDY SETTING: Twenty Hospital Service Areas (HSAs) in the United States. STUDY DESIGN: We developed and validated a novel scale to characterize interorganizational collaboration, and then tested its application by assessing whether the scale differentiated between HSAs with high vs low performance on potentially avoidable health care use and spending for Medicare beneficiaries. DATA COLLECTION: Health care and social service organizations (N = 173 total) in each HSA completed a 12-item collaboration scale, three questions about collaboration behaviors, and a detailed survey documenting collaborative network ties. PRINCIPAL FINDINGS: We identified two distinguishable subscales of interorganizational collaboration: (a) Aligning Strategy and (b) Coordinating Current Work. Each subscale demonstrated convergent validity with the organization's position in the collaborative network, and with collaboration behaviors. The full scale and Coordinating Current Work subscale did not differentiate high- vs low-performing HSAs, but the Aligning Strategy subscale was significantly higher in high-performing HSAs than in low-performing HSAs (P = .01). CONCLUSIONS: Cross-sector collaboration-and particularly Aligning Strategy-is associated with health care use and spending for older adults. This new survey measure could be used to track the impact of interventions to foster interorganizational collaboration.


Asunto(s)
Conducta Cooperativa , Relaciones Interinstitucionales , Medicare/organización & administración , Reproducibilidad de los Resultados , Servicio Social/organización & administración , Encuestas y Cuestionarios/normas , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Medicare/estadística & datos numéricos , Persona de Mediana Edad , Servicio Social/estadística & datos numéricos , Estados Unidos
2.
Res Dev Disabil ; 94: 103477, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31494354

RESUMEN

BACKGROUND: Disability support organisations have embraced Active Support, but it has proved difficult to embed in services. AIMS: This study aimed to identify the factors associated with increases over time in the quality of Active Support. METHOD: Data were collected on the predicted variable of the quality of Active Support, and predictor variables of service user, staff and service characteristics, including practice leadership, and composition and size of services from 51 services in 8 organisations over 2-7 time points. Data were analysed using multi-level modelling. RESULTS: There was significant linear change in Active Support scores (group mean centered at the organisational level) over time. Individuals with lower support needs received better Active Support and those with higher support needs experienced greater increases over time. Stronger practice leadership and more staff with training in Active Support were significant predictors of the quality of Active Support. Larger services with seven or more individuals and where there was a very heterogeneous mix of individuals were associated with lower quality of support. CONCLUSIONS: Ensuring strong practice leadership, and staff training in Active Support that emphasises the principle of adapting support to each individual's level of ability and preferences are key to delivering high levels of Active Support.


Asunto(s)
Discapacidad Intelectual , Participación en las Decisiones/normas , Rehabilitación Psiquiátrica , Sistemas de Apoyo Psicosocial , Mejoramiento de la Calidad/organización & administración , Servicio Social , Desarrollo de Personal/normas , Compromiso Laboral , Adulto , Australia , Participación de la Comunidad/métodos , Personas con Discapacidad/psicología , Femenino , Humanos , Discapacidad Intelectual/psicología , Discapacidad Intelectual/rehabilitación , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Rehabilitación Psiquiátrica/métodos , Rehabilitación Psiquiátrica/organización & administración , Rehabilitación Psiquiátrica/normas , Calidad de la Atención de Salud , Servicio Social/métodos , Servicio Social/organización & administración , Servicio Social/normas
3.
N C Med J ; 80(5): 306-311, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31471516

RESUMEN

Given the known impacts of social, behavioral, and economic factors on health and longevity, health policy reforms are being developed and deployed at both the state and federal levels that support the integration and alignment of health care and social services.


Asunto(s)
Accesibilidad a los Servicios de Salud/organización & administración , Determinantes Sociales de la Salud , Prestación de Atención de Salud/organización & administración , Política de Salud , Humanos , Tamizaje Masivo , North Carolina , Derivación y Consulta , Servicio Social/organización & administración , Estados Unidos
4.
Int J Prison Health ; 15(3): 282-292, 2019 08 29.
Artículo en Inglés | MEDLINE | ID: mdl-31329039

RESUMEN

PURPOSE: Many offenders struggle when attempting to reintegrate into society after release from prison, and the conditions they face after release often lead to reoffending. The purpose of this paper is to present a conceptual model on reintegration after prison. The model has the potential to guide practitioners in their understanding of the relationships between welfare services and the agency of the offender. DESIGN/METHODOLOGY/APPROACH: The model was developed from a small-scale study in the Norwegian Criminal Justice system, which is well known for its emphasis on rehabilitation and crime prevention. Data collection aimed to explore the reintegration process from the perspective of the hard-to-reach and vulnerable population of serial offenders. Nine prisoners in two different prisons were interviewed. A thematic analysis identified two main themes that related, first, to the personal challenges the offenders faced in the rehabilitation and reintegration process and, second, to the factors in the welfare services that interacted with the prisoners' psychosocial issues in the reintegration process. FINDINGS: Findings suggest that the interaction between the psychosocial needs of the prisoners and the organization of the welfare services is complex and does not harmonize. The findings underpin the argument that the current reintegration strategies for certain groups of inmates need to be questioned and challenged. RESEARCH LIMITATIONS/IMPLICATIONS: The model is a conceptual model intended to provide a lens from which to reinterpret offenders' experiences of reintegration and applied to only the small and exploratory study described in this paper. As such, it requires further testing and substantiation, and the model and the study's findings should be regarded as tentative and cannot be generalized to a larger population. The prisoners were selected by the first author for convenience, and it is possible that this also influenced the findings. Other inmates may have presented other experiences. ORIGINALITY/VALUE: There are few studies looking into reintegration from the reoffenders' perspective, and this study also presents a model that serves as a reflective and analytical tool to developing new approaches to supporting offenders in their reintegration into society from prison in the future.


Asunto(s)
Prisioneros/psicología , Servicio Social/organización & administración , Poblaciones Vulnerables/psicología , Adulto , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , Noruega
5.
Soc Work Health Care ; 58(1): 108-125, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-31307342

RESUMEN

Healthcare reform, including the focus on chronic illness, the growing role of neuroscience, the emphasis on collaborative interprofessional care, and more recently, on integrated medical and behavioral healthcare, have important implications for social work education and practice. Parkinson's disease, a chronic neurodegenerative illness exemplifying these trends, is an area in which social workers are increasingly involved. This paper provides (1) an overview of Parkinson's disease and its complexity, (2) a summary of role and functions identified in a survey of health social workers working with Parkinson's disease and/or neurology, and (3) education and practice recommendations for the social work profession.


Asunto(s)
Enfermedad de Parkinson/terapia , Rol Profesional , Servicio Social/educación , Servicio Social/organización & administración , Integración de Sistemas , Adulto , Manejo de Caso/organización & administración , Enfermedad Crónica , Conducta Cooperativa , Consejo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/psicología , Educación del Paciente como Asunto
6.
Cien Saude Colet ; 24(6): 2053-2064, 2019 Jun 27.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31269164

RESUMEN

The public health network of the Federal District, as in the rest of the Brazilian Unified Health System, suffers from inefficiencies related to the difficulty in hiring and managing professionals, as well as the implementation of supply and maintenance contracts. In Brasilia, a new management model was implemented in 2018 in its largest hospital. With the creation of the autonomous social service "Instituto Hospital de Base", a health unit in operation since 1960, the possibility of providing agility to these contracts was opened, in addition to establishing a management based on goals and outcome indicators, with expressive efficiency gains. This article reports the steps for the implementation of this decentralized model of hospital management, the alternatives considered, the difficulties faced and some of the first results of this new model. One can already verify and affirm the success of the legal-administrative model of "Instituto Hospital de Base", which can serve as a paradigm for other health units in the Federal District and in Brazil.


Asunto(s)
Hospitales Públicos/organización & administración , Modelos Organizacionales , Programas Nacionales de Salud/organización & administración , Salud Pública , Brasil , Humanos , Indicadores de Calidad de la Atención de Salud , Servicio Social/organización & administración
7.
Int J Prison Health ; 15(2): 126-137, 2019 06 10.
Artículo en Inglés | MEDLINE | ID: mdl-31172854

RESUMEN

PURPOSE: Most women who serve time in prison will eventually be released and expected to reintegrate back into society. To maximize the chances of success, careful support is usually required. An example of this support work was the Healthy Relationships Program (HRP, 2016) offered to women inmates of the Adelaide Women's Prison (South Australia) pre-release. The content of the HRP was influenced by a gender-responsive framework and constructed as a social work program. The purpose of this paper is to report on a small qualitative study that used semi-structured interviews pre- and post-program to explore women participants' expectations, perceptions and experiences of the program. In this paper, the focus is on the women inmates' interview transcripts where a thematic analysis was conducted. Two main research questions drove this analysis. First: How did the women experience the HRP? Second: What does their reported experience reveal about the ongoing need for gender-responsive support? The key findings are that domestic violence and relationships with children are strong motivators for participation in programs; therefore, gender-responsive support is still required in prison programs. However, the paper also advocates that future iterations of gender-responsive support and social work interventions become more consciously intersectional feminist in orientation. DESIGN/METHODOLOGY/APPROACH: A qualitative design was used to explore what women thought the HRP taught them. Individual face-to-face interviews were used to explore women's perceptions, ideas and experiences of healthy relationships. Thematic analysis was used to draw out the themes across interviews. FINDINGS: The key arguments made are that gender-responsive support is still required but that future iterations of gender-responsive support become more consciously intersectional feminist in orientation. RESEARCH LIMITATIONS/IMPLICATIONS: The researchers experienced strict time restrictions to conduct interviews and therefore depth was somewhat compromised. To try and compensate for this restriction, the researchers visited potential participants as part of program recruitment and information sharing to help enable and build general rapport before the interviews. Time restrictions and prison security protocols did not allow for researchers to check transcripts with the women. PRACTICAL IMPLICATIONS: Reporting on this case study also showed that social work practice can influence relationships with institutions, such as prisons, that perpetrate marginalization and therefore enable a setting that facilitates safe participation in programs. SOCIAL IMPLICATIONS: Gender-responsive frameworks provide the much needed validation of gender differences, but also require a feminist intersectional lens to more consciously aid in the conceptualization and evaluation of future programs for women in prison. It is this intersectional lens that is more likely to bring multiple experiences of oppression into focus so that personal issues and problems can be analyzed in a richer wider social context, particularly intersections between gender, class and/ethnicity race. ORIGINALITY/VALUE: This paper has reported on women's expectations and experiences of a health relationships program and provides insight and learnings for future practitioners intending to run similar programs. Overall, the women participants were able to articulate their own personal learnings about interpersonal relationships and were able to acknowledge the impacts of abuse and violence in their lives in the program.


Asunto(s)
Prisioneros/psicología , Prisiones/organización & administración , Servicio Social/organización & administración , Adulto , Femenino , Humanos , Relaciones Interpersonales , Entrevistas como Asunto , Persona de Mediana Edad , Estudios de Casos Organizacionales , Percepción , Investigación Cualitativa , Australia del Sur , Adulto Joven
9.
Am J Hosp Palliat Care ; 36(10): 864-870, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30974954

RESUMEN

BACKGROUND: Women with metastatic breast cancer (MBC) experience unique symptom management and psychosocial needs due to aggressive, yet palliative treatment with a progressive, chronic illness. OBJECTIVE: This article describes the effect of a quality improvement project for coordination of supportive care in MBC. Program evaluations included referral rates for supportive services, patient-reported outcomes of symptom distress, generalized anxiety, and overall well-being. DESIGN: An interdisciplinary Support, Education and Advocacy Program (MBC-SEA) was developed. The 1-hour, weekly, patient review included collaborative assessments to determine needs for social service, psychological counseling, and palliative care. A prospective pre- and postexperimental cohort design with convenience sampling was used. Analysis was conducted with paired t test analysis of pre- and postimplementation outcomes. SETTING/PARTICIPANTS: Program outcomes of 118 women with MBC visiting an urban outpatient breast cancer clinic during September 2016 to November 2016 (pre) and January 2017 to March 2017 (post) were evaluated. MEASUREMENTS: Referral rates to social work and palliative care, symptom, anxiety, and overall well-being scores. RESULTS: Following program implementation, referrals to palliative care and social work supportive services increased significantly including patient-reported outcomes symptom distress scores mean difference 1.4 (95% confidence interval [CI]: 0.4306-2.6428), P = .004; generalized anxiety scores mean difference 1.5 (95% CI: 0.5406-2.5781), P = .003; and overall well-being mean difference of -0.7 (95% CI: -1.3498 to -0.0570), P = .03. CONCLUSIONS: Purposeful nurse-led assessment for social service and palliative care needs increases referrals with improvement in patient-reported outcomes.


Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Cuidados Paliativos/organización & administración , Calidad de Vida , Derivación y Consulta/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad/epidemiología , Neoplasias de la Mama/patología , Instituciones Oncológicas/organización & administración , Conducta Cooperativa , Consejo/organización & administración , Femenino , Enfermería de Cuidados Paliativos al Final de la Vida , Humanos , Persona de Mediana Edad , Metástasis de la Neoplasia , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Mejoramiento de la Calidad/organización & administración , Servicio Social/organización & administración
11.
PLoS One ; 14(3): e0213613, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30870484

RESUMEN

BACKGROUND: The benefits of clinical supervision are more pronounced for health professionals in rural and remote areas. Most clinical supervision studies to date have occurred in metropolitan centres and have used the survey methodology to capture participant experiences. There is a lack of qualitative research that captures participants' lived experiences with clinical supervision at the frontline. METHODS: Participants were recruited from rural and remote sites of two Australian states using a purposive maximum variation sampling strategy. Data were collected through individual, semi-structured interviews with participants. Data were analysed using content analysis and themes were developed. Sixteen participants from six professions completed the interviews. RESULTS: Eight themes were developed including the content of supervision, context of supervision, value of supervision, increased need for professional support and unique characteristics of rural and remote clinical supervision. CONCLUSIONS: This study has highlighted the value of clinical supervision for the rural and remote health professional workforce. Furthermore, it has shed light on the unique characteristics of clinical supervision in this population. This information can be used by organisations and health professionals to ensure clinical supervision partnerships are effective thereby enhancing rural and remote workforce recruitment and retention.


Asunto(s)
Técnicos Medios en Salud , Actitud del Personal de Salud , Área sin Atención Médica , Servicios de Salud Rural/organización & administración , Prestación de Atención de Salud , Dietética/organización & administración , Femenino , Personal de Salud , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Terapia Ocupacional/organización & administración , Selección de Personal , Fisioterapia/organización & administración , Podiatría/organización & administración , Investigación Cualitativa , Queensland , Población Rural , Servicio Social/organización & administración , Australia del Sur , Patología del Habla y Lenguaje/organización & administración
12.
Artículo en Inglés | MEDLINE | ID: mdl-30892139

RESUMEN

Family members are often involved in medical decision-making on behalf of a nursing home resident. Prospect theory provides a framework for understanding how people weigh decisions. In the current study, prospect theory concepts are used to build understanding about how family members weigh medical decisions for an NH resident diagnosed with cancer. This is a secondary analysis of qualitative interview data from 24 family members of nursing home residents. Prospect theory concepts of gain, loss, risk, and reference point were used deductively in qualitative content analysis. Themes were developed by comparing content related to these four concepts, across the transcripts from the 24 participants. Three themes comprise the main findings, including "Don't prolong this," "A good ending is a gain," and "Experience can facilitate seeing the big picture." Prospect theory concepts applied to decisions faced by family members were useful in building an understanding of what participants considered as gains, losses, risks, and reference points. Many participants framed the medical decisions within the larger context of the resident's life and concluded that jeopardizing the chance for a peaceful dying process was too high a risk. Medical interventions were selected or avoided because of the impact on a comfortable dying process; considered a gain. Advance care planning discussions and goals of care discussions can benefit by directly addressing what residents/patients, families, and health practitioners consider outcomes worth pursuing and avoiding.


Asunto(s)
Planificación Anticipada de Atención/organización & administración , Familia/psicología , Hogares para Ancianos/organización & administración , Neoplasias/epidemiología , Casas de Salud/organización & administración , Cuidado Terminal/organización & administración , Adulto , Anciano , Anciano de 80 o más Años , Toma de Decisiones , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Servicio Social/organización & administración
13.
J Med Syst ; 43(4): 86, 2019 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-30820675

RESUMEN

The care networks of community-dwelling older adults require cooperation between different actors, including health and social caregivers, assistant providers, care receivers, and their informal caregivers (e.g. relatives or friends), across time, space, and organizational boundaries. In this context, the project Social Cooperation for Integrated Assisted Living (SOCIAL) aims at the development of a platform of services to support the care networks of community-dwelling older adults. Therefore, the study reported in this article assess the adequacy of the Fast Healthcare Interoperability Resources (FHIR) to guarantee the interoperability of the relevant information related to the assisted persons of the SOCIAL platform, which are mainly older adults that need care and assistance services.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Vida Independiente , Servicio Social/organización & administración , Telemetría , Dispositivos Electrónicos Vestibles , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Seguridad Computacional , Anciano Frágil , Estado de Salud , Humanos , Relaciones Interpersonales , Entrevistas como Asunto , Investigación Cualitativa , Automanejo , Apoyo Social , Factores Socioeconómicos
14.
Med Care ; 57(5): 327-333, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30908380

RESUMEN

BACKGROUND: Services targeting social determinants of health-such as income support, housing, and nutrition-have been shown to improve health outcomes and reduce health care costs for older adults. Nevertheless, evidence on the properties of effective collaborative networks across health care and social services sectors is limited. OBJECTIVES: The main objectives of this study were to identify features of collaborative networks of health care and social services organizations associated with avoidable health care use and spending for older adults. RESEARCH DESIGN: Through a 2017 survey, we collected data on collaborative ties among health care and social service organizations in 20 US communities with either high or low performance on avoidable health care use and spending for Medicare beneficiaries. Six types of ties were measured: any collaboration, referrals, sharing information, cosponsoring projects, financial contracts, and joint needs assessment. We examined how characteristics of collaborative networks were associated with performance. RESULTS: High-performing networks were distinguished from low-performing networks by 2 features: (1) health care organizations occupied positions of significantly greater centrality (P<0.01), and (2) subnetworks of cosponsorship ties were more cohesive, as measured by centralization (P=0.05) and density (P=0.06). Across all networks, Area Agencies on Aging were more centrally positioned than any other type of organization (P<0.05). CONCLUSIONS: Cross-sector engagement by health care organizations, particularly development of deeper types of collaborative ties such as cosponsorship, may reduce preventable health care use and spending. Efforts to foster effective partnerships could leverage the Area Agencies on Aging, which are already positioned as network brokers.


Asunto(s)
Redes Comunitarias/organización & administración , Conducta Cooperativa , Medicare/economía , Aceptación de la Atención de Salud/estadística & datos numéricos , Servicio Social/organización & administración , Anciano , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Estados Unidos
16.
BMC Public Health ; 19(1): 334, 2019 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-30902081

RESUMEN

BACKGROUND: Chronic homelessness is a problem characterised by longstanding inability to attain or maintain secure accommodation. Longitudinal research with homeless populations is challenging, and randomised controlled trials that evaluate the effectiveness of intensive, case management interventions aimed at improving housing and health-related outcomes for chronically homelessness people are scant. More research is needed to inform programmatic design and policy frameworks in this area. This study protocol details an evaluation of the Journey to Social Inclusion - Phase 2 program, an intervention designed to reduce homelessness and improve outcomes in chronically homeless adults. METHODS/DESIGN: J2SI Phase 2 is a three-year, mixed methods, multi-site, RCT that enrolled 186 participants aged 25 to 50 years between 07 January 2016 and 30 September 2016 in Melbourne. The intervention group (n = 90 recruited) receives the J2SI Phase 2 program, a trauma-informed intervention that integrates intensive case management and service coordination; transition to housing and support to sustain tenancy; and support to build social connections, obtain employment and foster independence. The comparison group (n = 96 recruited) receives standard service provision. Prior to randomisation, participants completed a baseline survey. Follow-up surveys will be completed every six months for three years (six in total). In addition to self-report data on history of homelessness and housing, physical and mental health, substance use, quality of life, social connectedness and public service utilisation, linked administrative data on participants' public services utilisation (e.g., hospitalisation, justice system) will be obtained for the three-year period pre- and post-randomisation. Semi-structured, qualitative interviews will be conducted with a randomly selected subset of participants and service providers at three time-points to explore changes in key outcome variables and to examine individual experiences with the intervention and standard service provision. An economic evaluation of the intervention and associated costs will also be undertaken. DISCUSSION: Results of this trial will provide robust evidence on the effectiveness of J2SI Phase 2 compared to standard service provision. If the intervention demonstrates effectiveness in improving housing, health, quality-of-life, and other social outcomes, it may be considered for broader national and international dissemination to improve outcomes among chronically homeless adults. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12616000162415 (retrospectively registered 10-February-2016).


Asunto(s)
Personas sin Hogar/estadística & datos numéricos , Participación Social , Servicio Social/organización & administración , Adulto , Australia , Manejo de Caso , Femenino , Estado de Salud , Vivienda/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Calidad de Vida , Encuestas y Cuestionarios
17.
BMJ Open ; 9(2): e022975, 2019 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-30772845

RESUMEN

OBJECTIVES: Social services are increasingly commissioned to third and for-profit sector providers, but little is known about whether and how these changes influence quality indicators. We assessed quality-related outcomes across for-profit, public and third sector organisations delivering social care services. DESIGN: A secondary analysis was conducted on publically available data collected by the independent regulator of social care organisations in Scotland. All outcomes are reported as predicted probabilities derived from multivariate logistic regression coefficients. Generalised ordered logit models are utilised for the quality domains and the risk assessment score and logistic regression for whether complaints or requirements were issued to organisations. SETTING: Organisations inspected by the Care Inspectorate in Scotland. POPULATION: 13 310 social care organisations (eg, nursing homes and day care organisations). PRIMARY OUTCOMES: The quality and risk domains collected by the Care Inspectorate and complaints and requirements issued to organisations within the last 3 years. RESULTS: Controlling for multiple factors, we find that public and third sector providers performed consistently and statistically significantly better than for-profit organisations on most outcomes. For example, for-profit services were the most likely to be rated as high and medium risk (6.9% and 13.2%, respectively), and the least likely to be classified as low risk (79.9%). Public providers had the highest probability of being categorised as low risk (91.1%), and the lowest probability of having their services classified as medium (6.9%) and high risk (2%), followed by third sector providers (86%, 8.5% and 4.5%, respectively). Public providers performed better than third sector providers in some outcomes, but differences were relatively low and inconsistent. CONCLUSION: Public and third sector providers were rated considerably higher than their for-profit counterparts on most observed outcomes. Regulators might use this information to consider how social care providers across sector are incentivised to manage their resources.


Asunto(s)
Servicio Social/normas , Regulación Gubernamental , Humanos , Sector Privado , Sector Público , Garantía de la Calidad de Atención de Salud , Calidad de la Atención de Salud , Escocia , Servicio Social/organización & administración
19.
Res Dev Disabil ; 86: 41-52, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30658272

RESUMEN

Recently, the Children and Families Act 2014 was introduced in England to regulate provision for children with disabilities. According to this policy, statements of special educational needs were replaced with education, health and care plans, which should include high-quality, holistic and participation-focused outcomes to regulate provision; this change aligns with international recommendations regarding provision for children with disabilities. This study aimed to evaluate the outcomes defined for children with education, health and care plans in England. 236 Education Health and Care plans were included in the analysis, providing 2813 outcomes to be examined, which came from 11 local authorities and 42 schools and belong to 69 girls and 167 boys from 4 to 21 years of age. The outcomes were independently rated by two experienced researchers using a Goal Functionality Scale. Inter-rater agreement was calculated for 10% of the outcomes. Most outcomes were considered not to be functional or high-quality; differences in quality were found between local authorities, types of school, type of outcome, and the children's main need. There are important quality concerns regarding the outcomes that have been designed for children with disabilities in England, which should be addressed through standardised training and guidelines on procedures.


Asunto(s)
Servicios de Salud del Niño/organización & administración , Niños con Discapacidad/educación , Educación Especial/organización & administración , Servicio Social/organización & administración , Adolescente , Trastorno del Espectro Autista/rehabilitación , Niño , Preescolar , Trastornos de la Comunicación/rehabilitación , Discapacidades del Desarrollo/rehabilitación , Inglaterra , Femenino , Humanos , Masculino , Trastornos Mentales/rehabilitación , Medicina Estatal , Adulto Joven
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