Models to promote medical health care delivery for indigent families: computerized tracking to case management.
Poor patient/parental medical compliance is one of the most important health care issues of today. Multiple interrelated factors contribute to this problem. Of prime importance is patient/parental maturity and knowledge. Reversal of this process is undoubtably harder than prevention. The cost effectiveness of various methods of intervention is discussed in relation to a large mid-south indigent population. Computerized patient tracking is cost efficient and effectively promotes compliance in a percentage of patients. Its additional utility is the identification and triage of patients, most in need of intervention, to existing social service personnel for family-centered case management. Family-centered case management holds the best hope of reversing the many factors adversely affecting patient compliance. However, this method is costly and requires a low ratio of clients to caseworkers in order to be effective. Community-centered patient management is less costly to implement and is very useful in tightly woven communities resistant to outside intervention. However, this method often has a high client to caseworker ratio and has less utility in dealing with complex medical problems.
Kavanagh
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Boling Center for Developmental Disabilities, University of Tennessee, Memphis.
Tate
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D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D001071:Appointments and Schedules; D001131:Arkansas; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D005190:Family / Q000523:psychology; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D016347:Medical Records Systems, Computerized; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008922:Mississippi; D010347:Patient Care Planning / Q000379:methods*; D010349:Patient Compliance; D011204:Poverty Areas; D017010:Reminder Systems; D012947:Social Work / Q000458:organization & administration*; D012959:Socioeconomic Factors; D013714:Tennessee; D000078329:Workforce