Comorbidity and Integrated Care (14) Flashcards
1
Q
Comorbidity
A
A medical condition in a patient that causes, is caused by, or is otherwise related to another condition in the same patient
2
Q
Multi morbidity
A
Two/more medical conditions existing simultaneously regardless of their casual relationship
3
Q
Commissioning priorities
A
- Active support for self management
- Primary prevention
- Secondary prevention
- Managing ambulatory care sensitive conditions
- Improving the management of patients with mental and physical needs
- Care co-ordination through integrated health and social care teams
- Improving primary care management of end-of-life care
- Effective medicines management
- Managing elective activity-referral quality
- Managing emergency activity: urgent care
4
Q
Integrated Behaviour Change - b-You programme (Primary prevention)
A
- Combined commissioning pot
- Evidence based
- Pilot long term behaviour change for medium/high risk
- 12 month personalised motivational support
- 91% retention, 6% weight loss, 97% attended sports centre, 93% improve QoL
5
Q
First Diabetes (Secondary prevention)
A
- Individual appointments
- Reduction in HbA1c and weight in patients on new drugs
- 75% reduction in insulin doses and 1.25kg weight loss
6
Q
Care co-ordination through integrated health and social care teams
A
- Community-based multi-professional teams based around general practices that include generalists working alongside specialists
- Focus on immediate care, case management and support to home-based care
- Joint care planning and co-ordinated assessment of care needs
- Personalised health care plans and programmes
- Named care co-ordinators who acts as navigators and who retain responsibility for patient care and experiences throughout the patient journey
- Clinical records that are shared across MP team
7
Q
Polypharmacy
A
Cost-effective prescribing and reducing medication errors
