1. A continuum of care for the inner city: assessment of its benefits for Boston's elderly and high-risk populations
- Author
-
John Jainchill, Barbara Turner, Roger Mark, Sara Lennox, William N. Kavesh, Mitchell T. Rabkin, Robert J. Master, Marie Feltin, and Sarah Bachrach
- Subjects
Male ,medicine.medical_specialty ,Health Services for the Aged ,MEDLINE ,Ambulatory care ,Multidisciplinary approach ,Poverty Areas ,Health care ,medicine ,Ambulatory Care ,Humans ,Hospitals, Teaching ,Poverty ,Aged ,Social work ,business.industry ,Age Factors ,General Medicine ,Community Health Centers ,Middle Aged ,Home Care Services ,Nursing Homes ,Hospitalization ,Fees and Charges ,Family medicine ,Local government ,Ambulatory ,Chronic Disease ,Female ,business ,Delivery of Health Care ,Boston - Abstract
We describe an approach to health care in the inner city: a multidisciplinary system of physicians and mid-level practitioners that provides individualized care to chronically ill, elderly, homebound, and nursing-home residents of urban Boston who would otherwise be forced into an inappropriate reliance on teaching hospitals. Linked to four neighborhood health centers, three home-care programs, and a teaching hospital, and financially self-supporting except for the home-care component, the system cared for 3000 ambulatory, 280 homebound, and 358 nursing-home patients in the representative year described. In-hospital use, particularly hospital days, was reduced when judged by existing data for comparable (though not identical) populations. Based on stable physician practices, the system offers a workable approach to the related problems of care, manpower, and cost in the urban core.
- Published
- 1980