EPB Question: In impoverished patients, what is the efficiency of treatment if they are encouraged to attend the follow-up visit, compared to no intervention within three months?
Overall, the current landscape of the healthcare system exhibits a strong need for profound interventions that would promote the accessibility of care for vulnerable populations. In this regard, one of the key issues is related to the lack of follow-up consultations that undermines the health of financially insecure patients. As evidence suggests, this tendency is particularly strong outside of acute and emergency care. Spoken differently, impoverished patients tend to understate the severity of their issue unless an immediate threat to a person’s life is encountered. As a result of insufficient financial resources, they postpone their visits to medical institutions, limiting them to a single session. At the same time, the body of evidence suggests that follow-up procedures are necessary for supporting the initial progress of the treatment plan. Without them, the condition sees an increased chance of relapse with subsequent readmissions as a common implication, which equally becomes a costly ordeal for both patients and organizations.
The proposed intervention seeks to increase the rate of follow-up consultations among vulnerable patient groups. In most cases, this implies that the person is to return physically to the medical unit for a scheduled follow-up appointment. However, this intervention suggests a higher level of flexibility in this regard. There is a growing body of evidence in favor of new formats of practitioner-patient interaction that can mitigate the effect of economic barriers. From one perspective, some researchers suggest that home visits may be a fitting solution to the problem. Nevertheless, evidence suggests that this format does not have a direct effect on patient outcomes. Furthermore, the present reality of the COVID-19 pandemic has changed the rules of the craft. As such, modern researchers discuss the benefits of remote follow-up consultations. As per the present intervention, they will play an important role in engaging vulnerable patient groups. Remote procedures can account for the majority of interactions, especially when the situation is not threatening and requires an immediate physical examination. Advanced practice nurses will play the role of leading consultants and decision-makers in the development and implementation of the policy.
References
Aragona, M., Barbato, A., Cavani, A., Costanzo, G., & Mirisola, C. (2020). Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties. Public Health, 186, 52-56. Web.
Bell, L. C., Norris-Grey, C., Luintel, A., Bidwell, G., Lanham, D., Marks, M., Baruah, T., O’Shea, L., Heightman, M., & Logan, S. (2021). Implementation and evaluation of a COVID-19 rapid follow-up service for patients discharged from the emergency department. Clinical Medicine, 21(1), 57-62. Web.
Dantas, L. F., Fleck, J. L., Oliveira, F. L. C., & Hamacher, S. (2018). No-shows in appointment scheduling–a systematic literature review. Health Policy, 122(4), 412-421. Web.
Diez-Sampedro, A., Gonzalez, A., Delgado, V., Flowers, M., Maltseva, T., & Olenick, M. (2020). COVID-19 and advanced practice registered nurses: frontline update. The Journal for Nurse Practitioners, 16(8), 551-555. Web.
George, S., Daniels, K., & Fioratou, E. (2018). A qualitative study into the perceived barriers of accessing healthcare among a vulnerable population involved with a community centre in Romania. International Journal for Equity in Health, 17(1), 1-13. Web.
Lembeck, M. A., Thygesen, L. C., Sørensen, B. D., Rasmussen, L. L., & Holm, E. A. (2019). Effect of single follow-up home visit on readmission in a group of frail elderly patients: A Danish randomized clinical trial. BMC Health Services Research, 19(1), 1-10. Web.
Ofei-Dodoo, S., Kellerman, R., Hartpence, C., Mills, K., & Manlove, E. (2019). Why patients miss 8 scheduled outpatient appointments at urban academic residency clinics: A qualitative evaluation. Kansas Journal of Medicine, 12(3), 57. Web.
Rantz, M. J., Popejoy, L., Vogelsmeier, A., Galambos, C., Alexander, G., Flesner, M., Murray, C., Crecelius, C., Ge, B., & Petroski, G. (2018). Impact of advanced practice registered nurses on quality measures: The Missouri quality initiative experience. Journal of the American Medical Directors Association, 19(6), 541-550. Web.
Sloane, D. M., Smith, H. L., McHugh, M. D., & Aiken, L. H. (2018). Effect of changes in hospital nursing resources on improvements in patient safety and quality of care: A panel study. Medical Care, 56(12), 1001. Web.
Williamson, A. E., McQueenie, R., Ellis, D. A., McConnachie, A., & Wilson, P. (2021). ‘Missingness’ in health care: Associations between hospital utilization and missed appointments in general practice. A retrospective cohort study. PloS One, 16(6), e0253163.