Imagine that a 70-year old man has hypertension and diabetes in Autaugaville, Alabama. After a visit to the nearest emergency room, he is diagnosed with a stroke. Now think about how his situation might compare with that of a 70-year-old woman in Gilbert, Arizona, diagnosed with ovarian cancer and must have her ovaries removed. Both patients have received diagnosis from their respective care providers and must be admitted to a hospital for inpatient care. What services will he need through the duration of his recovery experience? How might the two patients’ experiences compare in terms of care coordination and the continuity and comprehensiveness of services they receive? Where will they receive care? Research Medicare’s Hospital Compare to research data related to their diagnosis, treatment, and outcomes. Compare three hospitals and based on your findings…

examine the continuum of care a patient may need, research the services available in your area to support the patient, and evaluate information needs. Review information about continuum of care and coordination among various health services, and the concept of integrated healthcare. Your assignment will include a written report and PowerPoint presentation.

In a report:

• Answer the questions in the scenario.
• Assume the patients in the scenario live near your local area. Assess potential available services, based on their healthcare needs. Analyze specific services the patient might need, beginning with the onset or diagnosis of an illness or injury and concluding with an end-point of your choosing (i.e., recovery, symptom management, end of life).
• Research the types of organizations that provide those services
• Based on the services for patient needs, select at least three actual settings in which he/she would receive care.
• Gather information related to the types of insurance each organization accepts. Typically, this would include Medicare, Medicaid, and various types of insurance programs. What challenges related to payment for services do you anticipate your selected patient may experience?

• Describe the patient you have selected (including his or her health problem/injury) and identify the geographic area where this patient is located.
• Analyze the continuum of care, including specific services the patient may require from three or four actual settings.
• Describe a potential challenge related to payment for services this patient may encounter.
• Explain why professionals in your selected settings need to be aware of the quality of services guidelines and requirements, in comparison to the continuum of care.

SOLUTION

Report: Comparison of Care Coordination for Two Patients in Different Geographic Locations

Patient Profiles:

1. Patient A: 70-year-old man residing in Autaugaville, Alabama, diagnosed with hypertension and diabetes. Recently diagnosed with a stroke and requires inpatient care.
2. Patient B: 70-year-old woman residing in Gilbert, Arizona, diagnosed with ovarian cancer and scheduled for surgery to have her ovaries removed. Requires inpatient care.

Comparison of Care Coordination:

1. Services Needed for Patient A (Stroke Diagnosis):
   • Acute stroke care including neurology consultation, diagnostic imaging (CT/MRI), and administration of clot-busting medications if applicable.
   • Rehabilitation services including physical therapy, occupational therapy, and speech therapy.
   • Long-term management of hypertension and diabetes.
   • Follow-up care with a primary care physician and neurologist.
   • Home health services for ongoing monitoring and support.
2. Services Needed for Patient B (Ovarian Cancer Diagnosis):
   • Surgical intervention for ovarian removal.
   • Oncology consultation and treatment planning.
   • Post-operative care including pain management and monitoring for complications.
   • Chemotherapy or radiation therapy as indicated.
   • Palliative care or hospice services for symptom management and end-of-life care if necessary.

Settings for Care Delivery:

1. Patient A: a. Baptist Medical Center South (Montgomery, AL) b. Vaughan Regional Medical Center (Selma, AL) c. Prattville Baptist Hospital (Prattville, AL)
2. Patient B: a. Banner Gateway Medical Center (Gilbert, AZ) b. Mercy Gilbert Medical Center (Gilbert, AZ) c. Chandler Regional Medical Center (Chandler, AZ)

Payment Challenges:

• Patient A may face challenges with Medicare coverage for rehabilitation services, especially if they exceed coverage limits.
• Patient B may encounter difficulties with insurance coverage for cancer treatment, particularly if certain medications or procedures are not covered by their insurance plan.

Importance of Quality of Services:

• Professionals in all settings need to adhere to quality guidelines to ensure optimal patient outcomes.
• Compliance with quality standards is essential for patient safety and satisfaction across the continuum of care.
• Healthcare providers must collaborate effectively to ensure seamless transitions between settings and continuity of care for patients.

Conclusion:

• Patients with different diagnoses in varying geographic locations require tailored care coordination to address their specific needs.
• Understanding the continuum of care and available services is crucial for healthcare professionals to deliver high-quality, comprehensive care to patients.