A study of selected home care programs : a joint project of the Public Health Service and the Commission on Chronic Illness.

  • United States. Public Health Service.
Date:
1955]
Catalogue details

Licence: Public Domain Mark

Credit: A study of selected home care programs : a joint project of the Public Health Service and the Commission on Chronic Illness. Source: Wellcome Collection.

    107/140 (page 97)
    The cash disbursements for operation of the home care program and the dispensary, ex- clusive of the mental hygiene clinic, during 1951—52 were as follows: Toteal@ash expenses 2... $26, 803. 04 URES 1 Ee re 11, 540. 00 Director, (assistant dean of College of BePiOIne jaca eee ere ok 5, 095. 00 Meenpericnry Nurse 220-2 kk 3, 045. 00 OP Gh ee a 3, 400. 00 OLS ee 2, 689. 00 SEES 20 of BS 0 (i r 900. 00 ee sa ee 1, 789. 00 Operating expense (drugs, surgical sup- plies, phone, rent, maintenance, and OMICGES Np PICS) ae eee Me Ee 12, 128. 04 Purchased of equipment. 2... _2_...__- 446. 00 Of the expenses listed above, the salary of the city physician ($3,400) can be applied en- tirely to home care, since he spent all of his time on this service. It was estimated that the director spent approximately one-tenth of his time working on the home medical service; thus, about $500 of his salary could be charged to home care. An undetermined proportion of the operating expense item would also be charged to home care. Cost figures were not available for certain services provided by other agencies in the community. ‘These services in- cluded nursing visits, laboratory tests, X-rays, social services, and transportation. Operational Policies and Procedures The policy of the home medical service pro- gram was to accept referrals 24 hours a day from any individual or agency in the community. Except for obstetrical, active pulmonary tuber- culosis, and mental cases, patients in all disease categories were accepted for care. However, in unusual situations, patients with mental ill- ness or active pulmonary tuberculosis were cared for in the home until another plan could be made. Calls for service were received through a tele- phone answering service and were relayed to the resident, who was responsible for providing service. Public Health Monograph No. 35, 1955 378451—56——_8 All persons requesting service were visited by the physician at least once. If they were found to be eligible for service, a plan for care was made. Individual cumulative medical records were kept. They contained such information as histories, summary reports from other medical facilities, physical findings, and medical progress notes. There were no formal conferences at which the physicians and representatives from com- munity agencies discussed patient care, but there were frequent informal conferences be- tween the physicians and the staffs of the nursing agency, the Howard Relief Society, and the public welfare agency. Services to Patients There was no record of the number of patients or of the services furnished to them other than medical services during the fiscal year 1951-52. Medical Services. Direct medical services to patients were provided by the resident and fourth-year medical students under the super- vision of the program director. The range of medical services included his- tories, physical examinations, uncomplicated diagnostic and laboratory procedures, dis- pensation of drugs, and administration of parenteral drugs. Revisits were based on patient needs. Patients requiring specialized medical con- sultation were admitted to one of the two Bur- lington hospitals. During the fiscal year 1951-52, a total of 7,212 home medical visits were made to patients by the resident and the medical students. Nursing Services. Direct nursing services were available upon request through the Bur- lington Visiting Nurse Association without charge and in accordance with its usual policy. The range of services included such care as dressings, injections, irrigations, personal care, health instruction, and teaching members of the household how to care for the patient, and occasional assistance with such procedures as abdominal taps. Social Services. Financial assistance, child placement, and some counseling services were available to home care patients upon request