The integration of harm reduction and healthcare: implications and lessons for healthcare reform
The integration of harm reduction and healthcare: implications and lessons for healthcare reform
- Collection:
- Health Policy and Services Research
- Author(s):
- Schafer, Peter, author
Calvo, Michele, author - Contributor(s):
- New York Academy of Medicine, issuing body.
- Publication:
- New York, N.Y. : New York Academy of Medicine, June 2015
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Behavioral Medicine -- organization & administration
Community Health Services -- organization & administration
Delivery of Health Care, Integrated -- organization & administration
Harm Reduction
Patient-Centered Care
Primary Health Care -- organization & administration
Analgesics, Opioid -- poisoning
Drug Overdose -- drug therapy
Health Care Reform
Health Policy
Health Services Accessibility
Health Services Needs and Demand
Interprofessional Relations
Medically Underserved Area
Naloxone -- therapeutic use
Narcotic Antagonists -- therapeutic use
Opioid-Related Disorders -- drug therapy
Organizational Case Studies
Patient Acceptance of Health Care
Poverty Areas
Professional Practice Location
Quality of Health Care
Social Determinants of Health
Substance Abuse, Intravenous
Substance-Related Disorders -- therapy
Syringes
Humans
New York
United States - Genre(s):
- Technical Report
- Abstract:
- Harm reduction services, i.e., syringe exchange programs and the array of services for injection drug users that have developed around syringe exchange, have a long history in addressing the health and basic needs of people at elevated risk for poor health outcomes. While not generally thought of as a point of reference for healthcare reform, harm reduction program participants share many characteristics with the broader Medicaid population, such as significant socioeconomic disadvantage, multiple chronic health conditions, and a history of crisis-oriented episodic care. Current healthcare system reforms carry with them an implicit critique of the manner in which healthcare delivery has evolved, based on the logic and demands of the healthcare system itself rather than the circumstances and needs of patients. This can be seen in Medicaid reform initiatives such as the Delivery System Reform Incentive Payment (DSRIP) Program, which includes healthcare system incentives to integrate behavioral and primary healthcare services, as well as incentives to meet the needs of those who utilize hospital Emergency Departments for primary care with less costly community-based services. This study reveals the many opportunities and challenges facing harm reduction providers and their healthcare provider partners as they work to improve and expand the integration of harm reduction and healthcare services. Key informant interviews, focus groups, a comprehensive literature review, and an in-depth case study of a successful co-location model of service integration uncovered effective strategies and instructive experiences to guide integration efforts. The overarching theme that emerged is the need for healthcare reform strategies to move beyond the array of clinical care needs of patients to embrace and promote models of holistic person-centered care. Clinical care should be coordinated and co-located with services that address basic needs including food, housing, counseling and advocacy, access to safe injection equipment and harm reduction education, as well as social support. For marginalized populations living in precarious circumstances, such services are essential to establishing the stability that allows them to take care of their health.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (69 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101661871 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101661871