Coordinated Care for Those Nearing Life's End — But Does It Save Money?

A novel way to help young men growing up in communities in which concentrated poverty, violence and unemployment are well-documented barriers to health and longevity: male youth of color are trained to be the emergency response team to help stabilize street victims before doctors or nurses begin procedures.

The highest hospital costs come from preventable emergency room visits. A doctor in Camden developed a home visit program which gives better and cheaper care.

According to the Centers for Disease Control and Prevention, drug overdoses are the leading cause of injury-related mortality. Naxolone, a drug used to revive overdose victims, is only available by prescription. However, private organizations have distributed Naxolone kits nationally, showing that the drug can save lives when it is more readily accessible.

In Nepal, a controversial drug is proving to be effective in saving mother's lives. It's the only shelf-stable, easy-to-administer solution to curbing postpartum hemorrhage. In trials, misoprostol is shown to save the lives of women who live far from medical care facilities. Since Nepal allowed use of the drug, postpartum hemorrhage has fallen from the leading cause of maternal death to number two.

To educate and prepare new mothers, Centering Pregnancy and Centering Parenting sites in the United States offer community-based patient-centered care in low-income areas. Centering offers interactive learning, check-ups, and social support, so that women can take charge of their health.

Latin American women in San Francisco have suffered from post-partum depression, social isolation, and chronic stress at the time of their pregnancies. Run by midwives, the Centering Pregnancy program at the San Francisco General Hospital provides patient-centered care, an environment to speak in Spanish, and a nurturing community for women’s group appointments. The results boast fewer c-sections and pre-term births, and an improvement in emotional support and overall prenatal health.

Post-traumatic stress has dire consequences for U.S. veterans, including an increase in suicide, and not all therapeutic treatments for the disorder have succeeded. To treat and potentially cure the effects of PTSD, the Center for Mind-Body Awareness offers veterans Buddhist-inspired meditation, and mindfulness, as well as skills to develop creative expression.

*Medical research has done wonders to rid populations of diseases; however, the U.S. health care system has failed to appropriate the right resources to Medicare patients with one or more chronic conditions. Health Quality Partners in Doylstown, PA enrolls Medicare patients with at least one chronic illness and hospitalization and sends a trained nurse to see them on a routine basis, whether they are healthy or sick. As a result, the HQP program has reduced hospitalizations and cut Medicare costs.

Many African American women are reluctant to breastfeed their babies. The Mother Nuture Project at Detroit’s St. John Hospital and Medical Center offers peer counseling to educate women (mostly African American) and encourage breastfeeding. Mother Nurture’s program has helped boost breastfeeding rates from 46 percent to 64 percent.

The Patient Support Corps at UC San Francisco Medical Center pairs interns with patients to provide support during visits. The program, which now acts as a model for other hospitals, encourages patients to speak up and offers them the information needed to make decisions about their care, rather than having the doctors make the decision for them.