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