An Overview of the Intentions of Health Care Reform

Tuma, Pepin Andrew

doi:10.1016/j.jand.2011.12.012

Cited by 7 publications

(3 citation statements)

References 2 publications

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“…Finally, the Patient Protection and Affordable Care Act (ACA 5 ; 21) mandates modernization of the disease prevention and public health systems. This law will shift health care away from a fee-for-service model to one that is focused on preventive care and wellness (22). In this new paradigm, nutrition is expected to be a central focus of health care in the future.…”

Section: Introductionmentioning

confidence: 99%

The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness

Kris-Etherton¹,

Akabas²,

Bales³

et al. 2014

The American Journal of Clinical Nutrition

204

177

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Nutrition is a recognized determinant in 3 (ie, diseases of the heart, malignant neoplasms, cerebrovascular diseases) of the top 4 leading causes of death in the United States. However, many health care providers are not adequately trained to address lifestyle recommendations that include nutrition and physical activity behaviors in a manner that could mitigate disease development or progression. This contributes to a compelling need to markedly improve nutrition education for health care professionals and to establish curricular standards and requisite nutrition and physical activity competencies in the education, training, and continuing education for health care professionals. This article reports the present status of nutrition and physical activity education for health care professionals, evaluates the current pedagogic models, and underscores the urgent need to realign and synergize these models to reflect evidence-based and outcomes-focused education.

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Section: Introductionmentioning

confidence: 99%

The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness

Kris-Etherton¹,

Akabas²,

Bales³

et al. 2014

The American Journal of Clinical Nutrition

204

177

View full text Add to dashboard Cite

show abstract

“…An initial examination of the ACA does highlight medical nutrition therapy for chronic diseases and employee wellness programs. However, it does not state that registered dietitians are essential providers of those services or credit dietitians as reimbursable practitioners across the healthcare spectrum 46 . It also does not allocate the funds for these proposed new programs.…”

Section: Future Directions For Nutrition Supportmentioning

confidence: 99%

State of Nutrition Support Teams

DeLegge

Kelley²

2013

Nut in Clin Prac

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The incidence of malnutrition in hospitalized patients is relatively high (up to 55%) despite breakthroughs in nutrition support therapies. These patients have increased morbidity and mortality, extended hospital stays, and care that is associated with higher costs. These patients are often poorly managed due to inadequate nutrition assessment and poor medical knowledge and practice in the field of nutrition. Nutrition support teams (NSTs) are interdisciplinary support teams with specialty training in nutrition that are often comprised of physicians, dietitians, nurses, and pharmacists. Their role includes nutrition assessment, determination of nutrition needs, recommendations for appropriate nutrition therapy, and management of nutrition support therapy. Studies have demonstrated significant improvements in patient nutrition status and improved clinical outcomes as well as reductions in costs when patients were appropriately managed by a multispecialty NST vs individual caregivers. Despite this, there has been steady decline in the number of formal NST in recent years (65% of hospitals in 1995 to 42% in 2008) as hospitals and other healthcare organizations look for ways to cut costs. Given the importance of nutrition status on clinical outcomes and overall healthcare costs, a number of institutions have introduced and sustained strong nutrition training and support programs and teams, demonstrating both clinical and economic benefit. The benefits of NST, training and implementation strategies, and tips for justifying these clinically and economically beneficial groups to healthcare organizations and governing bodies are discussed in this review.

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“…The 2010 Patient Protection and Affordable Care Act provides for coverage of obesity, physical activity, and dietary counseling, not just in the context of disease management but also to prevent chronic disease (Bleyer, 2010; Koh & Sebelius, 2010). For older adults, Medicare will now reimburse providers for an annual wellness visit including discussion of patient prevention plans (DeVille & Novick, 2011; Tuma, 2012). Unfortunately, providers often view this counseling as futile and many feel they lack the time to incorporate this additional level of counseling when addressing complex patients’ existing chronic health concerns (Sherman & Hershman, 1993; Walsh, Swangard, Davis, & McPhee, 1999).…”

mentioning

confidence: 99%

Older Patients’ Recall of Lifestyle Discussions in Primary Care

2016

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Despite the known benefits of engaging in healthy diet and physical activity across the life span, suboptimal diet and physical inactivity are pervasive among older adults. While health care providers can promote patients' engagement in health behaviors, patient recall of recommendations tends to be imperfect. This study sought to better understand older adults' recall of dietary and physical activity discussions in primary care. One hundred and fifteen adults aged 65 and older were interviewed immediately following a routine primary care visit on whether and what they recalled discussing pertaining to diet and physical activity. Compared against transcripts, most patients accurately recalled their diet and physical activity discussions. The inclusion of a recommendation, and for diet discussions longer duration, increased the likelihood of patient recall for these health behavior discussions. These findings suggest that specific recommendations and an extra minute of discussion, at least for dietary discussions, increase the likelihood of accurate patient recall.

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An Overview of the Intentions of Health Care Reform

Cited by 7 publications

References 2 publications

The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness

The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness

State of Nutrition Support Teams

Older Patients’ Recall of Lifestyle Discussions in Primary Care

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