Too drastic a shift in favour of access is likely to be at the cost of reduced continuity and a diminution of other services, such as screening and chronic disease management.
Are there any specific concerns about generalist palliative care in your area relating to: Knowledge and expertise Working with other agencies Availability of specialist support Care homes Cost effectiveness Continuity of care including out of hours care?
Inexorable increases in costs of care, the imperative of continuity of care, and the emergence of the Medical Home model appear to be sufficient justification for re-assessing the appropriate relative roles of primary care and specialist physicians.
Notice that any c-concave function shares the same modulus of continuity of the cost c.
With the low base-case PWID treatment rates, the continuity required for DBS to be cost-effective was approximately 35 40% of the estimated treatment/referral rates, but if the treatment/referral rates increased, then lower levels of continuity would be cost-effective.
By contrast, the Western adversarial system of competitive elections divides the body politic against itself at the cost of consensus and long-term continuity in governance.
Reasons for this included issues of cost, consistency, informational continuity, prescription duration, quality, trust, access to specialists and allied health professionals (in-house referrals) and access to tests and investigations.
The policy is, however, controversial because of fears about fragmentation, loss of continuity of care and increased costs.
All patient statements were broken down to single items and sorted by major domains, as used by the QUOTE-IBD study group (accessibility, costs, accommodation, continuity of care, courtesy, information, competence, patient autonomy) [ 25] adding auxiliary categories as needed (special situations in the young, therapy related issues, hospital care and rehabilitation).
