Palliative care: Dealing with the end

Despite years of change, African Americans feel ostracized from the medical care community that is dominated mainly by white people, especially when it comes to hospices. Some are trying to remove the stigma of hospice care as well as make health care systems more fair.

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.

Health insurance sign-ups made available to all inmates at the San Francisco county jail, partnered with guidance from a clinic once they are on the outside, allows them to receive better care upon release, and may help prevent a return to crime and substance abuse.

Hospitals in New York improve healthcare quality and reduce medical costs by staying in frequent contact with patients requiring frequent or long-term care. Montefiore's Accountable Care Organization pulls in care providers from across the medical and social spectrum to improve patient health while curbing expenses.

*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.

An investigation reveals a startling percentage of medical procedures provided in the United States are unnecessary or inappropriate - harming patients physically as well as financially. This "profit-maximizing medical culture" can be countered by incentivizing health care facilities to eliminate needless procedures, federal crackdowns, and increasing access to information for patients.

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.