A Paradigm Shift in Catholic Health Care: An Evaluation of a Community-Based Program for Homeless People
Rising costs in the U.S. health care industry have prompted a "paradigm shift" among health care systems from acute, diseased-focused care to community-based, population-focused care. Central to this shift is the formation of integrated systems of care that redefine the traditional boundaries that delineate agencies. Community health partnerships of various community agencies reflect this move towards integrated systems as they strategically restructure their respective organizations to collaborate more effectively in providing community-based, population-focused care. Catholic health systems are similarly engaged in shifting to community-based, population-focused care. By forming partnerships with other agencies, Catholic health systems are attempting to fulfill their mission of addressing the health needs of the community, especially those who are most vulnerable. They are also attempting to contain health costs that can be driven by community health issues. This project was an evaluation of the first six months of a collaborative venture between a Catholic health system and other community partners to address the health concerns of the homeless population in Tucson, Arizona. The collaborative purchased a mobile van to provide primary care to homeless individuals and to facilitate a continuum of care for them. The project used descriptive statistics to evaluate two short-term outcomes--the van's outreach to vulnerable homeless adults and the integration of services it provided for them. Due to gaps in data collection, results showing the effectiveness of the van for the two outcomes were inconclusive. The difficulties encountered in the initial months of the van's operation, however, confirmed the experience of other collaborative ventures found in the literature. The van's experience also affirmed the need for establishing strong processes within the partnership that promote the integration of agency resources. The available data revealed the characteristics of those whom the van did serve and the possibilities for expanding the van's outreach. The implication for Catholic health care is that creating healthy communities is a way of re-imagining its future. The project also points toward the need for nursing leaders who can effectively lead community partnerships, collaborating with Catholic health systems to develop new models for promoting population health.
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