A cadre of Johns Hopkins nurses are adapting a model for primary care that's been successful in Costa Rica. They will visit every household in a Baltimore community to assess health care and social needs at least once a year.
Nurses Lisa Stambolis and Ashley Gresh of the Neighborhood Nursing team talk with Percy Jones. Members of the nursing team visit his apartment building weekly, and Jones credits them with easing his worries about recovering from a hernia surgery when he couldn't get a timely appointment with his doctor.
“What's revolutionary,” Szanton says, “is that it’s for everybody” — whether they are sick or healthy, rich or poor, young or old, and no matter if they have private insurance, Medicare, Medicaid, or no insurance at all.The visits are free to the patient and prioritize each person’s unique goals, from managing chronic back pain to finding safer housing. They can take place in people’s homes, senior centers, libraries or even laundromats.
“There's both an incredible economic efficiency and effectiveness,” Bitton says of Costa Rica’s system, “and a deep humanity to it — a sense of reciprocal responsibility for every single person in the country.” In the U.S., specialty care comes with additional hurdles like the need to secure approvals from a person’s insurance plan for certain procedures or medications. People needing significant social support, such as help with affordable housing, can face
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