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Journal of Ambulatory Care Management

Stephen C Schoenbaum
Increased life expectancy in the United States has been accompanied by a concomitant increase in the prevalence of chronic conditions in persons of all ages, especially older Americans. This necessitates new ways of organizing and conducting medical practice, and this affects the roles and interactions of health professionals. Physicians and other health professionals require appropriate training and more efficient workplaces to enhance their functioning and reduce burnout. Additional factors influencing the success of health professionals in further advancing the health and well-being of Americans are health information technology and ensuring that all have access to care...
July 2017: Journal of Ambulatory Care Management
E Lee Rosenthal, Durrell J Fox
No abstract text is available yet for this article.
July 2017: Journal of Ambulatory Care Management
Azeem Majeed, Sonia Kumar
No abstract text is available yet for this article.
July 2017: Journal of Ambulatory Care Management
Kate Lorig
No abstract text is available yet for this article.
July 2017: Journal of Ambulatory Care Management
J Nell Brownstein, Gail R Hirsch
No abstract text is available yet for this article.
July 2017: Journal of Ambulatory Care Management
Linda H Aiken, Karen B Lasater
No abstract text is available yet for this article.
July 2017: Journal of Ambulatory Care Management
Norbert Goldfield
During the forty-year life of the Journal of Ambulatory Care Management, revolutionary transformations have occurred in the roles of existing health professions, as has the emergence of new categories of health professionals. This paper specifies the reasons for these dramatic changes, the new types of health care professions that have emerged, changes in existing professions, and suggestions of future directions. Many of these changes will be impacted by what occurs in Washington, DC in the debate over the Accountable Care Act...
July 2017: Journal of Ambulatory Care Management
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Journal of Ambulatory Care Management
Howard Gardner
No abstract text is available yet for this article.
July 2017: Journal of Ambulatory Care Management
Ruth A Bush, Cynthia D Connelly, Alexa Pérez, Neilson Chan, Cynthia Kuelbs, George J Chiang
The patient portal, increasingly available to patients, allows secure electronic communication with physicians. Although physician attitude toward the portal plays a crucial role in patient adoption, little information regarding physician opinion of the portal is available, with almost no information gathered in the pediatric environment. Using a mixed-methods approach, physicians in a large pediatric medical facility and integrated delivery network were surveyed using an online quantitative questionnaire and structured interviews...
July 2017: Journal of Ambulatory Care Management
Patricia K Foo, Richard M Frankel, Thomas G McGuire, Alan M Zaslavsky, Jennifer Elston Lafata, Ming Tai-Seale
This study investigated racial differences in patient-physician communication around mental health versus biomedical issues. Data were collected from audiorecorded periodic health examinations of adults with mental health needs in the Detroit area (2007-2009). Patients and their primary care physicians conversed for twice as long, and physicians demonstrated greater empathy during mental health topics than during biomedical topics. This increase varied by patient and physician race. Patient race predicted physician empathy, but physician race predicted talk time...
July 2017: Journal of Ambulatory Care Management
Signe Peterson Flieger
This study evaluated the impact of a patient-centered medical home (PCMH) pilot on utilization, costs, and quality and assessed variation in PCMH components. Data included the New Hampshire Comprehensive Healthcare Information System and Medical Home Index (MHI) scores for 9 pilot sites. A quasi-experimental, difference-in-difference model with propensity score-matched comparison group was employed. MHI scores were collected in late 2011. There were no statistically significant findings for utilization, cost, or quality in the expected direction...
July 2017: Journal of Ambulatory Care Management
Kyle Knierim, Tristen Hall, Douglas Fernald, Thomas J Staff, Emilie Buscaj, Jessica Cornett Allen, Mary Onysko, W Perry Dickinson
Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology...
July 2017: Journal of Ambulatory Care Management
Greg P Marconi, Phung K Pham, Alan L Nager
Health care delivery expectations that may affect patient and caregiver satisfaction are not clearly understood. This study examined caregiver expectations and satisfaction with urgent care in a pediatric emergency department. Of 201 caregivers surveyed, we found that caregivers have specific expectations regarding clinical care of their child in terms of radiographic imaging, blood testing, antibiotics, pain management, and subspecialty consultation. Caregivers were generally less dissatisfied with the actual care provided than the urgent care physicians expected...
July 2017: Journal of Ambulatory Care Management
Connor W Norwood, Hannah L Maxey, Courtney Randolph, Laura Gano, Komal Kochhar
Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers...
July 2017: Journal of Ambulatory Care Management
Langs de Arantes Ferreira de Mello, Teresa Tonini, Alexandre Sousa da Silva, Steven Dutt-Ross, Luciane de Souza Velasque
To assess the quality of the primary health care network, the Ministry of Health created the Program for Improving Access and Quality in Primary Care (PMAQ), a national evaluation of family health teams. Thus, this study aims to present the geolocation of PMAQ 2012 quality indicators in the city of Rio de Janeiro. The PMAQ data show that, in the city of Rio de Janeiro, 65% of the teams achieved the performances "good" or "excellent," 34.7% "regular," and 0.3% "unsatisfactory." The results show a clear PMAQ polarization between teams units classified as optimal and regular in program areas 5 and 3, respectively...
April 2017: Journal of Ambulatory Care Management
Márcia Cristina Rodrigues Fausto, Aylene Bousquat, Juliana Gagno Lima, Ligia Giovanella, Patty Fidelis de Almeida, Maria Helena Magalhães de Mendonça, Helena Seidl, Andréa Tenório Correia da Silva
The objective of this study was to examine the experience of primary care center (PCC) users in Brazil, classified according to the quality of its structure, in relation to the aspects of accessibility, continuity, and acceptability. The source of information was the National Program to Improve Access and Quality of Primary Care in 2013-2014. A total of 109 919 interviewees in 24 055 PCCs comprised the sample. Results show that the structure of a PCC was associated with better indicators of accessibility (oral health and medicines) and continuity of care (patient navigation in the health system)...
April 2017: Journal of Ambulatory Care Management
Antônio Thomaz Gonzaga Matta-Machado, Ângela Maria L Dayrell de Lima, Daisy Maria Xavier de Abreu, Lucas Lobato Araújo, Délcio Fonseca Sobrinho, Érica Araújo Silva Lopes, Gabriel Henrique Silva Teixeira, Alaneir de Fátima Dos Santos
The use of information and communication technology (ICT) is on the increase in the health systems, representing a means of improving the quality of health care. This study analyzed the ICT incorporation in primary care in Brazil and identified the different aspects that may be associated with better quality in the care provided, in relation to certain aspects of women's care. We noted an unevenness regarding ICT incorporation in Brazil. However, the findings indicate an association between ICT and certain aspects of the quality provided in women's health care, which reinforces the need for further studies on this type of evaluation...
April 2017: Journal of Ambulatory Care Management
Matheus Neves, Jessye Melgarejo do Amaral Giordani, Alcindo Antônio Ferla, Fernando Neves Hugo
This cross-sectional study aimed to evaluate the association between sociodemographic characteristics, health care indicators, work process characteristics, and the performance of preventive dental procedures by oral health care teams (OHCTs) assessed during the first phase of the PMAQ in Brazil. A census of 10 334 primary OHCTs was conducted. The outcome included topical application of fluoride, application of sealants, detection of oral lesions, and monitoring of suspected or confirmed cases of oral cancer...
April 2017: Journal of Ambulatory Care Management
Thiago Augusto Hernandes Rocha, Núbia Cristina da Silva, Erika Bárbara Abreu Fonseca Thomaz, Rejane Christine de Sousa Queiroz, Marta Rovery de Souza, Adriana Lein, João Victor Muniz Rocha, Viviane Alvares, Dante Grapiuna de Almeida, Allan Claudius Queiroz Barbosa, Elaine Thumé, Catherine Staton, João Ricardo Nickenig Vissoci, Luiz Augusto Facchini
Cervical cancer is a common neoplasm that is responsible for nearly 230 000 deaths annually in Brazil. Despite this burden, cervical cancer is considered preventable with appropriate care. We conducted a longitudinal ecological study from 2002 to 2012 to examine the relationship between the delivery of preventive primary care and cervical cancer mortality rates in Brazil. Brazilian states and the federal district were the unit of analysis (N = 27). Results suggest that primary health care has contributed to reducing cervical cancer mortality rates in Brazil; however, the full potential of preventive care has yet to be realized...
April 2017: Journal of Ambulatory Care Management
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