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Population Health Management

John J Stoeckle, Amy Cunningham, Dalea Al-Hawarri, Alexis Silverio, George Valko
Reporting primary care quality measures is an essential component of value-based care delivery and is part of the strategy to bend the health care cost curve. As primary care physicians are increasingly pressed for time, incorporating ancillary staff screening into pre-visit workflows can increase screening rates, but can pose a challenge in large practice settings. The objective was to improve screening rates for depression and falls risk at a large, urban primary care practice. Jefferson Family Medicine Associates is a practice in downtown Philadelphia that serves 35,000 patients and provides approximately 80,000 visits annually...
July 17, 2018: Population Health Management
Laura Ten Eyck, Stephanie MacLeod, Kevin Hawkins, Robyn Guimont, Stephen Hartley
Heart failure (HF) is currently among the most prevalent and costly chronic diseases among older adults, who are at increased risk because of other chronic conditions and the aging process. HF has a significant impact on the health care system, patient outcomes, and the unsustainable rising costs of care. The primary objectives were to: (1) determine cost savings differences in medical expenditures between engaged and non-engaged members referred to a HF management program; (2) examine differences in length of stay and time to first post-engagement acute inpatient admission; and (3) examine the impact of using a remote weight monitoring scale on medical expenditures and inpatient admissions...
July 3, 2018: Population Health Management
Francisco Soto Mas, Celia Iriart, Ronnie Pedroncelli, Douglas S Binder, Clifford R Qualls, Brittany Price
Understanding how unmet basic needs impact health care in patients with complex conditions is vital to improve health outcomes and reduce health care costs. The purpose of this observational study was to explore the association between health care and socioeconomic needs and health care utilization and disease management among patients with chronic conditions at an intensive, patient-centered, office-based program. The study used a cross-sectional design and a convenience sampling approach. Data were collected through a patient questionnaire and medical records...
July 3, 2018: Population Health Management
Albert Crawford, John McAna, Sonia Lee, William Dieter
The US health care system faces rising costs related to population aging, among other factors. One aspect of the high costs related to aging is Medicare outpatient therapy expenditures, which in 2010 totaled $5.642B for āˆ¼4.7 million beneficiaries. Given the magnitude of these costs and the need to maximize value, this study developed and tested a predictive model of outpatient therapy costs. Retrospective analysis was performed on electronic medical record data from October 31, 2014-September 30, 2016 for 15,468 Medicare cases treated by physical therapists associated with a large, national rehabilitation provider...
June 29, 2018: Population Health Management
Rebecca Berquist McKenzie, Lee Sanders, Jay Bhattacharya, M Kate Bundorf
The aim of this study was to assess: (1) the proportion of youth with special health care needs (YSHCN) with adequate transition preparation, (2) whether transition preparation differs by individual, condition-related and health care system-related factors, and (3) whether specific components of the medical home are associated with adequate transition preparation. The authors conducted a cross-sectional analysis of the 2009-2010 National Survey of Children with Special Health Care Needs, which surveyed a nationally representative sample of 17,114 parents of YSHCN ages 12 to 18 years...
June 29, 2018: Population Health Management
Noelle S Arroyo, Robert S White, Licia K Gaber-Baylis, Melvin La, Andrew D Fisher, Mahendranauth Samaru
Previous studies have addressed racial/ethnic and socioeconomic disparities in total knee arthroplasty (TKA) within the Medicare population. However, there is limited research examining these disparities across racial/ethnic and socioeconomic groups in the general population. This study used administrative data from the State Inpatient Databases from the Healthcare Cost and Utilization Project for the years 2007-2014 from California (2007-2011 only), Florida, New York, and Maryland (2012-2014 only). In all, 739,857 TKA readmission-eligible patients aged ā‰„8 years were included in the analysis...
June 29, 2018: Population Health Management
David H Smith, Maureen O'Keeffe Rosetti, David M Mosen, A Gabriela Rosales, Erin Keast, Nancy Perrin, Adrianne C Feldstein, Theodore R Levin, Elizabeth G Liles
Colorectal cancer (CRC) causes more than 50,000 deaths each year in the United States but early detection through screening yields survival gains; those diagnosed with early stage disease have a 5-year survival greater than 90%, compared to 12% for those diagnosed with late stage disease. Using data from a large integrated health system, this study evaluates the cost-effectiveness of fecal immunochemical testing (FIT), a common CRC screening tool. A probabilistic decision-analytic model was used to examine the costs and outcomes of positive test results from a 1-FIT regimen compared with a 2-FIT regimen...
June 21, 2018: Population Health Management
Joshua B Gruber, Weize Wang, Alexandra Quittner, Daria Salyakina, Jennifer McCafferty-Fernandez
Currently, Community Health Needs Assessment (CHNA) reports lack a standard structure, making it difficult to derive meaningful information. However, they have the potential to be a useful tool for analyzing pediatric outcomes, guiding resource allocation, and linking to Patient-Centered Outcomes Research Institute priorities. The objective was to evaluate the utility of CHNA for informing future pediatric, patient-centered outcomes research. The authors analyzed CHNA documents, published before July 1, 2016 by 61 nonprofit hospitals, focusing on 4 metropolitan areas in Florida: Miami, Orlando, Tampa, and Jacksonville...
June 19, 2018: Population Health Management
Emilia H De Marchis, Kirti Doekhie, Rachel Willard-Grace, J Nwando Olayiwola
Over the past decade, the Patient-Centered Medical Home (PCMH) has become a preeminent model for primary care delivery. Simultaneously, health care disparities have gained increasing attention. There has been limited research on whether and how the PCMH can or should affect health care disparities. The authors conducted qualitative interviews with key stakeholders and experts on the PCMH model and health care disparities, including grant and policy makers, accreditors, researchers, patient advocates, primary care practices, practice transformation organizations, and payers, to assess perspectives on the role of the PCMH in addressing health care disparities...
June 19, 2018: Population Health Management
Eric S Hall, Jennifer M McAllister, Scott L Wexelblatt
The objective was to compare diagnosis rates representing developmental outcomes and medical complications between infants with intrauterine opioid exposures who did not receive pharmacologic treatment for neonatal abstinence syndrome at the time of birth and infants for whom no exposure to substances of abuse were detected. This retrospective, descriptive study included approximately 95% of Hamilton County, Ohio resident births in 2014 and 2015. Universal maternal drug test results, performed at the time of birth, were documented and linked to electronic health records representing pediatric primary and subspecialty follow-up care as well as urgent care, emergency care, and inpatient services provided by Cincinnati Children's Hospital Medical Center through 2017, when all children were at least 24 months old...
June 12, 2018: Population Health Management
Shirley Musich, Shaohung S Wang, Kay Schwebke, Luke Slindee, Evonne Waters, Charlotte S Yeh
Secondary cardiovascular disease (CVD) clinical trials have demonstrated that higher intensity levels of statin therapy are more effective than lower levels in reducing mortality rates. Despite updated treatment guidelines, statin therapy may be underutilized, with evidence that females are treated less aggressively than males. The primary objective of this study was to determine the prevalence of statin utilization by varying therapy intensity by sex. The secondary objective was to document the benefits of statin therapy intensity levels on all-cause mortality for males and females...
June 12, 2018: Population Health Management
Alfred I Neugut, Sarah A MacLean, Wei F Dai, Judith S Jacobson
The guidelines provided by experts regarding various cancer screening tests are not universally accepted by physicians or patients. This systematic review describes the literature regarding the associations of physician characteristics with the implementation of and referral of patients for selected cancer screening tests. In October 2016, the authors conducted a thorough search of articles found in 4 databases, using keywords describing physician characteristics and cancer screening. English-language articles reporting on patient surveys or records of patients' screening history, and surveys of physicians' practices or opinions, in the United States were included...
June 11, 2018: Population Health Management
Amanda L Brewster, Suhna Lee, Leslie A Curry, Elizabeth H Bradley
Hospital readmissions remain frequent, and are partly attributable to patients' social needs. The authors sought to examine whether local community levels of social capital are associated with hospital readmission rates. Social capital refers to the connections among members of a society that foster norms of reciprocity and trust, which may influence the availability of support for postdischarge recovery after hospitalization. Associations between hospital-wide, risk-stratified readmission rates for hospitals in the United States (nā€‰=ā€‰4298) and levels of social capital in the hospitals' service areas were examined...
May 31, 2018: Population Health Management
Laura Tamasauskiene, Domantas Tamasauskas, Gintaras Zilinskas
No abstract text is available yet for this article.
May 31, 2018: Population Health Management
Jonathan Lichkus, Christina Wolf, Robin Hynds, Kerry Moorer, Derek Bourgoine, Nicole Garabedian, Pracha Eamranond
Safety net community hospitals face unique challenges when entering risk-based contracts. The financial viability of such programs in these settings has not been well studied. This study analyzed a bundled-payment program for congestive heart failure at one such facility. To assess financial performance, the authors calculated the net patient payment by quarter after bundle implementation, and also compared the leading cost drivers before and after bundle implementation, specifically the next site of care and readmission rate...
May 29, 2018: Population Health Management
Peter J Taub
No abstract text is available yet for this article.
May 29, 2018: Population Health Management
Sanne J Magnan, David A Kindig
No abstract text is available yet for this article.
May 18, 2018: Population Health Management
R Scott Braithwaite
No abstract text is available yet for this article.
May 14, 2018: Population Health Management
Lori T Armistead, Stefanie P Ferreri
No abstract text is available yet for this article.
May 14, 2018: Population Health Management
Susie Bergeron, Hilary Flint, Zeynep Hansen
Concussion, or mild traumatic brain injury, especially among young children, teenagers, and young adults, is a significant problem in Ada County, Idaho, and the United States. Although much has been learned about concussion, considerable controversy and gaps in knowledge still exist in many areas of research, leading to variation in concussion assessment, treatment, and management protocols. Health systems can positively impact concussion outcomes through community education and outreach, and provision of timely, coordinated, evidence-based clinical care...
May 14, 2018: Population Health Management
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