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Journal of Primary Care & Community Health

Lisa A Mueller, Alexa Sevin Valentino, Aaron D Clark, Junan Li
OBJECTIVES: The primary objective of this study was to determine the effect of a pharmacist-provided spirometry service within a federally qualified health center on the percentage of spirometry referrals completed with results reviewed by the ordering provider. Secondary objectives evaluated differences between internal and external referrals, medication recommendations made by the pharmacist, and revenue brought in by the service. METHODS: Chart reviews were completed to determine the referral completion rates between patients who received a spirometry referral before (December 2014-September 2015) and after (January 2016-October 2016) the implementation of the pharmacy-provided spirometry service...
January 2018: Journal of Primary Care & Community Health
Roxane Borgès Da Silva, Isabelle Brault, Raynald Pineault, Maud-Christine Chouinard, Alexandre Prud'homme, Danielle D'Amour
PURPOSE: Nurses are identified as a key provider in the management of patients in primary care. The objective of this study was to evaluate patients' experience of care in primary care as it pertained to the nursing role. The aim was to test the hypothesis that, in primary health care organizations (PHCOs) where patients are systematically followed by a nurse, and where nursing competencies are therefore optimally used, patients' experience of care is better. METHOD: Based on a cross-sectional analysis combining organizational and experience of care surveys, we built 2 groups of PHCOs...
January 2018: Journal of Primary Care & Community Health
Heidi S Kinsell, Allyson G Hall, Jeffrey S Harman, Sweta Tewary, Andrew Brickman
OBJECTIVE: Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida...
November 1, 2017: Journal of Primary Care & Community Health
Alice Yuen Loke, Miu Ling Kwan, Yuen-Ting Wong, Alice Kar Yan Wong
BACKGROUND: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. METHODS: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination...
November 1, 2017: Journal of Primary Care & Community Health
Ronald Dwinnells, Lauren Misik
Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99...
November 1, 2017: Journal of Primary Care & Community Health
Elizabeth M Vaughan, Craig A Johnston, David J Hyman, Daphne C Hernandez, Vagish Hemmige, John P Foreyt
BACKGROUND: There are variable recommendations regarding initiating monotherapy or dual therapy in patients with newly diagnosed type 2 diabetes (T2D). Clear initial strategies are of particular importance in underserved settings where access to care and financial burdens are significant barriers. OBJECTIVES: To provide descriptive data of metabolic outcomes to therapy regimens for low-income individuals with newly diagnosed T2D placed on oral hypoglycemic agents (OAs)...
October 2017: Journal of Primary Care & Community Health
Fabian Camacho, Nengliang Aaron Yao, Roger Anderson
INTRODUCTION: Under the American Affordable Care Act, Medicare insurance beneficiaries receive free Annual Wellness Visits (AWV); there is a need to examine the effectiveness of these visits. The purpose of this study is to examine their impact on subsequent screening rates. METHODS: Using 2011-2014 Medicare FFS (fee-for-service) claims data, seven preventive care services, including vaccinations and cancer screenings were compared among beneficiaries who received and did not receive AWVs...
October 1, 2017: Journal of Primary Care & Community Health
Ying Xue, James S Goodwin, Deepak Adhikari, Mukaila A Raji, Yong-Fang Kuo
OBJECTIVES: To document the temporal trends in alternative primary care models in which physicians, nurse practitioners (NPs), or physician assistants (PAs) engaged in care provision to the elderly, and examine the role of these models in serving elders with multiple chronic conditions and those residing in rural and health professional shortage areas (HPSAs). DESIGN: Serial cross-sectional analysis of Medicare claims data for years 2008, 2011, and 2014. SETTING: Primary care outpatient setting...
October 1, 2017: Journal of Primary Care & Community Health
Tamar Adar, Inbar Levkovich, Orit Cohen Castel, Khaled Karkabi
BACKGROUND: Data on patients' utilization of health services in primary care is relevant to planning healthcare. Data may be collected by numerous methods, but obtaining a true picture of content of care has practical difficulties. OBJECTIVES: To describe patient's reasons for visits to primary care physicians (PCPs) as presented by the patient; and to examine the effect of patient-, doctor- and clinic-related variables on the reasons for the visit. METHODS: Visits to PCPs were observed by peer doctors during 2014, at primary care clinics in Israel...
October 1, 2017: Journal of Primary Care & Community Health
Elina Tolvanen, Tuomas H Koskela, Mika Helminen, Elise Kosunen
BACKGROUND: Patient enablement is described as patient's ability to understand and cope with illness after a consultation. The purpose of this study was to analyze factors associated with enablement in Finnish primary health care. An additional aim was to evaluate whether a single question could be used to measure enablement. METHODS: A questionnaire survey was addressed to Finnish general practitioners (GPs) within the Quality and Costs of Primary Care in Europe (QUALICOPC) study framework...
October 2017: Journal of Primary Care & Community Health
Chanita Hughes Halbert, Melanie Jefferson, Cathy L Melvin, LaShanta Rice, Kemi M Chukwuka
OBJECTIVE: Primary care providers play an important role in obesity prevention and reduction by advising patients about weight loss strategies. This study examined receipt of provider advice to lose weight among primary care patients who were overweight and obese. METHODS: Observational study conducted among primary care patients (n = 282) who completed a survey that measured receipt of provider advice about weight loss/management, chronic health conditions, perceived weight status, and perceptions about shared decision making about weight loss/management...
October 2017: Journal of Primary Care & Community Health
Margaret M Paul, Stephanie L Albert, Tod Mijanovich, Sarah C Shih, Carolyn A Berry
BACKGROUND: The Primary Care Information Project (PCIP) is a program administered by the New York City Department of Health and Mental Hygiene to help primary care providers adopt a fully functional electronic health record (EHR) and focus on population health. PCIP also offers practices assistance with the National Committee for Quality Assurance (NCQA) patient-centered medical home (PCMH) recognition application. The objectives of this study were to assess the presence of key dimensions of PCMH among PCIP practices with 5 or fewer providers and to determine whether and to what extent NCQA recognition was related to the presence of these dimensions...
October 2017: Journal of Primary Care & Community Health
Brian A Lynch, Lila J Finney Rutten, Jon O Ebbert, Seema Kumar, Barbara P Yawn, Debra Jacobson, Jennifer St Sauver
The prevalence of childhood obesity has increased over the past 3 decades. This study was designed to understand how childhood body mass index (BMI) influences later risk of obesity. We calculated BMIs for children residing in Olmsted County, Minnesota, between January 1, 2005 and December 31, 2012 using medical records data. We defined homogenous BMI trajectory clusters using a nonparametric hill-climbing algorithm. Overall, 16,538 (47%) children had >3 weight assessments at least 1 year apart and were included in the analyses...
October 2017: Journal of Primary Care & Community Health
Andrea J Hoopes, Samantha K Benson, Heather B Howard, Diane M Morrison, Linda K Ko, Taraneh Shafii
BACKGROUND: Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. METHODS: Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews...
September 1, 2017: Journal of Primary Care & Community Health
(no author information available yet)
Agee, M. D., & Gates, Z. (2014). The Impact of an Insurance Administration-Free Primary Care Office on Hospital Admissions: A Community-Level Comparison With Traditional Fee-for-Service Family Practice Groups. Journal of Primary Care & Community Health, 5, 202-207. doi: 10.1177/2150131914522123 The following Conflict of Interest statement was originally omitted and will be added to the article: Author Zane Gates's affiliation, UPMC Altoona, is the parent organization of Partnering for Health Services. Additionally, author Zane Gates has an ownership interest in the Empower(3) Center for Health, a direct-pay primary care clinic using a subscription coverage model, that additionally provides insurance counseling and prescription programs...
September 1, 2017: Journal of Primary Care & Community Health
Kimberly R Enard, Deborah M Ganelin
BACKGROUND: An underlying assumption of strategies intended to promote appropriate primary care over emergency department (ED) use for ongoing health care needs is that patients will understand the "value proposition" of primary care: that they will receive specific benefits from primary care providers over and above what they receive from EDs. However, there is evidence that this value proposition may be unclear to safety-net patients. The goals of this study are to describe factors motivating ED use for low-acuity conditions; describe similarities and differences in usual source of care (USOC) experiences, by ED versus non-ED setting; and assess awareness and perceptions of the patient-centered medical home (PCMH) concept among safety-net patients...
July 1, 2017: Journal of Primary Care & Community Health
Robert Rick, Robert E Hoye, Raymond W Thron, Vibha Kumar
INTRODUCTION: For several decades, the Minneapolis American Indian population has experienced limited health care access and threefold diabetes health disparity. As part of an urban health initiative, the marketplace clinics located in nearby CVS, Target, and Supervalu stores committed financial support, providers, certified educators, and pharmacy staff for a community-based diabetes support group. OBJECTIVES: To measure the extent to which collaborating marketplace clinics and the community-based support group expanded diabetes care and provided self-management education for this largely urban Indian neighborhood...
July 1, 2017: Journal of Primary Care & Community Health
Nicholas C Arpey, Anne H Gaglioti, Marcy E Rosenbaum
INTRODUCTION: Clinician perceptions of patients with low socioeconomic status (SES) have been shown to affect clinical decision making and health care delivery in this group. However, it is unknown how and if low SES patients perceive clinician bias might affect their health care. METHODS: In-depth interviews with 80 enrollees in a state Medicaid program were analyzed to identify recurrent themes in their perceptions of care. RESULTS: Most subjects perceived that their SES affected their health care...
July 2017: Journal of Primary Care & Community Health
Abdulbari Bener, Funda Çatan, Hanadi R El Ayoubi, Ahmet Acar, Wanis H Ibrahim
BACKGROUND: The Gail model is the most widely used breast cancer risk assessment tool. An accurate assessment of individual's breast cancer risk is very important for prevention of the disease and for the health care providers to make decision on taking chemoprevention for high-risk women in clinical practice in Qatar. AIM: To assess the breast cancer risk among Arab women population in Qatar using the Gail model and provide a global comparison of risk assessment...
July 2017: Journal of Primary Care & Community Health
Jane W Seymour, Daniel E Polsky, Elizabeth J Brown, Corentin M Barbu, David Grande
INTRODUCTION: Racial minorities are more likely to live in primary care shortage areas. We sought to understand community health centers' (CHCs) role in reducing disparities. METHODS: We surveyed all primary care practices in an urban area, identified low access areas, and examined how CHCs influence spatial accessibility. RESULTS: Census tracts with higher rates of public insurance (≥40% vs <10%, odds ratio [OR] = 31.06, P < .001; 30-39% vs 10%, OR = 7...
July 2017: Journal of Primary Care & Community Health
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