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Caterina Hill, Khin-Kyemon Aung, Toyin Ajayi, Mika Cheng, Lauren Easton, Karen Derby, Jerome Genser, Bradley Keith, Peggy Johnson
No abstract text is available yet for this article.
August 8, 2017: Healthcare
Joe Feinglass, Celeste A Mallama, Angela Rogers, Caroline Teter, Courtney Hurt, Christine Schaeffer
BACKGROUND: This study evaluates the Northwestern Medicine Group Transitional Care clinic (NMG-TC), which transitions patients from an urban hospital to primary care at partner community clinics. We evaluate change over the 55 month study period in emergency department, observation or inpatient use within 90 days of an initial NMG-TC visit. METHODS: Electronic health records were used to determine patient demographic, insurance and clinical characteristics, including inflation-adjusted total hospital charges in the 90 days prior and the 90 days after an initial NMG-TC visit...
August 8, 2017: Healthcare
Kedar S Mate, Amy Berman, Mara Laderman, Andrea Kabcenell, Terry Fulmer
Safe and effective care of older adults is a crucial issue given the rapid growth of the aging demographic, many of whom have complex health and social needs. At the same time, the health care delivery environment is rapidly changing, offering a new set of opportunities to improve care of older adults. We describe the background, evidence-based changes, and testing, scale-up, and spread strategy that are part of the design of the Creating Age-Friendly Health Systems initiative. The goal is to reach 20% of U...
July 31, 2017: Healthcare
Edwin S Wong, Chuan-Fen Liu, Susan E Hernandez, Matthew R Augustine, Karin Nelson, Stephan D Fihn, Paul L Hebert
BACKGROUND: Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. METHODS: This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP)...
July 29, 2017: Healthcare
Gregory W Kurtzman, Megha A Keshav, Nikita P Satish, Mitesh S Patel
BACKGROUND: Digital platforms that allow patients to go online or use smartphone applications to view and schedule physician appointments have not been well evaluated. METHODS: We conducted systematic searches for primary care physician appointments in 20 cities using ZocDoc, an online appointment scheduling platform. Availability was determined for three insurance types (self-pay, Medicare, and Medicaid) in states with and without Medicaid expansion. We collected data on physician characteristics, number of appointments available, and distance to clinics...
July 27, 2017: Healthcare
Jennifer May, Nicole Kazee, Sheila Castillo, Neil Bahroos, Scott Kennedy, Amparo Castillo, William Frese, Monika Marko-Holguin, T J Crawford, Benjamin W Van Voorhees
No abstract text is available yet for this article.
July 21, 2017: Healthcare
Dean F Sittig, Elisabeth Belmont, Hardeep Singh
In 2011, an Institute of Medicine report on health information technology (IT) and patient safety highlighted that building health-IT for safer use is a shared responsibility between key stakeholders including: "vendors, care providers, healthcare organizations, health-IT departments, and public and private agencies". Use of electronic health records (EHRs) involves all these stakeholders, but they often have conflicting priorities and requirements. Since 2011, the concept of shared responsibility has gained little traction and EHR developers and users continue to attribute the substantial, long list of problems to each other...
July 14, 2017: Healthcare
Karen M Goldstein, Dawne Vogt, Alison Hamilton, Susan M Frayne, Jennifer Gierisch, Jill Blakeney, Anne Sadler, Bevanne M Bean-Mayberry, Diane Carney, Brooke DiLeone, Annie B Fox, Ruth Klap, Ellen Yee, Yasmin Romodan, Holly Strehlow, Julia Yosef, Elizabeth M Yano
No abstract text is available yet for this article.
July 12, 2017: Healthcare
Karleen F Giannitrapani, Sangeeta C Ahluwalia, R Thomas Day, Maura Pisciotta, Steven Dobscha, Karl Lorenz
No abstract text is available yet for this article.
July 12, 2017: Healthcare
Charlie M Wray, Vineet M Arora, Donald Hedeker, David O Meltzer
BACKGROUND: Inpatient service handoffs are a vulnerable transition during a patients' hospitalization. We hypothesized that performing the service handoff at the patients' bedside may be one mechanism to more efficiently transfer patient information between physicians, while further integrating the patient into their hospital care. METHODS: We performed a 6-month prospective study of performing a bedside handoff (BHO) at the service transition on a non-teaching hospitalist service...
July 5, 2017: Healthcare
Jennifer M Polinski, Sandra L Harmon, Kimberly J Henderson, Tobias Barker, Andrew Sussman, Nancy J Gagliano
In light of increasing antibiotic resistance and a slowed antibiotic development pipeline, stewardship is more urgent than ever. To date, most stewardship guidelines and best practice recommendations for implementation focus on local or regional health care organizations. CVS MinuteClinic has implemented a consistent, evidence-based stewardship approach in its >1100 clinics in 33 states. The approach is associated with higher quality antibiotic use than that in primary care practices and emergency departments...
July 4, 2017: Healthcare
Winston Liaw, Andrew W Bazemore, Robert L Phillips
No abstract text is available yet for this article.
June 29, 2017: Healthcare
Gabriel G Malseptic, Lauren H Melby, Kathleen A Connolly
Massachusetts' community hospitals face the challenge of achieving accountable care readiness with fewer financial and operational resources and a higher share of publicly-insured patients than their academic medical center counterparts. They are thus doubly constrained to make the investments necessary to perform in a value-based payment environment. Hallmark Health System and Lowell General Hospital are among 25 community hospital awardees engaged with the Massachusetts Health Policy Commission's Community Hospital Acceleration, Revitalization, and Transformation (CHART) investment program to implement clinical transformation programs to reduce unnecessary hospital utilization; enhance care for individuals with social, behavioral, and medical complexity; and improve post-acute community-based care, as means to advance accountable care readiness...
June 28, 2017: Healthcare
Andrew J Knighton, Lucy A Savitz, Jose Benuzillo, James A VanDerslice
BACKGROUND: Local social determinants may act as effect modifiers for the impact of neighborhood material deprivation on patient-level healthcare outcomes. The objective of this study was to understand the mediating effect of local social determinants on neighborhood material deprivation and delivery outcomes in heart failure (HF) patients. MATERIAL AND METHODS: A retrospective cohort study was conducted using 4737 HF patients receiving inpatient care (n=6065 encounters) from an integrated healthcare delivery system from 2010 to 2014...
June 24, 2017: Healthcare
Brian W Powers, Farzad Mostashari, Emily Maxson, Kimberly Lynch, Amol S Navathe
No abstract text is available yet for this article.
June 23, 2017: Healthcare
Katherine Shea Barrett, Katherine L Record, Vivian Haime
Addressing healthcare costs requires incenting providers to address both physical and behavioral health conditions, as well as social determinants of health. The most complex, and expensive, patients are often those with comorbid mental illness and/or addiction, who are at higher risk for exposure to violence, food insecurity, unstable housing and other adversities that negatively affect health. Yet today's value-based payment models and associated quality measures do not incent providers to address patients' behavioral and social needs...
June 22, 2017: Healthcare
Rachel Davis, Stephen A Somers
The Complex Care Innovation Lab convenes 15 organizations from across the country that are innovators in health care delivery for low-income populations with complex needs. These organizations have identified several elements that are core to successful complex care programs, including: (1) incorporating patient-centered approaches to care; (2) utilizing a non-traditional workforce; (3) employing data-driven strategies; and (4) leveraging flexible payment models that assign accountability to providers and facilitate interventions to integrate health and social services...
June 22, 2017: Healthcare
Jose F Figueroa, Austin B Frakt, Zoe M Lyon, Xiner Zhou, Ashish K Jha
BACKGROUND: Given that health care costs in Massachusetts continue to grow despite great efforts to contain them, we seek to understand characteristics and spending patterns of the costliest non-elderly adults in Massachusetts based on type of insurance. METHODS: We used the Massachusetts All-Payer Claims Database (APCD) from 2012 and analyzed demographics, utilization patterns and spending patterns across payers (Medicaid, Medicaid managed care, and private insurers) for high cost patients (those in the top 10% of spending) and non-high cost patients (the remaining 90%)...
June 21, 2017: Healthcare
Brandi Leach, Margaret Gradison, Perri Morgan, Christine Everett, Michael J Dill, Justine Strand de Oliveira
BACKGROUND: Given the growing roles of nurse practitioners (NPs) and physician assistants (PAs), patients are increasingly able to choose their primary care provider type. Studies examining patient preferences among provider types are limited and ours is the first to examine reasons for patients' provider type preferences. METHODS: Using data from the 2014 Association of American Medical Colleges' (AAMC) Consumer Survey of Health Care Access, we used qualitative analysis to identify themes in open text responses of reasons for respondents' provider type preference (N = 4220)...
June 9, 2017: Healthcare
Kyle Morawski, Jennifer Childs-Roshak, Alan Weitberg
No abstract text is available yet for this article.
May 16, 2017: Healthcare
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