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https://www.readbyqxmd.com/read/29785703/a-cross-sectional-study-evaluating-the-use-of-free-clinics-in-syracuse-ny-patient-demographics-and-barriers-to-accessing-healthcare-in-traditional-settings
#1
Simone Arvisais-Anhalt, Matthew MacDougall, Michael Rosenthal, Peter Congelosi, Daniel F Farrell, Paula Rosenbaum
Free clinics provide healthcare to underserved patient populations, playing a critical role in the medical safety-net. Syracuse, New York has notable racial, socioeconomic, and educational disparities and is home to four free clinics. Little is known about these clinics' patient population. This study attempts to better define this population and the barriers they face accessing traditional care. We developed a 27-question survey investigating patient demographics, barriers to traditional healthcare, and experience at local free clinics...
May 21, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29778258/new-treatments-have-changed-the-game-hepatitis-c-treatment-in-primary-care
#2
REVIEW
Shelley N Facente, Katie Burk, Kelly Eagen, Elise S Mara, Aaron A Smith, Colleen S Lynch
In the pre-direct-acting antiviral era, hepatitis C virus (HCV) treatments were complex and largely managed by hepatologists, gastroenterologists, and infectious disease physicians. As direct-acting antivirals have driven up demand for treatment, the relative scarcity of these specialists has created a bottleneck effect, resulting in only a fraction of HCV-infected individuals offered treatment. The San Francisco Health Network is a safety net system of care. Its intervention was designed to be sustainable and scalable; with minimal time commitments for training providers, primary care-based HCV treatment increased 3-fold in a period of just over 3 years...
June 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29777334/patient-engagement-in-community-health-center-leadership-how-does-it-happen
#3
Anjana E Sharma, Beatrice Huang, Margae Knox, Rachel Willard-Grace, Michael B Potter
Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs...
May 18, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29766260/supportive-care-priorities-of-low-income-latina-breast-cancer-survivors
#4
Alix G Sleight, Kathleen Doyle Lyons, Cheryl Vigen, Heather Macdonald, Florence Clark
PURPOSE: This study investigated the supportive care needs of a sample of low-income Latina breast cancer survivors. METHODS: Ninety-nine Spanish-speaking breast cancer survivors who self-identified as Latina and reported an income below the US Census Bureau low-income threshold were recruited from the oncology clinic of a major public safety net hospital. Eligible participants completed the supportive care needs survey (SCNS-SF34) and a demographic questionnaire...
May 16, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29766134/protocol-for-a-randomized-trial-of-the-effect-of-timing-of-cholecystectomy-during-initial-admission-for-predicted-mild-gallstone-pancreatitis-at-a-safety-net-hospital
#5
Krislynn M Mueck, Shuyan Wei, Mike K Liang, Tien C Ko, Jon E Tyson, Lillian S Kao
Background: There is evidence-based consensus for laparoscopic cholecystectomy during index admission for predicted mild gallstone pancreatitis, defined by the absence of organ failure and of local or systemic complications. However, the optimal timing for surgery within that admission is controversial. Early cholecystectomy may shorten hospital length of stay (LOS) and increase patient satisfaction. Alternatively, it may increase operative difficulty and complications resulting in readmissions...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29762164/cervical-cancer-screening-among-hiv-infected-women-in-an-urban-u-s-safety-net-healthcare-system
#6
Arti Barnes, Andrea C Betts, Eric K Borton, Joanne M Sanders, Sandi L Pruitt, Claudia Werner, Andres Bran, Carolee D Estelle, Bijal A Balasubramanian, Stephen J Inrig, Ethan A Halm, Celette Sugg Skinner, Jasmin A Tiro
OBJECTIVE: Little is known about cervical cancer screening and results patterns among HIV infected (HIV+) women in real-world healthcare settings. We characterized two periods of screening opportunity. DESIGN: Retrospective cohort. SETTING: U.S. safety-net healthcare system in Dallas County, Texas. SUBJECTS: We analyzed data from electronic medical records (EMR) of 1,490 HIV+ women receiving care 2010-2014. MAIN OUTCOME MEASURES: At baseline, we categorized a woman's Pap status 15 months prior to index date as under-screened (vs...
May 11, 2018: AIDS
https://www.readbyqxmd.com/read/29759013/adapting-to-a-shifting-health-care-landscape-illinois-breast-and-cervical-cancer-program-lead-agencies-perspectives
#7
Yamile Molina, Cindy San Miguel, Stephanie Sanz, Liliana San Miguel, Kristin Rankin, Arden Handler
Understanding how safety net programs adapt to systemic health care changes is pivotal for creating feasible recommendations for policy implementation. This study characterizes perspectives of Lead Agency (LA) coordinators of the Illinois Breast and Cervical Cancer Program (IBCCP) in response to sociopolitical changes at state and national levels. Our cross-sectional study included 29 semistructured telephone interviews between December 2015 and January 2016. Respondents indicated some changes in the priority population served, changes in referrals and clinical services, and, a continued commitment to IBCCP...
May 1, 2018: Health Promotion Practice
https://www.readbyqxmd.com/read/29753353/cost-effectiveness-of-a-technology-facilitated-depression-care-management-adoption-model-in-safety-net-primary-care-patients-with-type-2-diabetes
#8
Joel W Hay, Pey-Jiuan Lee, Haomiao Jin, Jeffrey J Guterman, Sandra Gross-Schulman, Kathleen Ell, Shinyi Wu
BACKGROUND: The Diabetes-Depression Care-Management Adoption Trial is a translational study of safety-net primary care predominantly Hispanic/Latino patients with type 2 diabetes in collaboration with the Los Angeles County Department of Health Services. OBJECTIVES: To evaluate the cost-effectiveness of an information and communication technology (ICT)-facilitated depression care management program. METHODS: Cost-effectiveness of the ICT-facilitated care (TC) delivery model was evaluated relative to a usual care (UC) and a supported care (SC) model...
May 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29748126/feeding-the-gut-after-revisional-bariatric-surgery-the-fate-of-126-enteral-access-tubes
#9
Andrew T Strong, Hana Fayazzadeh, Gautam Sharma, Kevin El-Hayek, Matthew Kroh, John Rodriguez
BACKGROUND: Revisional bariatric surgery (RBS) is associated with higher complication rates compared with primary bariatric surgery. Feeding tubes (FTs), including gastrostomy and jejunostomy tubes placed during RBS, may serve as a safety net to provide nutrition when oral intake is contraindicated or limited; however, FTs in this setting have not been well investigated. OBJECTIVES: This study aims to determine complications, use, and duration of FTs placed during RBS...
March 9, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29741765/advance-care-planning-for-older-homeless-experienced-adults-results-from-the-health-outcomes-of-people-experiencing-homelessness-in-older-middle-age-study
#10
Rebecca L Sudore, Isabel Arellano Cuervo, Lina Tieu, David Guzman, Lauren M Kaplan, Margot Kushel
Older homeless-experienced adults have low engagement in advance care planning (ACP) despite high morbidity and mortality. We conducted a cross-sectional analysis of a cohort of 350 homeless-experienced adults aged 50 and older in Oakland, California. We assessed the prevalence of potential surrogate decision-makers, ACP contemplation, discussions, and ACP documentation (surrogate designation, advance directives). We used multivariable logistic regression to examine factors associated with ACP discussions and documentation...
May 9, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29739779/gps-understanding-and-practice-of-safety-netting-for-potential-cancer-presentations-a-qualitative-study-in-primary-care
#11
Julie Evans, Sue Ziebland, John I MacArtney, Clare R Bankhead, Peter W Rose, Brian D Nicholson
BACKGROUND: Safety netting is a diagnostic strategy used in UK primary care to ensure patients are monitored until their symptoms or signs are explained. Despite being recommended in cancer diagnosis guidelines, little evidence exists about which components are effective and feasible in modern-day primary care. AIM: To understand the reality of safety netting for cancer in contemporary primary care. DESIGN AND SETTING: A qualitative study of GPs in Oxfordshire primary care...
May 8, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29735789/direct-acting-antivirals-improve-hcv-treatment-initiation-and-adherence-among-underserved-african-americans
#12
Kendall R Beck, Nicole J Kim, Mandana Khalili
INTRODUCTION: Adherence to hepatitis C (HCV) care was suboptimal in the interferon era among underserved African Americans (AA), but adherence data in the era of direct acting antivirals (DAA) is lacking in this population. We aimed to evaluate the impact of DAA on HCV care in underserved AA. MATERIAL AND METHODS: Clinical records of AAs undergoing HCV evaluation attending a safety net health system liver clinic were reviewed from 2006 to 2011 (pre-DAA), and January 1, 2014 to December 31, 2016 (post-DAA)...
April 9, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/29735477/finding-meaning-in-medication-reconciliation-using-electronic-health-records-qualitative-analysis-in-safety-net-primary-and-specialty-care
#13
George Yaccoub Matta, Elaine C Khoong, Courtney R Lyles, Dean Schillinger, Neda Ratanawongsa
BACKGROUND: Safety net health systems face barriers to effective ambulatory medication reconciliation for vulnerable populations. Although some electronic health record (EHR) systems offer safety advantages, EHR use may affect the quality of patient-provider communication. OBJECTIVE: This mixed-methods observational study aimed to develop a conceptual framework of how clinicians balance the demands and risks of EHR and communication tasks during medication reconciliation discussions in a safety net system...
May 7, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29734277/shifts-in-medicaid-and-uninsured-payer-mix-at-safety-net-and-non-safety-net-hospitals-during-the-great-recession
#14
Kathryn R Fingar, Rosanna M Coffey, Andrew W Mulcahy, Roxanne M Andrews, Carol Stocks
There has been ongoing concern regarding the viability of safety-net hospitals (SNHs), which care for vulnerable populations. The authors examined payer mix at SNHs and non-SNHs during a period covering the Great Recession using data from the 2006 to 2012 Healthcare Cost and Utilization Project State Inpatient Databases from 38 states. The number of privately insured stays decreased at both SNHs and non-SNHs. Non-SNHs increasingly served Medicaid-enrolled and uninsured patients; in SNHs, the number of Medicaid stays decreased and uninsured stays remained stable...
May 2018: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29732922/patient-perspectives-on-a-text-messaging-program-to-support-asthma-management-a-qualitative-study
#15
Reina Doyle, Karen Albright, Laura P Hurley, Catia Chávez, Melanie Stowell, Suzanne Dircksen, Edward P Havranek, Mark Anderson
INTRODUCTION: This study investigated participants' acceptance of a short messaging service (SMS) intervention designed to support asthma management, including suggestions regarding program delivery and message content. METHODS: Individual and group interviews were conducted with patients from a safety-net health care system in Denver, Colorado. Eligible participants were English or Spanish speakers between the ages of 13 and 40 years, with diagnosed persistent asthma...
May 1, 2018: Health Promotion Practice
https://www.readbyqxmd.com/read/29728349/-the-doctor-needs-to-know-acceptability-of-smartphone-location-tracking-for-care-coordination
#16
David T Liss, Eloisa Serrano, Julie Wakeman, Christine Nowicki, David R Buchanan, Ana Cesan, Tiffany Brown
BACKGROUND: Care coordination can be highly challenging to carry out. When care is fragmented across health systems and providers, there is an increased likelihood of hospital readmissions and wasteful health care spending. During and after care transitions, smartphones have the potential to bolster information transfer and care coordination. However, little research has examined patients' perceptions of using smartphones to coordinate care. OBJECTIVE: This study's primary objective was to explore patient acceptability of a smartphone app that could facilitate care coordination in a safety net setting...
May 4, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29728318/non-vitamin-k-dependent-oral-anticoagulants-for-nonvalvular-atrial-fibrillation-in-patients-with-ckd-pragmatic-considerations-for-the-clinician
#17
Gautam R Shroff, Rachel Stoecker, Allyson Hart
Management of atrial fibrillation (AF) in patients with advanced chronic kidney disease (CKD) poses a complex conundrum because of higher risks for both thromboembolic and bleeding complications compared to the general population. This makes it particularly important for clinicians to carefully weigh the risks versus benefits of anticoagulation therapy to determine the individualized net clinical benefit for every patient. During the past few years, 4 non-vitamin K-dependent oral anticoagulant (NOAC) agents have supplemented warfarin in the therapeutic armamentarium for the prevention of systemic thromboembolism in nonvalvular AF...
May 2, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29724207/next-of-kin-involvement-in-improving-hospital-cancer-care-quality-and-safety-a-qualitative-cross-case-study-as-basis-for-theory-development
#18
Inger Johanne Bergerød, Bjørnar Gilje, Geir S Braut, Siri Wiig
BACKGROUND: Next-of-kin are an extension of healthcare professionals in all stages of cancer care. They offer care activities such as interpretations of symptoms, and reporting of negative or adverse effects of treatment, without any professional knowledge or skills. Their participation is often expected from healthcare professionals, managers, or the patient. However, there is limited knowledge of next-of-kin's role in and contribution to quality and safety improvement in hospital cancer care...
May 3, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29720913/effects-of-methadone-on-corrected-q-t-interval-prolongation-in-critically-ill-children
#19
Travis S Heath, Rachel G Greenberg, Susan R Hupp, David A Turner, Christoph P Hornik, Kanecia O Zimmerman
OBJECTIVES: This study aimed to determine the association between methadone use and corrected Q-T interval (QTc) prolongation in critically ill children. METHODS: A retrospective cohort study of critically ill children receiving methadone at a tertiary care pediatric hospital was conducted. Patients younger than 19 years who had been admitted to the intensive care unit between January 1, 2009, and June 21, 2013, who had received methadone while inpatients, and who had had electrocardiograms (ECGs) performed within 30 days before and after methadone initiation were included...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29707530/shape-up-and-eat-right-families-pilot-program-feasibility-of-a-weight-management-shared-medical-appointment-model-in-african-americans-with-obesity-at-an-urban-academic-medical-center
#20
Gitanjali Srivastava, Kenya D Palmer, Kathy A Ireland, Ashley C McCarthy, Kate E Donovan, Aaron J Manders, Juhee McDougal, Carine M Lenders, Caroline M Apovian
Objectives: Disparities in obesity care exist among African-American children and adults. We sought to test the feasibility of a pilot program, a 1-year family-based intervention for African-American families with obesity [shape up and eat right (SUPER)], adopting the shared medical appointment model (SMA) at an urban safety net hospital. Outcomes: Primary outcomes: (1) family attendance rate and (2) program satisfaction. Secondary outcomes: change in body mass index (BMI), eating behaviors, and sedentary activity...
2018: Frontiers in Pediatrics
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