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https://www.readbyqxmd.com/read/29329520/effects-of-primary-care-clinician-beliefs-and-perceived-organizational-facilitators-on-the-delivery-of-preventive-care-to-individuals-with-mental-illnesses
#1
Bobbi Jo H Yarborough, Scott P Stumbo, Nancy A Perrin, Ginger C Hanson, John Muench, Carla A Green
BACKGROUND: Although many studies have documented patient-, clinician-, and organizational barriers/facilitators of primary care among people with mental illnesses, few have examined whether these factors predict actual rates of preventive service use. We assessed whether clinician behaviors, beliefs, characteristics, and clinician-reported organizational characteristics, predicted delivery of preventive services in this population. METHODS: Primary care clinicians (n = 247) at Kaiser Permanente Northwest (KPNW) or community health centers and safety-net clinics (CHCs), in six states, completed clinician surveys in 2014...
January 12, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29326964/transportation-and-other-nonfinancial-barriers-among-uninsured-primary-care-patients
#2
Akiko Kamimura, Samin Panahi, Zobayer Ahmmad, Mu Pye, Jeanie Ashby
Introduction: Nonfinancial barriers are frequent causes of unmet need in health-care services. The significance of transportation barriers can weigh more than the issues of access to care. The purpose of this cross-sectional study was to examine transportation and other nonfinancial barriers among low-income uninsured patients of a safety net health-care facility (free clinic). Methods: The survey data were collected from patients aged 18 years and older who spoke English or Spanish at a free clinic, which served uninsured individuals in poverty in the United States...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29320892/the-effect-of-the-global-financial-crisis-on-preventable-hospitalizations-among-the-homeless-in-new-york-state
#3
Brandi White, Charles Ellis, Walter Jones, William Moran, Kit Simpson
Objective Periods of economic instability may increase preventable hospitalizations because of increased barriers to accessing primary care. For underserved populations such as the homeless, these barriers may be more pronounced due to limited resources in the health care safety net. This study examined the impact of the global financial crisis of 2007-2008 on access to care for the homeless in New York State. Methods Hospitalizations for ambulatory care sensitive conditions (ACSCs) were used as a proxy measure for primary care access...
January 1, 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29319643/burnout-perceived-stress-and-job-satisfaction-among-trauma-nurses-at-a-level-i-safety-net-trauma-center
#4
Swapna Munnangi, Lynore Dupiton, Anthony Boutin, L D George Angus
Nurses are at the forefront of our health care delivery system and have been reported to exhibit a high level of burnout. Burnout and stress in trauma nurses at a safety-net hospital can negatively impact patient care. Safety-net hospitals are confronted with unique social, financial, as well as resource problems that can potentially make the work environment frustrating. The purpose of this study was to explore the levels of burnout, stress, and job satisfaction in nurses providing care to trauma patients at a Level I safety-net trauma center...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29315323/developing-a-theoretical-model-and-questionnaire-survey-instrument-to-measure-the-success-of-electronic-health-records-in-residential-aged-care
#5
Ping Yu, Siyu Qian
Electronic health records (EHR) are introduced into healthcare organizations worldwide to improve patient safety, healthcare quality and efficiency. A rigorous evaluation of this technology is important to reduce potential negative effects on patient and staff, to provide decision makers with accurate information for system improvement and to ensure return on investment. Therefore, this study develops a theoretical model and questionnaire survey instrument to assess the success of organizational EHR in routine use from the viewpoint of nursing staff in residential aged care homes...
2018: PloS One
https://www.readbyqxmd.com/read/29302881/could-pay-for-performance-worsen-health-disparities
#6
Mubeen Shakir, Katrina Armstrong, Jason H Wasfy
Pay-for-performance (P4P) has become a prominent component of health care funding in the Affordable Care Act (ACA) era. Although the ACA's future remains unclear, these programs receive bipartisan support and will likely continue to be a part of payment policies. At the same time, racial and class disparities remain among the most pressing of the many challenges facing the US health system. We review evidence of the effects of P4P on disparities at the population and individual levels. Providers caring for predominantly minority patients or those with lower socioeconomic status are known to have poorer quality metrics...
January 4, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29301822/unstable-housing-and-diabetes-related-emergency-department-visits-and-hospitalization-a-nationally-representative-study-of-safety-net-clinic-patients
#7
Seth A Berkowitz, Sara Kalkhoran, Samuel T Edwards, Utibe R Essien, Travis P Baggett
OBJECTIVE: Homelessness is associated with worse diabetes outcomes, but the relationship between other forms of unstable housing and diabetes is not well studied. We assessed whether unstable housing was associated with increased risk for diabetes-related emergency department use or hospitalization. RESEARCH DESIGN AND METHODS: We used data from the 2014 Health Center Patient Survey, a cross-sectional, nationally representative survey of patients who receive care at federally funded safety-net health centers...
January 4, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29299519/expeditious-emergency-room-referral-pathway-improves-patient-access-to-otolaryngology-care
#8
Jeffrey Johnson, Zi Yang Jiang, Daniel Martinez, David Smith, Elizabeth Curtis, David Robinson, Ibrahim Alava
Objectives: Historically at a multi-hospital residency program, there was an unexpected number of non-urgent consults from the county hospital emergency room (ER) that caused residents to make more trips between hospitals and come closer to violating duty hours. Moreover, there was also a poor follow-up rate for these patients. An alternate pathway to redirect such consults to the Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) clinic, staffed by an attending physician, was devised...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29298361/association-between-perceived-discrimination-and-emergency-department-use-among-safety-net-patients-in-the-southwestern-united-states
#9
Kimberly R Enard, Lucinda Nevarez, Deborah M Ganelin
OBJECTIVES: Patients' perceptions of how they are treated in their interactions with the healthcare system represent important and valid measures of healthcare quality that may influence health utilization, outcomes, and costs. Perceived discrimination or the sense of being treated unfairly is an important patient perception known to adversely affect health, but the relation of such perceptions to health-seeking behaviors related to low-acuity emergency department (ED) use is unclear...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29298115/caution-ahead-research-challenges-of-a-randomized-controlled-trial-implemented-to-improve-breast-cancer-treatment-at-safety-net-hospitals
#10
Nina A Bickell, Ajay Shah, Maria Castaldi, Theophilus Lewis, Alan Sickles, Shalini Arora, Kevin Clarke, Margaret Kemeny, Anitha Srinivasan, Kezhen Fei, Rebeca Franco, Michael Parides, Peter Pappas, Ann Scheck McAlearney
PURPOSE: To implement and test a Web-based tracking and feedback (T&F) tool to close referral loops and reduce adjuvant breast cancer treatment underuse in safety-net hospitals (SNHs). PATIENT AND METHODS: We randomly assigned 10 SNHs, identified patients with new stage 1 to stage 3 breast cancer, assessed their connection with the oncologist, and relayed this information to surgeons for follow-up. We interviewed key informants about the tool's usefulness. We conducted intention-to-treat and pre- and poststudy analyses to assess the T&F tool and implementation effectiveness, respectively...
January 3, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29290245/development-and-implementation-of-a-universal-suicide-risk-screening-program-in-a-safety-net-hospital-system
#11
Kimberly Roaten, Celeste Johnson, Russell Genzel, Fuad Khan, Carol S North
BACKGROUND: Many individuals who die by suicide present for nonbehavioral health care prior to death. The risk is often undetected. Universal suicide screening in health care may improve risk recognition. A quality improvement project involving a universal suicide screening program was designed and developed in a large safety-net health care system. METHODS: The steps in developing and implementing this quality improvement program were gathering intelligence, examining resources, designing the screening program, creating a clinical response, constructing an electronic health record screening protocol, clinical workforce education, and program implementation...
January 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29289540/a-randomized-controlled-study-comparing-a-dpp4-inhibitor-linagliptin-and-basal-insulin-glargine-in-patients-with-type-2-diabetes-in-long-term-care-and-skilled-nursing-facilities-linagliptin-ltc-trial
#12
Guillermo E Umpierrez, Saumeth Cardona, David Chachkhiani, Maya Fayfman, Sahebi Saiyed, Heqiong Wang, Priyathama Vellanki, J Sonya Haw, Darin E Olson, Francisco J Pasquel, Theodore M Johnson
OBJECTIVES: Safe and easily implemented treatment regimens are needed for the management of patients with type 2 diabetes mellitus (T2DM) in long-term care (LTC) and skilled nursing facilities. DESIGN: This 6-month open-label randomized controlled trial compared the efficacy and safety of a DPP4 inhibitor (linagliptin) and basal insulin (glargine) in LTC residents with T2DM. SETTINGS: Three LTC institutions affiliated with a community safety-net hospital, US Department of Veterans Affairs and Emory Healthcare System in Atlanta, Georgia...
December 27, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29286493/twenty-five-years-of-the-national-academy-of-medical-sciences-of-ukraine-progress-and-priorities-for-future-of-radiation-medicine-and-biology
#13
D Bazyka
After the creation of the Academy of Medical Sciences of Ukraine in 1993 the Research Center for Radiation Medicine was among the first institutions to join the Academy (fig. 1). Estab lishing the Academy was among the first steps of the independent Ukrainian government and aimed to provide a high level health care for population. It was extremely needed for the minimization of Chornobyl medical consequences. This choice was related to a growing recognition of the scientific research in fulfilling the Сenter's mission - study of the effects of low dose radiation on human body and radiation protection of the exposed population...
December 2017: Problemy Radiat︠s︡iĭnoï Medyt︠s︡yny Ta Radiobiolohiï
https://www.readbyqxmd.com/read/29283967/pediatric-appendicitis-is-referral-to-a-regional-pediatric-center-necessary
#14
Maggie M Hodges, Clay Cothren Burlew, Shannon N Acker, Ernest E Moore, Genie E Roosevelt, Anna Schubert, Lauren R S Hill, David A Partrick, Denis Bensard
BACKGROUND: Acute appendicitis is the most common emergent surgical procedure performed among children in the US, with an incidence exceeding 80,000 cases per year. Appendectomies are often performed by both pediatric surgeons and adult general/trauma acute care surgeons (TACS surgeons). We hypothesized that children undergoing appendectomy for acute appendicitis have equivalent outcomes whether a pediatric surgeon or a TACS surgeon performs the operation. METHODS: A retrospective chart review was performed for patients 6-18 years of age, who underwent appendectomy at either a regional children's hospital (CHCO, n=241) or an urban safety net hospital (n=347) between July 2010 and June 2015...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29276765/project-red-impacts-patient-experience
#15
Ramon S Cancino, Chris Manasseh, Lana Kwong, Suzanne E Mitchell, Jessica Martin, Brian W Jack
Background: Hospitalized patients are frequently unprepared to care for themselves after discharge often leading to unplanned hospital readmission. One strategy to reduce readmission rates is improving the quality of patient education and preparation before hospital discharge. The ReEngineered Discharge (RED) is a standardized hospital-based program designed to provide patients and caregivers the information they need to continue care at home. Objectives: We sought to study the impact of the RED intervention on posthospitalization adult patient experience scores in an urban academic safety-net hospital...
December 2017: Journal of Patient Experience
https://www.readbyqxmd.com/read/29261247/reduction-of-emergency-department-use-in-people-with-disabilities
#16
Lihao Chu, Neeraj Sood, Michael Tu, Katrina Miller, Lhasa Ray, Jennifer N Sayles
OBJECTIVES: To examine emergency department (ED) use by individuals with disabilities in safety-net clinics that have adopted the patient-centered medical home (PCMH) model. STUDY DESIGN: This is a retrospective matched cohort study. Prior to matching, we identified 2269 nonelderly Medicaid beneficiaries with disabilities from a Los Angeles Medicaid managed care plan in PCMH clinics and 21,897 in non-PCMH clinics. METHODS: To minimize self-selection bias from clinics and individuals, we created 3 comparison groups through a series of propensity score matching schemes that included matching clinics with similar health service utilization per patient and matching individuals with similar demographic characteristics and underlying health conditions...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29237650/needs-of-cancer-patients-in-palliative-care-during-medical-visits-qualitative-study
#17
Dominik Melhem, Serge Daneault
OBJECTIVE: To explore the needs of cancer patients in palliative care and to determine how care providers, including family physicians, could meet these needs more fully. DESIGN: Qualitative study performed using semistructured interviews. SETTING: Palliative care departments (ambulatory and intrahospital). PARTICIPANTS: Twelve patients with a diagnosis of cancer deemed to be in the palliative phase, who had already received either chemotherapy or radiation treatment...
December 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29234352/assessment-of-osteoporosis-in-injured-older-women-admitted-to-a-safety-net-level-one-trauma-center-a-unique-opportunity-to-fulfill-an-unmet-need
#18
Elisabeth S Young, May J Reed, Tam N Pham, Joel A Gross, Lisa A Taitsman, Stephen J Kaplan
Background: Older trauma patients often undergo computed tomography (CT) as part of the initial work-up. CT imaging can also be used opportunistically to measure bone density and assess osteoporosis. Methods: In this retrospective cohort study, osteoporosis was ascertained from admission CT scans in women aged ≥65 admitted to the ICU for traumatic injury during a 3-year period at a single, safety-net, level 1 trauma center. Osteoporosis was defined by established CT-based criteria of average L1 vertebral body Hounsfield units <110...
2017: Current Gerontology and Geriatrics Research
https://www.readbyqxmd.com/read/29232088/comparing-the-affordable-care-act-s-financial-impact-on-safety-net-hospitals-in-states-that-expanded-medicaid-and-those-that-did-not
#19
Allen Dobson, Joan E DaVanzo, Randy Haught, Luu Phap-Hoa
Issue: Safety-net hospitals play a vital role in delivering health care to Medicaid enrollees, the uninsured, and other vulnerable patients. By reducing the number of uninsured Americans, the Affordable Care Act (ACA) was also expected to lower these hospitals’ significant uncompensated care costs and shore up their financial stability. Goal: To examine how the ACA’s Medicaid expansion affected the financial status of safety-net hospitals in states that expanded Medicaid and in states that did not...
November 1, 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/29231130/development-and-testing-of-the-provider-and-staff-perceptions-of-integrated-care-pspic-survey
#20
Sarah Derrett, Kathryn E Gunter, Ari Samaranayaka, Sara J Singer, Robert S Nocon, Michael T Quinn, Mary Breheny, Amanda Campbell, Cynthia T Schaefer, Loretta J Heuer, Marshall H Chin
This article discusses development and testing of the Provider and Staff Perceptions of Integrated Care Survey, a 21-item questionnaire, informed by Singer and colleagues' seven-construct framework. Questionnaires were sent to 2,936 providers and staff at 100 federally qualified health centers and other safety net clinics in 10 Midwestern U.S. states; 332 were ineligible, leaving 2,604 potential participants. Following 4 mailings, 781 (30%) responded from 97 health centers. Item analyses, exploratory factor analysis, and confirmatory factor analysis were undertaken...
December 1, 2017: Medical Care Research and Review: MCRR
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