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https://www.readbyqxmd.com/read/28335011/understanding-public-perception-of-the-need-for-major-change-in-latin-american-healthcare-systems
#1
Ricardo Pérez-Cuevas, Frederico C Guanais, Svetlana V Doubova, Leonardo Pinzón, Luis Tejerina, Diana Pinto Masis, Marcia Rocha, Donna O Harris, James Macinko
The opinions and experiences of the public regarding health services are valuable insights into identifying opportunities to improve healthcare systems. We analyzed the 2012-2013 Public Opinion Health Policy Survey carried out in Brazil (n = 1486), Colombia (n = 1485), El Salvador (n = 1460), Jamaica (n = 1480), México (n = 1492) and Panama (n = 1475). In these countries between 82 and 96% of participants perceived that their health systems needed fundamental changes. The most frequent barrier to access to healthcare was lack of the primary medical home, difficulties in obtaining medical care during the weekends and financial barriers...
March 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28323747/supporting-a-youth-with-cerebellar-ataxia-into-adolescence
#2
Veronica Meneses, Zurisadai Gonzalez-Castillo, Veronica B Edgar, Marilyn Augustyn
Zoe, a 13-year-old white girl, presents as a new patient to your pediatric clinic with complaints of frequent emesis, anxiety, and learning problems, and previous diagnosis of cerebellar ataxia. Parents accompany Zoe and state, "it is really hard for her to go out, she gets sick and falls easily." She was born full term by vaginal delivery without complications. Given globally delayed milestones, she received early intervention services. Feeding problems began at infancy, including gastroesophageal reflux and aspiration pneumonia...
March 17, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28319991/practitioner-application-a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#3
Pamela J Stoyanoff
No abstract text is available yet for this article.
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319990/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#4
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28301449/differences-in-health-care-family-and-community-factors-associated-with-mental-behavioral-and-developmental-disorders-among-children-aged-2-8-years-in-rural-and-urban-areas-united-states-2011-2012
#5
Lara R Robinson, Joseph R Holbrook, Rebecca H Bitsko, Sophie A Hartwig, Jennifer W Kaminski, Reem M Ghandour, Georgina Peacock, Akilah Heggs, Coleen A Boyle
PROBLEM/CONDITION: Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. REPORTING PERIOD: 2011-2012. DESCRIPTION OF SYSTEM: The National Survey of Children's Health (NSCH) is a cross-sectional, random-digit-dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged <18 years in the United States...
March 17, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28295249/development-and-validation-of-the-modified-patient-centered-medical-home-assessment-for-the-comprehensive-primary-care-initiative
#6
Dmitriy Poznyak, Deborah N Peikes, Breanna A Wakar, Randall S Brown, Robert J Reid
OBJECTIVE: To describe the modified Patient-Centered Medical Home Assessment (M-PCMH-A) survey module developed to track primary care practices' care delivery approaches over time, assess whether its underlying factor structure is reliable, and produce factor scores that provide a more reliable summary measure of the practice's care delivery than would a simple average of question responses. DATA SOURCES/STUDY SETTING: Survey data collected from diverse practices participating in the Comprehensive Primary Care (CPC) initiative in 2012 (n = 497) and 2014 (n = 493) and matched comparison practices in 2014 (n = 423)...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28290952/transitioning-to-patient-centered-medical-homes-associations-with-appointment-availability
#7
Todd C Leroux, Murray J Côté, Hye-Chung Kum, Alan Dabney, Rebecca Wells
INTRODUCTION: Recent implementation of the Patient-Centered Medical Home (PCMH) in military primary care has gained significant traction and attention from leadership and policy makers. The study objective was to measure the rate of change in appointment availability before and after primary care clinics were certified as a medical home. Access to care is one core tenet of the medical home and appointment availability is an important indicator of access. MATERIALS AND METHODS: This was a retrospective, longitudinal observational study involving 21 U...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290063/behavioral-health-integration-in-large-multi-group-pediatric-practice
#8
REVIEW
Abigail Boden Schlesinger
There is increasing interest in methods to improve access to behavioral health services for children and adolescents. Children's Community Pediatric Behavioral Health Service (CCPBHS) is an integrated behavioral health service whose method of (a) creating a leadership team with empowered administrative and clinical stakeholders who can act on a commitment to change and (b) having a clear mission statement with integrated administrative and clinical care processes can serve as a model for implementing integration efforts within the medical home...
March 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28289140/detention-of-immigrant-children
#9
Julie M Linton, Marsha Griffin, Alan J Shapiro
Immigrant children seeking safe haven in the United States, whether arriving unaccompanied or in family units, face a complicated evaluation and legal process from the point of arrival through permanent resettlement in communities. The conditions in which children are detained and the support services that are available to them are of great concern to pediatricians and other advocates for children. In accordance with internationally accepted rights of the child, immigrant and refugee children should be treated with dignity and respect and should not be exposed to conditions that may harm or traumatize them...
March 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/28277088/do-changes-in-socio-demographic-characteristics-impact-up-to-date-immunization-status-between-3-and-24-months-of-age-a-prospective-study-among-an-inner-city-birth-cohort-in-the-united-states
#10
Susmita Pati, Jiayu Huang, Angie Wong, Zeinab Baba, Svetlana Ostapenko, Alexander G Fiks, Avital Cnaan
INTRODUCTION: Low-income child populations remain under-vaccinated. Our objective was to determine differences in the relative importance of maternal health literacy and socio-demographic characteristics that often change during early childhood on up-to-date (UTD) immunization status among a low-income population. METHODS: We performed secondary data analysis of a longitudinal prospective cohort study of 744 Medicaid-eligible mother-infant dyads recruited at the time of the infant's birth from an inner-city hospital in the United States and surveyed every 6 months for 24 months...
February 27, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28274389/human-papillomavirus-hpv-vaccine-initiation-in-minority-americans
#11
P De, H Budhwani
OBJECTIVES: Transmission of the human papillomavirus (HPV) is a significant public health concern. HPV is preventable through a series of vaccinations; however, knowledge gaps exist as to which groups are least likely to initiate vaccination. Considering this gap, the aim of this study is to examine HPV vaccine initiation rates in racial minorities, comparing foreign-born individuals to their American-born peers. STUDY DESIGN: Population-based data from the 2013 National Health Interview Survey (NHIS), a repeated large-scale household interview survey of a statistically representative sample of the United States civilian non-institutionalized population, were applied...
March 2017: Public Health
https://www.readbyqxmd.com/read/28264952/synthesis-of-research-on-patient-centered-medical-homes-brings-systematic-differences-into-relief
#12
Anna D Sinaiko, Mary Beth Landrum, David J Meyers, Shehnaz Alidina, Daniel D Maeng, Mark W Friedberg, Lisa M Kern, Alison M Edwards, Signe Peterson Flieger, Patricia R Houck, Pamela Peele, Robert J Reid, Katharine McGraves-Lloyd, Karl Finison, Meredith B Rosenthal
The patient-centered medical home (PCMH) model emphasizes comprehensive, coordinated, patient-centered care, with the goals of reducing spending and improving quality. To evaluate the impact of PCMH initiatives on utilization, cost, and quality, we conducted a meta-analysis of methodologically standardized findings from evaluations of eleven major PCMH initiatives. There was significant heterogeneity across individual evaluations in many outcomes. Across evaluations, PCMH initiatives were not associated with changes in the majority of outcomes studied, including primary care, emergency department, and inpatient visits and four quality measures...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264948/early-impact-of-carefirst-s-patient-centered-medical-home-with-strong-financial-incentives
#13
Christopher C Afendulis, Laura A Hatfield, Bruce E Landon, Jonathan Gruber, Mary Beth Landrum, Robert E Mechanic, Darren E Zinner, Michael E Chernew
In 2011 CareFirst BlueCross BlueShield, a large mid-Atlantic health insurance plan, implemented a payment and delivery system reform program. The model, called the Total Care and Cost Improvement Program, includes enhanced payments for primary care, significant financial incentives for primary care physicians to control spending, and care coordination tools to support progress toward the goal of higher-quality and lower-cost patient care. We conducted a mixed-methods evaluation of the initiative's first three years...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264944/innovative-oncology-care-models-improve-end-of-life-quality-reduce-utilization-and-spending
#14
Erin Murphy Colligan, Erin Ewald, Sarah Ruiz, Michelle Spafford, Caitlin Cross-Barnet, Shriram Parashuram
Three models that received Health Care Innovation Awards from the Centers for Medicare and Medicaid Services (CMS) aimed to reduce the cost and use of health care services and improve the quality of care for Medicare beneficiaries with cancer. Each emphasized a different principle: the oncology medical home, patient navigation, or palliative care. Comparing participants in each model who died during the study period to matched comparators, we found that the oncology medical home and patient navigation models were associated with decreased costs in the last ninety days of life ($3,346 and $5,824 per person, respectively) and fewer hospitalizations in the last thirty days of life (fifty-seven and forty per 1,000 people, respectively)...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264792/enhancing-mhealth-technology-in-the-patient-centered-medical-home-environment-to-activate-patients-with-type-2-diabetes-a-multisite-feasibility-study-protocol
#15
Ronald Gimbel, Lu Shi, Joel E Williams, Cheryl J Dye, Liwei Chen, Paul Crawford, Eric A Shry, Sarah F Griffin, Karyn O Jones, Windsor W Sherrill, Khoa Truong, Jeanette R Little, Karen W Edwards, Marie Hing, Jennie B Moss
BACKGROUND: The potential of mHealth technologies in the care of patients with diabetes and other chronic conditions has captured the attention of clinicians and researchers. Efforts to date have incorporated a variety of tools and techniques, including Web-based portals, short message service (SMS) text messaging, remote collection of biometric data, electronic coaching, electronic-based health education, secure email communication between visits, and electronic collection of lifestyle and quality-of-life surveys...
March 6, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28256999/characteristics-of-primary-care-physicians-in-patient-centered-medical-home-practices-united-states-2013
#16
Esther Hing, Ellen Kurtzman, Denys T Lau, Caroline Taplin, Andrew B Bindman
Objective-This report describes the characteristics of primary care physicians in patient-centered medical home (PCMH) practices and compares these characteristics with those of primary care physicians in non-PCMH practices. Methods-The data presented in this report were collected during the induction interview for the 2013 National Ambulatory Medical Care Survey, a national probability sample survey of nonfederal physicians who see patients in office settings in the United States. Analyses exclude anesthesiologists, radiologists, pathologists, and physicians in community health centers...
February 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/28255992/the-reduction-in-ed-and-hospital-admissions-in-medical-home-practices-is-specific-to-primary-care-sensitive-chronic-conditions
#17
Lee A Green, Hsiu-Ching Chang, Amanda R Markovitz, Michael L Paustian
OBJECTIVE: To determine whether the Patient-Centered Medical Home (PCMH) transformation reduces hospital and ED utilization, and whether the effect is specific to chronic conditions targeted for management by the PCMH in our setting. DATA SOURCES AND STUDY SETTING: All patients aged 18 years and older in 2,218 primary care practices participating in a statewide PCMH incentive program sponsored by Blue Cross Blue Shield of Michigan (BCBSM) in 2009-2012. STUDY DESIGN: Quantitative observational study, jointly modeling PCMH-targeted versus other hospital admissions and ED visits on PCMH score, patient, and practice characteristics in a hierarchical multivariate model using the generalized gamma distribution...
March 2, 2017: Health Services Research
https://www.readbyqxmd.com/read/28250024/care-system-redesign-for-preterm-children-after-discharge-from-the-nicu
#18
Dennis Z Kuo, Robert E Lyle, Patrick H Casey, Christopher J Stille
Approximately 1 in 8 children in the United States are born preterm. Existing guidelines and research examine the cost of prematurity from the NICU stay and developmental surveillance and outcomes after discharge from the NICU. Preterm children are at greater risk for excess hospitalizations, outpatient visits, and societal costs after NICU discharge. Improved delivery of care and health promotion from the community setting, particularly from the patient-centered medical home, may result in improved growth, health, and development, with accompanying reduction of post-NICU discharge costs and encounters...
March 1, 2017: Pediatrics
https://www.readbyqxmd.com/read/28246025/pediatricians-comfort-level-in-caring-for-children-with-special-health-care-needs
#19
Megumi J Okumura, Heather Knauer, Kris Calvin, John I Takayama
BACKGROUND: Few studies have investigated pediatrician attitudes about providing primary medical care for children with special health care needs (CSHCN). OBJECTIVE: To determine pediatrician perspectives on their comfort level in providing care, and on where the medical home should be for children with chronic medical and developmental conditions. METHODS: Survey of pediatricians in California in 2014. Pediatricians were randomized to receive surveys featuring either a case of a child with a chronic medical (neurofibromatosis) or a developmental condition (autism)...
February 25, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28245657/perceptions-of-the-medical-home-by-parents-of-children-with-chronic-illnesses
#20
Emily B Vander Schaaf, Elisabeth P Dellon, Rachael A Carr, Neal A deJong, Asheley C Skinner, Michael J Steiner
OBJECTIVES: The patient-centered medical home (PCMH) strives to improve the quality of care in the primary care setting. Recently, certification programs for patient-centered coordinated care have expanded to subspecialty care. Children with chronic conditions are particularly in need of patient-centered and coordinated care. Our objective was to compare parent perceptions of PCMH elements at primary care and specialty practices for children receiving specialty care. STUDY DESIGN: Cross-sectional survey study...
February 1, 2017: American Journal of Managed Care
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