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"medical home"

Maki Matsukawa, Yumi Fukuyama, Yuko Nakakita, Akiko Akiyama
The purpose of this study is to investigate the comparative changes over time of the home care supporting clinics(HCSCs) in each of the 4 Secondary Medical Areas within Mie Prefecture. There were 129 HCSCs activity reports in 2008, and 170 in 2014. The number of patients and the number of deceased patients have increased in Mie Prefecture. These findings suggest that improvements in the home-care staff recruitment system should be further expanded throughout Mie Prefecture and, in particular, the quality improved in the Higashi-Kishu area...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Karen McNeil, Meg Gemmill, Dara Abells, Samantha Sacks, Terry Broda, Catherine R Morris, Cynthia Forster-Gibson
OBJECTIVE: To review health information exchange (HIE) processes that affect the health of people with intellectual and developmental disabilities (IDD) and to suggest practical tips and strategies for communicating, collaborating, and coordinating in the primary care setting. SOURCES OF INFORMATION: The "Primary care of adults with intellectual and developmental disabilities. 2018 Canadian consensus guidelines" literature review and interdisciplinary input...
April 2018: Canadian Family Physician Médecin de Famille Canadien
Jaya Aysola, Marilyn M Schapira, Hairong Huo, Rachel M Werner
BACKGROUND: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. OBJECTIVE: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. RESEARCH DESIGN: We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system...
April 6, 2018: Medical Care
Laura D Sander, Michael Albert, Nkem Okeke, Steven Kravet, Katherine Rediger, Sarah Johnson Conway, Maura J McGuire
Five percent of Medicaid patients account for 50% of total costs. Preventable costs are often incurred by patients with complex medical, behavioral, and social needs who disproportionately utilize acute care services. Evidence for design, implementation, and evaluation of complex care programs in the urban Medicaid population is lacking. The article provides a description of a complex care program (CCP), challenges, and early outcomes based on a pre-post evaluation. The CCP was located within an existing urban medical home...
April 5, 2018: Population Health Management
LeChauncy D Woodard, Omolola E Adepoju, Amber B Amspoker, Salim S Virani, David J Ramsey, Laura A Petersen, Lindsey A Jones, Lea Kiefer, Praveen Mehta, Aanand D Naik
BACKGROUND: Given its widespread dissemination across primary care, the Veterans Health Administration (VA) is an ideal setting to examine the impact of the patient-centered medical home (PCMH) on diabetes outcomes. OBJECTIVE: To assess the impact of PCMH implementation on diabetes outcomes among patients receiving care in the Veterans Health Administration. DESIGN: Retrospective cohort analysis and multilevel logistic regression. PATIENTS: Twenty thousand eight hundred fifty-eight patients in one Midwest VA network who had a diabetes diagnosis in both 2009 and 2012 and who received primary care between October 1, 2008 and September 30, 2009...
April 2, 2018: Journal of General Internal Medicine
Jessica E Rast, Paul T Shattuck, Anne M Roux, Kristy A Anderson, Alice Kuo
BACKGROUND: Our objective in this study was to describe the association between the receipt of health care transition services (HCTS) and having a medical home in youth with autism spectrum disorder (ASD). Youth with ASD receive HCTS less often than other youth with special health care needs but are in particular need of continuous, comprehensive health care. METHODS: We used the National Survey of Children with Special Health Care Needs to describe the receipt of HCTS in youth with ASD and its association with presence of a medical home...
April 2018: Pediatrics
Abigail R Grant, Beth E Ebel, Nasra Osman, Kiersten Derby, Cheryl DiNovi, H Mollie Grow
OBJECTIVE: To improve Early Head Start/Head Start (EHS/HS) screening, referral, and enrollment for children from diverse, low-income communities. METHOD: Using existing resources, we built a pediatric clinic-Head Start partnership. Key steps included (1) screening protocol and tracking system, (2) a community partner as a single point of referral contact, (3) provider education, and (4) monthly outcome reporting. A pre- and post-cross-sectional study design was used to evaluate outcomes, with medical chart review conducted for all wellness visits among children aged 0 to 4 years pre- and postintervention...
March 1, 2018: Health Promotion Practice
Anne C Spaulding, Ana Drobeniuc, Paula M Frew, Tiffany L Lemon, Emeli J Anderson, Colin Cerwonka, Chava Bowden, John Freshley, Carlos Del Rio
BACKGROUND: Linkage to and retention in care for US persons living with HIV (PLWH) after release from jail usually declines. We know of no rigorously evaluated behavioral interventions that can improve this. We hypothesized that a strengths-based case management intervention that we developed for PLWH leaving jail would increase linkage/retention in care (indicated by receipt of laboratory draws) and a suppressed HIV viral load (VL) in the year following release. METHODS AND FINDINGS: We conducted a quasi-experimental feasibility study of our intervention for PLWH jailed in Atlanta...
2018: PloS One
Jeffrey F Hine, Catherine G Herrington, Alice M Rothman, Rachel L Mace, Barron L Patterson, Kathryn L Carlson, Zachary E Warren
Long waits for diagnostic assessment prevent early identification of children suspected of having autism spectrum disorder. We evaluated the benefit of embedded diagnostic consultation within primary care clinics. Using a streamlined diagnostic model, 119 children with concerns for autism spectrum disorder were seen over 14 months. Diagnostic clarity was determined through streamlined assessment for 59% of the children, while others required follow-up. Latency from first concern to diagnosis was 55 days and median age at diagnosis was 32 months: considerably lower than national averages or comparable tertiary clinics...
March 27, 2018: Journal of Autism and Developmental Disorders
Hyunsung Oh, Kathleen Ell
OBJECTIVE: This study examined whether changes in depressive symptoms and social support prospectively predicted diabetes management among Hispanic patients with probable depression in patient-centered medical homes at safety-net clinics in East Los Angeles, CA. RESEARCH DESIGN AND METHODS: Data were collected from 251 patients enrolled in a randomized clinical trial testing the effectiveness of a promotora-assisted self-management intervention. Cross-lagged analyses examined associations between changes in depression symptoms and social support between baseline and 6-month follow-up and self-efficacy and adherence to diabetes management at the 6- and 12-month follow-ups...
March 27, 2018: Diabetes Care
Sarabeth Broder-Fingert, Morgan Walls, Marilyn Augustyn, Rinad Beidas, David Mandell, Shannon Wiltsey-Stirman, Michael Silverstein, Emily Feinberg
BACKGROUND: Significant racial, ethnic, and socioeconomic disparities exist in access to evidence-based treatment services for children with autism spectrum disorder (ASD). Patient Navigation (PN) is a theory-based care management strategy designed to reduce disparities in access to care. The purpose of this study is to test the effectiveness of PN a strategy to reduce disparities in access to evidence-based services for vulnerable children with ASD, as well as to explore factors that impact implementation...
March 27, 2018: BMC Psychiatry
Hae Mi Choe, Alexandra Tungol Lin, Kathleen Kobernik, Marc Cohen, Laurie Wesolowicz, Nabeel Qureshi, Tom Leyden, David A Share, Rozanne Darland, David A Spahlinger
BACKGROUND: Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes. PROGRAM DESCRIPTION: Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan...
April 2018: Journal of Managed Care & Specialty Pharmacy
James Nugent, Gregory Gorman, Christine R Erdie-Lalena
OBJECTIVE: To compare healthcare transition planning in adolescents with Down syndrome with adolescents with other special healthcare needs. STUDY DESIGN: Data were drawn from the 2009-2010 National Survey of Children with Special Health Care Needs, a nationally representative sample with 17 114 adolescents aged 12-17 years. Parents were asked whether providers and the study child had discussed shifting to an adult provider, changing healthcare needs, maintaining health insurance coverage, and taking responsibility for self-care...
March 20, 2018: Journal of Pediatrics
Marian F Earls
Trauma-informed care integrates an understanding of the prevalence of adverse childhood experiences and their impact on lifelong health. The science of early brain development reveals that the environment in which children develop-family, community, and culture-impacts brain development, health, and genetics. In the medical home, being trauma-informed is important for prevention and amelioration of this impact.
March 2018: North Carolina Medical Journal
Lonnie Wen, Christine Divers, Melissa Lingohr-Smith, Jay Lin, Scott Ramsey
OBJECTIVES: To provide an overview of alternative payment models (APMs) and describe how leading national organizations involved with oncology care and payment are linking quality improvement initiatives and payment reform. STUDY DESIGN: Literature review. METHODS: For this review, we summarized the literature on APMs and their goals of improving healthcare quality while jointly controlling the cost of care. We described the types of APMs that have been examined in the real-world setting, specifically in the area of oncology, and how they have affected the quality of oncology care...
March 1, 2018: American Journal of Managed Care
Nathan D Shippee, Michael Finch, Douglas R Wholey
OBJECTIVES: Patient-centered medical homes (PCMHs) represent a widespread model of healthcare transformation. Despite evidence that PCMHs can improve care quality, the mechanisms by which they improve outcomes are relatively unexamined. We aimed to assess the mechanisms linking certification as a Health Care Home (HCH), a statewide PCMH initiative, with asthma care quality and outcomes. We compared direct certification effects versus indirect clinical effects (via improved care process)...
March 1, 2018: American Journal of Managed Care
Dina Hafez, Laurence F McMahon, Linda Balogh, Floyd John Brinley, John Crump, Mark Ealovega, Audrey Fan, Yeong Kwok, Kristen Krieger, Thomas O'Connor, Elisa Ostafin, Heidi Reichert, Jennifer Meddings
OBJECTIVES: To characterize patterns of emergency department (ED) utilization for ambulatory care-sensitive conditions (ACSCs) among patients with established care within a patient-centered medical home. STUDY DESIGN: Retrospective chart review using Michigan Medicine's (formerly University of Michigan Health System) electronic health record. METHODS: Ten general medicine (GM) physicians reviewed 256 ambulatory care-sensitive ED encounters that occurred between January 1, 2014, and December 31, 2014, among patients of a GM medical home...
March 1, 2018: American Journal of Managed Care
Bonita Sasnett, Susie T Harris, Shelly White
Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators...
March 16, 2018: Health Care Manager
Amber Hoffman, Ingrid A Larson
It can be difficult to assist children with medical complexities (CMC) in maintaining wellness outside of hospital and emergency department settings. This growing population, with high use of medical technology and specialty care, has created a challenge for community providers who may infrequently care for children with these rare disorders and needs. CMCs have increased hospitalization rates and emergency care use. It is not realistic to believe that emergency health providers will know how to manage every type of CMC when they present for emergency care...
March 1, 2018: Pediatric Annals
James M Gill
No abstract text is available yet for this article.
March 2018: Family Medicine
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