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Incentive underserved practice

Judith N Lasker, Myron Aldrink, Ramaswami Balasubramaniam, Paul Caldron, Bruce Compton, Jessica Evert, Lawrence C Loh, Shailendra Prasad, Shira Siegel
BACKGROUND: Growing concerns about the value and effectiveness of short-term volunteer trips intending to improve health in underserved Global South communities has driven the development of guidelines by multiple organizations and individuals. These are intended to mitigate potential harms and maximize benefits associated with such efforts. METHOD: This paper analyzes 27 guidelines derived from a scoping review of the literature available in early 2017, describing their authorship, intended audiences, the aspects of short term medical missions (STMMs) they address, and their attention to guideline implementation...
February 7, 2018: Globalization and Health
Marcy B Bolster, Anne R Bass, Jonathan S Hausmann, Chad Deal, Marcia Ditmyer, Kamilah L Greene, Seetha U Monrad, Daniel F Battafarano
OBJECTIVE: Graduate medical education (GME), through fellowship training, plays a critical role in providing new rheumatologists into our workforce and is an essential component when addressing the gap of excess demand for adult rheumatology care. METHODS: Primary and secondary data sources were used to develop an integrated workforce model. Factors specific to new graduates entering the workforce included available and filled fellowship positions, gender shifts, planned work schedules (part-time, full- time), practice settings (academic, non-academic private practice), and number of international medical graduates (IMGs) projecting U...
February 5, 2018: Arthritis & Rheumatology
Sunita Desai, J Michael McWilliams
Background The 340B Drug Pricing Program entitles qualifying hospitals to discounts on outpatient drugs, increasing the profitability of drug administration. By tying the program eligibility of hospitals to their Disproportionate Share Hospital (DSH) adjustment percentage, which reflects the proportion of hospitalized patients who are low-income, the program is intended to expand resources for underserved populations but provides no direct incentives for hospitals to use financial gains to enhance care for low-income patients...
January 24, 2018: New England Journal of Medicine
Andrea N Garcia, Tony Kuo, Lisa Arangua, Eliseo J Pérez-Stable
PURPOSE: Given projected U.S. physician shortages across all specialties that will likely impact underserved areas disproportionately, the authors sought to explore factors most correlated with medical school graduates' intention to work with underserved populations (IWUP). METHOD: Data from the 2010-2012 Association of American Medical Colleges Medical School Graduation Questionnaire (n = 40,846) were analyzed. Variables (demographics, career preference, debt burden, intention to enter loan forgiveness programs) were examined using chi-square tests and logistic regression models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Andrew J Hung, Jian Chen, Ankeet Shah, Inderbir S Gill
PURPOSE: Tremendous interest and need lie at the intersection of telemedicine and minimally invasive surgery. Robotics provides an ideal environment for surgical telementoring and telesurgery given its endoscopic optics and mechanized instrument movement. We review the present status, current challenges and future promise of telemedicine in endoscopic and minimally invasive surgery with a focus on urological applications. MATERIALS AND METHODS: Two paired investigators screened PubMed(®), Scopus(®) and Web of Science(®) databases for all full text English language articles published between 1995 and 2016 using the key words "telemedicine," "minimally invasive surgical procedure," "robotic surgical procedure," "education" and "distance...
June 26, 2017: Journal of Urology
Laura Diaz Anadon, Gabriel Chan, Alicia G Harley, Kira Matus, Suerie Moon, Sharmila L Murthy, William C Clark
This paper presents insights and action proposals to better harness technological innovation for sustainable development. We begin with three key insights from scholarship and practice. First, technological innovation processes do not follow a set sequence but rather emerge from complex adaptive systems involving many actors and institutions operating simultaneously from local to global scales. Barriers arise at all stages of innovation, from the invention of a technology through its selection, production, adaptation, adoption, and retirement...
August 30, 2016: Proceedings of the National Academy of Sciences of the United States of America
Ligia Paina, Marius Ungureanu, Victor Olsavszky
BACKGROUND: The Romanian health system is struggling to retain its health workers, who are currently facing strong incentives for migration to Western European health systems. Retention issues, coupled with high levels of migration, complicate Romania's efforts in providing basic health services for rural, underserved, and marginalized populations, as well as in achieving equitable health access for all. The WHO Global Code of Practice on International Recruitment of Health Personnel (the Code) aims to promote ethical international recruitment and health systems strengthening...
June 30, 2016: Human Resources for Health
Fernando A Wilson, Sankeerth Rampa, Kate E Trout, Jim P Stimpson
Telehealth technologies promise to increase access to care, particularly in underserved communities. However, little is known about how private payer reimbursements vary between telehealth and non-telehealth services. We use the largest private claims database in the United States provided by the Health Care Cost Institute to identify telehealth claims and compare average reimbursements to non-telehealth claims. We find average reimbursements for telehealth services are significantly lower than those for non-telehealth for seven of the ten most common services...
June 3, 2016: Journal of Telemedicine and Telecare
Amelia Goodfellow, Jesus G Ulloa, Patrick T Dowling, Efrain Talamantes, Somil Chheda, Curtis Bone, Gerardo Moreno
PURPOSE: The authors conducted a systematic review of the medical literature to determine the factors most strongly associated with localizing primary care physicians (PCPs) in underserved urban or rural areas of the United States. METHOD: In November 2015, the authors searched databases (MEDLINE, ERIC, SCOPUS) and Google Scholar to identify published peer-reviewed studies that focused on PCPs and reported practice location outcomes that included U.S. underserved urban or rural areas...
September 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Sima Rafiei, Mohammad Arab, Arash Rashidian, Mahmood Mahmoudi, Vafa Rahimi-Movaghar
BACKGROUND: Health workforce shortages in rural and remote areas are a global challenge that almost every health system has to deal with. This study aimed to discover neurosurgeons' job preferences and propose policy interventions that could possibly increase their retention in rural, remote, or underserved areas. METHODS: A discrete choice experiment (DCE) was conducted in November 2014 with a sample of Iranian neurosurgeons selected from five contrary's provinces representing the geographical diversity...
October 7, 2015: Iranian Journal of Neurology
Raul A Borracci, Eduardo B Arribalzaga, Juan L Couto, Mario Dvorkin, Rodolfo A Ahuad Guerrero, Carmen Fernandez, Luis N Ferreira, Leticia Cerezo
INTRODUCTION: Previous research has explored the effect of motivations, incentives and working conditions on willingness to accept jobs in rural and remote areas. These studies demonstrated that difficult working conditions, low job satisfaction and remuneration, and poor security, predisposed new medical graduates to select cities instead of rural districts. Since Argentina has a critical shortage of health staff in rural and low-income marginal suburban settings, and limited qualitative and quantitative local research has been done to address this issue, the present study was developed to assess the factors associated with the willingness of medical students to work in low-resource underprivileged areas of the country after graduation...
October 2015: Rural and Remote Health
Jennifer J Infanti, Ragnhild Lund, Munas M Muzrif, Berit Schei, Kumudu Wijewardena
Domestic violence in pregnancy is a significant health concern for women around the world. Globally, much has been written about how the health sector can respond effectively and comprehensively to domestic violence during pregnancy via antenatal services. The evidence from low-income settings is, however, limited. Sri Lanka is internationally acknowledged as a model amongst low-income countries for its maternal and child health statistics. Yet, very little research has considered the perspectives and experiences of the key front line health providers for pregnant women in Sri Lanka, public health midwives (PHMs)...
November 2015: Social Science & Medicine
Maria Mathews, Dana Ryan
Financial incentives are increasingly offered to recruit nursing personnel to work in underserved communities. The authors describe and compare the characteristics of federal, provincial and territorial financial recruitment incentive programs for registered nurses (RNs), nurse practitioners (NPs), licensed practical nurses (LPNs), registered practical nurses or registered psychiatric nurses. The authors identified incentive programs from government, health ministry and student aid websites and by contacting program officials...
March 2015: Nursing Leadership
Fadima Yaya Bocoum, Eddine Koné, Seni Kouanda, W Maurice E Yaméogo, Aristide Romaric Bado
BACKGROUND: The lack of motivation of health workers to practice in rural areas remains a crucial problem for decision-makers, as it deprives the majority of access to health care. To solve the problem, many countries have implemented health worker retention strategies. However, the development of such strategies requires an understanding of the preferences of health workers. The objective of the study was to identify a package for attracting and retaining health workers in underserved areas...
2014: Human Resources for Health
Jason Q Purnell, Tess Thompson, Matthew W Kreuter, Timothy D McBride
Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture)...
2015: Preventing Chronic Disease
James Rohlfing, Ryan Navarro, Omar Z Maniya, Byron D Hughes, Derek K Rogalsky
BACKGROUND: Median indebtedness at graduation is now more than $170,000 for graduates of US Medical Schools. Debate still exists as to whether higher debt levels influence students to choose high paying non-primary care specialties. Notably, no previous research on the topic has taken into account cost of attendance when constructing a debt model, nor has any research examined the non-career major life decisions that medical students face. METHODS: Medical students were surveyed using an anonymous electronic instrument developed for this study...
2014: Medical Education Online
Robin L Hynds, Jessica L Hatch, Joanne G Samuels
The Patient Protection and Affordable Care Act of 2010 (ACA) significantly impacts bedside nurses who must participate in organizational change and provide resources to patients. A health reform educational needs assessment was distributed to nurses from a midsized community hospital located in an elevated-need and medically underserved area in New England. Many nurses indicated that more knowledge was needed and they lacked information about the educational incentives. Health policy professional development opportunities are required to inform bedside nursing practice...
November 2014: Journal for Nurses in Professional Development
Julie A Gorzkowski, Jonathan D Klein, Donna L Harris, Kristen R Kaseeska, Regina M Whitmore Shaefer, Alison B Bocian, James B Davis, Edward M Gotlieb, Richard C Wasserman
BACKGROUND: Competing priorities in pediatric practice have created challenges for practice-based research. To increase recruitment success, researchers must design studies that provide added value to participants. This study evaluates recruitment of pediatricians into a study, before and after the development and addition of a quality improvement (QI) curriculum approved for American Board of Pediatrics Maintenance of Certification (MOC) Part 4 Credit as an enrollment incentive. METHODS: Researchers implemented multiple outreach methods to enroll pediatric practices over 28 months...
October 2014: Pediatrics
Diana M Godwin, Ha Hoang, Leonard A Crocombe, Erica Bell
INTRODUCTION: There is a globally observed unequal distribution of dental and other health practitioners between urban and rural areas in OECD countries. Dental practitioners provide important primary healthcare services to rural populations. Workforce shortages and stability issues in underserved areas can have negative effects on rural communities. Strategies used to fix the dental practitioner workforce maldistribution need to be investigated. METHOD: The study had primary focus on Australia and included relevant international literature...
2014: Rural and Remote Health
Alyna T Chien, Marshall H Chin, G Caleb Alexander, Hui Tang, Monica E Peek
OBJECTIVES: To estimate: (1) the percentage of physicians whose compensation is variable; (2) the frequency at which performance incentives for productivity, care quality, patient satisfaction, and resource use were used to determine compensation; and (3) how much incentives differ for physicians who serve greater percentages of patients who are Medicaid-insured, racial/ethnic minorities, or who face language barriers, versus those who do not. STUDY DESIGN: Cross-sectional study of 3234 nationally representative physicians responding to the 2008 Center for Studying Health System Change's Health Tracking Physician Survey (HTPS)...
February 2014: American Journal of Managed Care
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