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Kim J, Wang H, Ma J, Jeffrey D, Mohring S, Recher A, Potter JF. Addressing Social Determinants of Health in Primary Care Patients May Reduce Hospital Readmissions: A Quasi-Experimental Study. J Gen Intern Med 2024; 39:3104-3112. [PMID: 39289288 PMCID: PMC11618550 DOI: 10.1007/s11606-024-08813-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/10/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Health care systems are increasingly partnering with community-based organizations to address social determinants of health (SDH). We established a program that educates and connects patients with SDH needs at a primary care clinic to community services and facilitated referrals. OBJECTIVE To evaluate the effect of addressing SDH soon after discharge on hospital readmission in a clinic population. DESIGN Pre/post, quasi-experimental design with longitudinal data analysis for quality improvement. PARTICIPANTS Clinic patients (n = 754) having at least one hospital discharge between June 1, 2020, and October 31, 2021, were included. Of these, 145 patients received the intervention and 609 served as comparison. INTERVENTIONS A primary care liaison was employed to assess and educate recently discharged clinic patients for SDH needs and refer them for needed community services from June 1, 2020, to October 31, 2021. MAIN MEASURES Hospital readmissions within 30, 60, and 90 days of discharge were tracked at 6-month intervals. Covariates included patient age, sex, race/ethnicity, insurance status, income, Hierarchical Condition Category risk scores, and Clinical Classification Software diagnosis groups. Data for all hospital discharges during the intervention period were used for the main analysis and data for the year before the intervention were extracted for comparison. KEY RESULTS Overall, patients in the intervention group were older, sicker, and more likely to have public insurance. The reductions in 30-, 60-, and 90-day readmissions during the intervention period were 14.39%, 13.28%, and 12.04% respectively in the intervention group, while no significant change was observed in the comparison group. The group difference in reduction over time was statistically significant for 30-day (Diff = 12.54%; p = 0.032), 60-day (Diff = 14.40%; p = 0.012), and 90-day readmissions (Diff = 14.71%; p = 0.036). CONCLUSION Our findings suggest that screening clinic patients for SDH, and educating and connecting them to community services during post-hospital care may be associated with reductions in hospital readmissions.
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Affiliation(s)
- Jungyoon Kim
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Hongmei Wang
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jihyun Ma
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Daniel Jeffrey
- Department of Internal Medicine, Division of General Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Stephen Mohring
- Department of Internal Medicine, Division of General Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Jane F Potter
- Department of Internal Medicine, Division of Geriatrics, Gerontology and Palliative Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Marier P, Joy M, Smele S, Zakaria R, Beauchamp J, Bourgeois-Guérin V, Lupien PL, Sussman T. Older Adults in Administrative Quagmire: A Scoping Review of Policy and Program Coordination Across Six Marginalized Older Adult Populations. THE GERONTOLOGIST 2024; 64:gnae120. [PMID: 39211980 PMCID: PMC11535365 DOI: 10.1093/geront/gnae120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Coordination of governmental action is crowded with policies and programs that are highly interdependent, sometimes operating in silos if not contradicting each other. These dilemmas, or administrative quagmires, are heightened for older adults in general, but they are particularly problematic for marginalized older adults because these groups often require public assistance and support. This scoping review studies the coordination of governmental action on aging published in social science journals, focusing on 6 groups of marginalized older adults: those with histories of immigration, individuals with severe mental health problems, those who have had experiences of homelessness, formerly incarcerated individuals, members of the LGBT (lesbian, gay, bisexual, and transgender) community, and individuals living in a rural area. RESEARCH DESIGN AND METHODS A 5-stage scoping review methodology was followed, and 53 articles (published between 2000 and 2022) from 5 social science databases were analyzed. RESULTS The analysis revealed a limited number of contributions with coordination as a primary focus. Understandings of coordination varied but tended to examine structure, organization, and relationships between sectors. When coordination was the primary object of a study, it was often analyzed in 1 specific policy area or within a clinical setting along the lines of facilitating care coordination. DISCUSSION AND IMPLICATIONS This scoping review reveals a mutual neglect on the part of public administration and policy scholars toward marginalized older adults and a lack of public administration considerations on the part of scholars studying long-term care and social service programs for these marginalized older adults.
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Affiliation(s)
- Patrik Marier
- Department of Political Science, Concordia University, Montreal, Québec, Canada
- Centre for Research and Expertise in Social Gerontology, Côte St-Luc, Québec, Canada
| | - Meghan Joy
- Department of Political Science, Concordia University, Montreal, Québec, Canada
| | - Sandra Smele
- Centre for Research and Expertise in Social Gerontology, Côte St-Luc, Québec, Canada
- Simone de Beauvoir Institute, Concordia University, Montreal, Québec, Canada
| | - Rym Zakaria
- Centre for Research and Expertise in Social Gerontology, Côte St-Luc, Québec, Canada
| | - Julie Beauchamp
- Department of Psychiatry and Neurosciences, Université Laval, Quebec City, Québec, Canada
| | | | - Pierre-Luc Lupien
- Department of Sociology, Cégep de la Gaspésie et des Îles, Gaspé, Québec, Canada
| | - Tamara Sussman
- School of Social Work, McGill University, Montreal, Québec, Canada
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3
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Wei W, Wang P, Qing P, Li Z, He Q. Non-surgical nursing care for tumor patients: an overview of sedation, analgesia, and recent innovations. Front Oncol 2024; 14:1322196. [PMID: 39355133 PMCID: PMC11443224 DOI: 10.3389/fonc.2024.1322196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/12/2024] [Indexed: 10/03/2024] Open
Abstract
With the increasing prevalence of tumors, effective symptom management has emerged as a cornerstone of patient care. While surgical interventions remain pivotal, non-surgical nursing methods have gained prominence in providing relief from pain, discomfort, and other tumor-related symptoms. This review delves into the various non-surgical approaches employed, emphasizing tumor sedation and analgesia. We discuss the array of non-pharmacological and pharmacological strategies, shedding light on their indications, contraindications, and potential side effects. Furthermore, the importance of addressing individual differences in pain perception and the ethical considerations in symptom management are highlighted. We conclude by providing insights into the recent innovations in the field, emphasizing the need for personalized and comprehensive care to enhance patients' quality of life. Tumor sedation, Tumor analgesia, Non-surgical nursing care, Pain management, Non-pharmacological interventions, Palliative care, Recent innovations, Symptom management.
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Affiliation(s)
- Wei Wei
- Department of Anesthesiology, Affiliated Sport Hospital of CDSU, Chengdu, Sichuan, China
| | - Pan Wang
- Department of Pain, Zibo Central Hospital, Zibo, Shandong, China
| | - Pan Qing
- Department of Geriatric Orthopaedics II, Sichuan Orthopaedic Hospital, Chengdu, Sichuan, China
| | - Zhang Li
- Department of Anesthesiology, Affiliated Sport Hospital of CDSU, Chengdu, Sichuan, China
| | - Qi He
- Department of Anesthesiology, Affiliated Sport Hospital of CDSU, Chengdu, Sichuan, China
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Kamei T, Kawada A, Minami K, Takahashi Z, Ishigaki Y, Yamanaka T, Yamamoto N, Yamamoto Y, Suzuki Y, Watanabe T, Iijima K. Effectiveness of an interdisciplinary home care approach for older adults with chronic conditions: A systematic review and meta-analysis. Geriatr Gerontol Int 2024; 24:827-840. [PMID: 39021240 DOI: 10.1111/ggi.14931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/15/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024]
Abstract
The effectiveness of interdisciplinary home healthcare service consisting of at least two or more healthcare providers, such as a nurse, physician and physiotherapist, for community-dwelling older adults remains unclear. This systematic review assesses the effects of interdisciplinary home care on quality of life (QOL) and health outcomes in older adults with chronic conditions using validated tools. Databases were searched using CINAHL Plus with Full Text, PubMed, EMBASE, CENTRAL, PsycINFO, and OpenGrey from inception to January 25, 2021. Eligibility criteria included (i) an interdisciplinary home care approach, (ii) participants aged 65 years and older with chronic conditions, (iii) randomized controlled trials (RCTs), and (iv) original literature in English. The study reviewer's dyad independently screened the literature and assessed the study quality using the Cochrane's Risk of Bias 2 tool. The analysis employed qualitative and quantitative integration and Grading of Recommendations Assessment, Development, and Evaluation. This study included 13 RCTs with 4709 participants. Four RCTs indicated that interdisciplinary home healthcare services reduced hospital admissions during the initial 6 months after the start of home care interventions (risk ratio [RR] = 0.73; 95% confidence interval [CI] = 0.61-0.88; p < 0.001; I2 = 0%). However, evidence certainty was moderate; QOL and mortality showed low certainty; and institutionalization and adherence showed moderate certainty of evidence. This study suggests that the interdisciplinary home care approach reduces hospital admissions but lacks effects on other outcomes. More robust studies are required to evaluate this evidence. Geriatr Gerontol Int 2024; 24: 827-840.
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Affiliation(s)
- Tomoko Kamei
- Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Aki Kawada
- Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Kotoko Minami
- Graduate School of Nursing Science, St Luke's International University, Tokyo, Japan
| | - Zaiya Takahashi
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Takashi Yamanaka
- Department of Home Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto
- Department of Gerontological Homecare and Long-term Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuko Yamamoto
- Chiba Faculty of Nursing, Tokyo Healthcare University, Chiba, Japan
| | - Yusuke Suzuki
- Centre for Community Liaison and Patient Consultations, Nagoya University Hospital, Aichi, Japan
| | - Takamasa Watanabe
- Centre for Family Medicine Development, Japanese Health and Welfare Co-operative Federation, Tokyo, Japan
| | - Katsuya Iijima
- Institute for Future Initiatives, Institute of Gerontology, The University of Tokyo, Tokyo, Japan
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Michielsen L, Bischoff EWMA, Schermer T, Laurant M. Primary healthcare competencies needed in the management of person-centred integrated care for chronic illness and multimorbidity: Results of a scoping review. BMC PRIMARY CARE 2023; 24:98. [PMID: 37046190 PMCID: PMC10091550 DOI: 10.1186/s12875-023-02050-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/30/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Chronic disease management is important in primary care. Disease management programmes focus primarily on the respective diseases. The occurrence of multimorbidity and social problems is addressed to a limited extent. Person-centred integrated care (PC-IC) is an alternative approach, putting the patient at the centre of care. This asks for additional competencies for healthcare professionals involved in the execution of PC-IC. In this scoping review we researched which competencies are necessary for healthcare professionals working in collaborative teams where the focus lies within the concept of PC-IC. We also explored how these competencies can be acquired. METHODS Six literature databases and grey literature were searched for guidelines and peer-reviewed articles on chronic illness and multimorbidity in primary care. A data synthesis was carried out resulting in an overview of the competencies that healthcare professionals need to deliver PC-IC. RESULTS Four guidelines and 21 studies were included and four core competencies could be derived through the synthesis: 1. interprofessional communication, 2, interprofessional collaborative teamwork, 3. leadership and 4. patient-centred communication. Included papers mostly lack a clear description of the competencies in terms of knowledge, skills and attitudes which are necessary for a PC-IC approach and on how these competencies can be acquired. CONCLUSION This review provides insight on competencies necessary to provide PC-IC within primary care. Research is needed in more depth on core concepts of these competencies which will then benefit educational programmes to ensure that healthcare professionals in primary care are better equipped to deliver PC-IC for patients with chronic illness and multimorbidity.
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Affiliation(s)
- Leslie Michielsen
- School of Health Studies, HAN University of Applied Sciences, Nijmegen, the Netherlands.
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Erik W M A Bischoff
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Tjard Schermer
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
- Science Support Office, Gelre Hospitals, Apeldoorn, The Netherlands
| | - Miranda Laurant
- School of Health Studies, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, the Netherlands
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Gabutti I, Barneschi C. Understanding the gap between policy and facts: The Italian experience on federal decoupling in the implementation of breast units. WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Irene Gabutti
- Graduate School of Health Economics and Management (ALTEMS) Faculty of Economics, Università, Cattolica del Sacro Cuore Rome Italy
| | - Chiara Barneschi
- Department of Anesthesiology and Perioperative Medicine Usl Sud est Toscana, Hospital Montepulciano Siena Italy
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Minvielle E, Fourcade A, Ricketts T, Waelli M. Current developments in delivering customized care: a scoping review. BMC Health Serv Res 2021; 21:575. [PMID: 34120603 PMCID: PMC8201906 DOI: 10.1186/s12913-021-06576-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care. METHODS Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included "care customization", "personalized service and health care", individualized care" and "targeting population" in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. RESULTS We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. CONCLUSIONS There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.
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Affiliation(s)
- Etienne Minvielle
- i3-Centre de Recherche en Gestion, Institut Interdisciplinaire de l’Innovation (UMR 9217), École polytechnique, Batiment Ensta, 828, Boulevard des Maréchaux, 91762 Palaiseau Cedex, France
- Institut Gustave Roussy, 114, rue Edouard Vaillant, 94800 Villejuif, France
| | - Aude Fourcade
- Institut Gustave Roussy, 114, rue Edouard Vaillant, 94800 Villejuif, France
| | - Thomas Ricketts
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA
| | - Mathias Waelli
- MOS (EA 7418), French School of Public Health, Rennes, France
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8
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Foley KT, Luz CC. Retooling the Health Care Workforce for an Aging America: A Current Perspective. THE GERONTOLOGIST 2021; 61:487-496. [PMID: 33095881 DOI: 10.1093/geront/gnaa163] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Indexed: 11/14/2022] Open
Abstract
A 2008 Institute of Medicine (IoM) report outlined a vision for health care and a workforce capable of addressing health and extended care needs of our aging population. It highlighted dramatic shortages necessitating bold action and outlined recommendations aimed at building a sizable and qualified workforce. This study updates report findings and progress made on its recommendations. Through review of publicly accessible, internet-based literature and government and professional organization websites, current workforce data and recent policy changes are compared to the report's statistics and recommendations. Direct comparisons are limited by changing definitions, context, and data collection and analyses methods. Future workforce-need projections are estimated using reports from various sources. Inability to forecast medical advances, socioeconomic changes, and world events affects the accuracy of these projections. Nonetheless, clear conclusions emerge despite such limitations. Progress toward fulfilling the IoM goals is variable and insufficient. The current and projected numbers for all geriatric health providers remain inadequate compared to estimated 2030 demand. Challenges in meeting estimated needs persist essentially unchanged. The 2008 IoM framework and recommendations remain relevant and constitute an important roadmap to complete unfinished goals. Initial findings from this update provide a platform for developing practice and policy reforms.
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Affiliation(s)
- Kevin T Foley
- Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing
| | - Clare C Luz
- Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing
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Schwabenbauer AK, Knight CM, Downing N, Morreale-Karl M, Mlinac ME. Adapting a whole health model to home-based primary care: Bridging person-driven priorities with veteran and family-centered geriatric care. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2021; 39:374-393. [PMID: 34410781 PMCID: PMC8406673 DOI: 10.1037/fsh0000613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Through the integration of Whole Health for Life into the Department of Veterans Affairs (VA) health care system, the VA aims to transform health care delivery from a disease management approach to one that embraces person-centered care. The home-based primary care (HBPC) program is a care model that, within the VA, provides holistic primary care services to homebound veterans with multiple chronic medical conditions, mental health issues, and functional declines. These veterans may have limited access to VA programs delivered in a traditional outpatient format. This article describes adaptations to the whole health model of care that could improve its accessibility and applicability to HBPC veterans, caregivers, and the interdisciplinary teams that serve this population. These modifications are informed by whole-person geriatric and gerontological and family-systems theories and address population-based differences in the focus and approach to care. The focus on care is expanded to (a) reflect the importance of attending to caregiver needs and well-being and (b) shift from a preventative model to one that prioritizes resilience and maintenance. The approach to care emphasizes alternative modes of delivery, adaptations to interventions, and integration of geriatric-specific medical considerations into the self-care domains and more directly centers the collaboration between family, the VA, and community partners. This adapted model also addresses the unique needs of health care teams providing in-home services to medically complex veterans and offers suggestions for enhancing self-care and preventing burnout. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Cynthia M. Knight
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
| | - Nicole Downing
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
| | - Michelle Morreale-Karl
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
- Department of Medicine, Harvard Medical School
| | - Michelle E. Mlinac
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
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Cochran RA, Feldman SS, Ivankova NV, Hall AG, Opoku-Agyeman W. Intention to Use Behavioral Health Data From a Health Information Exchange: Mixed Methods Study. JMIR Ment Health 2021; 8:e26746. [PMID: 34042606 PMCID: PMC8193493 DOI: 10.2196/26746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Patients with co-occurring behavioral health and chronic medical conditions frequently overuse inpatient hospital services. This pattern of overuse contributes to inefficient health care spending. These patients require coordinated care to achieve optimal health outcomes. However, the poor exchange of health-related information between various clinicians renders the delivery of coordinated care challenging. Health information exchanges (HIEs) facilitate health-related information sharing and have been shown to be effective in chronic disease management; however, their effectiveness in the delivery of integrated care is less clear. It is prudent to consider new approaches to sharing both general medical and behavioral health information. OBJECTIVE This study aims to identify and describe factors influencing the intention to use behavioral health information that is shared through HIEs. METHODS We used a mixed methods design consisting of two sequential phases. A validated survey instrument was emailed to clinical and nonclinical staff in Alabama and Oklahoma. The survey captured information about the impact of predictors on the intention to use behavioral health data in clinical decision making. Follow-up interviews were conducted with a subsample of participants to elaborate on the survey results. Partial least squares structural equation modeling was used to analyze survey data. Thematic analysis was used to identify themes from the interviews. RESULTS A total of 62 participants completed the survey. In total, 63% (n=39) of the participants were clinicians. Performance expectancy (β=.382; P=.01) and trust (β=.539; P<.001) predicted intention to use behavioral health information shared via HIEs. The interviewees (n=5) expressed that behavioral health information could be useful in clinical decision making. However, privacy and confidentiality concerns discourage sharing this information, which is generally missing from patient records altogether. The interviewees also stated that training for HIE use was not mandatory; the training that was provided did not focus specifically on the exchange of behavioral health information. CONCLUSIONS Despite barriers, individuals are willing to use behavioral health information from HIEs if they believe that it will enhance job performance and if the information being transmitted is trustworthy. The findings contribute to our understanding of the role HIEs can play in delivering integrated care, particularly to vulnerable patients.
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Affiliation(s)
- Randyl A Cochran
- Department of Health Sciences, College of Health Professions, Towson University, Towson, MD, United States
| | - Sue S Feldman
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Nataliya V Ivankova
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Allyson G Hall
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - William Opoku-Agyeman
- School of Health and Applied Human Sciences, College of Health and Human Services, University of North Carolina Wilmington, Wilmington, NC, United States
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11
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Liu H. Research on Disability Grading Based on ICF Functional Framework: Empirical Evidence From Zhejiang Province, China. Front Public Health 2021; 9:616180. [PMID: 34046386 PMCID: PMC8144326 DOI: 10.3389/fpubh.2021.616180] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 03/17/2021] [Indexed: 11/30/2022] Open
Abstract
Through assignment method, the total score of disability in multiple dimensions is obtained, and it is divided into five functional states—severe disability, partial disability, moderate disability, mild disability, and health—according to the score, and the probability of death is constructed. Using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database tracking survey data, by constructing a multistate transition probability matrix, the empirical calculation of the multistate disability transfer probability, with the help of the sixth national census data, we estimated maintenance time of each state, life expectancy, etc. The results show that the 3 year transfer probability of the initial healthy elderly is the highest, and the mortality rate is also the lowest. It can be found that the disability state transition probability measurement based on the data is more accurate than the model estimation; the disability scale and life expectancy estimated based on the multistate transition probability matrix are more reliable.
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Affiliation(s)
- Huan Liu
- School of Public Administration, Zhejiang University of Finance and Economics, Hangzhou, China
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Yoon K, Park G, Lee M. How Should the Social Service Quality Evaluation in South Korea Be Verified? Focusing on Community Care Services. Healthcare (Basel) 2020; 8:healthcare8030294. [PMID: 32846999 PMCID: PMC7551021 DOI: 10.3390/healthcare8030294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/16/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022] Open
Abstract
The quality evaluation (QE) of social services tends to have a large variation in results depending on the object and method of service measurement. To overcome these limitations, an analysis of the internal consistency or validity of the social service QE index is necessary, but meta-research on this is insufficient. This study analyzes the internal consistency and validity of evaluation indexes based on the results of social service QE. We utilized the social services QE manual of the Social Security Information Service’s Facility Evaluation Department. The social service QE indexes implemented in 2013 and 2016 were coded and analyzed. We found that there was internal consistency between the results of the care services evaluation in 2013 and 2016. In addition, there were differences between the care services QE indexes by service type in 2013 and 2016. It is necessary to construct effective indexes by simplifying, diversifying, and differentiating social service QE indexes. In addition, control devices for external factors (region, composition of the evaluation team, etc.) must be prepared to maintain the consistency of evaluation scores, and in the long term, standardization of social service QE indexes is necessary.
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Affiliation(s)
- Kichan Yoon
- Social Security Information Institute, Social Security Information Service, Seoul 04554, Korea; (K.Y.); (G.P.)
| | - Gyubeom Park
- Social Security Information Institute, Social Security Information Service, Seoul 04554, Korea; (K.Y.); (G.P.)
| | - Munjae Lee
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Correspondence:
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Spetz J, Periyakoil VS. Introduction to the Special Issue on the Workforce for Seriously Ill Older Adults in the Community. J Am Geriatr Soc 2020; 67:S390. [PMID: 31074848 DOI: 10.1111/jgs.15942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Joanne Spetz
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California
| | - Vyjeyanthi S Periyakoil
- Department of Medicine/Primary Care and Population Health, Stanford University, Palo Alto, California
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Edes TE. Connecting Social, Clinical, and Home Care Services: Where Healthcare Needs to Go. J Am Geriatr Soc 2019; 67:S419-S422. [DOI: 10.1111/jgs.15933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/04/2019] [Accepted: 03/17/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Thomas E. Edes
- US Department of Veterans AffairsOffice of Geriatrics and Extended Care Washington District of Columbia
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