Journal of General Internal Medicine最新文献

{"title":"Assessment of Spanish Language Interpretation Access at Primary Care Offices in Allegheny County: A Secret Shopper Study.","authors":"Christina White, Tanya Nikiforova, Eliana Bonifacino","doi":"10.1007/s11606-025-09857-0","DOIUrl":"https://doi.org/10.1007/s11606-025-09857-0","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for Communities: Comparing Health Care System Patient Populations to Regional Populations.","authors":"John P Powers, Timothy S Carey, Taylor W Hargrove, Aubrey Limburg, Victoria Udalova, Amy Shaheen, Robert Bowers, Emily R Pfaff, Barbara Entwisle","doi":"10.1007/s11606-025-09867-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09867-y","url":null,"abstract":"<p><strong>Background: </strong>Recent years have seen an increase in the number and size of integrated health care delivery systems in the USA. The size and sophistication of these systems afford a greater focus on population health, leading to a fundamental question: How do the patients of these systems compare to the underlying regional populations that the systems serve?</p><p><strong>Objective: </strong>To demonstrate an approach to answering this question for a large public integrated delivery system, with a particular focus on neighborhood social determinants of health (SDOH).</p><p><strong>Design: </strong>We present a descriptive, graphical comparison of the neighborhood characteristics of UNC Health patients and the overall population of North Carolina (NC).</p><p><strong>Subjects: </strong>We leveraged electronic health record data from a 5-year period for patients at UNC Health, an integrated health care delivery system focused on serving the NC population. Estimates for the NC population were obtained from the American Community Survey (ACS).</p><p><strong>Main measures: </strong>Measures included neighborhood SDOH indices for NC census tracts derived from ACS data as well as race and ethnicity.</p><p><strong>Key results: </strong>Overall, patients were more concentrated in neighborhoods with the least and greatest disadvantage. However, the density patterns of specific racial and ethnic groups across neighborhood SDOH scores were similar between the patients and NC population.</p><p><strong>Conclusions: </strong>Using a large, public integrated health care delivery system, we illustrate an approach for comparing the demographic and neighborhood characteristics of the patients of such a system and its underlying regional population using freely available data and open-source software. Our findings indicate many similar patterns between the health care system patients and regional population, but overall higher concentrations of patients in neighborhoods with the least and greatest disadvantage.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling the Budgetary Impacts of Sickle Cell Disease Gene Therapies on State Medicaid Programs.","authors":"Jessica Preston Harvey, Adam J N Raymakers, Leah Z Rand, George Goshua, Aaron S Kesselheim, Ankur Pandya","doi":"10.1007/s11606-025-09865-0","DOIUrl":"https://doi.org/10.1007/s11606-025-09865-0","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Access, Perceived Need for Treatment, and the Decision to Seek Care for COPD Exacerbations.","authors":"Vincent S Fan, Paul L Hebert, Emily R Locke, Tracy L Simpson, Erik R Swenson, Jeff D Edelman, Cathy Battaglia, Ranak B Trivedi, John C Fortney","doi":"10.1007/s11606-025-09786-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09786-y","url":null,"abstract":"<p><strong>Background: </strong>Patients often delay care for COPD exacerbations, delaying recovery and increasing the risk of emergency visits.</p><p><strong>Objective: </strong>This study examined the relative importance of access to care and perception of need for care in the decision to seek care for COPD exacerbations.</p><p><strong>Design: </strong>A 1-year prospective cohort study.</p><p><strong>Participants: </strong>A total of 410 patients with COPD in the Department of Veterans Affairs (VA).</p><p><strong>Main measures: </strong>Participants completed baseline spirometry and questionnaires regarding social support, comorbidity, cognition, psychological symptoms, perceived access to care, and perceived need for care. Participants were contacted every 2 weeks to identify exacerbations, and information was collected regarding symptoms, care seeking, and health care utilization. For each exacerbation, participants completed the Response to Symptoms Questionnaire regarding emotional and cognitive responses to the exacerbations. A shared-frailty survival model was used to estimate the correlates of time to seeking care.</p><p><strong>Key results: </strong>There were 1094 exacerbations among 356 participants; mean age of these patients was 69.4 (SD 7.4), 4.2% were women, and mean FEV₁% predicted was 44.2% (SD 18.7). In adjusted analyses, those who were very or extremely anxious in response to symptoms were more likely to seek care; those with very or extremely high perceived control over symptoms were less likely to seek care, and access to a VA pulmonary provider was associated with earlier care seeking.</p><p><strong>Conclusions: </strong>In the VA, patients' perceived need for care was an important determinant of care seeking for COPD exacerbations. Understanding and addressing the emotional and cognitive responses to worsening breathing symptoms may help inform programs for prompt and appropriate treatment of COPD exacerbations.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EBM BLS: Treating Anal High-grade Squamous Intraepithelial Lesions Reduces Progression to Invasive Anal Cancer in People Living with HIV.","authors":"Steven Allon, Jason T Alexander, Christopher Terndrup","doi":"10.1007/s11606-025-09828-5","DOIUrl":"https://doi.org/10.1007/s11606-025-09828-5","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Self-Measured Blood Pressure Devices Change Outcomes? Implementation Does: Team-Based Insights from the ASPIRE Hybrid Trial.","authors":"Osamu Takahashi, Gautam A Deshpande, Paul Glasziou","doi":"10.1007/s11606-025-09866-z","DOIUrl":"https://doi.org/10.1007/s11606-025-09866-z","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Implementation of Population Health Outreach to Increase Breast Cancer Screening.","authors":"Maxim Yaskolko, Catherine Reitz, Christopher K Snider, Stephanie Subbio, Caitlin Brophy, Shivan J Mehta, Corinne Rhodes","doi":"10.1007/s11606-025-09870-3","DOIUrl":"https://doi.org/10.1007/s11606-025-09870-3","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voting Characteristics of US Healthcare Workers with Disabilities: A National Survey Analysis.","authors":"Mihir Kakara, Megan A Morris","doi":"10.1007/s11606-025-09856-1","DOIUrl":"https://doi.org/10.1007/s11606-025-09856-1","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the Relationship-centered Care Framework to Longitudinal Patient-student Relationships Early in Medical Training to Promote Professional Identity Formation.","authors":"Rachel H Kon, Simon Lehtinen, Milad Memari","doi":"10.1007/s11606-025-09863-2","DOIUrl":"https://doi.org/10.1007/s11606-025-09863-2","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnant Patients are Less Likely to Disclose Substance USE if They Perceive Stigma in Their Clinic Notes.","authors":"Marianne Sharko, Jessica S Ancker, Mohit Sharma, Meghan E Davis, Braja Gopal Patra, Jyotishman Pathak","doi":"10.1007/s11606-025-09869-w","DOIUrl":"https://doi.org/10.1007/s11606-025-09869-w","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}