Population Health Management最新文献

{"title":"Developing a Strategy to Increase Lung Cancer Screening in Areas of Need.","authors":"Garrett Melby, Charnita Zeigler-Johnson, Melissa Dicarlo, Kristine Pham, Christine S Shusted, Ronald Myers","doi":"10.1089/pop.2024.0193","DOIUrl":"10.1089/pop.2024.0193","url":null,"abstract":"<p><p>Lung cancer screening (LCS) rates are low, and lung cancer mortality is high in the United States. This report describes a strategy that health systems can use to identify LCS areas of need and engage associated primary care providers and patients in screening. A research team from Jefferson Health (JH), a large, urban health system, used geocoded standardized lung cancer mortality rates (SMRs) to identify zip codes in Philadelphia where lung cancer mortality is high. In addition, health system electronic medical record data were used to identify primary care practices serving these areas. The study also developed an online program to train providers in shared decision making (SDM) about LCS. Finally, primary care leaders were interviewed to learn about training obstacles and opportunities. The JH research team identified 8 high-SMR zip codes and 8 practices with patients from those areas. Working with the American College of Chest Physicians and the National Lung Cancer Round Table, the authors developed a free, online, accredited course to train providers in patient education, values elicitation, and decision support for LCS. Interview analyses with practice leaders encouraged the health system to incentivize provider training and use of SDM tools in practice. Health systems can implement a systematic approach to identify LCS areas of need and train primary care providers to engage patients in SDM about LCS. Research is needed to implement such an approach and evaluate the program's impact on patient engagement, screening, and related outcomes among patients' diverse populations.</p>","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"15-21"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth as a Tool for Increasing Health Determinant Risk Assessment: An Analysis of the 2024 Physician Fee Schedule's New Health Equity Codes.","authors":"H Alex Hoyen, Mitchell Kaminski","doi":"10.1089/pop.2024.0136","DOIUrl":"10.1089/pop.2024.0136","url":null,"abstract":"","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"50-52"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI and Falls Detection: Great Promise but Gaps in Evidence.","authors":"Brian D'Anza, Claudia Cabrera, Jennifer Gonzalez, Peter Pronovost","doi":"10.1089/pop.2024.0230","DOIUrl":"10.1089/pop.2024.0230","url":null,"abstract":"","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"53-55"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping Review of Indices to Measure a Community's Health Status.","authors":"Susan T Pastula, Lauren C Bylsma, Saumitra V Rege, R Jeffrey Lewis, Naimisha Movva","doi":"10.1089/pop.2024.0138","DOIUrl":"10.1089/pop.2024.0138","url":null,"abstract":"<p><p>Composite health indicators are valuable tools to assess population health over time and identify areas for intervention. This scoping review (ScR) aimed to map the literature describing comprehensive health-related metrics used to assess community health. The Arksey and O'Malley framework was used to conduct the ScR, using the following steps: identifying the research question, identifying relevant studies, charting the data, collating and reporting results. United States-based studies that developed/utilized a composite health index using geographic information system (GIS) mapping capabilities to assess community health at the county level or more granular were identified through literature searches conducted in PubMed and EMBASE databases. Literature searches identified 5112 articles; of these, 8 studies describing composite health indices were included. The number of indicators used in each index ranged from 4 to 75 (median: 22). Health outcomes, health behaviors, education, and economics were incorporated into most indices. High school graduation rate (<i>n</i> = 6 indices), health insurance status (<i>n</i> = 5), commute time, median household income, unemployment, and obesity rates (<i>n</i> = 4 each) were the most common indicators across indices. All indicators were derived from publicly available data sources, such as the American Community Survey and US Census Bureau. Although a limited number of community health indices were identified in the ScR, the indices included a broad range of indicators covering both health outcomes and factors contributing to health vulnerabilities. The public data sources and GIS integration of the indices provide potential for broad, insightful applications to various contexts across the United States.</p>","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"37-49"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Stakeholder Engagement in Statewide Primary Care Cardiovascular Health Improvement Cooperatives.","authors":"Kimberly A Smith, Adam T Perzynski, Cori C Grant, Demetria Hubbard, Larry R Hearld, James E Bailey, Satya Surbhi, Umar Kabir, Andrea L Cherrington","doi":"10.1089/pop.2024.0175","DOIUrl":"10.1089/pop.2024.0175","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) remains a major national health challenge with significant disparities linked to socioeconomic status, race, ethnicity, sex, and geography, prompting federal efforts to build statewide primary care quality improvement (QI) cooperatives to improve heart health. To be effective, cooperatives require high levels of member engagement and leaders need ways to assess engagement. The objective of this study was to develop and validate a novel Cooperative Member Survey to assess cooperative member engagement and assess the value of the cooperative to members across three statewide heart health QI cooperatives. The 14-item survey included fixed-response and open-ended questions and was developed through multiple iterative rounds across the three cooperatives to gain consensus on the wording of final items using a Delphi process. The survey then was administered to the key stakeholders in the three cooperatives. Findings from both the quantitative and qualitative items were analyzed and reported based on frequencies and emerging themes. The survey was then analyzed to determine factor structure and validity. Analysis revealed a two-factor structure which the research team identified as: (1) Cooperative Engagement, consisting of 11 items that measured how well the cooperative functioned overall, and (2) Cooperative Value, consisting of two items that assessed the perceived value of mutual learning and respect within the cooperative. This two-factor structure indicated that the Cooperative Member Survey successfully captured both the practical aspects of how the cooperative operates and the members' perceived benefits of their involvement. Successful QI cooperatives not only require efficient operations but also a sense of shared value among members. These findings suggest that cooperatives designed to improve public health outcomes may benefit from focusing not only on practical aspects of engagement but also on cultivating mutual respect and collective learning.</p>","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Based Mental Health Improvement Initiatives: A Narrative Review and Indiana Case Study.","authors":"William M Tierney, Cassidy McNamee, Sydney S Harris, Stephen M Strakowski","doi":"10.1089/pop.2024.0153","DOIUrl":"10.1089/pop.2024.0153","url":null,"abstract":"<p><p>There is a global mental health crisis: mental illness is underrecognized, underdiagnosed, and undertreated with adverse effects on mental, physical, and social health. In the United States, there is an insufficient number of traditional psychiatric and psychological resources to provide the mental health care needed to solve this crisis. Community-based interventions could be an important adjunct to traditional mental health care. An evaluation of peer-reviewed articles was performed describing community-based interventions and identified 3 approaches with some evidence of effectiveness: (1) interventions that enhance community mental health literacy to improve recognition of early signs of mental illness for early engagement and provide community, family, and peer support; (2) community clinics providing social, medical, and mental health care and support to transition-age youth (15-25 years); and (3) social networking activities to enhance interactions among elders suffering from social isolation and loneliness. Multisector, multidisciplinary, and multicomponent interventions involving health care providers and community-based organizations had the best evidence of effectiveness and should target transition-age youth and elders.</p>","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"31-36"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Cost Savings of Care Coordination for Older Adults: Evidence from the Iowa Return to Community Program.","authors":"Erblin Shehu, Brian Kaskie, Kent Ohms, Daniel Liebzeit, Sato Ashida, Harleah G Buck, Dan M Shane","doi":"10.1089/pop.2024.0192","DOIUrl":"10.1089/pop.2024.0192","url":null,"abstract":"<p><p>In response to rising costs associated with providing health care services to Americans over 65 years old, policymakers have called for the expansion of care coordination programs to reduce total spending while improving patient outcomes and provider efficiency. This study uses a Markov Chain model to estimate financial impacts associated with the implementation of a care coordination program across the state of Iowa. Estimates revealed an association between the implementation of the Iowa Return to Community (IRTC) and a reduction in health care service use, which yielded per capita cost savings of $7,920.24 over a 5-year span. Subgroup analysis showed that inclusion of informal care partners enhances these savings, as they contributed to reduced inpatient hospital use and deferred nursing home admissions. The continued expansion of the IRTC appears as a viable strategy to curtail aggregate health care spending while supporting older adults stay at home.</p>","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"22-30"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Control in Patients with Employer-Sponsored Health Benefits.","authors":"Judy Z Louie, Charles M Rowland, Dov Shiffman, Rajesh Garg, Ernesto Bernal-Mizrachi, Michael J McPhaul","doi":"10.1089/pop.2024.0144","DOIUrl":"https://doi.org/10.1089/pop.2024.0144","url":null,"abstract":"<p><p>Lack of health care insurance is strongly associated with poor glycemic control in patients with diabetes. However, even among insured patients, achieving glycemic control can be challenging. We investigated whether demographics, physical activity, engagement with health care providers, as well as medical and socioeconomic factors were associated with poor glycemic control (hemoglobin A1c [HbA1c] >8.5%) in patients with type 2 diabetes (T2D) who had employer-sponsored health insurance. We studied data of 2981 employees and spouses with T2D who participated in an annual health assessment in 2019 and had medical insurance benefits for at least 12 consecutive months prior to the assessment. T2D was defined by International Classification of Diseases codes, self-reported physician diagnoses, or test results (fasting glucose >125 mg/dL or HbA1c >6.4%). HbA1c was >7% in 43% of the patients and >8.5% in 16% of patients. Among patients with poor glycemic control, 90% had HbA1c data for at least 2 of the previous 3 years; 76% had poor control in at least 1 of the previous 3 years. Poor glycemic control was associated with demographics (younger age men), disease severity (greater number of diabetes complications and prescription medications), poor engagement with health care providers (eg, more years since last physical exam, less confidence talking with physician), and less physical activity. Thus, lack of glycemic control is persistent and unexpectedly frequent in patients with T2D despite access to health care benefits. Improving physical activity and engagement with providers may improve glycemic control in this population.</p>","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":"28 1","pages":"8-14"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Socioeconomic Deprivation and Healthy Days Among Commercially Insured Adults Using a Digital Health Application: An Observational Study.","authors":"Jaclyn Marshall, Oliver-John M Bright, Nicholas Leiby, Todd Thames, Alexandra Yurkovic","doi":"10.1089/pop.2024.0202","DOIUrl":"https://doi.org/10.1089/pop.2024.0202","url":null,"abstract":"<p><p>Population health research has long demonstrated that where someone lives is highly correlated with health outcomes and quality of life. This study explored if this relationship remained between zip code socioeconomic deprivation index (SDI) and member-reported healthy days among commercially insured adults interacting with virtual care and navigation services between May 1, 2023 and May 31, 2024, offered by Included Health. Members received an SMS-based survey that included the 4 Centers for Disease Control and Prevention Healthy Days questions after interacting with the digital health application. The proportion of members who reported frequent (14 or more) physically unhealthy, mentally unhealthy, and total unhealthy days during the past 30 days was calculated. The adjusted odds ratio for reporting frequent total unhealthy days was estimated by members' zip code SDI quartile, accounting for member demographic characteristics. Of the 6692 survey respondents, 13.7% reported frequent physically unhealthy days, 20.8% reported frequent mentally unhealthy days, and 29.2% reported frequent total unhealthy days. After adjusting for covariates, members in the highest SDI quartile were 1.2 times more likely to report frequent unhealthy days (<i>P</i> = 0.047) than those in the lowest SDI quartile. The results demonstrate the importance of geographic indices, in the absence of other data, to assist employers in identifying members with potentially higher need of digital health services. It also highlights the feasibility of collecting quality of life measures to identify members who could benefit from timely intervention.</p>","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital Safety-Net Burden is Associated with Perioperative Outcomes in Primary Total Hip Arthroplasty: A Multistate Retrospective Analysis, 2015-2020.","authors":"Margaret Darko, Virginia E Tangel, Abbey Gilman, Maressa Cumbermack, Deirdre C Kelleher, Tiffany Tedore, Robert S White","doi":"10.1089/pop.2024.0194","DOIUrl":"https://doi.org/10.1089/pop.2024.0194","url":null,"abstract":"<p><p>Total hip arthroplasty (THA) is a widely performed surgical procedure in the United States, but disparities in THA outcomes related to hospital-level factors, such as safety-net burden, are underexplored. This study expands on previous research by analyzing multicenter, multistate data from 2015 to 2020 to investigate the impact of hospital safety-net burden-defined as the proportion of services billed to Medicaid and uninsured patients-on THA outcomes. This study is a retrospective analysis using data from the State Inpatient Databases for Florida, Kentucky, Maryland, New York, Washington, New Jersey, and North Carolina. The study cohort included 543,814 inpatient primary THA admissions, with patient demographics, comorbidities, and hospital characteristics analyzed across 3 categories of hospital safety-net burden (low, medium, and high). Generalized linear mixed models assessed the association between safety-net burden and in-hospital mortality and postoperative complications, whereas multilevel negative binomial regression evaluated the impact on hospital length of stay. The study findings indicate that patients undergoing THA at hospitals with high safety-net burden had significantly higher odds of in-hospital mortality (adjusted odds ratio [aOR]: 1.20, 95% confidence interval [CI]: 1.02-1.42), postoperative complications (aOR 1.33, 95% CI 1.20-1.48), and longer hospital stays (adjusted incidence rate ratio 1.15, 95% CI 1.10-1.21) compared with those at low-burden hospitals. These results suggest that hospitals with higher safety-net burden, often serving more vulnerable populations, may have suboptimal perioperative processes and protocols, leading to poorer outcomes. The study underscores the need for targeted interventions to improve THA outcomes in these hospitals.</p>","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}