Population Health Management最新文献_第4页

Pay for Quality, Not Volume or Misplaced Risk: Quality-Based Payment as the Missing Mechanism for Population Health. 支付质量，而不是数量或错位风险：基于质量的支付作为人口健康的缺失机制。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-21 DOI: 10.1177/19427891261481309

Richard G Stefanacci

引用次数: 0

Medical Respite as a Transitional Care Intervention to Improve Health and Housing Outcomes for Women Experiencing Homelessness. 医疗暂息作为一种过渡性护理干预措施，改善无家可归妇女的健康和住房结果。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-05 DOI: 10.1177/19427891261475144

Karen Distelhorst Arnold, Beth Graham, Delaney Ryan, Tom Albanese

{"title":"Medical Respite as a Transitional Care Intervention to Improve Health and Housing Outcomes for Women Experiencing Homelessness.","authors":"Karen Distelhorst Arnold, Beth Graham, Delaney Ryan, Tom Albanese","doi":"10.1177/19427891261475144","DOIUrl":"https://doi.org/10.1177/19427891261475144","url":null,"abstract":"People experiencing homelessness have high medical complexity and are at increased risk for poor post-acute outcomes after hospital discharge, yet evidence on medical respite programs for women is limited. We conducted a retrospective evaluation of a 10-bed medical respite program serving women experiencing homelessness in Northeast Ohio. Records of all women referred between March 2022 and May 2024 were reviewed to assess program implementation and resident outcomes, including health care utilization, health and health management improvement, and housing transitions at discharge. Among 226 referrals, 73 women were admitted. The median age was 56 years, and residents exhibited substantial medical, functional, and behavioral health complexity. At discharge, 45.2% transitioned to permanent housing and 19.2% to skilled nursing facilities. Most residents demonstrated improvements in primary diagnosis status, medication management, self-care ability, and health knowledge, along with reductions in hospitalizations and emergency department visits following admission. Substance use disorder, Medicare enrollment, and history of domestic violence were associated with lower odds of discharge to permanent housing. Medical respite appears to be an effective transitional care intervention for medically fragile women experiencing homelessness, supporting health stabilization, reduced acute care utilization, and housing transitions.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"19427891261475144"},"PeriodicalIF":2.1,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674065","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}

引用次数: 0

Assessing the Impact of Housing on 30-Day ED Readmission: A Retrospective Analysis of Hospital Discharges in Maryland. 评估住房对30天ED再入院的影响：马里兰州医院出院的回顾性分析

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-04 DOI: 10.1177/19427891261475143

Xingyu Chen, Christopher Kitchen, Chintan Pandya, Hadi Kharrazi

{"title":"Assessing the Impact of Housing on 30-Day ED Readmission: A Retrospective Analysis of Hospital Discharges in Maryland.","authors":"Xingyu Chen, Christopher Kitchen, Chintan Pandya, Hadi Kharrazi","doi":"10.1177/19427891261475143","DOIUrl":"https://doi.org/10.1177/19427891261475143","url":null,"abstract":"Despite being an important social determinant of health (SDOH), independent association of housing with emergency department (ED) utilization is not well characterized. This study evaluated whether a previously validated ZIP code-level multidimensional housing index is associated with 30-day ED readmission in Maryland. We conducted a retrospective analysis of Maryland ED visits from 2019 to 2023, linked to the American Community Survey housing estimates. The primary outcome was 30-day ED readmission. The variable of interest was a validated ZIP code-level housing index reflecting housing value, quality, occupancy, facilities, transportation access, and cost burden. Multivariable logistic regression was used to adjust for age, sex, race, Elixhauser comorbidity score, and procedure category. Mixed-effects logistic regression with ZIP code random intercepts assessed geographic clustering. Predictive performance was evaluated using 100 repeated 50/50 train-test splits. In 2019, higher housing index was strongly associated with lower odds of readmission in adjusted models (odds ratio [OR] 0.33, 95% CI 0.32-0.34; P < 0.0001), with comparable results generated by the mixed-effects models (OR 0.32, 95% CI 0.29-0.37). This protective association was consistent across all study years. Adding the housing index modestly improved predicting ED readmission in 2019, increasing area under the curve (AUC) from 0.5703 to 0.5888. As a key SDOH, community-level housing conditions were independently associated with reduced 30-day ED readmission. Housing-specific indices may enhance population health risk stratification and inform targeted interventions.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"19427891261475143"},"PeriodicalIF":2.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673999","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}

引用次数: 0

Pediatric Care Coordination and Oral Health Outcomes in the United States: A Cross-Sectional Analysis of 2022-23 National Survey of Children's Health. 美国儿科护理协调和口腔健康结果：2022-23年全国儿童健康调查的横断面分析

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-01 Epub Date: 2026-04-09 DOI: 10.1177/19427891261442063

McKing Izeiza Amedari, Thomas Dobbs, Michael Abimbola Alade, Victoria Gholar, Osayande Agbonlahor, Benjamin Walker

{"title":"Pediatric Care Coordination and Oral Health Outcomes in the United States: A Cross-Sectional Analysis of 2022-23 National Survey of Children's Health.","authors":"McKing Izeiza Amedari, Thomas Dobbs, Michael Abimbola Alade, Victoria Gholar, Osayande Agbonlahor, Benjamin Walker","doi":"10.1177/19427891261442063","DOIUrl":"10.1177/19427891261442063","url":null,"abstract":"The association between pediatric care coordination (PCC) and the prevalence of oral health problems (OHP) among children and youths in the United States was investigated. Using data from the 2022 to 23 National Survey of Children's Health for participants ≤17 years, multivariable Poisson regression models were employed to estimate the association between effective PCC and OHP (the presence of ≥1 parent-reported case of dental caries, gum bleeding, or dental pain). The study estimated the population attributable risk (PAR) to quantify the proportion of potentially avoidable OHP with effective PCC. All models were weighted to account for the complex survey design and adjusted for sociodemographic, health insurance, and geographic covariates. The analytical sample comprised 56,287 participants, representing an estimated target population of 34 million children ≤17 years of age who needed PCC. After controlling for covariates, the difference in the prevalence of OHP between children who received effective PCC (13.1%) and those who did not (17.5%) was statistically significant (adjusted prevalence ratio: 1.33, 95% CI:1.22, 1.44). The PAR was 9.9%, indicating OHP was 9.9% more prevalent among children who lacked effective PCC. Not receiving needed effective PCC was associated with a greater burden of OHP among U.S. children and adolescents. This finding highlights the importance of intentional organization of health services among relevant stakeholders to support optimal oral health.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"242-249"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646190","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}

引用次数: 0

Trends in Cardiomyopathy and Atrial Fibrillation-Related Mortality Among US Adults, 1999-2024. 1999-2024年美国成人心肌病和房颤相关死亡率趋势

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-01 Epub Date: 2026-03-10 DOI: 10.1177/19427891261428795

Hashim Mohamed Siraj, Onyekachi Emmanuel Anyagwa, Oluwatoyin Adalia Dairo, Mohammad Alkhateeb, Anas Abdulkader, Nivedita Pant, Muskan Joshi, Abhirami Babu, Asraf Hussain, Anand Balasubramanian

{"title":"Trends in Cardiomyopathy and Atrial Fibrillation-Related Mortality Among US Adults, 1999-2024.","authors":"Hashim Mohamed Siraj, Onyekachi Emmanuel Anyagwa, Oluwatoyin Adalia Dairo, Mohammad Alkhateeb, Anas Abdulkader, Nivedita Pant, Muskan Joshi, Abhirami Babu, Asraf Hussain, Anand Balasubramanian","doi":"10.1177/19427891261428795","DOIUrl":"10.1177/19427891261428795","url":null,"abstract":"Atrial fibrillation (AF) is a highly prevalent comorbidity in patients with cardiomyopathy (CM), associated with worse cardiovascular outcomes. This study aims to provide a comprehensive, national-level analysis of AF and CM-related mortality in the United States. The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was utilized, using death certificates from 1999 to 2024. The study included patients aged ≥15 years with CM and AF. Statistical analyses were conducted to calculate age-adjusted mortality rates (AAMRs) per 100,000 individuals and annual percent changes with 95% confidence intervals (CIs). Between 1999 and 2024, CM with concomitant AF accounted for 134,470 deaths among individuals aged 15 years or older. The overall AAMR rose from 1.5 per 100,000 in 1999 to 2.3 in 2024. From 1999 to 2016, the AAMR rose modestly (1.5-1.8), followed by a pronounced rise from 2016 to 2022 (1.8-2.5), and a relative decline by 2024 (2.5-2.3). Compared with 2019, mortality in 2020 demonstrated a 15% relative increase (incidence rate ratio = 1.15; 95% CI: 1.11-1.19). Males had disproportionately higher AAMRs compared to females. By race, the highest AAMRs were observed in non-Hispanic (NH) Black and White populations (1.8 each). Regionally, the West and Midwest exhibited the highest AAMRs (1.9 each). Urban-rural stratification revealed higher AAMRs among rural areas (2.2) when compared with urban (1.8) areas. Targeted public-health interventions and resource allocation to address this growing cardiovascular mortality burden, particularly in high-risk demographic groups, are needed.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"233-241"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390766","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}

引用次数: 0

Chronic Care Management and Mortality Among Diabetic Patients with Multiple Chronic Conditions. 合并多种慢性疾病的糖尿病患者的慢性护理管理与死亡率

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-01 Epub Date: 2026-04-07 DOI: 10.1177/19427891261437477

Mariétou H Ouayogodé, Yingying Zheng

{"title":"Chronic Care Management and Mortality Among Diabetic Patients with Multiple Chronic Conditions.","authors":"Mariétou H Ouayogodé, Yingying Zheng","doi":"10.1177/19427891261437477","DOIUrl":"10.1177/19427891261437477","url":null,"abstract":"In 2015, the Centers for Medicare and Medicaid Services started reimbursing chronic care management (CCM) services for patients with multiple chronic conditions. This study used 2015-2020 Medicare claims data from Illinois, Iowa, Minnesota, and Wisconsin and conducted a retrospective cohort study of 885,132 beneficiaries with an evaluation and management visit, following a diabetes diagnosis with other co-occurring chronic conditions. A competing-risk model was estimated to analyze factors associated with patients' receipt of their first CCM services and a Cox proportional hazard model was estimated to assess the risk of death post-CCM initiation. Diabetic patients with multiple chronic conditions had mean age of 70 years (SD = 10.3), 50.7% were female, and 81.3% were white. 1.0% (9,075 beneficiaries) had CCM claims. Excluding chronic conditions, variables associated with a higher likelihood of CCM initiation included age (sub-distribution hazard ratios [SHR] = 1.003 for each additional year, 95% CI:1.00-1.01), female (SHR = 1.10, 95%CI:1.05-1.15), Black (SHR = 1.27, 95% CI:1.19-1.36) or Hispanic (SHR = 1.40, 95% CI:1.23-1.58), receiving care at home (SHR = 5.00, 95% CI:4.55-5.51) or skilled nursing facilities (SHR = 1.60, 95% CI:1.48-1.73), being a non-Iowa resident, and getting a diabetes diagnosis post-2015. However, patients in non-urban areas were less likely to receive such services. No statistical difference was found in the likelihood of mortality with CCM initiation vs. non-CCM. After accounting for CCM initiation, variables associated with a higher likelihood of death included age, American Indian/Alaska Native, residing in non-urban areas, getting a diabetes diagnosis in 2020, and receiving care in non-outpatient settings. CCM remains largely underutilized among Medicare beneficiaries. Addressing barriers, including improving access in non-urban areas and managing chronic condition earlier, may enhance adoption and decrease the risk of death for patients with multimorbidity.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"263-278"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628452","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}

引用次数: 0

Population Health, Right: A Framework for Core Services, Bounded Risk, and Strategic Partnerships for Health Systems. 人口健康，右：核心服务框架、有限风险和卫生系统战略伙伴关系。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-01 Epub Date: 2026-03-18 DOI: 10.1177/19427891261431038

Richard G Stefanacci, Nathan Kaufman

引用次数: 0

Rethinking Blood Pressure Quality Measurement: Accounting for Seasonal Variation in Value-Based Care. 重新思考血压质量测量：考虑基于价值的护理的季节变化。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-01 Epub Date: 2026-04-25 DOI: 10.1177/19427891261445716

Jennifer Stephens, Debra Carter, Beth Careyva, Eric Gertner, Cathryn Kelly

{"title":"Rethinking Blood Pressure Quality Measurement: Accounting for Seasonal Variation in Value-Based Care.","authors":"Jennifer Stephens, Debra Carter, Beth Careyva, Eric Gertner, Cathryn Kelly","doi":"10.1177/19427891261445716","DOIUrl":"10.1177/19427891261445716","url":null,"abstract":"Blood pressure (BP) control is a core quality metric in value-based care (VBC). The Healthcare Effectiveness Data and Information Set (HEDIS) Controlling High Blood Pressure (CBP) measure uses the final BP reading of the calendar year, a method that overlooks well-documented seasonal variation-BP declines in summer and rises in winter. We evaluated the impact of this pattern on measured performance in a large health system. We conducted a retrospective analysis of monthly BP control rates (July 2019 to December 2025) across the Jefferson Health-Lehigh ambulatory network, totaling 78 months and approximately 7.6 million patient-months. Summer (June to August) and winter (December to February) rates were compared using paired t-tests and ordinary least square regression with seasonal adjustment. Year-end performance was assessed using both the HEDIS final-reading (December rate) and a rolling Q4 average (October to December mean). Standard VBC quality improvement initiatives with Q4 intensification were in place. BP control rates were significantly higher in summer (75.2%; 95% confidence interval [CI]: 73.5%-77.0%) than winter (73.1%; 95% CI: 71.2%-75.1%), a 2.1-percentage-point difference (paired t = 5.13, P = 0.002). This pattern was consistent across all 7 years. Within-year peak-to-trough amplitude averaged 2.8 percentage points in nonpandemic years. The rolling Q4 average exceeded the December-only rate in all years, with differences of 0.06-0.59 percentage points, reclassifying 60-520 additional patients as controlled annually. Seasonal BP variation is robust and inadequately addressed by current quality measures. Multi-reading or seasonally adjusted methods would improve measurement accuracy and fairness. Engagement with NCQA and CMS to pilot redesigned measures is recommended.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"256-262"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779324","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}

引用次数: 0

A Theoretically Grounded Chronic Illness Model Integrating Medical- and Community-Based Social Service Providers. 整合医疗和社区社会服务提供者的理论基础慢性病模型。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-01 Epub Date: 2026-04-12 DOI: 10.1177/19427891261437468

Jennifer Drost, Susan Fosnight, Michelle Hughes, Susan Hazelett, Brandi Chrzanowski, Joseph Marchiano, Michele Gareri, Denise Kropp, Kris Baughman, Margaret Sanders

{"title":"A Theoretically Grounded Chronic Illness Model Integrating Medical- and Community-Based Social Service Providers.","authors":"Jennifer Drost, Susan Fosnight, Michelle Hughes, Susan Hazelett, Brandi Chrzanowski, Joseph Marchiano, Michele Gareri, Denise Kropp, Kris Baughman, Margaret Sanders","doi":"10.1177/19427891261437468","DOIUrl":"10.1177/19427891261437468","url":null,"abstract":"Traditional medical care accounts for 10% of health outcomes, whereas SDOH account for over 60%. Optimal care of older adults with chronic illnesses requires integration of medical and social service providers. Such partnerships remain uncommon. The authors describe a successful health system/Area Agency on Aging (AAA) integrated team model that meets weekly to discuss challenging community-dwelling older adults and generate care recommendations back to the primary care providers. As part of a quality improvement project, outcomes measured over 6 months during 1 year show a statistically significant decline in the number of important threats to independent living related to the 4Ms (ie, lower fall risk, fewer high-risk medication issues, less behavioral health concerns, and less frequent health care utilization). AAA care managers expressed high satisfaction with the team process and indicated that it helped them address important issues. This model is easily replicated and modifiable to differing local needs. If replicable in rigorously designed research studies, these results would argue for changes in Medicare and Medicaid reimbursement policies to support this interagency integrated model of collaborative care.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"223-232"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675788","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}

引用次数: 0

Application of Narrative Nursing Combined with Psychological Resilience Training in Patients and Their Families in Hospice Care. 叙事护理结合患者及家属心理弹性训练在临终关怀中的应用。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-01 Epub Date: 2026-04-05 DOI: 10.1177/19427891261420084

Jiaojuan Ma, Hongyu Li

{"title":"Application of Narrative Nursing Combined with Psychological Resilience Training in Patients and Their Families in Hospice Care.","authors":"Jiaojuan Ma, Hongyu Li","doi":"10.1177/19427891261420084","DOIUrl":"10.1177/19427891261420084","url":null,"abstract":"Terminal patients and their families face severe psychological distress-including anxiety, depression, caregiving stress, and grief-that exceeds the capacity of routine hospice care. While narrative nursing and psychological resilience training have shown individual efficacy, the synergistic effects of their combination remain unexamined. This study aimed to unravel the effects of narrative nursing combined with psychological resilience training in enhancing the psychological adaptation of patients and their families in hospice care. Seventy-four patients and their families receiving hospice care were allocated into an observation group (received an 8-week intervention of narrative nursing combined with psychological resilience training on top of routine hospice care) and a control group (received routine hospice care). Hospital Anxiety and Depression Scale (HADS) scores and Connor-Davidson Resilience Scale-10 (CD-RISC-10) scores of patients and their families before and after nursing were compared between the 2 groups. Psychological Distress Thermometer (PDT) and Pittsburgh Sleep Quality Index (PSQI) scores of patients before and after nursing were also compared. The modified hospice care satisfaction scale (based on the FAMCARE-2 scale) was applied to compare the nursing satisfaction of patients and their families after nursing. After nursing, the observation group demonstrated significantly greater reductions in HADS-A and HADS-D scores, more pronounced improvements in CD-RISC-10, PDT, and PSQI scores, as well as higher nursing satisfaction scores compared to the control group (all P < 0.05). The integration of narrative nursing with psychological resilience training in hospice care enhances the psychological adaptability of both patients and their families, while also contributing to improved sleep quality and greater satisfaction with care delivery.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"250-255"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623537","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}

引用次数: 0