Population Health Management最新文献_第5页

Participants in Medicare's New Mandatory Bundled Payment Program. 医疗保险新强制性捆绑付款计划的参与者。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-08-01 Epub Date: 2026-05-28 DOI: 10.1177/19427891261450739

Joshua M Liao, Yixin Tang, Danielle S Browne, Isabelle J Carroll, Ayush Arora, Jennifer R Cardin, Aidan P Crowley, Vrushabh Ladage, Austin S Kilaru, Amol S Navathe

{"title":"Participants in Medicare's New Mandatory Bundled Payment Program.","authors":"Joshua M Liao, Yixin Tang, Danielle S Browne, Isabelle J Carroll, Ayush Arora, Jennifer R Cardin, Aidan P Crowley, Vrushabh Ladage, Austin S Kilaru, Amol S Navathe","doi":"10.1177/19427891261450739","DOIUrl":"10.1177/19427891261450739","url":null,"abstract":"To date, most bundled payment programs have been voluntary in design. However, such programs are limited by provider and patient selection, the potential exacerbation of health disparities, and results with limited generalizability. In 2026, Medicare will address these concerns through the Transforming Episode Accountability Model (TEAM), the first mandatory program to require nationwide participation across multiple surgical procedures. To anticipate whether the TEAM model can provide generalizable evidence for scaling bundled payments nationwide, the authors used Medicare data to conduct a cross-sectional analysis comparing the characteristics of markets and hospitals selected to participate in TEAM with those that were not. The current study found that, although the 186 TEAM markets were larger than the 618 markets that will not participate, they were similar with regard to structural characteristics (e.g., Medicare advantage penetration, exposure to prior bundled payment programs) and population characteristics (e.g., education, income). The 727 TEAM hospitals differed from the 2155 others with regard to key characteristics, including teaching and safety-net status, profit margin, and patient volume. Overall, these findings suggest that TEAM may generate findings that can be generalized to all US markets while expanding the types of hospitals that have participated in bundled payment programs.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"215-222"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Infrastructure to Capacity: Toward a Framework for Research Ecosystem Development in RCMI Centers. 从基础设施到能力：构建RCMI中心研究生态系统发展框架。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-07-22 DOI: 10.1177/19427891261470941

Marino A Bruce, Bettina M Beech

引用次数: 0

Corrigendum to: "Single and Dual Sensory Loss and Cardiovascular Disease in US Adults: Findings from the 2021 Behavioral Risk Factor Surveillance System". 对“美国成年人的单、双感觉丧失和心血管疾病：来自2021年行为风险因素监测系统的发现”的更正。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-07-15 DOI: 10.1177/19427891261468875

引用次数: 0

Corrigendum to: Identifying and Measuring Caregiver Burdens: A Scoping Review. 识别和测量照顾者负担：范围审查的勘误表。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-06-24 DOI: 10.1177/19427891261461482

引用次数: 0

Cost-Effectiveness of Screening and Early Diagnosis Strategies for Cancer in the General Adult Population in Low- and Middle-Income Countries: A Systematic Review. 低收入和中等收入国家普通成人癌症筛查和早期诊断策略的成本效益：一项系统综述

IF 2.1 4区医学

Population Health Management Pub Date : 2026-06-01 Epub Date: 2025-12-24 DOI: 10.1177/19427891251407691

Akram Hernández-Vásquez, Lucía Villar Bernaola, Rodrigo Vargas-Fernández, Raúl Timaná Ruiz

{"title":"Cost-Effectiveness of Screening and Early Diagnosis Strategies for Cancer in the General Adult Population in Low- and Middle-Income Countries: A Systematic Review.","authors":"Akram Hernández-Vásquez, Lucía Villar Bernaola, Rodrigo Vargas-Fernández, Raúl Timaná Ruiz","doi":"10.1177/19427891251407691","DOIUrl":"10.1177/19427891251407691","url":null,"abstract":"Cancer is one of the leading causes of morbidity and mortality worldwide, disproportionately affecting low- and middle-income countries (LMICs) due to barriers to obtaining access to health care services and screening programs. The current study aimed to synthesize evidence on cost-effective strategies for cancer screening and early diagnosis in adults (≥18 years) in LMICs. The literature search was conducted in PubMed, the Cochrane Library, Embase, EconLit, CINAHL, LILACS, Global Health, and the Web of Science Core Collection databases. The review included cost-effectiveness studies compared with standard practices in LMICs. Two reviewers independently assessed eligibility, extracted data, and evaluated methodological quality using the Drummond and Jefferson guidelines. Twelve studies conducted in nine countries across four global regions were included. The results identified that the most cost-effective strategies for cervical cancer were human papillomavirus DNA testing, visual inspection with acetic acid, and combined tests. For breast and prostate cancer, digital breast tomosynthesis and the Prostate Health Index were promising options, repectively. However, limitations were noted in the studies, such as the lack of analysis on productivity changes and the justification of variables in sensitivity analyses. Population-based cancer screening strategies exist but must be adapted to the implementation context to maximize their cost-effectiveness in LMICs.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"151-163"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865028","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

Inequities in Prenatal Care for Socially and Medically Vulnerable Pregnancies in North Carolina. 北卡罗来纳州在社会和医学上脆弱的孕妇产前护理方面的不平等。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-06-01 Epub Date: 2026-04-20 DOI: 10.1177/19427891261420042

Cynthia Williams, Charleata Battle, Wanyun Chou

{"title":"Inequities in Prenatal Care for Socially and Medically Vulnerable Pregnancies in North Carolina.","authors":"Cynthia Williams, Charleata Battle, Wanyun Chou","doi":"10.1177/19427891261420042","DOIUrl":"10.1177/19427891261420042","url":null,"abstract":"To examine the structural and health-related risk factors associated with prenatal care (PNC) adequacy among women in North Carolina as measured by the Kotelchuck Prenatal Care Index, a retrospective cohort study was designed to utilize data from the 2017 to 2021 Pregnancy Risk Assessment Monitoring System. The analysis used the independent t-test, chi-square tests, and logistic regression modeling to examine study objectives. The study population comprises 286,835 women with documented live births and recorded Kotelchuck PNC Index scores; 77% received adequate PNC. Receiving adequate PNC was more primarily attributed to White women, married, privately insured, and educated women (P < 0.001). Risk factors such as prepregnancy body mass index (BMI), smoking, diabetes, hypertension, previous preterm birth, and infections significantly impacted adequate PNC, often favoring White women. Black and American Indian/Alaska Native (AI/AN) women had a lower likelihood (P < 0.001) of receiving adequate PNC across BMI categories. AI/AN women who smoked during pregnancy had lower odds of adequate PNC (P < 0.001). Black and AI/AN women with previous poor pregnancy outcomes and previous preterm birth had lower odds of adequate PNC (P < 0.05). Sociodemographic factors, health behaviors, and preexisting medical conditions contribute to pervasive inequities among women of color. Targeted interventions and evidence-informed policy reforms are essential to reducing disparities and improving maternal and neonatal health outcomes.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"173-184"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723542","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

Comparing Clinician Impression of Cognition with Standardized Screening in Medicare Annual Wellness Visits. 比较医疗保险年度健康访视中临床医生对认知的印象与标准化筛查。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-06-01 Epub Date: 2026-02-13 DOI: 10.1177/19427891261422978

Lauren R Hersh, Brooke Salzman, Amy T Cunningham, Lilli Flink, Dayna Hovern, Beverly Ng, Christopher Azzolino, Susan Parks

{"title":"Comparing Clinician Impression of Cognition with Standardized Screening in Medicare Annual Wellness Visits.","authors":"Lauren R Hersh, Brooke Salzman, Amy T Cunningham, Lilli Flink, Dayna Hovern, Beverly Ng, Christopher Azzolino, Susan Parks","doi":"10.1177/19427891261422978","DOIUrl":"10.1177/19427891261422978","url":null,"abstract":"Early identification of cognitive changes is crucial for accessing timely interventions, implementing care planning, and optimizing quality of life for patients. Underdiagnosis of cognitive changes, particularly the subtle findings associated with mild cognitive impairment, is a significant issue in primary care. This pilot study compared provider's impression of a patient's cognitive status (provider gestalt) with a standardized screening tool (Mini-Cog©) during the Medicare Annual Wellness Visit (AWV). During patient encounters, medical assistants administered the Mini-Cog in addition to the standard AWV. Clinicians were blinded to the Mini-Cog test result and provided an independent impression of cognitive status. Cohen's kappa was calculated to determine rates of agreement between providers' impression and Mini-Cog findings. Statistical analysis with Cohen's kappa indicated only fair agreement between the provider's impression of cognitive impairment and the Mini-Cog result (N = 76, k = 0.315). When discordance occurred between provider impression and Mini-Cog results, providers were more likely to document \"no concern\" for cognitive impairment in the presence of an abnormal Mini-Cog. Specifically, 19.7% of patients demonstrated a positive Mini-Cog when providers identified no cognitive concerns versus 5.3% of patients who demonstrated a negative Mini-Cog when providers documented concerns for cognitive impairment. Our study suggests under-identification of patients with cognitive impairment when provider impression alone is used to guide the diagnosis. Utilization of a standardized screening tool, such as the Mini-Cog, may minimize the risk of missing early signs of cognitive change.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"194-198"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195333","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

Improving Screening Rates for Social Determinants of Health in Pediatric Primary Care Practices. 提高儿童初级保健实践中健康社会决定因素的筛查率。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-06-01 Epub Date: 2026-03-20 DOI: 10.1177/19427891261434673

Vara S Rao, Celeste Chamberlain, Bruce Bernstein, Na-Tasha Williams, Mary Reich Cooper

{"title":"Improving Screening Rates for Social Determinants of Health in Pediatric Primary Care Practices.","authors":"Vara S Rao, Celeste Chamberlain, Bruce Bernstein, Na-Tasha Williams, Mary Reich Cooper","doi":"10.1177/19427891261434673","DOIUrl":"10.1177/19427891261434673","url":null,"abstract":"The COVID-19 pandemic highlighted pediatric health care disparities and disrupted routine care, including social needs assessments. The American Academy of Pediatrics recommends universal screening for Social Determinants of Health (SDOH), yet implementation remains inconsistent in primary care settings. This quality improvement (QI) project aimed to implement a standardized, sustainable SDOH screening and referral process in pediatric primary care, hypothesizing that structured interventions would improve screening rates. This QI initiative was conducted from January to September 2023 across six practices within a large pediatric health system. Eligible patients (ages 0-19) included those attending their first well visit of the calendar year. The SMART aim targeted a 50% increase in SDOH screening compliance, from 28% at baseline to 42% over 9 months. Using the Consolidated Framework for Implementation Research and two Plan-Do-Study-Act cycles, the team addressed key implementation barriers and refined interventions. The primary measure was screening completion rate; the balancing measure was the number of refusals to screen. SDOH screening rates increased from 28% to 55%, with eligible patient volumes ranging from 2400 to 5500. All six practices demonstrated statistically significant improvements (P < 0.001). Positive screens ranged from 3.3% to 8% of patients screened. Screening refusals increased significantly (P < 0.001). Standardized SDOH screening, implemented through structured QI methods and stakeholder engagement, significantly improved screening rates in pediatric primary care. Future studies should assess referral effectiveness, clinical outcomes, cost-effectiveness, and strategies to mitigate patient discomfort and systemic barriers.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"164-172"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491402","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

Cervical Cancer and Sexually Transmitted Infections Screening Among Individuals with a Substance Use Disorder: A Retrospective Cohort Study. 宫颈癌和性传播感染筛查与物质使用障碍个体：一项回顾性队列研究。

IF 2.1 4区医学

Population Health Management Pub Date : 2026-06-01 Epub Date: 2026-03-24 DOI: 10.1177/19427891261434371

Kento Sonoda, Timothy Chrusciel, Sarah C Gebauer, Jennifer K Bello, Theresa Drallmeier, Jeffrey F Scherrer

{"title":"Cervical Cancer and Sexually Transmitted Infections Screening Among Individuals with a Substance Use Disorder: A Retrospective Cohort Study.","authors":"Kento Sonoda, Timothy Chrusciel, Sarah C Gebauer, Jennifer K Bello, Theresa Drallmeier, Jeffrey F Scherrer","doi":"10.1177/19427891261434371","DOIUrl":"10.1177/19427891261434371","url":null,"abstract":"Substance use disorders (SUDs) have been associated with barriers to preventive medicine screening, but little is known about the association of SUDs and cervical cancer and sexually transmitted infections (STIs) screening rates. This retrospective cohort study used de-identified medical records to select women aged 31-59 as of January 1, 2019. Logistic regression models were computed to estimate the association between any SUDs, including alcohol, compared to no SUD diagnoses, and odds of cervical cancer and STIs screening during the observation period (2019-2024) before and after controlling for covariates. The final cohort included 315,748 people with an average age of 39.4 (±11.6) years old, of whom 22,343 had SUDs. Eighty-two percent were White, and 12.6% were Black individuals. During the 6-year follow-up period, 41% of the cohort received a cervical cancer screening test. After controlling for covariates, individuals with SUDs were less likely to receive cervical cancer screening compared to those without SUDs (odds ratio [OR] = 0.95; 95% confidence interval [CI]: 0.92-0.98). Opioid and sedative use disorders were significantly associated with lower odds of cervical cancer screening (OR = 0.86; 95% CI: 0.81-0.92 and OR = 0.85; 95% CI: 0.72-0.99, respectively). Individuals with SUDs were more likely to receive STI screen compared with those without SUDs (OR = 1.08; 95% CI: 1.05-1.12). An SUD diagnosis is a modest barrier to cervical cancer screening and is associated with more STI screening. Health care professionals must work with multidisciplinary teams to identify and address these barriers.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"199-209"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between Social Vulnerability and Postoperative Complications and Readmission Among Cardiovascular Surgery Patients. 社会脆弱性与心血管手术患者术后并发症和再入院的关系

IF 2.1 4区医学

Population Health Management Pub Date : 2026-06-01 Epub Date: 2026-03-10 DOI: 10.1177/19427891261428802

Ria Tilve, Guangjin Zhou, Jean-Luc A Maigrot, Siran M Koroukian, Edward G Soltesz, Wyatt P Bensken

{"title":"Association Between Social Vulnerability and Postoperative Complications and Readmission Among Cardiovascular Surgery Patients.","authors":"Ria Tilve, Guangjin Zhou, Jean-Luc A Maigrot, Siran M Koroukian, Edward G Soltesz, Wyatt P Bensken","doi":"10.1177/19427891261428802","DOIUrl":"10.1177/19427891261428802","url":null,"abstract":"Despite the well-established importance of health-related social needs in shaping patient outcomes, gaps remain in the literature examining these relationships at the individual level among patients undergoing cardiac surgery. This retrospective study used data from the 2016-2018 Nationwide Readmission Database to evaluate postoperative complications and readmissions in patients undergoing cardiac surgery (coronary artery bypass grafting, aortic surgery, valve surgery, or a combination) using individual-level social vulnerability clinically acknowledged using ICD-10 Z-codes. Six domains of ICD-10 Z-codes (employment, family, housing, psychosocial needs, socioeconomic status, dependence) were considered social vulnerabilities. Data were analyzed using stratification by social vulnerability status and multivariable logistic regression. Among the 846,837 included patients, dependence-related needs were the most documented domain. Patients with social vulnerability at any point were younger, had a longer length of stay, and had a higher prevalence of comorbid conditions, readmissions, and complications. For patients with social vulnerability, the odds ratio of complications was 1.12 (1.03-1.22), and the odds ratio of 90-day readmissions was 1.15 (1.03-1.27). Clinically acknowledged social vulnerability at any point was associated with higher odds of complications or readmissions after cardiac surgery. Z-codes may be useful for identifying nonmedical factors that can affect patient outcomes, but further standardization and assessment are needed.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"185-193"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390751","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