Population Health Management最新文献_第5页

Preparing for Value: Evaluating Organizational Culture in Health Care Transformation. 为实现价值做好准备：评估医疗转型中的组织文化。

IF 1.8 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-07-05 DOI: 10.1089/pop.2024.0013

Karen Marie Joswick, Linda Reese

引用次数: 0

The Clinical and Economic Burdens of Obesity and the Value of Weight Loss for an EMR-Derived US Cohort: A Modeling Study. 肥胖症的临床和经济负担以及 EMR 衍生的美国队列的减肥价值：一项建模研究。

IF 1.8 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-08-07 DOI: 10.1089/pop.2024.0037

Joshua Toliver, Volker Schnecke, Laura Rizkallah

{"title":"The Clinical and Economic Burdens of Obesity and the Value of Weight Loss for an EMR-Derived US Cohort: A Modeling Study.","authors":"Joshua Toliver, Volker Schnecke, Laura Rizkallah","doi":"10.1089/pop.2024.0037","DOIUrl":"10.1089/pop.2024.0037","url":null,"abstract":"Obesity-related comorbidities (ORCs) cause significant economic and clinical burdens for people with obesity and the US health care system. A reduction in weight at the population level may reduce incident ORC diagnoses and associated costs of treatment. The aim of this work is to describe obesity burden in the United States through the prevalence and direct treatment costs of ORCs, as well as the clinical and economic value of 15% weight loss in a population of adults with obesity. The IQVIA Ambulatory US electronic medical record database was used to create a cohort (7,667,023 individuals 20-69 years of age, body mass index of 30-50 kg/m2), utilized to characterize the prevalence of 10 ORCs. Direct treatment costs were collected from literature reports. A risk model was leveraged to estimate the number and cost of additional ORC diagnoses over 5 years from baseline through two scenarios: stable weight and 15% lower body weight at baseline for all members of the population. Prevalence, incidence, and cost data were scaled down to a representative subset of 100,000 individuals. In 2022, the annual treatment costs for all 10 ORCs exceeded $918 million for the representative cohort. In a stable-weight scenario, these costs were estimated to increase to ≈$1.4 billion by 2027. With 15% lower body weight at baseline, $221 million in cumulative savings was estimated, corresponding to $2205 in savings/patient over 5 years. Consequently, weight loss in this population may correspond to significantly reduced numbers of incident ORC complications translating to substantial cost savings.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"300-306"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898098","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

The Cost of Unhealthy Days: A New Value Assessment. 不健康日子的代价：新的价值评估。

IF 1.8 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-08-27 DOI: 10.1089/pop.2024.0102

Kelsey C McNamara, Ellen T Rudy, John Rogers, Zachary N Goldberg, Howard S Friedman, Prakash Navaratnam, David B Nash

{"title":"The Cost of Unhealthy Days: A New Value Assessment.","authors":"Kelsey C McNamara, Ellen T Rudy, John Rogers, Zachary N Goldberg, Howard S Friedman, Prakash Navaratnam, David B Nash","doi":"10.1089/pop.2024.0102","DOIUrl":"10.1089/pop.2024.0102","url":null,"abstract":"For-profit companies addressing disparities in social determinants of health (SDOH), also known as SDOH Industry companies, often lack member-level claims data to evaluate their organizational interventions. Health-related quality of life (HRQOL) measures, such as the Centers for Disease Control and Prevention's Healthy Days Measure, offer a unique proxy metric to evaluate impact. This retrospective study sought to explore the association between self-reported physically and mentally unhealthy days with health care costs among a Medicare Advantage (MA) population. A cross-sectional study of MA members receptive to a companion care program, and thus likely to have unmet social needs, was conducted. The analysis included members with recorded baseline unhealthy days and complete claims data (n = 2,354). Least squares regression analyses were performed to determine the relationship between baseline medical costs, physically unhealthy days, and mentally unhealthy days. A review of Major Diagnostic Categories (MDCs) was also included to elucidate the strength of the Healthy Days Measure as an indicator of the burden of health conditions. Each additional unhealthy day reported was associated with an increase in 30-day medical costs of $60 and $34 for physically and mentally unhealthy days, respectively. Unhealthy days and costs increased with an increasing number of MDCs. Compared with previous studies linking unhealthy days and health care expenditure, these data reveal the potential for even higher savings by reducing the number of unhealthy days in a high-risk population. This evidence supports using unhealthy days as a HRQOL measure and as an important tool for cost estimations.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"307-311"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073701","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

Bridging the Evidence and Practice Gap in Chronic Kidney Disease: A System Thinking Approach to Population Health. 缩小慢性肾脏病的证据与实践差距：人口健康的系统思维方法》。

IF 2.5 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-05-27 DOI: 10.1089/pop.2023.0275

Aparna Padiyar, Nagaraju Sarabu, Shruti Ahlawat, Esther J Thatcher, Brooke A Roeper, Aravindh Anantharamakrishnan, Patrick Runnels, Carol Bahner, Sarah E Lang, Tyler D Barnett, Yashashvi Raghuwanshi, Peter J Pronovost

{"title":"Bridging the Evidence and Practice Gap in Chronic Kidney Disease: A System Thinking Approach to Population Health.","authors":"Aparna Padiyar, Nagaraju Sarabu, Shruti Ahlawat, Esther J Thatcher, Brooke A Roeper, Aravindh Anantharamakrishnan, Patrick Runnels, Carol Bahner, Sarah E Lang, Tyler D Barnett, Yashashvi Raghuwanshi, Peter J Pronovost","doi":"10.1089/pop.2023.0275","DOIUrl":"10.1089/pop.2023.0275","url":null,"abstract":"Chronic kidney disease (CKD) is common, costly, and life-limiting, requiring dialysis and transplantation in advanced stages. Although effective guideline-based therapy exists, the asymptomatic nature of CKD together with low health literacy, adverse social determinants of health, unmet behavioral health needs, and primary care providers' (PCP) limited understanding of CKD result in defects in screening and diagnosis. Care is fragmented between PCPs and specialty nephrologists, with limited time, expertise, and resources to address systemic gaps. In this article, the authors define how they classified defects in care and report the current numbers of patients exposed to these defects, both nationally and in their health system Accountable Care Organization. They describe use of the health system's three-pillar leadership model (believing, belonging, and building) to empower providers to transform CKD care. Believing entailed engaging individuals to believe defects in CKD care could be eliminated and were a collective responsibility. Belonging fostered the creation of learning communities that broke down silos and encouraged open communication and collaboration between PCPs and nephrologists. Building involved constructing a fractal management infrastructure with transparent reporting and shared accountability, which would enable success in innovation and transformation. The result is proactive and relational CKD care organized around the patient's needs in University Hospitals Systems of Excellence. Systems of excellence combine multiple domains of expertise to promote best practice guidelines and integrate care throughout the system. The authors further describe a preliminary pilot of the CKD System of Excellence in primary care.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"151-159"},"PeriodicalIF":2.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155720","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

Social Needs Screening in Academic Health Systems: A Landscape Assessment. 学术医疗系统中的社会需求筛查：景观评估。

IF 1.8 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-07-29 DOI: 10.1089/pop.2024.0111

Jennifer K Bretsch, Andrea S Wallace, Rosha McCoy

{"title":"Social Needs Screening in Academic Health Systems: A Landscape Assessment.","authors":"Jennifer K Bretsch, Andrea S Wallace, Rosha McCoy","doi":"10.1089/pop.2024.0111","DOIUrl":"10.1089/pop.2024.0111","url":null,"abstract":"Screening for social needs has gained traction as an approach to addressing social determinants of health, but it faces challenges regarding standardization, resource allocation, and follow-up care. The year-long study, conducted by the Association of American Medical Colleges, integrated data from conferences, surveys, and key informant interviews to examine the integration of social needs screening into health care services within Academic Health Systems (AHS). The authors' analysis unveiled eight key themes, showcasing AHS's active involvement in targeted social needs screening alongside persistent resource allocation obstacles. AHS are dedicated to efficiently identifying high-risk populations, fostering partnerships with community-based organizations, and embracing technology for closed-loop referrals. However, concerns endure about the utilization of reimbursement codes for social needs and regulatory compliance. AHS confront staffing issues, resource allocation intricacies, and the imperative for seamless integration across clinical and nonclinical departments. Notably, opportunities arise in standardized training, alignment of AHS priorities, exploration of social investment models, and engagement with state-level health information exchanges. Aligning clinical care, research pursuits, and community engagement endeavors holds promise for AHS in effectively addressing social needs.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"312-319"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788898","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

Ambulatory Care Utilization Among Medicare Beneficiaries with Depression. 患有抑郁症的医疗保险受益人使用非住院医疗服务的情况。

IF 1.8 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-08-14 DOI: 10.1089/pop.2024.0097

Evguenia Makovkina, Joanna B Ringel, Laura C Pinheiro, Monika M Safford, Lisa M Kern

{"title":"Ambulatory Care Utilization Among Medicare Beneficiaries with Depression.","authors":"Evguenia Makovkina, Joanna B Ringel, Laura C Pinheiro, Monika M Safford, Lisa M Kern","doi":"10.1089/pop.2024.0097","DOIUrl":"10.1089/pop.2024.0097","url":null,"abstract":"The association between depression and ambulatory care utilization is unclear. The authors sought to determine the association between untreated depression and ambulatory care utilization, including the extent to which care is fragmented, or spread across providers. The authors conducted a longitudinal study using data from the nationwide REasons for Geographic and Racial Differences in Stroke study linked to Medicare fee-for-service claims (N = 1412). They categorized participants into three study groups, based on self-reported depressive symptoms (Center for Epidemiological Studies Depression Scale score ≥ 4) and a medication inventory for antidepressants: Symptomatic Untreated (SU), Symptomatic Treated (ST), and Asymptomatic Treated (AT). The authors used descriptive statistics to characterize ambulatory care patterns by study group. They determined the association between the study group and fragmentation score (with high fragmentation defined as a reversed Bice-Boxerman Index ≥ 0.85) using multivariable logistic regression. All groups had similar numbers of primary care visits, but the SU group had the fewest specialist visits. The SU group had the lowest proportion of participants who received care from a psychiatrist (3.4% vs. 10.7% for ST and 11.9% for AT, pairwise P-values < 0.001). The SU group was the least likely to have highly fragmented care (adjusted odds ratio 0.68; 95% confidence interval 0.48, 0.95, compared with the ST group). These results suggest that older adults with untreated depression are not engaged in excess care-seeking behaviors. Rather, the results suggest undertreatment of depression in primary care and underutilization of psychiatric care.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"338-344"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983039","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

The Academic Payvider Model: Commentary. 学术付费者模式：评论。

IF 2.5 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-05-06 DOI: 10.1089/pop.2024.0058

Josh M Berlin

引用次数: 0

Interventions to Increase Affordable Care Act Marketplace Enrollment: A Systematic Review and Meta-Analysis. 提高《平价医疗法案》市场注册率的干预措施：系统回顾与元分析》。

IF 1.8 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-09-05 DOI: 10.1089/pop.2024.0091

Lizzie Martin, Andrew Feher, William Schultz, Elana Safran, Alison K Cohen

{"title":"Interventions to Increase Affordable Care Act Marketplace Enrollment: A Systematic Review and Meta-Analysis.","authors":"Lizzie Martin, Andrew Feher, William Schultz, Elana Safran, Alison K Cohen","doi":"10.1089/pop.2024.0091","DOIUrl":"10.1089/pop.2024.0091","url":null,"abstract":"Over 10 million uninsured individuals are eligible for subsidized health insurance coverage through the Affordable Care Act (ACA) marketplaces, and millions more were projected to become eligible with the end of the federal COVID-19 Public Health Emergency in 2023. Individual studies on behaviorally informed interventions designed to encourage enrollment suggest that some are more effective than others. This study summarizes evidence on the efficacy of these interventions and suggests which administrative burdens might be most relevant for potential enrollees. Published and unpublished studies were identified through a systematic review of studies assessing the impact of behaviorally informed interventions on ACA marketplace enrollment from 2014 to 2022. Thirty-four studies comprising over 18 million participants were included (32 randomized controlled trials and 2 quasiexperimental studies). At the time of data extraction, 8 were published. Twenty-seven of the studies qualified for inclusion in a meta-analysis, which found that the average rate of enrollment was about 1 percentage point higher for those who received an intervention (0.009, P < 0.001), a 24% increase relative to control households; for every 1000 people who receive an intervention, that would correspond to about 9 additional enrollees. When stratifying by intervention intensity, support-based interventions increased enrollment by 2 percentage points (0.020, P = 0.004), while information-based interventions increased enrollment by 0.6 percentage points (0.006, P < 0.001). The meta-analysis found that behaviorally informed interventions can increase ACA marketplace enrollment. Interventions aimed at alleviating compliance costs by providing enrollment support were about three times as effective as information alone.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"327-337"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133497","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

Is End of Race-Conscious Admissions the Beginning of an Historically Black Colleges and University Renaissance? 种族意识招生的结束是否是黑人历史院校文艺复兴的开始？

IF 1.8 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-04-01 DOI: 10.1089/pop.2024.0025

Shani R Scott, Tracey L Henry

引用次数: 0

The Power of Commitment: Creating an Award-Winning Culture of Health and Well-Being at DTE Energy. 承诺的力量：在 DTE Energy 创建屡获殊荣的健康与幸福文化。

IF 1.8 4区医学

Population Health Management Pub Date : 2024-06-01 Epub Date: 2024-08-30 DOI: 10.1089/pop.2024.0096

Karen Personett, Raymond Fabius, David Kirshenbaum, Dixon Thayer, Sharon Phares

引用次数: 0