Population Health Management最新文献_第9页

Apply a Venture Investor Mindset to Improve Program Success. 运用风险投资者思维提高计划的成功率。

IF 2.5 4区医学

Population Health Management Pub Date : 2024-02-01 Epub Date: 2023-12-12 DOI: 10.1089/pop.2023.0269

Harry H Liu, Sophia H Zhao

引用次数: 0

Comprehensive Approach to Opioid Management in a Primary Care Network. 基层医疗网络中阿片类药物管理的综合方法。

IF 2.5 4区医学

Population Health Management Pub Date : 2024-02-01 Epub Date: 2024-01-18 DOI: 10.1089/pop.2023.0234

Robert J Fortuna, Jineane Venci, Wallace Johnson, John S Clark, Shalom Schlagman, Kelly Vandermark, Alisa Stetzer, George S Nasra, Sheniece Griffin Martin-Stancil-El, Stephen Judge

{"title":"Comprehensive Approach to Opioid Management in a Primary Care Network.","authors":"Robert J Fortuna, Jineane Venci, Wallace Johnson, John S Clark, Shalom Schlagman, Kelly Vandermark, Alisa Stetzer, George S Nasra, Sheniece Griffin Martin-Stancil-El, Stephen Judge","doi":"10.1089/pop.2023.0234","DOIUrl":"10.1089/pop.2023.0234","url":null,"abstract":"In response to the opioid epidemic, the Centers for Disease Control and Prevention released best practice recommendations for prescribing, yet adoption of these guidelines has been fragmented and frequently met with uncertainty by both patients and providers. This study aims to describe the development and implementation of a comprehensive approach to improving opioid stewardship in a large network of primary care providers. The authors developed a 3-tier approach to opioid management: (1) establishment and implementation of best practices for prescribing opioids, (2) development of a weaning process to decrease opioid doses when the risk outweighs benefits, and (3) support for patients when opioid use disorders were identified. Across 44 primary care practices caring for >223,000 patients, the total number of patients prescribed a chronic opioid decreased from 4848 patients in 2018 to 3106 patients in 2021, a decrease of 36% (P < 0.001). The percent of patients with a controlled substance agreement increased from 13% to 83% (P < 0.001) and the percent of patients completing an annual urine drug screen increased from 17% to 53% (P < 0.001). The number of patients coprescribed benzodiazepines decreased from 1261 patients at baseline to 834 at completion. A total of 6.5% of patients were referred for additional support from a certified alcohol and substance abuse counselor embedded within the program. Overall, the comprehensive opioid management program provided the necessary structure to support opioid prescribing and resulted in improved adherence to best practices, facilitated weaning of opioids when medically appropriate, and enhanced support for patients with opioid use disorders.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"1-7"},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139491796","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

Chart Review Is Dead; Long Live Chart Review: How Artificial Intelligence Will Make Human Review of Medical Records Obsolete, One Day. 图表评审已失效；长寿图表回顾：人工智能将如何让人类对病历的回顾过时，有一天。

IF 2.5 4区医学

Population Health Management Pub Date : 2023-12-01 Epub Date: 2023-10-04 DOI: 10.1089/pop.2023.0227

Kevin Agatstein

引用次数: 0

Perspectives on Lower Extremity Peripheral Artery Disease: A Qualitative Study of Early Diagnosis and Treatment and the Impact of Health Disparities. 对下肢外周动脉疾病的展望：早期诊断和治疗的定性研究以及健康差异的影响。

IF 2.5 4区医学

Population Health Management Pub Date : 2023-12-01 Epub Date: 2023-11-10 DOI: 10.1089/pop.2023.0095

Cori Grant, John K Cuddeback, Olamide Alabi, Caitlin W Hicks, Kay Sadik, Elizabeth L Ciemins

{"title":"Perspectives on Lower Extremity Peripheral Artery Disease: A Qualitative Study of Early Diagnosis and Treatment and the Impact of Health Disparities.","authors":"Cori Grant, John K Cuddeback, Olamide Alabi, Caitlin W Hicks, Kay Sadik, Elizabeth L Ciemins","doi":"10.1089/pop.2023.0095","DOIUrl":"10.1089/pop.2023.0095","url":null,"abstract":"Lower-extremity peripheral artery disease (PAD), the accumulation of atherosclerotic plaque in the arteries of the legs, causes substantial morbidity and mortality. Frequent under- and delayed diagnosis result in poor outcomes, disproportionately affecting individuals from racial and ethnic minority groups. To understand barriers to early detection and treatment and factors contributing to disparities, American Medical Group Association (AMGA) conducted roundtable discussions and semistructured interviews in 2021. Eighteen participants discussed PAD evaluation, diagnosis, early medical management, and disparities in care. A qualitative case study approach and data reduction methods were used to generate themes, draw conclusions, and make actionable recommendations. Identified themes included lack of (1) prioritization of PAD for population health; (2) engagement of primary care providers in early evaluation and referral; (3) \"ownership\" of lower-extremity PAD within health systems; and (4) focus on disparities in care. Participant solutions included (1) financial impact of early PAD management, in the context of value-based payment; (2) embedding an advanced practice provider into a vascular surgery practice to facilitate evaluation and provide medical therapy; and (3) leveraging care coordination, multidisciplinary clinics, and telehealth technology to provide comprehensive care for patients with PAD and address disparities. A deliberate focused effort is necessary to close gaps and the accompanying disparities in early evaluation, diagnosis, and treatment for people with lower-extremity PAD. The authors describe 3 models that can be emulated to improve care for this high-risk population. With improved reimbursement and better medical therapies, now is the time to focus on early diagnosis and management of PAD.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"387-396"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72210510","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

Hospital-at-Home: The Good, the Bad, and the Ugly. 家里的医院：好的、坏的和丑的。

IF 2.5 4区医学

Population Health Management Pub Date : 2023-12-01 Epub Date: 2023-10-13 DOI: 10.1089/pop.2023.0211

Pouya Afshar

引用次数: 0

A Call to Action to Increase Uptake of Follow-Up Colonoscopy After Initial Positive Stool-Based Colorectal Cancer Screening. 一项行动呼吁：在最初的基于粪便的结直肠癌癌症筛查呈阳性后，通过结肠镜检查增加毛囊摄取。

IF 2.5 4区医学

Population Health Management Pub Date : 2023-12-01 Epub Date: 2023-11-07 DOI: 10.1089/pop.2023.0199

A Mark Fendrick, John B Kisiel, Durado Brooks, Vahab Vahdat, Chris Estes, Derek W Ebner, Paul Limburg

引用次数: 0

Racial Disparities in Cardiovascular Health Among the Acute Coronary Syndrome Population. 急性冠状动脉综合征人群心血管健康的种族差异。

IF 1.8 4区医学

Population Health Management Pub Date : 2023-12-01 Epub Date: 2023-11-06 DOI: 10.1089/pop.2023.0142

Abraham Enyeji, Boubakari Ibrahimou, Noël C Barengo, Gilbert Ramirez, Alejandro Arrieta

{"title":"Racial Disparities in Cardiovascular Health Among the Acute Coronary Syndrome Population.","authors":"Abraham Enyeji, Boubakari Ibrahimou, Noël C Barengo, Gilbert Ramirez, Alejandro Arrieta","doi":"10.1089/pop.2023.0142","DOIUrl":"10.1089/pop.2023.0142","url":null,"abstract":"The relative distribution of proportions of cardiovascular health (CVH) categories within racial groups has been examined. However, little scientific evidence exists on the gap trend in racial/ethnic disparities in mean CVH score among non-Hispanic (NH) Whites and Blacks. This study examined the trend(s) in the gap(s) in predicted CVH scores between NH Whites and Blacks over 10 years. In a cross-sectional analytical study, 10 years of Medical Expenditure Panel Survey data from 2008 to 2018 were pooled, utilizing multivariate Poisson's regression of CVH metrics on race, while controlling for relevant covariates. The interactions of acute coronary syndrome (ACS) with CVH metrics, and other key variables such as trends and grouped Charlson Comorbidity Index allowed for variations in the effect of these variables on the subgroups. The mean gap in CVH scores was on average 0.15 [95% confidence interval (CI) 0.137 to 0.170], with Blacks consistently having reduced odds of having ideal CVH until 2014. The overall impact of having an ACS decreased acquired CVH scores by 24.1% [95% CI -0.275 to 0.207], and was equal for both racial subgroups (P < 0.05). The Affordable Care Act (ACA)-trend was positive, increasing the likelihood of improved CVH in the sample (P < 0.05), deflecting a downward trend in acquired CVH scores for both races, as the gap narrowed into more recent years. The CVH gap was stabilized by the ACA, but never really converged, suggesting that efforts to reduce existing disparities between Blacks and NH Whites in the United States would require government policies to look beyond mere \"access\" and/or \"affordability\" to health care.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"378-386"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71485201","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

Validating and Improving Adjusted Clinical Group's Future Hospitalization and High-Cost Prediction Models for Dutch Primary Care. 验证和改进荷兰初级保健调整后临床组未来住院和高成本预测模型。

IF 2.5 4区医学

Population Health Management Pub Date : 2023-12-01 Epub Date: 2023-11-02 DOI: 10.1089/pop.2023.0162

Shelley-Ann M Girwar, Marta Fiocco, Stephen P Sutch, Mattijs E Numans, Marc A Bruijnzeels

{"title":"Validating and Improving Adjusted Clinical Group's Future Hospitalization and High-Cost Prediction Models for Dutch Primary Care.","authors":"Shelley-Ann M Girwar, Marta Fiocco, Stephen P Sutch, Mattijs E Numans, Marc A Bruijnzeels","doi":"10.1089/pop.2023.0162","DOIUrl":"10.1089/pop.2023.0162","url":null,"abstract":"The rise in health care costs, caused by older and more complex patient populations, requires Population Health Management approaches including risk stratification. With risk stratification, patients are assigned individual risk scores based on medical records. These patient stratifications focus on future high costs and expensive care utilization such as hospitalization, for which different models exist. With this study, the research team validated the accuracy of risk prediction scores for future hospitalization and high health care costs, calculated by the Adjusted Clinical Group (ACG)'s risk stratification models, using Dutch primary health care data registries. In addition, they aimed to adjust the US-based predictive models for Dutch primary care. The statistical validity of the existing models was assessed. In addition, the underlying prediction models were trained on 95,262 patients' data from de Zoetermeer region and externally validated on data of 48,780 patients from Zeist, Nijkerk, and Urk. Information on age, sex, number of general practitioner visits, International Classification of Primary Care coded information on the diagnosis and Anatomical Therapeutic Chemical Classification coded information on the prescribed medications, were incorporated in the model. C-statistics were used to validate the discriminatory ability of the models. Calibrating ability was assessed by visual inspection of calibration plots. Adjustment of the hospitalization model based on Dutch data improved C-statistics from 0.69 to 0.75, whereas adjustment of the high-cost model improved C-statistics from 0.78 to 0.85, indicating good discrimination of the models. The models also showed good calibration. In conclusion, the local adjustments of the ACG prediction models show great potential for use in Dutch primary care.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"430-437"},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426250","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

Examining the Association of Social Needs with Future Health Care Utilization in an Older Adult Population: Which Needs Are Most Important? 研究老年人的社会需求与未来医疗保健利用的关系：哪些需求最重要？

IF 1.8 4区医学

Population Health Management Pub Date : 2023-12-01 Epub Date: 2023-10-31 DOI: 10.1089/pop.2023.0171

David M Mosen, Matthew P Banegas, Erin M Keast, John F Dickerson

{"title":"Examining the Association of Social Needs with Future Health Care Utilization in an Older Adult Population: Which Needs Are Most Important?","authors":"David M Mosen, Matthew P Banegas, Erin M Keast, John F Dickerson","doi":"10.1089/pop.2023.0171","DOIUrl":"10.1089/pop.2023.0171","url":null,"abstract":"Abstract Social needs, such as social isolation and food insecurity, are important individual-level social determinants of health, especially for adults ages 65 years and older. These needs may be associated with future health care utilization, but this research area has not been studied extensively. The objective of this study was to examine the independent association of 5 individual social needs with future (1) emergency department (ED) visits and (2) hospital admissions. This observational study included 9649 Kaiser Permanente Northwest (KPNW) Medicare members who completed the Medicare Total Health Assessment (MTHA) quality improvement survey between August 17, 2020 and January 31, 2022. The 5 social needs assessed by the MTHA, defined as binary measures (yes/no), included (1) financial strain, (2) food insecurity, (3) housing instability, (4) social isolation, and (5) transportation needs. ED utilization (yes/no) and hospitalization (yes/no), the current study outcome measures, were measured in the 12 months after MTHA assessment. In multivariable analyses, 3 of the 5 social needs were significantly associated with higher ED utilization: financial strain (odds ratio [OR] = 1.40, 95% confidence interval [CI] = 1.11-1.76, P < 0.05), housing instability (OR = 1.43, 95% CI = 1.02-1.99, P < 0.05), and social isolation (OR = 1.19, 95% CI = 1.05-1.34, P < 0.05), and 1, financial strain, was significantly associated with hospital admissions (OR = 1.66, 95% CI = 1.23-2.23, P < 0.05). The study results identified which social needs are most strongly associated with future ED utilization and hospital admissions. Further research is needed to better understand whether addressing social needs is associated with improved patient-level health outcomes over time.","PeriodicalId":20396,"journal":{"name":"Population Health Management","volume":" ","pages":"413-419"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522417","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

Put All Your Health Investments Under the Same Lens. 把你所有的健康投资放在同一个镜头下。

IF 2.5 4区医学

Population Health Management Pub Date : 2023-12-01 Epub Date: 2023-10-30 DOI: 10.1089/pop.2023.0175

Ronald J Ozminkowski

引用次数: 0