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A Novel Gap Staffing Metric for Primary Care in the Veterans Health Administration and Implications for Rural and Urban Clinics. 退伍军人健康管理局初级保健的新缺口人员配置指标及其对农村和城市诊所的影响。
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2023-01-01 Epub Date: 2022-08-03 DOI: 10.1097/JAC.0000000000000429
Amy M J O'Shea, Bjarni Haraldsson, Ariana F Shahnazi, Ryan A Sterling, Edwin S Wong, Peter J Kaboli
{"title":"A Novel Gap Staffing Metric for Primary Care in the Veterans Health Administration and Implications for Rural and Urban Clinics.","authors":"Amy M J O'Shea,&nbsp;Bjarni Haraldsson,&nbsp;Ariana F Shahnazi,&nbsp;Ryan A Sterling,&nbsp;Edwin S Wong,&nbsp;Peter J Kaboli","doi":"10.1097/JAC.0000000000000429","DOIUrl":"10.1097/JAC.0000000000000429","url":null,"abstract":"<p><p>Primary care providers (PCPs), including physicians and advanced practice providers, are the front line of medical care. Patient access must balance PCP availability and patient needs. This work develops a new PCP staffing metric using panel size and full-time equivalent data to determine whether a clinic is adequately staffed and describes variation by clinic rurality. Data were from the Veterans Health Administration, 2017-2021. Results describe the gap staffing metric, provide summary graphics, and compare the gap staffing between rural and urban clinics. This novel gap staffing metric can inform strategic clinic staffing in health care systems.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 1","pages":"25-33"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510806/pdf/jamcm-46-25.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reasons Primary Care Practices Chose Patient Experience Surveys During Patient-Centered Medical Home Transformation. 基层医疗机构在 "以患者为中心的医疗之家 "转型过程中选择患者体验调查的原因。
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2023-01-01 Epub Date: 2022-10-08 DOI: 10.1097/JAC.0000000000000442
Denise D Quigley, Nabeel Qureshi, Ron D Hays
{"title":"Reasons Primary Care Practices Chose Patient Experience Surveys During Patient-Centered Medical Home Transformation.","authors":"Denise D Quigley, Nabeel Qureshi, Ron D Hays","doi":"10.1097/JAC.0000000000000442","DOIUrl":"10.1097/JAC.0000000000000442","url":null,"abstract":"<p><p>Patient-centered medical home takes years to attain. Fifteen-to-eighteen percent of US primary care practices in 2008-2017 sought or maintained patient-centered medical home recognition. We conducted interviews with a stratified-random sample of 105 of these practices to determine why patient experience surveys were chosen. Fifty-one were using a Consumer Assessment of Healthcare Providers and Systems survey and 53 administering another patient survey. The 3 most common reasons were (1) to compare performance against other practices, which requires systematically collected data across large numbers of practices (ie, the Consumer Assessment of Healthcare Providers and Systems survey), (2) participation in an external patient-centered medical home program, and (3) survey administration cost. Leaders invested in a second patient survey for quality improvement needs.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 1","pages":"34-44"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10592286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High-Risk Patient Experiences Associated With an Intensive Primary Care Management Program in the Veterans Health Administration. 退伍军人健康管理局强化初级保健管理计划相关的高风险患者经历。
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2023-01-01 Epub Date: 2022-08-27 DOI: 10.1097/JAC.0000000000000428
Linnaea Schuttner, Rong Guo, Edwin Wong, Elvira Jimenez, Melissa Klein, Sudip Roy, Ann-Marie Rosland, Evelyn T Chang
{"title":"High-Risk Patient Experiences Associated With an Intensive Primary Care Management Program in the Veterans Health Administration.","authors":"Linnaea Schuttner, Rong Guo, Edwin Wong, Elvira Jimenez, Melissa Klein, Sudip Roy, Ann-Marie Rosland, Evelyn T Chang","doi":"10.1097/JAC.0000000000000428","DOIUrl":"10.1097/JAC.0000000000000428","url":null,"abstract":"<p><p>Intensive management programs may improve health care experiences among high-risk and complex patients. We assessed patient experience among (1) prior enrollees (n = 59) of an intensive management program (2014-2018); (2) nonenrollees (n = 356) at program sites; and (3) nonprogram site patients (n = 728), using a patient survey based on the Consumer Assessment of Healthcare Providers and Systems in 2019. Outcomes included patient ratings of patient-centered care; overall health care experience; and satisfaction with their usual outpatient care provider. In multivariate models, enrollees were more satisfied with their current provider versus nonenrollees within program sites (adjusted odds ratio 2.36; 95% confidence interval 1.15-4.85).</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 1","pages":"45-53"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9691513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 Self-Sustainability of Federally Qualified Health Centers: Examining the Impact of Medicaid Expansion. 联邦合格医疗中心的自我可持续性:检查医疗补助扩张的影响。
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2023-01-01 DOI: 10.1097/JAC.0000000000000441
Ganisher Davlyatov, Sidney Hiller, Philip Cendoma, Nancy Borkowski
{"title":"The Self-Sustainability of Federally Qualified Health Centers: Examining the Impact of Medicaid Expansion.","authors":"Ganisher Davlyatov,&nbsp;Sidney Hiller,&nbsp;Philip Cendoma,&nbsp;Nancy Borkowski","doi":"10.1097/JAC.0000000000000441","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000441","url":null,"abstract":"<p><p>States' decisions to expand Medicaid eligibility would make most low-income uninsured people eligible for Medicaid, while also increasing the financial viability of Federally Qualified Health Centers (FQHCs) by reducing their grant to total revenue ratios. We extracted a national sample of 729 FQHCs for the period 2009 to 2018. The dependent variable was grant to revenue ratio and the independent variable was the states' Medicaid expansion status. FQHCs operating in Medicaid expansion states had lower grant ratios during the postexpansion period. As past decades' funding volatilities have shown, overreliance on one revenue source may increase financial risk. Medicaid expansion can support FQHCs by improving their long-term financial sustainability.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 1","pages":"12-19"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10574593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
COVID-19 Vaccine Hesitancy in a Predominantly Minority Population and Trust in Primary Care Physicians as a Potential Solution. COVID-19 以少数民族为主的人群不愿接种疫苗以及信任初级保健医生的潜在解决方案。
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2023-01-01 Epub Date: 2022-10-28 DOI: 10.1097/JAC.0000000000000443
Lisa M Kern, Joselyne E Aucapina, Andrea Jacobson, Megan J Shen, Jessica S Ancker, Joanna B Ringel, Tim Kelly, Navarra V Rodriguez
{"title":"COVID-19 Vaccine Hesitancy in a Predominantly Minority Population and Trust in Primary Care Physicians as a Potential Solution.","authors":"Lisa M Kern, Joselyne E Aucapina, Andrea Jacobson, Megan J Shen, Jessica S Ancker, Joanna B Ringel, Tim Kelly, Navarra V Rodriguez","doi":"10.1097/JAC.0000000000000443","DOIUrl":"10.1097/JAC.0000000000000443","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 1","pages":"63-68"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10144426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10592295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Whom Do Incentive Program Physicians Serve? New Measures for Assessing Program Reach. 激励计划医生为谁服务?评估项目覆盖面的新措施。
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2022-10-01 DOI: 10.1097/JAC.0000000000000425
Leo Quigley
{"title":"Whom Do Incentive Program Physicians Serve? New Measures for Assessing Program Reach.","authors":"Leo Quigley","doi":"10.1097/JAC.0000000000000425","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000425","url":null,"abstract":"<p><p>One approach to ameliorating health workforce maldistribution is incentivizing health professionals, including physicians, to locate in underserved areas. However, eligibility for programs typically relies on large geographic areas whereas it is subpopulations within underserved areas who are typically at risk. New measures introduced in this article capture data on the patients actually served by incentive program physicians. A pilot study of one state's J-1 Visa Waiver and loan repayment programs validated the new measures of medical need, low income, rural location, and population-to-provider ratios of provider location, providing a nuanced picture of the groups actually served by incentive program physicians.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"45 4","pages":"266-278"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10280238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Practice Environment and Workforce Outcomes of Nurse Practitioners in Community Health Centers. 社区卫生中心执业护士的执业环境和工作成果。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2022-10-01 DOI: 10.1097/JAC.0000000000000427
Supakorn Kueakomoldej, Jianfang Liu, Patricia Pittman, Eleanor Turi, Lusine Poghosyan
{"title":"Practice Environment and Workforce Outcomes of Nurse Practitioners in Community Health Centers.","authors":"Supakorn Kueakomoldej, Jianfang Liu, Patricia Pittman, Eleanor Turi, Lusine Poghosyan","doi":"10.1097/JAC.0000000000000427","DOIUrl":"10.1097/JAC.0000000000000427","url":null,"abstract":"<p><p>The nurse practitioner (NP) workforce in community health centers (CHCs) increases access to primary care for underserved populations. Working with medically complex patients, high workloads, and low resources in the CHC setting, CHC NPs may be susceptible to poor workforce outcomes. This study uses NP survey data collected from 6 US states to describe and assess the relationship between CHC NP practice environment and burnout, job satisfaction, and turnover intention. CHC NPs rated their practice environments favorably, and more than 89% of CHC NPs reported satisfaction with their job. Better rating of NPs' relationship with CHC administration was associated with improved job satisfaction and decreased turnover intention.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"45 4","pages":"289-298"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9429595/pdf/nihms-1805166.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10228961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictors of VA Primary Care Clerical Staff Burnout Using the Job Demands-Resources Model. 基于工作需求-资源模型的退伍军人基层医疗文职人员职业倦怠的预测因素。
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2022-10-01 DOI: 10.1097/JAC.0000000000000431
Melissa Medich, Danielle Rose, Michael McClean, Karin Nelson, Gregory Stewart, David A Ganz, Elizabeth M Yano, Susan E Stockdale
{"title":"Predictors of VA Primary Care Clerical Staff Burnout Using the Job Demands-Resources Model.","authors":"Melissa Medich,&nbsp;Danielle Rose,&nbsp;Michael McClean,&nbsp;Karin Nelson,&nbsp;Gregory Stewart,&nbsp;David A Ganz,&nbsp;Elizabeth M Yano,&nbsp;Susan E Stockdale","doi":"10.1097/JAC.0000000000000431","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000431","url":null,"abstract":"<p><p>Primary care clerical staff may experience burnout if not adequately prepared and supported for patient-facing customer service tasks. Guided by the Job Demands-Resources (JD-R) model, we use national survey data from 707 primary care clerks at 349 VA clinics (2018; response rate: 12%) to evaluate associations between clerks' perceptions of tasks, work environment, training, and burnout. We found challenges with customer-facing tasks contribute to higher burnout, and supportive work environment was associated with lower burnout. Although perceptions of training were not associated with burnout, our results combined with the JD-R model suggest that customer service training may protect against burnout.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"45 4","pages":"321-331"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9422767/pdf/jamcm-45-321.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10225527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Employers' Perspectives on the Use of Medical Assistant Apprenticeships: A Qualitative Study. 雇主对医疗助理学徒制使用的看法:一项定性研究。
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2022-07-01 DOI: 10.1097/JAC.0000000000000424
Andrew D Jopson, Allison G Cummings, Bianca K Frogner, Susan M Skillman
{"title":"Employers' Perspectives on the Use of Medical Assistant Apprenticeships: A Qualitative Study.","authors":"Andrew D Jopson,&nbsp;Allison G Cummings,&nbsp;Bianca K Frogner,&nbsp;Susan M Skillman","doi":"10.1097/JAC.0000000000000424","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000424","url":null,"abstract":"<p><p>Medical assistants (MAs) are among the fastest-growing occupations in the United States, yet health care employers report high turnover rates and difficulty filling MA positions. Employers are increasingly using apprenticeship to meet emerging workforce needs. This qualitative study examined the perspectives of 14 employers using registered MA apprenticeships in 8 states. The findings revealed motivations for using apprenticeship, perceived benefits to the organization, challenges with implementation, and reflections on successful implementation. We detail how MA apprenticeship is successfully meeting recruitment and training needs in a variety of health care organizations, especially where program support resources are available.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"45 3","pages":"191-201"},"PeriodicalIF":2.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Observational Trends in Publicly Reported Quality Measures of Hospital Outpatient Quality Reporting Program, 2013-2019 2013-2019年医院门诊质量报告项目公开报告质量指标的观察趋势
IF 2.3
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2022-07-01 DOI: 10.1097/JAC.0000000000000416
H. Hamadi, Mei Zhao, D. R. Haley, Jing Xu, Shyam Paryani, A. Spaulding
{"title":"Observational Trends in Publicly Reported Quality Measures of Hospital Outpatient Quality Reporting Program, 2013-2019","authors":"H. Hamadi, Mei Zhao, D. R. Haley, Jing Xu, Shyam Paryani, A. Spaulding","doi":"10.1097/JAC.0000000000000416","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000416","url":null,"abstract":"In 2011, the Centers for Medicare & Medicaid Services (CMS) implemented the Hospital Outpatient Quality Reporting Program to assess the quality of outpatient imaging efficiency (OIE). In this study, trends in hospital performance on these national hospital OIE measures a year after inception and public reporting were described. An observational trend analysis was conducted using 2013-2019 data from CMS 6 OIE measures. The trend analysis of metric scores indicates year-to-year variability in all 6 OIE variables. The reporting of these measures appears to have effectively improved the efficiency of most of the measures since the inception of the program.","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"3 1","pages":"202 - 211"},"PeriodicalIF":2.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85339117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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