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Changes in Patient Care Experiences and the Nurse Work Environment: A Longitudinal Study of U.S. Hospitals. 病人护理体验和护士工作环境的变化：美国医院纵向研究》。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-10-02 DOI: 10.1177/10775587241282403
Kathleen E Fitzpatrick Rosenbaum, Karen B Lasater, Matthew D McHugh, Eileen T Lake
{"title":"Changes in Patient Care Experiences and the Nurse Work Environment: A Longitudinal Study of U.S. Hospitals.","authors":"Kathleen E Fitzpatrick Rosenbaum, Karen B Lasater, Matthew D McHugh, Eileen T Lake","doi":"10.1177/10775587241282403","DOIUrl":"https://doi.org/10.1177/10775587241282403","url":null,"abstract":"<p><p>Addressing patient experience is a priority in the health care system. Hospital Consumer Assessment of Providers and Systems (HCAHPS) survey results incentivize hospitals to elevate patient experience, a factor in patient-centered care. Although hospital nursing resources have been positively associated with better HCAHPS ratings, it is unknown how changes in nursing resources are associated with changes in HCAHPS ratings over time. This two-period longitudinal study ranked the associations between changes in nurse staffing, skill mix, nurse education, and work environment on HCAHPS ratings and found that changes in the work environment had the strongest associations (β = 2.29; <i>p</i> < .001) with improved HCAHPS ratings. Our findings provide hospital administrators with empirical evidence that may help make informed decisions on how to best invest limited resources to improve HCAHPS ratings, including the potential utility of improving the work environment through enhancing Nursing Quality of Care and Nurse Participation in Hospital Affairs.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Varying Estimates of Social Workers in the United States: Which Data Source to Use? 美国社会工作者的估计值各不相同：使用哪种数据来源？
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-10-01 Epub Date: 2024-06-12 DOI: 10.1177/10775587241257983
Brianna M Lombardi, Lisa de Saxe Zerden, Erin Fraher
{"title":"Varying Estimates of Social Workers in the United States: Which Data Source to Use?","authors":"Brianna M Lombardi, Lisa de Saxe Zerden, Erin Fraher","doi":"10.1177/10775587241257983","DOIUrl":"10.1177/10775587241257983","url":null,"abstract":"<p><p>Behavioral health needs continue rise in the United States and constitute a key driver of health care utilization, costs, and outcomes. Social workers provide a wide range of services across health, behavioral health, and community settings, and while this heterogeneity in practice benefits care delivery, it complicates health workforce analyses. This analysis compares five commonly used national data sources and details similarities and differences in their estimates of the number, type, and practice characteristics of social workers. The analysis suggests that estimates vary significantly between data sets ranging from 282,425 to 1,022,859 social workers; as well as yield different findings of types of social workers in the United States, depending on the data set used. These differences have the potential to shape how researchers and policy makers assess the adequacy of the social work workforce and identify solutions to address the nation's behavioral health and social care needs.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Strengthening Primary Care Workforce Capacity in Dementia Diagnosis and Care: A Qualitative Study of Project Alzheimer's Disease-ECHO. 加强痴呆症诊断和护理方面的基层医疗队伍能力：阿尔茨海默氏症-ECHO 项目定性研究》。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-10-01 Epub Date: 2024-05-31 DOI: 10.1177/10775587241251868
Alissa B Sideman, Alma Hernandez de Jesus, Cecilia Alagappan, Melissa Ma, Christopher J Koenig, Loren I Alving, Freddi Segal-Gidan, Rachel Goldberger, Dana Sohmer, Howie Rosen
{"title":"Strengthening Primary Care Workforce Capacity in Dementia Diagnosis and Care: A Qualitative Study of Project Alzheimer's Disease-ECHO.","authors":"Alissa B Sideman, Alma Hernandez de Jesus, Cecilia Alagappan, Melissa Ma, Christopher J Koenig, Loren I Alving, Freddi Segal-Gidan, Rachel Goldberger, Dana Sohmer, Howie Rosen","doi":"10.1177/10775587241251868","DOIUrl":"10.1177/10775587241251868","url":null,"abstract":"<p><p>Primary care practitioners (PCPs) are the first point of contact for most patients with suspected dementia and have identified a need for more training and support around dementia diagnosis and care. This qualitative study examined the Alzheimer's Disease-Extension for Community Healthcare Outcomes (AD-ECHO) program. AD-ECHO was designed to strengthen PCP capacity in dementia through bimonthly virtual meetings with a team of dementia experts. We conducted 24 hr of direct observations at AD-ECHO sessions and interviewed 14 participants about their experiences participating. Using thematic analysis, we found that participants valued the supportive learning environment and resources; knowledge gained empowered them to take more action around dementia; they identified ways of disseminating knowledge gained into their practice settings, and many desired ongoing AD-ECHO engagement. However, most identified time as a barrier to participation. AD-ECHO has the potential to strengthen the primary care workforce's knowledge and confidence around dementia care.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Engaging Interdisciplinary Innovation Teams in Federally Qualified Health Centers. 让跨学科创新团队参与联邦合格医疗中心。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-10-01 Epub Date: 2024-03-07 DOI: 10.1177/10775587241235244
Olivia S Jung, Patricia Satterstrom, Sara J Singer
{"title":"Engaging Interdisciplinary Innovation Teams in Federally Qualified Health Centers.","authors":"Olivia S Jung, Patricia Satterstrom, Sara J Singer","doi":"10.1177/10775587241235244","DOIUrl":"10.1177/10775587241235244","url":null,"abstract":"<p><p>To foster bottom-up innovations, health care organizations are leveraging interdisciplinary frontline innovation teams. These teams include workers across hierarchical levels and professional backgrounds, pooling diverse knowledge sources to develop innovations that improve patient and worker experiences and care quality, equity, and costs. Yet, these frontline innovation teams experience barriers, such as time constraints, being new to innovation, and team-based role hierarchies. We investigated the practices that such teams in federally qualified health centers (FQHCs) used to overcome these barriers. Our 20-month study of two FQHC innovation teams provides one of the first accounts of how practices that sustained worker engagement in innovation and supported their ideas to implementation evolve over time. We also show the varied quantity of engagement practices used at different stages of the innovation process. At a time when FQHCs face pressure to innovate amid staff shortages, our study provides recommendations to support their work.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Motivators, Barriers, and Facilitators to Choosing Care in VA Facilities Versus VA-Purchased Care. 选择退伍军人机构护理与退伍军人机构购买护理的动机、障碍和促进因素。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-10-01 Epub Date: 2024-07-29 DOI: 10.1177/10775587241264594
Christopher G Slatore, Jennifer Y Scott, Elizabeth R Hooker, Natalie Disher, Sara Golden, Diana Govier, Denise M Hynes
{"title":"Motivators, Barriers, and Facilitators to Choosing Care in VA Facilities Versus VA-Purchased Care.","authors":"Christopher G Slatore, Jennifer Y Scott, Elizabeth R Hooker, Natalie Disher, Sara Golden, Diana Govier, Denise M Hynes","doi":"10.1177/10775587241264594","DOIUrl":"10.1177/10775587241264594","url":null,"abstract":"<p><p>Many Veterans receive Department of Veterans Affairs (VA)-purchased care from non-VA facilities but little is known about factors that Veterans consider for this choice. Between May 2020 and August 2021, we surveyed VA-purchased care-eligible VA patients about barriers and facilitators to choosing where to receive care. We examined the association between travel time to their VA facility and their choice of VA-purchased care (VA-paid health care received in non-VA settings) versus VA facility and whether this association was modified by distrust. We received 1,662 responses and 692 (42%) chose a VA facility. Eighty percent reported quality care was in their top three factors that influenced their decision. Respondents with the highest distrust and who lived >1 hr from the nearest VA facility had the lowest predicted probability (PP) of choosing VA (PP 15%; 95% confidence interval: 10%-20%). Veterans value quality of care. VA and other health care systems should consider patient-centered ways to improve and publicize quality and reduce distrust.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Health Care Use of ACA Marketplace Enrollees During the COVID-19 Pandemic. 在 COVID-19 大流行期间，ACA 市场参保者的医疗保健使用情况。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-09-19 DOI: 10.1177/10775587241277954
Xinqi Li, Lex Frazier, Brett Lissenden, John Kautter, Robin McCrea
{"title":"Health Care Use of ACA Marketplace Enrollees During the COVID-19 Pandemic.","authors":"Xinqi Li, Lex Frazier, Brett Lissenden, John Kautter, Robin McCrea","doi":"10.1177/10775587241277954","DOIUrl":"https://doi.org/10.1177/10775587241277954","url":null,"abstract":"<p><p>The onset of the COVID-19 pandemic in March 2020 had a sudden and substantial impact on health care utilization for most, if not all, individuals. We study the impact the pandemic had on the population insured in the individual and small group markets under the Patient Protection and Affordable Care Act (ACA) of 2010, using administrative claims data from January 2019 through December 2021. Our results demonstrated how health care utilization differed between the acute phase (i.e., 2020) and the post-acute phase (i.e., 2021) compared with the pre-pandemic phase. We found that in the ACA markets, most spending and utilization categories decreased drastically during the initial months of the pandemic and recovered by the end of 2021. While the role of telehealth among office visits decreased substantially by the end of 2021, it remained the main mode of delivery for mental health services.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Medicaid Take-Up Among Eligible Adults After the Affordable Care Act Medicaid Expansions: 2014-2019. 平价医疗法案》扩大医疗补助范围后，符合条件的成年人接受医疗补助的趋势：2014-2019.
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-09-05 DOI: 10.1177/10775587241273429
Salam Abdus
{"title":"Trends in Medicaid Take-Up Among Eligible Adults After the Affordable Care Act Medicaid Expansions: 2014-2019.","authors":"Salam Abdus","doi":"10.1177/10775587241273429","DOIUrl":"https://doi.org/10.1177/10775587241273429","url":null,"abstract":"<p><p>Little is known about how take-up of Medicaid among eligible adults has changed since 2014. This study used data from the Medical Expenditure Panel Survey to examine changes in Medicaid enrollment among Medicaid-eligible adults between 2014 and 2019. Eligibility for Medicaid was simulated using state- and year-specific eligibility rules. Among all Medicaid-eligible citizen adults aged 19-64 years, the proportion enrolled in Medicaid increased from 55.5% in 2014-2015 to 61.9% in 2016-2017, and then remained approximately at the same level in 2018-2019 (61.5%). Among adults who became eligible because of the Medicaid expansions, the proportion enrolled in Medicaid increased from 44.1% in 2014-2015 to 53.8% in 2016-2017. Among pre-Affordable Care Act (ACA)-eligible adults, there was no statistically significant change in the proportion enrolled in Medicaid between 2014-2015 and 2016-2017 (66.8% and 69.7%, respectively). There were significant differences in changes in take-up rates across population subgroups.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Framework for the Design of Risk-Adjustment Models in Health Care Provider Payment Systems. 医疗服务提供者支付系统中风险调整模型的设计框架》（A Framework for the Design of Risk-Adjustment Models in Health Care Provider Payment Systems）。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-09-03 DOI: 10.1177/10775587241273355
Andreea Panturu, Richard van Kleef, Frank Eijkenaar, Daniëlle Cattel
{"title":"A Framework for the Design of Risk-Adjustment Models in Health Care Provider Payment Systems.","authors":"Andreea Panturu, Richard van Kleef, Frank Eijkenaar, Daniëlle Cattel","doi":"10.1177/10775587241273355","DOIUrl":"10.1177/10775587241273355","url":null,"abstract":"<p><p>Prospective payments for health care providers require adequate risk adjustment (RA) to address systematic variation in patients' health care needs. However, the design of RA for provider payment involves many choices and difficult trade-offs between incentives for risk selection, incentives for cost control, and feasibility. Despite a growing literature, a comprehensive framework of these choices and trade-offs is lacking. This article aims to develop such a framework. Using literature review and expert consultation, we identify key design choices for RA in the context of provider payment and subsequently categorize these choices along two dimensions: (a) the choice of risk adjusters and (b) the choice of payment weights. For each design choice, we provide an overview of options, trade-offs, and key references. By making design choices and associated trade-offs explicit, our framework facilitates customizing RA design to provider payment systems, given the objectives and other characteristics of the context of interest.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Program Implementation Strategies Associated With Reduced Acute Care Utilization for Medicaid Beneficiaries in California's Whole Person Care Pilot Program. 加利福尼亚州全人护理试点计划中与减少医疗补助受益人急症护理使用相关的计划实施策略》（Program Implementation Strategies Associated With Reduced Acute Care Utilization for Medicaid Beneiciaries in California's Whole Person Care Pilot Program）。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-09-03 DOI: 10.1177/10775587241273404
Emmeline Chuang, Dahai Yue, Brenna O'Masta, Leigh Ann Haley, Weihao Zhou, Nadereh Pourat
{"title":"Program Implementation Strategies Associated With Reduced Acute Care Utilization for Medicaid Beneficiaries in California's Whole Person Care Pilot Program.","authors":"Emmeline Chuang, Dahai Yue, Brenna O'Masta, Leigh Ann Haley, Weihao Zhou, Nadereh Pourat","doi":"10.1177/10775587241273404","DOIUrl":"https://doi.org/10.1177/10775587241273404","url":null,"abstract":"<p><p>Public health care policymakers and payers are increasingly investing in efforts to address patients' health-related social needs (HRSNs) as a strategy for improving health while controlling or reducing costs. However, evidence regarding the implementation and impact of HRSN interventions remains limited. California's Whole Person Care Pilot program (WPC) was a Medicaid Section 1115 waiver demonstration program focused on the provision of care coordination and other services to address eligible beneficiaries' HRSN. In this study, we examine pilot-level variation in impact on acute care utilization and identify factors associated with differential outcomes. The majority of pilots reduced emergency department (ED) visits for enrollees relative to matched controls; however, only four pilots reduced both ED visits and hospitalizations. Coincidence analysis results highlight the importance of cross-sector partnerships, field-based outreach and engagement, and adequate program investment in differentiating pilots that reduced acute care utilization from those that did not.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Association Between Self-Direction and Personal Care Aide Wages. 自我指导与个人护理助理工资之间的关系。
IF 2.4 3区 医学
Medical Care Research and Review Pub Date : 2024-08-26 DOI: 10.1177/10775587241273413
Denise A Tyler, Miku Fujita, Susan A Chapman
{"title":"Association Between Self-Direction and Personal Care Aide Wages.","authors":"Denise A Tyler, Miku Fujita, Susan A Chapman","doi":"10.1177/10775587241273413","DOIUrl":"https://doi.org/10.1177/10775587241273413","url":null,"abstract":"<p><p>The supply of personal care aides (PCAs), who assist people receiving home care, is a growing concern. PCA shortages result, in part, from the low wages earned by these workers. State policies have had some effect on wages. Self-direction (SD) may be associated with wages because SD allows home care recipients to hire and manage workers, including setting wages in most states. We used wage data from the Bureau of Labor Statistics to examine the association between SD and the wages of PCAs. We found implementation of SD did not have a consistent association with PCA wages, with wages improving in some states and worsening in others. We also found little difference in PCA wages between states that allow participants to set worker wages and those that do not. SD does not seem to improve PCA wages in states, so other policy strategies will be needed.</p>","PeriodicalId":51127,"journal":{"name":"Medical Care Research and Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
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