Within the community-orientated primary care module for training family physicians at the Kamuzu University of Health Sciences in Malawi, a relationship was formed between Nkhoma Mission Hospital’s Family Medicine Department and the Diamphwe Community Health Centre (HC) to strengthen the continuity of healthcare and capacity team building. The initial focus was on improving the management of hypertension and diabetes in terms of diagnosis, tracking of the patients in a registry and timely referral to secondary care facilities The relationship has received positive support from Diamphwe healthcare workers, which then improved the management of non-communicable diseases and patient care at Diamphwe. It has also shown how family medicine physicians can improve HC capacity through support and mentorship.
Collaboration among diverse stakeholders involved in the value transformation of health care requires consistent use of terminology. The objective of this study was to reach consensus definitions for the terms value-based care, value-based payment, and population health. A modified Delphi process was conducted from February 2017 to July 2017. An in-person panel meeting was followed by 3 rounds of surveys. Panelists anonymously rated individual components of definitions and full definitions on a 9-point Likert scale. Definitions were modified in an iterative process based on results of each survey round. Participants were a panel of 18 national leaders representing population health, health care delivery, academic medicine, payers, patient advocacy, and health care foundations. Main measures were survey ratings of definition components and definitions. At the conclusion of round 3, consensus was reached on the following definition for value-based payment, with 13 of 18 panelists (72.2%) assigning a high rating (7-9) and 1 of 18 (5.6%) assigning a low rating (1-3): ''Value-based payment aligns reimbursement with achievement of value-based care (health outcomes/cost) in a defined population with providers held accountable for achieving financial goals and health outcomes. Value-based payment encourages optimal care delivery, including coordination across healthcare
Latina women continue to face disproportionate breast cancer risk and well-documented breast health care barriers in Philadelphia. In response to breast health needs among Latinas in Philadelphia, a health-focused community-based organization, in partnership with a network of social and health service providers, began offering community-based navigation in 2005. Later, through funding from a federal agency, the organization launched the Naveguemos con Salud (NCS) Breast Health Partnership Project from 2010 to 2013. NCS offered breast health awareness and education to a broad audience of Latinas in Philadelphia and community-based navigation services to all interested in accessing a clinical breast exam (CBE) and/or mammogram. A 2017 survey revisited breast health needs among the same core population to inform next steps. Here, we explore how findings and lessons learned from a past program and an assessment of current needs can inform future community-clinical linkage and community-based navigation to improve access to breast cancer screening and a continuum of care for Latinas.
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