A population-based approach to the management of depression in a patient-centered medical home

Kushner, Kenneth; Schell, Gwynneth

doi:10.15212/fmch.2015.0102

Cited by 3 publications

(3 citation statements)

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“…Currently, automated health examination equipment is already allocated to "community health homes" [13][14][15] in a few areas, which with a "health ID card" allows residents to easily obtain their measurements, such as height, body weight, BP, and blood glucose. These measured results are then transferred and input into residents' electronic health records (EHRs) [16] so that community doctors can conveniently grasp the health status of community residents, identify patients with chronic diseases or residents with high risks, and provide relevant management services accordingly.…”

Section: Comprehensive Approaches To Promote the Initiative Of Commun...mentioning

confidence: 99%

Availability and social determinants of community health management service for patients with chronic diseases: An empirical analysis on elderly hypertensive and diabetic patients in an eastern metropolis of China

Jian

2015

family med commun hlth

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Objective: This study aimed to determine the availability of community health management services and the relevant social determinants for elderly patients with chronic diseases.Methods: All data were obtained from the 2013 random sampling household survey on an elderly population conducted by the School of Public Health of Peking University in an eastern metropolis in China. Information from the database of the above survey involving 1495 hypertensive or diabetic patients >60 years of age, as representatives of the city, were included. The study described the availability of follow-up services by community doctors among elderly hypertensive and diabetic patients during the 12 months before the survey. An ordinal multinomial logistic regression model was used to conduct the analysis on the influence of socio-economic background upon such availability.Results: Eighty-one percent of hypertensive patients and 84.7% of diabetic patients had not received any follow-up service from community doctors within 12 months prior to the survey. Among elderly hypertensive patients, those registered as non-agricultural household members, those with high and above-average income, as well as management personnel of government agencies, enterprises, and social programs have a greater chance of accepting follow-up service by community doctors because of their relatively higher socio-economic rankings. Among elderly diabetic patients, such socio-economic factors had no significant influence on the availability of the follow-up service for chronic diseases. Conclusion:The coverage of community health management services for elderly hypertensive and diabetic patients needs improvement. More effort should focus on promoting the availability of community health management services for elderly hypertensive patients, especially those with lower socio-economic status.

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Section: Comprehensive Approaches To Promote the Initiative Of Commun...mentioning

confidence: 99%

Availability and social determinants of community health management service for patients with chronic diseases: An empirical analysis on elderly hypertensive and diabetic patients in an eastern metropolis of China

Jian

2015

family med commun hlth

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“…In this commentary, we described examples of how the OCHIN PBRN is testing interventions designed to help patients maintain continuous coverage and track insurance status beyond the traditional focus on the day of their scheduled appointment. Although the use of EHRs to track insurance and support patients in obtaining coverage may be most relevant to community health centers in the US, EHRs functionality allows primary care practices to track and improve a variety of clinical metrics as well as issues beyond traditional quality metrics [33]. For example, the length of time a patient waits for an appointment, the volume of telephone calls received by a clinic, and/or the commonest requests by patients over the telephone could also be used to reengineer workflows and develop new tools to meet patients' unmet needs.…”

Section: Beyond Tracking and Improving Health Insurancementioning

confidence: 99%

A new role for primary care teams in the United States after “Obamacare:” Track and improve health insurance coverage rates

DeVoe¹,

Angier

Hoopes³

et al. 2016

family med commun hlth

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Maintaining continuous health insurance coverage is important. With recent expansions in access to coverage in the United States after “Obamacare,” primary care teams have a new role in helping to track and improve coverage rates and to provide outreach to patients. We describe efforts to longitudinally track health insurance rates using data from the electronic health record (EHR) of a primary care network and to use these data to support practice-based insurance outreach and assistance. Although we highlight a few examples from one network, we believe there is great potential for doing this type of work in a broad range of family medicine and community health clinics that provide continuity of care. By partnering with researchers through practice-based research networks and other similar collaboratives, primary care practices can greatly expand the use of EHR data and EHR-based tools targeting improvements in health insurance and quality health care.

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“…Snipes et al [9] describe the importance of team-based, stepped-care treatment in population health. This is followed by Kushner's [10] description of this model for depressed patients in primary care. chronic medical disease and associated higher costs.…”

mentioning

confidence: 99%

Introduction to special edition: The challenge of chronic non-communicable disease and the opportunity for transforming health care through primary care based population health management

O’Donnell¹

2015

family med commun hlth

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A population-based approach to the management of depression in a patient-centered medical home

Cited by 3 publications

References 0 publications

Availability and social determinants of community health management service for patients with chronic diseases: An empirical analysis on elderly hypertensive and diabetic patients in an eastern metropolis of China

Availability and social determinants of community health management service for patients with chronic diseases: An empirical analysis on elderly hypertensive and diabetic patients in an eastern metropolis of China

A new role for primary care teams in the United States after “Obamacare:” Track and improve health insurance coverage rates

Introduction to special edition: The challenge of chronic non-communicable disease and the opportunity for transforming health care through primary care based population health management

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