An Asthma and Diabetes Quality Improvement Project: Enhancing Care in Clinics and Community Health Centers

Silver, Alan; Figge, James; Haskin, Donna L.; Pryor, Veronica; Fuller, Karen; Lemme, Thomas; Li, Nancy; O’Brien, Mary Jane

doi:10.1007/s10900-010-9296-8

Cited by 9 publications

(4 citation statements)

References 10 publications

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“…The intervention found that patients in the intervention group had improved control of HbA1c, LDL, systolic blood pressure, patient satisfaction, and quality of life (21). Non-randomized studies conducted in PCMH settings found similar results with the diabetes care coordinator being associated with reductions in glycemic control (17, 22) and improvements in CVD risk factors (20, 23) and preventive care measures (24, 25). …”

Section: Elements Of Pcmh That Support Better Diabetes Care and Outcomesmentioning

confidence: 72%

Effectiveness of Diabetes Interventions in the Patient-Centered Medical Home

Ackroyd

Wexler

2014

Curr Diab Rep

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The patient-centered medical home (PCMH) is an innovative care model for the provision of primary care that is being rapidly adopted in the U.S. with the support of federal agencies and professional organizations. Its goal is to provide comprehensive, patient-centered care with increased access, quality, and efficiency. Diabetes, as a common, costly, chronic disease that requires ongoing management by patients and providers, is a condition that is frequently monitored as a test case in PCMH implementations. While in theory a PCMH care model that supports patient engagement and between-visit care may help improve diabetes care delivery and outcomes, the success of this approach may depend largely upon the specific strategies used and implementation approach. The cost-effectiveness of diabetes care in the PCMH model is not yet clear. Interventions have been most effective and most cost-effective for those with the poorest diabetes management at baseline.

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Section: Elements Of Pcmh That Support Better Diabetes Care and Outcomesmentioning

confidence: 72%

Effectiveness of Diabetes Interventions in the Patient-Centered Medical Home

Ackroyd

Wexler

2014

Curr Diab Rep

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“…Several ongoing programs or disease-related professional organizations have supported intensive efforts to improve influenza vaccination among persons with high-risk conditions (18-21). For example, the Diabetes Quality Improvement Project, a collaborative effort between public and private organizations to improve preventive care for persons with diabetes, including influenza vaccination, has been ongoing for more than 10 years (18, 19).…”

Section: Discussionmentioning

confidence: 99%

“…For example, the Diabetes Quality Improvement Project, a collaborative effort between public and private organizations to improve preventive care for persons with diabetes, including influenza vaccination, has been ongoing for more than 10 years (18, 19). The National Asthma Education and Prevention Program panel identified influenza vaccination as one of several “key clinical activities that should be considered as essential for quality asthma care” (20).…”

Section: Discussionmentioning

confidence: 99%

Uptake of Influenza Vaccination and Missed Opportunities Among Adults with High-Risk Conditions, United States, 2013

O’Halloran

Ding

et al. 2016

The American Journal of Medicine

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Background Since 1960, the Advisory Committee on Immunization Practices (ACIP) has recommended influenza vaccination for adults with certain high-risk conditions because of increased risk for complications from influenza infection. We assessed national influenza vaccination among persons 18-64 years with high-risk conditions. Methods We analyzed data from the 2012 and 2013 National Health Interview Survey (NHIS). The Kaplan-Meier survival analysis procedure was used to estimate the cumulative proportion of influenza vaccination among adults 18-64 years with high-risk conditions. Potential missed opportunities for influenza vaccination were also evaluated. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with vaccination. Results Overall, 39.9 million adults 18-64 years (18.9%) had at least one high-risk condition. For adults 18-64 years with high-risk conditions, overall influenza vaccination coverage was 49.5%. Coverage among adults 50-64 years was significantly higher compared with those 18-49 years (59.3% vs. 39.0%; p<0.05). Among adults 18-64 years, coverage was 46.2% for those with chronic lung diseases, 50.5% for those with heart disease, 58.0% for those with diabetes, 62.5% for those with renal disease, and 56.4% for those with cancer. Overall, 90.1% reported at least one visit to a health care setting where vaccination could have been provided. Among adults 18-64 years with high-risk conditions, older age, being female, Hispanic ethnicity or Asian race, having one or more physician visits, a regular physician for health care, health insurance, and having ever received pneumococcal vaccination were independently associated with a higher likelihood of influenza vaccination. Being widowed/divorced/separated or never married and not being employed were independently associated with a lower likelihood of influenza vaccination Conclusions Influenza vaccination coverage varies substantially by age and high-risk conditions but remains low. Approximately 50% of those with high-risk conditions remain unvaccinated. Healthcare providers should ensure they routinely assess influenza vaccination status, recommend and offer vaccines to those with high-risk conditions.

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“…Furthermore, community health workers are very effective in counseling to the mothers of their sick children at home, resulting in a 40% reduction in mortality for children less than five years of age (Haines et al, 2007). In the USA, community health centers have a significant role in reducing diabetes and asthma through regular check-ups of urine, blood, and diet (Silver et al, 2011). The critical challenges in the management of local primary health care services include lack of skilled workforce, lack of finance, inadequate transportation and political instability as well (Adeyemo et al, 2005).…”

Section: Service Delivery Of Cc: How Far Does It Meet the Local Demands?mentioning

confidence: 99%

Decentralized Health Service Delivery System in Bangladesh: Evaluating Community Clinics in Promoting Healthcare for the Rural Poor

Seddiky

2020

ESJ

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The Awami League government of Bangladesh has established community clinics as decentralized healthcare units at the village level to ensure smooth and equal access to family planning, preventive health services, and limited curative care for the local community. The primary aspiration of this study is to evaluate the dynamics of service delivery systems under decentralized community clinics in rural areas of Bangladesh. It also aims to explore the challenges of accessing healthcare services and the impacts of decentralization on the promotion of the service delivery system of the community clinics. A qualitative field study was conducted in Sylhet District in the northeastern part of Bangladesh to collect the necessary data regarding the study objectives. The respondents were sampled through a purposive sampling method. Data collection was done through in-depth interviews and focus group discussions. The study findings revealed that the aspect of services in community clinics is being questioned due to different sociocultural, political, economic, and administrative stumbling blocks. If the government ensures skilled workforce, structural and technical support, locallevel planning, adequate funding, strategic coordination, and delegation of functions to address the challenges in providing health services to community clinics, then it is believed that these community-knit clinics would be considered as the lighthouse for providing primary healthcare for the disadvantaged rural sections of Bangladesh.

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An Asthma and Diabetes Quality Improvement Project: Enhancing Care in Clinics and Community Health Centers

Cited by 9 publications

References 10 publications

Effectiveness of Diabetes Interventions in the Patient-Centered Medical Home

Effectiveness of Diabetes Interventions in the Patient-Centered Medical Home

Uptake of Influenza Vaccination and Missed Opportunities Among Adults with High-Risk Conditions, United States, 2013

Decentralized Health Service Delivery System in Bangladesh: Evaluating Community Clinics in Promoting Healthcare for the Rural Poor

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