Clinical Quality Performance in U.S. Health Centers

Shi, Leiyu; Lebrun, Lydie A.; Zhu, Jinsheng; Hayashi, A. Seiji; Sharma, Ravi; Daly, Charles A.; Sripipatana, Alek; Ngo‐Metzger, Quyen

doi:10.1111/j.1475-6773.2012.01418.x

Cited by 41 publications

(41 citation statements)

References 37 publications

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“…8 Patient characteristics included: total number of patients; percent of minority patients (including non-Hispanic Asian, non-Hispanic Hawaiian/Other Pacific Islander, non-Hispanic Black/African American, non-Hispanic American Indian/Alaska Native, and Hispanic/Latino); percent of uninsured patients; percent of Medicaid-insured patients; percent of patients with managed care; and percent of patients with chronic conditions (ie, HIV, asthma, chronic bronchitis and emphysema, diabetes mellitus, heart disease, hypertension).…”

Section: Methodsmentioning

confidence: 99%

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Patient-centered Medical Home Capability and Clinical Performance in HRSA-supported Health Centers

Shi¹,

Lock

Lee

et al. 2015

Medical Care

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Objectives To evaluate the relationship between Patient-centered Medical Home (PCMH) model adoption in health centers (HCs) and clinical performance measures and to determine if adoption of PCMH characteristics is associated with better clinical performance. Research Design Data came from the Health Resources and Services Administration’s 2009 Uniform Data System and the 2009 Commonwealth Fund National Survey of Federally Qualified Health Centers. Clinical performance measures included 2 process measures (childhood immunization and cervical cancer screening) and 2 outcome measures (hypertension control and diabetes control). Total and subscale PCMH scores were regressed on the clinical performance measures, adjusting for patient, provider, financial, and institutional characteristics. Results The findings showed different directional relationships, with some PCMH domains (care management, test/referral tracking, quality improvement, and external coordination) showing little or no effect on outcome measures of interest, 1 domain (access/communication) associated with improved outcomes, and 1 domain (patient tracking/registry) associated with worse outcomes. Conclusions This study is among the first to examine the association between PCMH transformation and clinical performance in HCs, providing an understanding of the impact of PCMH adoption within safety-net settings. The mixed results highlight the importance of examining relationships between specific PCMH domains and specific clinical quality measures, in addition to analyzing overall PCMH scores which could yield distorted findings.

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Section: Methodsmentioning

confidence: 99%

“…8,9 HRSA’s PCMH initiative supports HCs’ efforts to adopt PCMH features and gain recognition by the National Committee for Quality Assurance, by providing education, training, technical assistance, and fee waivers for gaining recognition. 10 By the end of fiscal year 2014, HRSA aims to have approximately 40% of HCs recognized.…”

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confidence: 99%

Patient-centered Medical Home Capability and Clinical Performance in HRSA-supported Health Centers

Shi¹,

Lock

Lee

et al. 2015

Medical Care

Self Cite

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“…Their anxiety has also an impact on in retelling performance. Concluding from the records show that highanxious test-takers live problem to give their attention fully to the task and at the end of this, they forget retelling important points (Shi, 2012). Because of the possible problems which may occur during the speaking test, this study aims at voicing the language learners' opinions and feelings specifically about the assessment of speaking skills of the bilingual university students.…”

Section: Background Of the Studymentioning

confidence: 98%

The Impact of Speaking Component of an Institutional Test on Bilingual Students' Anxiety Level

Ramos¹

2017

ijlet

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The aim of the current study was to investigate whether bilingual university/ college students may have speaking test anxiety. Additionally, it was examined whether there were differences in anxiety levels among bilingual students according to gender. To collect data, 140 bilingual university students were given a GEP-TAS (General English Proficiency test anxiety scale) consisting 3 categories. The 36 items in the questionnaire was subjected to Exploratory Factor Analysis (EFA) to determine the subcategories of the scale. Addition to that, the bilingual students were interviewed to get their opinions on how to overcome speaking test anxiety. The results showed that, bilingual university students got extremely anxious during the speaking test. They had experienced sweaty palms, shaky hands and pain in their stomach when they were asked to answer the questions in the speaking test. Also, it was found out that male students were much more relaxed during the speaking test comparing to female students. Students also believe they can tackle down with the speaking anxiety by organizing English speaking activities, making foreign friends, talking to their native teachers and going abroad. Those results were discussed within the context of relevant literature.

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“…2 Despite serving sociodemographically vulnerable populations, the quality of care provided at health centers is similar to care provided in other settings, on average. 3 Racial/ethnic disparities are generally narrower among health center patients compared to patients seen in other care settings, though they are still present. 4,5,6,7 …”

Section: Introductionmentioning

confidence: 99%

State Variation in Quality Outcomes and Disparities in Outcomes in Community Health Centers

2017

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Background Prior studies have reported that community health centers perform as well as other sites of care, despite serving more vulnerable patient populations. However, there is little prior study of geographic variation in quality outcomes and disparities in outcomes in this setting. Quantifying geographic variation is important so as to target quality improvement efforts and funding and to learn from states where total quality is highest and racial/ethnic disparities are lowest. Objectives To estimate between-state variation in hypertension, diabetes, and pregnancy outcomes and racial/ethnic disparities in these outcomes for health center patients. Methods Using data on all US health centers from 2010–2014 (N=1047 health centers/year, or 21.2 million patients in 2014), we used linear regression models to estimate adjusted quality outcomes and racial/ethnic disparities in quality outcomes by state for hypertension control, diabetes control, and normal birthweight. Results We found wide variation in both outcomes and racial/ethnic disparities in outcomes between states for patients seen at health centers. For instance, between states, the mean proportion of patients with hypertension control ranged from 58% to 70% for white patients, from 49% to 64% for black patients, and from 53% to 74% for Hispanic patients (p<0.001). Racial/ethnic disparities in outcomes ranged from negative or non-significant in some states to positive in others. Conclusions Wide variation in health center patient outcomes and disparities in outcomes is observed between states. This variation suggests that policymakers should target funding and interventions to underperforming states, and identify determinants of high quality in higher performing states.

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Clinical Quality Performance in U.S. Health Centers

Abstract: Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients.

Cited by 41 publications

References 37 publications

Patient-centered Medical Home Capability and Clinical Performance in HRSA-supported Health Centers

Patient-centered Medical Home Capability and Clinical Performance in HRSA-supported Health Centers

The Impact of Speaking Component of an Institutional Test on Bilingual Students' Anxiety Level

State Variation in Quality Outcomes and Disparities in Outcomes in Community Health Centers

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