The Whole Health Transformation at the Veterans Health Administration: Moving From “What’s the Matter With You?” to “What Matters to You?”
The Veterans Health Administration is undergoing a system-wide transformation to a Whole Person/Whole Health approach to care. The Whole Health model of care is described including early outcome data on utilization and effectiveness. The paper describes the first 10 years of this transformation and provides lessons learned during that process regarding large-scale system change. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Invited Commentary Source Type: research
Development and Structure of an Accurate Machine Learning Algorithm to Predict Inpatient Mortality and Hospice Outcomes in the Coronavirus Disease 2019 Era
Conclusion:
A deep-learning model using large-volume, structured electronic health record data can effectively predict short-term mortality or hospice outcomes on the second day of admission in the general inpatient population without significant racial bias. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Brief Reports Source Type: research
Out-of-Network Care in Commercially Insured Pediatric Patients According to Medical Complexity
Conclusions:
Commercially insured children with medical complexity experience higher rates of OON care with higher OON cost-sharing payments compared with those with no chronic disease. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Brief Reports Source Type: research
Caregiver Burden in Caregivers of Children With Special Health Care Needs and Association With Chronic Pain
Conclusions:
Chronic pain is more common among caregivers with high caregiver burden. Our findings highlight the need to further explore the nature and impact of risk factors on caregiver health and disability. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Brief Reports Source Type: research
A Multi-site Case Study of Care Coordination Between Primary Care and Specialty Care
Discussion:
We noted that professional relationships were highly related to coordination and both affected other facilitators and barriers and were affected by them. We suggested actions to improve relationships directly, and to address other facilitators and barriers that affect relationships and coordination. Among these is the use of the Primary Care Mental Health Integration model. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Suicide Deaths Before and During the Coronavirus Disease 2019 Pandemic: An Interrupted Time-series Study
Conclusions:
Overall suicide mortality rates did not increase with the pandemic, and in fact slightly declined from March to December 2020. Our findings should be confirmed across other settings and, when available, using final adjudicated state mortality data. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Imputing Race and Ethnicity: A Fresh Voices Commentary From The Medical Care Blog
No abstract available (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Special Commentary Source Type: research
The Affordable Care Act Medicaid Expansion, Social Disadvantage, and the Practice Location Choices of New General Internists
Conclusions:
States that opted not to expand Medicaid lost new general internists to expansion states. A highly disproportionate share of the physicians lost by nonexpansion states were lost from high disadvantage areas, potentially compromising access for all residents irrespective of insurance coverage. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Characteristics Associated With Disparities Among Older Adults in Coronavirus Disease 2019 Outcomes in an Academic Health Care System
Conclusions:
Increased age was the single greatest independent risk factor for mortality. Comorbidities and serious illness were independently associated with mortality. Understanding these risk factors can guide medical decision-making for older adults with COVID-19. Older adults and those admitted from a skilled nursing facility were half as likely to be admitted to the ICU. This finding requires further investigation to understand how age and treatment preferences factored into resource allocation. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Original Articles Source Type: research
Patient-Provider Communication Quality, 2002–2016: A Population-based Study of Trends and Racial Differences
Conclusions:
Our findings suggest that providers are increasingly likely to use patient-centered communication strategies. While racial differences have narrowed, Asians report the lowest quality throughout the study period, warranting future research. (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Patient-centered Care Source Type: research
Commentary on Patient-Provider Communication Quality, 2002–2016: A Population-based Study of Trends and Racial Differences
No abstract available (Source: Medical Care)
Source: Medical Care - April 14, 2022 Category: Health Management Tags: Editorial Source Type: research
Reduced Cognitive Burden and Increased Focus: A Mixed-methods Study Exploring How Implementing Scribes Impacted Physicians
Conclusions:
Working with scribes was associated with reduced time to close charts and reduced time using the electronic health record, markers of efficiency. Increased satisfaction accrued once scribes had experience. (Source: Medical Care)
Source: Medical Care - March 16, 2022 Category: Health Management Tags: Brief Reports Source Type: research
Prevalence of Private and Public Health Insurance Among Transgender and Gender Diverse Adults
Conclusion:
These findings provide foundational information about the payer mix among TGD people and provide insight into barriers to health insurance that TGD adults may face. (Source: Medical Care)
Source: Medical Care - March 16, 2022 Category: Health Management Tags: Brief Reports Source Type: research
Do Financial Incentives Affect Utilization for Chronically Ill Medicare Beneficiaries?
The objective of this study was to examine the price sensitivity for provider visits among Medicare Advantage beneficiaries.
Data Sources:
We used Medicare Advantage encounter data from 2014 to 2017 accessed as part of an evaluation for the Center for Medicare & Medicaid Innovation.
Study Design:
We analyzed the effect of cost-sharing on the utilization of 2 outcome categories: number of visits (specialist and primary care) and the probability of any visit (specialist and primary care). Our main independent variable was the size of the copayment for the visit, which we regressed on the outcomes with several b...
Source: Medical Care - March 16, 2022 Category: Health Management Tags: Original Articles Source Type: research
Risk Factors of Skilled Nursing Facility Admissions and the Interrelation With Hospitalization and Amount of Informal Caregiving Received
Conclusions:
Sociodemographic and health factors were important for predicting SNF admissions. After adjustment for important risk factors, SNF evidenced a strong positive correlation with the number of hospitalizations and a weak positive correlation with the hours of informal caregiving received. (Source: Medical Care)
Source: Medical Care - March 16, 2022 Category: Health Management Tags: Original Articles Source Type: research
