Medicine and Health Sciences Commons^™

“In Principle We Have Agreement, But In Practice It Is A Bit More Difficult": Obtaining Organizational Buy-In To Patient-Centered Medical Home Transformation, Janelle Applequist, Michelle Miller-Day, Peter F. Cronholm, Robert Gabbay, Deborah S. Bowen

Communication Faculty Articles and Research

The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis …

Health And Health Care In Kentucky: Variations By Region And Metro/Micro/Rural Status, Tyrone F. Borders, Keith Branham

Institute for Rural Health Policy Reports

Health policy makers and health system managers frequently make decisions to allocate and organize resources according to differences in unmet needs across geographic areas. This report describes, compares, and contrasts key health, health behavior, and health care access indicators by region and metropolitan status in Kentucky.

‘Because I Don’T Know’: Uncertainty And Ambiguity In Closed-Ended Reports Of Perceived Discrimination In Us Health Care, Chih-Yuan Lee, Amy Irby-Shasanmi

Department of Public Health Scholarship and Creative Works

Objective

Surveys often ask respondents to assess discrimination in health care. Yet, patients’ responses to one type of widely used measure of discrimination (single-item, personally mediated) tend to reveal prevalence rates lower than observational studies would suggest. This study examines the meaning behind respondents’ closed-ended self-reports on this specific type of measure, paying special attention to the frameworks and references used within the medical setting.

Design

Twenty-nine respondents participated in this study. They were asked the widely used question: ‘Within the past 12 months when seeking health care do you feel your experiences were worse than, the same as, or …

Patient Satisfaction As A Reflection Of Quality Health Care And Outcomes, Ian C. Brown, Taylor M. Piatkowski

Physician Assistant Capstones, 2016 to 2019

Background: In 2006 the Centers of Medicaid and Medicare Services mandated that acute care centers begin submitting HCAHPS survey data for financial reimbursement for Medicare patients. The national shift to a patient centered focus and the financial incentive to improve patient satisfaction scores has stimulated debate regarding the relationship between patient satisfaction and quality healthcare.

Clinical Question: Does improvement in patient satisfaction with their healthcare and its providers, as measured by the HCAHPS survey, improve healthcare quality and outcomes?

Design: Systematic literature review.

Methods: Searches were performed using PubMed and Scopus databases.The terms used for the PubMed search were “patient …

Identification Of Medicare Recipients At Highest Risk For Clostridium Difficile Infection In The Us By Population Attributable Risk Analysis, Erik R. Dubberke, Margaret A. Olsen, Dustin Stwalley, Ciarán P. Kelly, Dale N. Gerding, Yinong Young-Xu, Cedric Mahé

Dartmouth Scholarship

Background: Population attributable risk percent (PAR%) is an epidemiological tool that provides an estimate of the percent reduction in total disease burden if that disease could be entirely eliminated among a subpopulation. As such, PAR% is used to efficiently target prevention interventions. Due to significant limitations in current Clostridium difficile Infection (CDI) prevention practices and the development of new approaches to prevent CDI, such as vaccina- tion, we determined the PAR% for CDI in various subpopulations in the Medicare 5% random sample. Methods: This was a retrospective cohort study using the 2009 Medicare 5% random sample. Comorbidities, infections, and healthcare …