Annals of family medicine
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Annals of family medicine · Sep 2013
Comparative StudyPotential adult Medicaid beneficiaries under the Patient Protection and Affordable Care Act compared with current adult Medicaid beneficiaries.
Under health care reform, states will have the opportunity to expand Medicaid to millions of uninsured US adults. Information regarding this population is vital to physicians as they prepare for more patients with coverage. Our objective was to describe demographic and health characteristics of potentially eligible Medicaid beneficiaries. ⋯ Under the ACA, physicians can anticipate a potentially eligible Medicaid population with equal if not better current health status and lower prevalence of obesity and depression than current Medicaid beneficiaries. Federal Medicaid expenditures for newly covered beneficiaries therefore may not be as high as anticipated in the short term. Given the higher prevalence of tobacco smoking and alcohol use, however, broad enrollment and engagement of this potentially eligible population is needed to address their higher prevalence of modifiable risk factors for future chronic disease.
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Annals of family medicine · Sep 2013
Relationship between clinical quality and patient experience: analysis of data from the english quality and outcomes framework and the National GP Patient Survey.
Clinical quality and patient experience are both widely used to evaluate the quality of health care, but the relationship between these 2 domains remains uncertain. The aim of this study was to examine this relationship using data from 2 established measures of quality in primary care in England. ⋯ Although there are associations between clinical quality and measures of patient experience, the 2 domains of care quality remain predominantly distinct. The strongest correlations are observed between practice clinical quality and practice access, with very low correlations between clinical quality and interpersonal aspects of care. The quality of clinical care and the quality of interpersonal care should be considered separately to give an overall assessment of medical care.
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Annals of family medicine · Sep 2013
eCHAT for lifestyle and mental health screening in primary care.
Early detection and management of unhealthy behaviors and mental health issues in primary care has the potential to prevent or ameliorate many chronic diseases and increase patients' well-being. This study aimed to assess the feasibility and acceptability of the systematic use of a Web-based eCHAT (electronic Case-finding and Help Assessment Tool) screening patients for problematic drinking, smoking, and other drug use, gambling, exposure to abuse, anxiety, depression, anger control, and physical inactivity, and whether they want help with these issues. Patients self-administered eCHAT on an iPad in the waiting room and received summarized results, including relevant scores and interpretations, which could be by a family physician on the website and in the electronic health record (EHR) at the point of care. ⋯ eCHAT is an acceptable and feasible means of systemic screening patients for unhealthy behaviors and negative mood states and is easily integrated into the primary care electronic health record.
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Annals of family medicine · Sep 2013
Measuring up: musings of a family doctor on the employee time clock.
Recently, at the health maintenance organization (HMO) where I work, they introduced an employee time clock. As in many other workplaces, doctors across the country are now obligated to punch the clock at the beginning and end of their workday. ⋯ I provide details on how the introduction of the clock influences small everyday clinical decisions that potentially affect the quality and depth of treatment while sharing the internal dialogue that accompanies me as I reaffirm my professional integrity again and again with each hastened visit. I also bring the internal dialogue of 2 of my patients, to illustrate the emotional world on the other side of these 10-minute interventions.