The Journal of ambulatory care management
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Many small- and medium-sized physician practices have developed specific programs and models toward becoming a successful patient-centered medical home. This article reports on a case-control quality improvement study of a multilingual population health management program for chronic disease management at International Community Health Services. In its first 2.5 years of operation, the International Community Health Services Population Health Management program for patients with hypertension and diabetes is associated with significant improvements in key health outcome measures for blood pressure and hemoglobin A1c control. This has significant implications for similar practices.
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J Ambul Care Manage · Apr 2013
Hospital readmission rates: the impacts of age, payer, and mental health diagnoses.
We examine impacts of age, payer, and mental health conditions upon hospital readmissions and the comparability of same-hospital and multiple-hospital readmission rates. Medicaid primary payment and extreme age are associated with significantly higher readmission rates. We find low correlation between same-hospital and multiple-hospital readmission rates and identify urban hospitals with high proportions of Medicaid patients and mental health admissions as factors driving the use of multiple hospitals within readmission chains. Hospital payment incentives and performance measures using readmission rates will be distorted if factors leading to higher readmission rates are ignored, or if readmissions to different hospitals cannot be identified.
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A well-established primary care sector has allowed England's National Health Service (NHS) to make efficient use of resources through the gatekeeping role that general practitioners have in controlling access to specialist services. Because of the poor economic situation in the United Kingdom, there is now considerable pressure on the NHS to use its resources more efficiently. These financial challenges are putting enormous pressure on general practices at a time when the NHS is also going through other major structural changes. Consequently, general practitioners in England increasingly find themselves having to make difficult decisions about the future of their practices.