The Journal of ambulatory care management
-
J Ambul Care Manage · Jan 2014
Avoidable hospitalizations for ambulatory care sensitive conditions as an indicator of primary health care effectiveness in Argentina.
Avoidable hospitalizations for ambulatory care sensitive conditions (AH-ACSCs) identify health problems that could be avoided by improving primary health care (PHC). On the basis of hospital discharges from Argentine public sector facilities, an expert panel convened to define a list of AH-ACSCs for children and adults. ⋯ Compared with country averages, poorer districts showed large differences in trends for adults but not for children. Despite that AH-ACSCs have demonstrated empirical validity to evaluate health system performance, its implementation to assess PHC in countries like Argentina, with pluralistic and fragmented health care systems, remains a big challenge.
-
J Ambul Care Manage · Oct 2013
Community health workers in Canada: innovative approaches to health promotion outreach and community development among immigrant and refugee populations.
This article provides results from an empirical case study that showcases a community health worker practice targeting immigrants and refugees in Canada. The study focuses on the Multicultural Health Brokers practice, which offers an innovative approach to health promotion outreach and community development addressing broad social determinants of health. This article offers new evidence of both the role of community health worker interventions in Canada and community health workers as an invisible health and human services workforce. It also discusses the Multicultural Health Brokers contribution both to the "new public health" vision in Canada and to a practice that fosters feminist urban citizenship.
-
J Ambul Care Manage · Oct 2013
Medical group practice characteristics influencing inappropriate emergency department and avoidable hospitalization rates.
The inappropriate use of emergency departments (EDs) and ambulatory care sensitive hospital admission rates by patients attributed to a national sample of 212 medical group practices is documented, and the characteristics of practices that influence these rates are identified. Hospital-owned practices have higher nonemergent and emergent primary care treatable ED rates and higher ambulatory care sensitive hospitalization rates. Practices with electronic health records have lower inappropriate ED rates but those in rural areas have significantly higher rates. Practices with lower operating costs have higher inappropriate ED and ambulatory care sensitive rates, raising questions about the costs of preventing these incidents at the medical group practice level.
-
J Ambul Care Manage · Jul 2013
Internet access and patient portal readiness among patients in a group of inner-city safety-net practices.
The use of online personal health records (PHRs) threatens to transform the digital divide to a health care divide among the underserved. Little is known about underserved patients' ability to access online PHRs. ⋯ Age, sex, and race were not associated with interest in PHRs. A majority of patients have access to the Internet and are interested in using a PHR to manage their care, but they are not prepared.