The American journal of managed care
-
To explore the associations among activation, physical activity, hemoglobin A1c (HbA1c), and healthy days in older adults with type 2 diabetes (T2D) who participated in wellness programs. ⋯ Increasing patient activation levels encourages physical activity, which can help improve glycemic control and health-related quality of life, especially among older adults.
-
Observational Study
Predictors of discharge from the VA Caregiver Support Program.
The Department of Veterans Affairs (VA) Program of Comprehensive Assistance for Family Caregivers (PCAFC) is a clinical program providing training, a monthly stipend, and other services to caregivers of qualifying post-9/11 veterans with service-related injuries. Veteran-caregiver discharge from the program occurs when veteran recovery is achieved, participation is no longer in the veteran's best interest, or caregiving ceases. Public scrutiny about potentially inappropriate discharges resulted in a nationwide freeze on all discharges. PCAFC expanded to pre-9/11 veterans in October 2020; thus, lessons learned can continue to inform the expanded program. We pursued 3 objectives: (1) describe the discharge rate, reasons for discharge, and veteran and caregiver characteristics by discharge status; (2) identify factors associated with discharge from PCAFC nationally; and (3) characterize network variation in discharge predictors. ⋯ Training on clinically appropriate discharge criteria could improve practice and increase equity.
-
To examine changes in plan composition and enrollee experience associated with Medicaid expansion among Medicaid managed care organization (MCO) enrollees. ⋯ State policy makers may need to account for the role that Medicaid expansion may have in changing Medicaid MCO enrollee composition to prevent unfair penalization on performance metrics.
-
To assess the impact of preappointment surveys and reminder phone calls on show rate and time spent in new patient appointments at a multidisciplinary pediatric chronic pain clinic. ⋯ With new patients, preappointment surveys can improve clinic show rate and decrease time spent in initial appointments. Clinics may consider policies targeting completion of preappointment surveys to assist with show rate, but they must consider their patients' barriers to completing surveys so access to care is not limited.
-
Comparative Study
Validation of the FINE-CKD model for future health technology assessments for finerenone in patients with chronic kidney disease and type 2 diabetes.
The FINE-CKD model was developed to estimate the cost-effectiveness of finerenone in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D). ⋯ This study demonstrates that the FINE-CKD model adequately reflects the clinical data and provides reliable extrapolation relative to the existing predictive tools while also being conservative in its approach.