J Am Board Fam Med
-
Older veterans in urban settings rely less on the Veterans Health Administration (VHA) health care, suggesting deficits of access and services for aging veterans. We aimed to identify reasons for VHA and non-VHA use across the health status of older, urban-dwelling veterans. ⋯ Even in an urban environment, proximity was a leading issue with worse health. Addressing urban accessibility and coordination for older, sicker veterans may enhance care for a growing vulnerable VHA population.
-
Mental health disorders are associated with persistent knee pain, but the association between these conditions has had little investigation in the military. The purpose of this study was to identify rates of mental health disorders in patients with patellofemoral pain (PFP) and determine differences by sex and whether mental health copresence influences outcomes. ⋯ Mental health disorders are common in military service members seeking care for patellofemoral pain. Differences in prevalence vary by sex, and presence of mental health disorders adversely affected long-term health care outcomes.
-
To understand changes in reasons for visit to primary care in the face of an aging population, growing evidence for proactive preventive and chronic disease services, and the rise of the chronic care model. ⋯ Growing emphasis on chronic disease management is not reflected in the percent of primary care visits for chronic illness. This study highlights the potential utility of longitudinal data within a historical interpretive frame, while raising questions about the utility of using a main reason for visit to classify complex primary care visits.
-
Although solo and small practices are a vital part of primary care, the proportion of family physicians reporting working in practices with 5 or fewer providers declined from 15% to 11% for solo and 37% to 34% for small (2 to 5 providers) practices from 2014 to 2018. These decreasing trends are concerning, mainly when a low proportion of family physicians have solo practices in rural locations given the access to care challenges in these underserved populations.
-
In addition to the collection of veterans' health articles, this edition of the journal contains a wide range of family medicine research reports, commentaries, clinical reviews, and scholarly observations. These articles clearly exemplify a key strength of family medicine scholarship: the focus is on our patients. ⋯ Two other articles explore the role of pharmacists in an interdisciplinary team. A clever use of big databases provides a thought-provoking answer about the long-term health of patients with methicillin-resistant Staphylococcus aureus Three articles give us possible glimpses into the future of family medicine, exploring a potential payment reform model, suggesting an alternative approach to cancer screening guideline development, and considering how family physicians remain relevant in the technology-laden medical world of tomorrow.