Articles: ninos.
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. Community-based health insurance (CBHI) is a health-financing mechanism based on voluntary membership, risk pooling, with a non-profit objective and relies on social capital as a driving force. It aims to improve equity in healthcare utilization in the community. We did this study to understand if CBHI schemes reach the poor, improve healthcare utilization and protect them from catastrophic health events. ⋯ . CBHI schemes improve healthcare utilization and protect against catastrophic health expenditure among those who get hospitalized. However, there also exists a socioeconomic gradient both in membership and in utilization of healthcare services favouring those who are more affluent.
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Inspired by the ABIM Foundation's Choosing Wisely® campaign, the "Things We Do for No Reason™ " (TWDFNR) series reviews practices that have become common parts of hospital care but may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent "black and white" conclusions or clinical practice standards but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion.
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Group sharing of prenatal care and inpatient obstetric (OB) call is increasingly replacing single-provider longitudinal models including in family medicine (FM) residencies. Such change in care models could impact continuity of prenatal and delivery care.The University of Rochester's family medicine residency program changed the resident maternal care coverage to an obstetric group model from a single-provider model in 2016 to improve work-life balance, which provided an opportunity to examine how these two practice styles impacted provider continuity. ⋯ This study provides quantitative evidence on how differing models of residency maternal care coverage impact continuity of care. Study findings did not show an inferiority of an OB group-provider model compared to a single-provider model when considering how often patients were seen prenatally and delivered by providers from their continuity group.
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Interprofessional education is a critical component of medical student training, yet it is often difficult to implement. Medical students who learn with, from, and about learners from other disciplines have been shown to create more effective and safe health care teams. The investigators wanted to know how participating in two interprofessional observed structured clinical exams (OSCEs) at Tufts University School of Medicine (TUSM) would affect changes in medical students' attitudes and values in interprofessional teamwork. ⋯ Placing interprofessional cases involving AEAs into OSCE events is easily replicated, and positively impacts students' attitudes and values in interprofessional knowledge.
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As the opioid crisis worsens across the United States, the factors that impact physician training in management of substance use disorders become more relevant. A thorough understanding of these factors is necessary for family medicine residency programs to inform their own residency curricula. The objective of our study was to identify factors that correlate with increased residency training in addiction medicine across a broad sample of family medicine residencies. ⋯ Our quantitative secondary analysis of CERA survey data of family medicine residency program directors revealed that resident training in addiction medicine is strongly correlated with both residency clinic setting (FQHC or FQHC/PCMH) as well as residency faculty possession of DEA-X licenses.