National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Alcohol Use (1)
- Ambulatory Care and Surgery (1)
- Behavioral Health (3)
- Cardiovascular Conditions (4)
- Care Coordination (2)
- Care Management (3)
- Chronic Conditions (3)
- Community-Based Practice (2)
- Comparative Effectiveness (2)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Elderly (1)
- Evidence-Based Practice (5)
- Family Health and History (1)
- Guidelines (1)
- Healthcare Costs (1)
- Healthcare Delivery (11)
- Health Information Technology (HIT) (1)
- Health Insurance (1)
- Health Systems (1)
- Heart Disease and Health (2)
- Implementation (6)
- Medicaid (1)
- Medication (1)
- Opioids (1)
- Outcomes (1)
- Pain (1)
- Patient-Centered Healthcare (7)
- Patient-Centered Outcomes Research (4)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Practice Patterns (1)
- Pregnancy (1)
- Prevention (3)
- Primary Care (22)
- (-) Primary Care: Models of Care (23)
- Provider (2)
- Provider: Clinician (1)
- Provider: Physician (1)
- Quality Improvement (7)
- Quality of Care (8)
- Rural Health (2)
- Screening (1)
- Substance Abuse (1)
- Teams (3)
- Telehealth (1)
- Women (1)
- Workforce (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedYeung K, Richards J, Goemer E
Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system.
The purpose of this study was to describe the cost of using evidence-based implementation strategies for sustained behavioral health integration (BHI) involving population-based screening, assessment, and identification at 25 primary care sites of Kaiser Permanente Washington (2015-2018). The investigators concluded that when spread across patients screened in a single year, BHI implementation costs were well within the range for commonly used diagnostic assessments in primary care (eg, laboratory tests).
AHRQ-funded; HS023173.
Citation: Yeung K, Richards J, Goemer E .
Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system.
Health Serv Res 2020 Dec;55(6):913-23. doi: 10.1111/1475-6773.13592..
Keywords: Healthcare Costs, Evidence-Based Practice, Implementation, Behavioral Health, Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare
Qureshi N, Quigley DD, Hays RD
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
The purpose of this study was to examine reasons practices obtained and maintained patient-centered medical home (PCMH) recognition and what resources were needed. The investigators concluded that PCMH efforts necessitated support and assistance to frontline, on-site practice leaders leading care delivery changes. They suggested that change efforts should include financial incentives (e.g., direct payment or additional reimbursement), leadership direction and support, and internal or external staff with experience with the PCMH application process, implementation changes, and QI expertise in monitoring process and outcome data.
AHRQ-funded; HS016980.
Citation: Qureshi N, Quigley DD, Hays RD .
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
J Gen Intern Med 2020 Dec;35(12):3501-09. doi: 10.1007/s11606-020-06052-1..
Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care, Healthcare Delivery
Quigley DD, Qureshi N, Masarweh LA
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
This study looked at how primary care practices implemented changes during the transition to becoming a patient-centered medical home (PCMH). The authors examined 105 primary care practice leader experiences during PCMH transformation using semi-structured interviews. Practices most commonly targeted changes in care coordination (30%), access to care (25%), and provider communication (24%). Reported areas for PCMH transformation were measured by Clinician & Group CAHPS, PCMH CAHPS, or supplemental CAHPS survey items, including team-based care (35%), providing more on-site services (28%), care management (22%), patient-centered culture (18%), and chronic condition health education (13%). Many PCMH changes are captured by CAHPS survey items, but some are not.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Masarweh LA .
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
J Patient Exp 2020 Dec;7(6):1509-18. doi: 10.1177/2374373520934231..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Patient Experience, Care Coordination, Quality Improvement, Quality of Care, Implementation
Aysola J, Xu C, Huo H
The relationships between patient experience and quality and utilization of primary care services.
This study examined the associations between visit-triggered patient-reported experience measures and both quality of care measures and the number of missed primary care appointments. A cross-sectional analysis of 8355 primary care patients from 22 primary care practices was conducted. Outcomes measured included: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status, diabetes control hemoglobin A1c, blood pressure control, cholesterol control LDL among patients with diabetes, and visit no shows 2 and 5 years after the index visit. The authors found that patient experience can be an important stand-alone metric of care quality, although it may not relate to clinical outcomes or process measures in the outpatient setting.
AHRQ-funded; HS021706.
Citation: Aysola J, Xu C, Huo H .
The relationships between patient experience and quality and utilization of primary care services.
J Patient Exp 2020 Dec;7(6):1678-84. doi: 10.1177/2374373520924190..
Keywords: Patient Experience, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Quality Improvement, Quality of Care
Harvey JB, Vanderbrink J, Mahmud Y
Understanding how health systems facilitate primary care redesign.
The objectives of this study were to understand how health systems are facilitating primary care redesign (PCR), examine the PCR initiatives taking place within systems, and identify barriers to this work. A sample of 24 health systems in 4 states was used to identify how system leaders define and implement initiatives to redesign primary care delivery and identify challenges. Codes based on the theoretical PCR literature was used and researchers also created new codes. Semi-structured telephone interviews with 162 system executives and physician organization leaders from 24 systems were conducted. Initiatives to redesign the delivery of primary care were described by leaders, but many were still in the early stages. Motivating factors for team-based care included improvement efficiency and enhancing clinician job satisfaction. Changes in payment and risk assumption as well as community needs were commonly cited as motivators for population health management and care coordination. Challenges health systems face in redesigning primary included return on investment and slower than anticipated rate in moving from fee-for-service to value-based payment.
AHRQ-funded; HS024067.
Citation: Harvey JB, Vanderbrink J, Mahmud Y .
Understanding how health systems facilitate primary care redesign.
Health Serv Res 2020 Dec;55(Suppl 3):1144-54. doi: 10.1111/1475-6773.13576..
Keywords: Health Systems, Primary Care: Models of Care, Primary Care, Healthcare Delivery
Guo F, Lin YL, Raji M
Processes and outcomes of diabetes mellitus care by different types of team primary care models.
This study compared processes and outcomes of care provided to older patients with diabetes by primary care teams composed of only primary care physicians (PCPs) versus team care that included nurse practitioners (NPs) or physician assistants (PAs). The authors studied 3,524 primary care practices identified via social network analysis and 306,741 patients aged 66 and older diagnosed with diabetes mellitus in or before 2015 from Medicare data. Outcomes looked for was more adherence to guideline-recommended care including eye examination, hemoglobin A1c test, and nephropathy monitoring. Preventable hospitalizations and high-risk medication prescribing rates were also measured. Patients in the team care practices received more guideline-recommended diabetes care than patients in PCP only teams. Patients in team care practices had a slightly higher likelihood of being prescribed high-risk medications. The likelihood of preventable hospitalizations was similar among all types of practices.
AHRQ-funded; HS020642.
Citation: Guo F, Lin YL, Raji M .
Processes and outcomes of diabetes mellitus care by different types of team primary care models.
PLoS One 2020 Nov 5;15(11):e0241516. doi: 10.1371/journal.pone.0241516..
Keywords: Elderly, Teams, Primary Care: Models of Care, Healthcare Delivery, Outcomes, Care Coordination, Practice Patterns
Soylu TG, Cuellar AE, Goldberg DG
Readiness and implementation of quality improvement strategies among small- and medium-sized primary care practices: an observational study.
Grounded in organizational readiness theory, the authors examined how readiness and practice characteristics affect QI strategy implementation. The study was a component of a larger practice-level intervention, Heart of Virginia Healthcare, which sought to transform primary care while improving cardiovascular care. The investigators concluded that QI strategy implementation varied by practice ownership. Independent practices focused on patient care-related activities.
AHRQ-funded; HS023913.
Citation: Soylu TG, Cuellar AE, Goldberg DG .
Readiness and implementation of quality improvement strategies among small- and medium-sized primary care practices: an observational study.
J Gen Intern Med 2020 Oct;35(10):2882-88. doi: 10.1007/s11606-020-05978-w..
Keywords: Primary Care, Primary Care: Models of Care, Quality Improvement, Quality of Care, Implementation
Nagykaldi Z, Scheid D, Zhao YD
A sustainable model for preventive services in rural counties: the healthier together study.
The Healthier Together study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices located in 3 rural counties in Oklahoma. Forty-four eligible clinician practices participated in the study. Results showed that, although health care is under-resourced and segmented in many rural counties, when stakeholder partnerships are established, they may be able to achieve and economically sustain community-wide health improvement by creating a win-win situation for all partners.
AHRQ-funded; HS023237.
Citation: Nagykaldi Z, Scheid D, Zhao YD .
A sustainable model for preventive services in rural counties: the healthier together study.
J Am Board Fam Med 2020 Sep-Oct;33(5):698-706. doi: 10.3122/jabfm.2020.05.190357..
Keywords: Rural Health, Prevention, Primary Care: Models of Care, Primary Care, Community-Based Practice
McClellan C, Maclean JC, Saloner B
AHRQ Author: McClellan C
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
This study provided the first population-level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use. As of 2016, 16 states had adopted an HH for enrollees with serious mental illness and/or substance use disorder. Using data from the National Survey on Drug Use and Health, the authors found that HH adoption increased service use among enrollees and enrollee self-reported health improved post-HH.
AHRQ-authored.
Citation: McClellan C, Maclean JC, Saloner B .
Integrated care models and behavioral health care utilization: quasi-experimental evidence from Medicaid health homes.
Health Econ 2020 Sep;29(9):1086-97. doi: 10.1002/hec.4027..
Keywords: Behavioral Health, Medicaid, Substance Abuse, Primary Care: Models of Care, Primary Care, Ambulatory Care and Surgery, Patient-Centered Outcomes Research
Dickinson WP, Nease DE, Rhyne RL
Practice transformation support and patient engagement to improve cardiovascular care: from EvidenceNOW Southwest (ENSW).
The purpose of this study was to improve cardiovascular care through supporting primary care practices' adoption of evidence-based guidelines; a cluster randomized trial compared standard practice support--practice facilitation, practice assessment with feedback, health information technology assistance, and collaborative learning sessions--and standard support plus patient engagement support. Findings showed that practice transformation support can assist practices with improving quality of care. Patient engagement in practice transformation can further enhance practices' implementation of aspects of new models of care.
AHRQ-funded; HS023904.
Citation: Dickinson WP, Nease DE, Rhyne RL .
Practice transformation support and patient engagement to improve cardiovascular care: from EvidenceNOW Southwest (ENSW).
J Am Board Fam Med 2020 Sep-Oct;33(5):675-86. doi: 10.3122/jabfm.2020.05.190395..
Keywords: Cardiovascular Conditions, Primary Care: Models of Care, Primary Care, Patient and Family Engagement, Evidence-Based Practice, Implementation, Quality Improvement, Quality of Care
Du S, Wiegmann D, Beasley J
Defining team membership in primary care: qualitative analysis.
This study explored the question: "How do healthcare professionals in primary care clinics define who is on their team?" Participants had very different perspectives on how their teams were defined, and multiple themes emerged. This study can inform healthcare professionals and administrators, as well as health IT designers, consultants, architects, and researchers interested in primary care teams and how they function in a clinic environment.
AHRQ-funded; HS022505.
Citation: Du S, Wiegmann D, Beasley J .
Defining team membership in primary care: qualitative analysis.
IISE Trans Healthc Syst Eng 2020;10(4):251-60. doi: 10.1080/24725579.2020.1800869..
Keywords: Primary Care: Models of Care, Primary Care, Teams, Provider
Halladay JR, Weiner BJ, In Kim J
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
In this analysis, the authors explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Using data from the EvidenceNow initiative's NC Cooperative, named Heart Health Now, they found that their analysis provided information for practice facilitation stakeholders to consider when determining which practices may be more amendable to embracing facilitation services.
AHRQ-funded; HS023912.
Citation: Halladay JR, Weiner BJ, In Kim J .
Practice level factors associated with enhanced engagement with practice facilitators; findings from the Heart Health Now study.
BMC Health Serv Res 2020 Jul 28;20(1):695. doi: 10.1186/s12913-020-05552-4.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Evidence-Based Practice, Teams
Islam N, Rogers ES, Schoenthaler EA
A cross-cutting workforce solution for implementing community-clinical linkage models.
This article discusses the use of employing community health workers (CHWs) in primary care practices to create community-clinical linkage models to address the underlying role of social determinants of health and achieve health equity. Federal initiatives such as EvidenceNOW and Million Hearts have supported a renewed focus on small, independently owned practices. These initiatives emphasize the role of practice facilitation. The authors drew from the literature and propose that small, independently owned practices strategically employ practice facilitators to help integrate CHWs into their primary care teams. These facilitators help provide a “population health management” infrastructure to develop effective partnerships. Several ways that practice facilitation can help do this is outlined in this paper.
AHRQ-funded; HS023922.
Citation: Islam N, Rogers ES, Schoenthaler EA .
A cross-cutting workforce solution for implementing community-clinical linkage models.
Am J Public Health 2020 Jul;110(S2):S191-s93. doi: 10.2105/ajph.2020.305692..
Keywords: Community-Based Practice, Primary Care, Workforce, Primary Care: Models of Care, Healthcare Delivery
Upadhya KK, Psoter KJ, Connor KA
AHRQ Author: Mistry KB
Cluster randomized trial of a pre/interconception health intervention for mothers in pediatric visits.
Recognizing that pediatric primary care focuses on family health and is an important location of contact for women of childbearing age, this project assessed the effectiveness of a pre/interconception women's health intervention delivered during pediatric primary care using a cluster randomized trial. The investigators concluded that pediatric visits are an opportune location for addressing maternal health. They indicated that this intervention demonstrated feasibility and improved outcomes for some but not all outcome.
AHRQ-authored.
Citation: Upadhya KK, Psoter KJ, Connor KA .
Cluster randomized trial of a pre/interconception health intervention for mothers in pediatric visits.
Acad Pediatr 2020 Jul;20(5):660-69. doi: 10.1016/j.acap.2019.10.003..
Keywords: Family Health and History, Pregnancy, Women, Primary Care: Models of Care, Primary Care, Healthcare Delivery
Huffstetler AN, Kuzel AJ, Sabo RT
Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial.
Investigators are initiating a clinic-level randomized controlled trial aimed to evaluate how primary care clinicians can impact unhealthy alcohol use through screening, counseling, and medication-assisted therapy (MAT). After completion of the intervention, researchers will conduct a mixed methods analysis to identify changes in screening rates, increase in provision of brief counseling and interventions as well as MAT, and the reduction of alcohol intake for patients after practices receive practice facilitation. They propose practice facilitation as a robust and feasible intervention to assist in making changes within the practice and believe that the process can be replicated and used in a broad range of clinical settings. They anticipate that these statements will be supported by their evaluation of this approach.
AHRQ-funded; HS027077.
Citation: Huffstetler AN, Kuzel AJ, Sabo RT .
Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial.
BMC Fam Pract 2020 May 20;21(1):93. doi: 10.1186/s12875-020-01147-4..
Keywords: Alcohol Use, Primary Care, Primary Care: Models of Care, Screening, Care Management, Prevention
Persell SD, Liss DT, Walunas TL
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
Effective quality improvement (QI) strategies are needed for small practices. The objective of this study was to compare practice facilitation implementing point-of-care (POC) QI strategies alone versus facilitation implementing point-of-care plus population management (POC+PM) strategies on preventive cardiovascular care. The investigators concluded that facilitator-led QI promoting population management approaches plus POC improvement strategies was not clearly superior to POC strategies alone.
AHRQ-funded; HS023921.
Citation: Persell SD, Liss DT, Walunas TL .
Effects of 2 forms of practice facilitation on cardiovascular prevention in primary care: a practice-randomized, comparative effectiveness trial.
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Keywords: Cardiovascular Conditions, Prevention, Primary Care: Models of Care, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery
Poghosyan L, Ghaffari A, Liu J
Physician-nurse practitioner teamwork in primary care practices in New York: a cross-sectional survey.
Primary care practices increasingly rely on the growing workforce of nurse practitioners (NPs) to meet primary care demand. Understanding teamwork between NPs and physicians in primary care practices is critically important. In this study, the investigators assessed teamwork between NPs and physicians practicing within the same primary care practice and determined how teamwork affected their job satisfaction, intent to leave their current job, and quality of care.
AHRQ-funded; HS024758.
Citation: Poghosyan L, Ghaffari A, Liu J .
Physician-nurse practitioner teamwork in primary care practices in New York: a cross-sectional survey.
J Gen Intern Med 2020 Apr;35(4):1021-28. doi: 10.1007/s11606-019-05509-2..
Keywords: Primary Care: Models of Care, Primary Care, Provider: Clinician, Provider: Physician, Provider, Workforce, Quality of Care
Nguyen AM, Cuthel A, Padgett DK
How practice facilitation strategies differ by practice context.
The purpose of this study was to identify contextual factors that drive facilitators' strategies to meet practice improvement goals, and how these strategies are tailored to practice context. This study was conducted as part of a larger study, HealthyHearts New York City, which evaluated the impact of practice facilitation on adoption of cardiovascular disease prevention and treatment guidelines.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel A, Padgett DK .
How practice facilitation strategies differ by practice context.
J Gen Intern Med 2020 Mar;35(3):824-31. doi: 10.1007/s11606-019-05350-7..
Keywords: Quality Improvement, Evidence-Based Practice, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care: Models of Care
Golberstein E, Joseph JM, Druss BG
The use of psychiatric econsults in primary care.
This study examined the use of an electronic consultation tool (eConsult) by primary care physicians (PCPs) with psychiatrists. The authors investigated the use of psychiatric eConsults in a large integrated delivery system in Minnesota (Allina Health). The tool was introduced in 22 of its primary care clinics on August 1, 2015. Patients had no fee and psychiatrists received 0.75 work relative value units for each eConsult. Out of 95,105 encounters across 219 PCPs from August 2015 through December 2016 only 256 (0.27%) had a psychiatric eConsult order. Among 37.606 encounters with a primary mental health diagnosis only 138 (0.37%) had an eConsult order. Anxiety and depressive disorders were the most common diagnosis types for PCP visits without an eConsult order as well as bipolar disorder, but schizophrenia and psychotic disorder diagnoses were more common with eConsult orders. Over half of eConsults were for medication-related issues, 33% for a specific mental health diagnosis, and 15% for psychiatry without any details. Most PCPs (63%) never ordered an eConsult but the top ten users of eConsults accounted for 46% of the total orders.
AHRQ-funded; HS025245.
Citation: Golberstein E, Joseph JM, Druss BG .
The use of psychiatric econsults in primary care.
J Gen Intern Med 2020 Feb;35(2):616-17. doi: 10.1007/s11606-019-05048-w..
Keywords: Telehealth, Health Information Technology (HIT), Behavioral Health, Primary Care: Models of Care, Primary Care, Healthcare Delivery
Parchman ML, Ike B, Osterhage KP
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
This paper discusses the barriers and facilitators to implementing changes in opioid prescription in rural areas using the Six Building Blocks evidence-based program to reduce opioid prescription in primary care practices. The program was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. Interviews and focus groups with conducted with the organizations at the end of the program period. Facilitators included a desire to help patients and their community; external pressures to make changes in opioid management; a desire to reduce workplace stress; external support for the clinic; supportive clinic leadership; and receptivity of patients. Barriers included competing demands on clinicians and staff; a culture of clinician autonomy; inadequate data systems; and a lack of patient resources in rural areas.
AHRQ-funded; HS023750.
Citation: Parchman ML, Ike B, Osterhage KP .
Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics.
J Clin Transl Sci 2020 Jan 10;4(5):425-30. doi: 10.1017/cts.2019.448..
Keywords: Opioids, Medication, Rural Health, Primary Care, Primary Care: Models of Care, Implementation, Pain, Chronic Conditions, Healthcare Delivery
Bierman AS, Tinetti ME
AHRQ Author: Bierman AS
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation: Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords: Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Luo Z, Chen Q, Annis AM
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
Two contrasting strategies of chronic care management include provider-delivered care management (PDCM) and health plan-delivered care management (HPDCM). The researchers aimed to compare the effectiveness of PDCM vs. HPDCM on improving clinical outcomes for patients with chronic diseases. They found that in a commercially insured population, neither PDCM nor HPDCM resulted in substantial improvement in patients' clinical indicators in the first year.
AHRQ-funded; HS020108.
Citation: Luo Z, Chen Q, Annis AM .
A comparison of health plan- and provider-delivered chronic care management models on patient clinical outcomes.
J Gen Intern Med 2016 Jul;31(7):762-70. doi: 10.1007/s11606-016-3617-2.
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Keywords: Chronic Conditions, Care Management, Primary Care: Models of Care, Primary Care, Healthcare Delivery, Comparative Effectiveness, Patient-Centered Outcomes Research, Health Insurance
Stults CD, McClellan S, Panattoni L
Estimating the human resource costs of developing and implementing shared medical appointments in primary care.
The authors conducted interviews to estimate the human resource costs for developing and implementing a program to support shared medical appointments (SMAs) and an additional SMA on cancer survivorship. They found that introducing new providers or a new type of SMA may require relatively modest incremental organizational resources and provider time. They concluded that time and cost could possibly be further decreased by leveraging relevant materials from existing SMAs.
AHRQ-funded; HS022631.
Citation: Stults CD, McClellan S, Panattoni L .
Estimating the human resource costs of developing and implementing shared medical appointments in primary care.
J Ambul Care Manage 2016 Jan-Mar;39(1):23-31. doi: 10.1097/jac.0000000000000084.
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Keywords: Primary Care: Models of Care, Primary Care, Healthcare Delivery, Implementation