A5032399461- Primary Care and Health Outcomes
- Chronic Disease Management Strategies
- Diabetes Management and Education
- Healthcare Policy and Management
- Health Systems, Economic Evaluations, Quality of Life
- Health Policy Implementation Science
- Health disparities and outcomes
- Blood Pressure and Hypertension Studies
- Global Cancer Incidence and Screening
- Smoking Behavior and Cessation
- Frailty in Older Adults
- Patient Satisfaction in Healthcare
- Patient-Provider Communication in Healthcare
- Pharmaceutical Practices and Patient Outcomes
- Food Security and Health in Diverse Populations
- Health Sciences Research and Education
- Mental Health Treatment and Access
- Healthcare Systems and Technology
- Nutrition and Health in Aging
- Obesity, Physical Activity, Diet
- Clinical practice guidelines implementation
- Community Health and Development
- Behavioral Health and Interventions
- School Health and Nursing Education
- Interprofessional Education and Collaboration
Western University of Health Sciences
2024
Geisinger Medical Center
2023
Genomic Health (United States)
2023
University Hospital Cologne
2023
University of Wisconsin–Madison
2022
Kaiser Permanente Washington Health Research Institute
2012-2021
Robert Wood Johnson Foundation
2001-2019
Community Health Center
2018-2019
Johnson University
2019
Rutgers, The State University of New Jersey
2019
The growing number of persons suffering from major chronic illnesses face many obstacles in coping with their condition, not least which is medical care that often does meet needs for effective clinical management, psychological support, and information. primary reason this may be the mismatch between delivery systems largely designed acute illness. Evidence system changes improve mounting. We have tried to summarize evidence Chronic Care Model (CCM) guide quality improvement. In paper we...
The chronic care model is a guide to higher-quality illness management within primary care. predicts that improvement in its 6 interrelated components—self-management support, clinical information systems, delivery system redesign, decision health organization, and community resources—can produce reform which informed, activated patients interact with prepared, proactive practice teams. Case studies are provided describing how components of the have been implemented practices 4 organizations.
Usual medical care often fails to meet the needs of chronically ill patients, even in managed, integrated delivery systems. The literature suggests strategies improve outcomes these patients. Effective interventions tend fall into one five areas: use evidence-based, planned care; reorganization practice systems and provider roles; improved patient self-management support; increased access expertise; greater availability clinical information. challenge is organize components an system chronic...
This article reviews research evidence showing to what extent the chronic care model can improve management of conditions (using diabetes as an example) and reduce health costs. Thirty-two 39 studies found that interventions based on components improved at least 1 process or outcome measure for diabetic patients. Regarding whether costs, 18 27 concerned with 3 examples (congestive heart failure, asthma, diabetes) demonstrated reduced costs lower use services. Even though has potential...
Developed more than a decade ago, the Chronic Care Model (CCM) is widely adopted approach to improving ambulatory care that has guided clinical quality initiatives in United States and around world. We examine evidence of CCM’s effectiveness by reviewing articles published since 2000 used one five key CCM papers as reference. Accumulated appears support an integrated framework guide practice redesign. Although work remains be done areas such cost-effectiveness, these studies suggest...
To assess the association between first myocardial infarction and use of antihypertensive agents.We conducted a population-based case-control study among enrollees Group Health Cooperative Puget Sound (GHC).Cases were hypertensive patients who sustained fatal or nonfatal from 1986 through 1993 women 1989 men. Controls stratified random sample GHC enrollees, frequency matched to cases on age, sex, calendar year. All 623 2032 controls had pharmacologically treated hypertension. Data collection...
There is a need for brief, validated patient self-report instrument to assess the extent which patients with chronic illness receive care that aligns Chronic Care Model-measuring patient-centered, proactive, planned and includes collaborative goal setting; problem-solving follow-up support.A total of 283 adults reporting one or more from large integrated health delivery system were studied.Participants completed 20-item Patient Assessment Illness (PACIC) as well measures demographic factors,...
Background. The study tested the effect of strength and endurance training on gait, balance, physical health status, fall risk, services use in older adults. Methods. was a single-blinded, randomized controlled trial with intention-to-treat analysis. Adults (n = 105) age 68–85 at least mild deficits balance were selected from random sample enrollees maintenance organization. intervention supervised exercise (1-h sessions, three per week, for 24–26 weeks), followed by self-supervised...
Because of the additional costs associated with improving diabetes management, there is interest in whether improved glycemic control leads to reductions health care costs, and, if so, when such cost savings occur.To determine sustained improvements hemoglobin A(1c) (HbA(1c)) levels among diabetic patients are followed by utilization and costs.Historical cohort study conducted 1992-1997 a staff-model maintenance organization (HMO) western Washington State.All aged 18 years or older who were...
Objective: To test the effectiveness of two programmes to improve treatment acute depression in primary care. Design: Randomised trial. Setting: Primary care clinics Seattle. Patients: 613 patients starting antidepressant treatment. Intervention: Patients were randomly assigned continued usual or one interventions: feedback only and plus management. Feedback comprised algorithm based recommendations doctors on basis data from computerised records pharmacy visits. management included...
Although the relationship between strength and physical performance in older adults is probably non-linear, few empirical studies have demonstrated that this so. In a population-based sample of aged 60-96 years (n = 409), leg was measured four muscle groups (knee extensor, knee flexor, ankle plantar dorsiflexor) both legs using an isokinetic dynamometer. A score calculated as sum measurements right leg. Usual gait speed over 15.2 metre course. With linear model, explained 17% variance speed....
BackgroundClinical trials demonstrated that women treated for breast cancer with anthracycline or trastuzumab are at increased risk heart failure and/or cardiomyopathy (HF/CM), but the generalizability of these findings is unknown. We estimated real-world adjuvant and use their associations incident HF/CM.
Physician profiling is widely used by many health care systems, but little known about the reliability of commonly systems.To determine a set physician performance measures for diabetes care, one most common conditions in medical practice, and to examine whether physicians could substantially improve their profiles preferential patient selection.Cohort study performed from 1990 1993 at 3 geographically organizationally diverse sites, including large staff-model maintenance organization, an...
Previous studies have found that patients with the acquired immunodeficiency syndrome (AIDS) who are admitted to hospitals admit many such lower mortality rates than in less experience AIDS. We examined relation between physicians' AIDS and survival of their