Annals of Family Medicine

NOVEMBER 20, 2024

Objective: Evaluate the economic impact of receiving tele-legal services from Medicaid’s perspective with regard to a) fee- for service (FFS) total cost of care; b) FFS cost of primary care; c) utilization for FFS primary care; d) utilization for FFS and capitated behavioral health (BH) and BH emergency department encounters.

Primary Care 130

Primary Care Medical Behavioral Health Services Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: The impact of the COVID-19 pandemic on patients with acute kidney injury (AKI) in Academic Medical Centers (AMCs) remains unclear. Objective: To assess the epidemiology and mortality risk among patients with AKI discharged from AMCs in the US from October 2019 to December 2023. The mean observed LOS was 7.1

Patient-Centered 130

Patient-Centered Patients Medical Diagnosis 130

Annals of Family Medicine

NOVEMBER 20, 2024

Participating clinic sites offered convenience sample frame, patients with legal needs were identified through universal and secondary screening approach. Descriptive analysis utilized primary legal record and secondary electronic health record sources. Nine focus groups were conducted and recorded, using semi-structured interviews.

Medical 130

Medical Referral Screening Internal Medicine 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Virtual visits have emerged as a new mode of accessing healthcare, however not all patients have equal access to virtual care. Patients who may benefit most from virtual care, such as those living in rural areas, may be at greatest risk of not being able to complete a clinical video visit with their provider.

Patients 130

Patients Appointment Utilities Provider 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Prenatal care can be difficult for patients to accomplish, with frequent visits and time-sensitive health screenings. Patient interviews, providing qualitative information to augment study findings. Semi-structured interviews of post-partum patients. Intervention/Instrument: Optional virtual prenatal visits.

Patients 130

Patients Clinic Utilities Provider 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: In May 2023, Mayo Clinic implemented a revised screening tool to assess social determinants of health (SDOH) for its patients. The final question asked patients, who have at least one risk factor, if they would like assistance with their need(s). Study Design and Analysis: Descriptive analysis of secondary data.

Primary Care 130

Primary Care Referral Routine Screenings Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

The electronic health records are stored in the American Family Cohort, the largest national United States primary care database. Intervention/Instrument: Key patient characteristics such as race/ethnicity and social determinants of health were considered. treatment rates, respectively.

Primary Care 130

Primary Care Families Family Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: The Patient Navigator Program (PNP) is a unique medical student-run program providing services for persons experiencing homelessness (PEH) in Dallas, Texas, at United Gospel Mission (UGM) clinics. With homelessness becoming more prevalent, PNP patient navigators aim to help the PEH population maneuver complex healthcare systems.

Medical Student 130

Medical Student Patients Healthcare Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Study Design and Analysis: We used information gathered from site visits and team meetings to understand how Compass Rose was being utilized across sites. We also assessed patterns of social risks and need for assistance among our patient populations. Of those patients with an episode (i.e.,

Referral 130

Referral Community Transportation Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Patient messaging to providers has dramatically increased since the pandemic, leading to informatics efforts to categorize messages to facilitate more efficient review. Conclusion Clinicians generally lack the time to prioritize patient messages. The increased inbox burden has particularly impacted primary care physicians.

Primary Care 130

Primary Care Management Primary Care Physician Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective To introduce the novel approach of using a T-Connector between a patient’s HBPM and their physician’s office sphygmomanometer to permit a simultaneous blood pressure reading. Setting Kaye Edmonton Clinic Family Medicine Clinic and a hypertension research lab. Population Adults who own a HBPM.

Hypertension 130

Hypertension Family Physician Family Medicine DO 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: High-utilizer patient populations reflect poor health for those patients and high resource use for health systems. Few studies of high-utilization patient programs found improvements in the intervention groups compared to controls. Patients in both groups averaged approximately 12 ED visits, 5.7

Utilities 130

Utilities Primary Care Finance Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Chronic pain stands as a leading cause of disability globally, with patients often reporting inadequate access to primary care. Relevant primary care nursing activities for CP management remain poorly defined, limiting the full utilization of nurses' competencies and expertise in chronic disease management.

Primary Care 130

Primary Care Management Chronic Disease Management Finance 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective: To evaluate the associations between opioid dose tapers with continued opioid use and opioid tapers with discontinuation, and subsequent pain-related utilization primary care visits, ED encounters, and hospitalizations. Study Design: Retrospective cohort study. 1.31) and hospitalizations (aIRR 0.74, 95% CI: 0.54-1.02).

Primary Care 130

Primary Care Management Utilities Chronic Condition 130

Annals of Family Medicine

NOVEMBER 20, 2024

Patients with the worst outcomes often lack continuity of primary care and receive care at emergency departments during exacerbations. Improved asthma outcomes are associated with effective communication between patients and providers, such as using shared decision-making. to 0.08, p=0.44), 5% to 2% ([95%]CI -0.03 to 0.24, p=0.28).

Primary Care 130

Primary Care Asthma Utilities Provider 130

Annals of Family Medicine

NOVEMBER 20, 2024

Healthcare research involving patient medical data is often delayed by lengthy approval processes. The Shared Health Research Information Network (SHRINE) offers rapid, secure access to aggregate counts of patient data from participating hospitals. Phenotypes were defined using ICD-9 and ICD-10 diagnostic codes. Setting or Dataset.

Electronics 130

Electronics Patient-Centered Utilities Hospital 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Continuity of care between a patient and their primary care practitioner (PCP) is a cornerstone of primary care (PC) and is associated with many positive health outcomes including decreased utilization of ER services and lower costs for some populations. Patients were attributed to the PCPs with whom they had the most visits.

PCP 130

PCP PCP ER Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Hospice aims to manage a patient’s symptoms as they near end of life. While not the ideal case, patients may be discharged alive from hospice for a number of reasons, including: patient revocation of care, improved prognosis, or transfer of care to a different facility or geographic area. metropolitan area.

Primary Care Physician 130

Primary Care Physician Utilities PCP PCP 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: COPD patient self-management plans, including rescue packs (antibiotic and steroid combinations), are effective in reducing respiratory related emergency department (ED) visits and hospital readmissions. Utilization of action plans/rescue packs within our health system remains relatively limited.

Utilities 130

Utilities Education Management Healthcare 130

Annals of Family Medicine

NOVEMBER 20, 2024

Dataset: We conducted a qualitative study utilizing the Database of Individual Patient Experiences (DIPEx) methodology - a time-tested, research-based approach for conducting and disseminating health and healthcare experiences. Structured follow-up questions were posed.

Healthcare 130

Healthcare Provider Healthcare Experience Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objectives: To link primary care electronic medical record (EMR) data with community and hospital data and to test the utility of the merged dataset through a targeted quality improvement (QI) intervention among high-risk patients with chronic obstructive pulmonary disease (COPD). Risk factors (i.e.,

Primary Care 130

Primary Care Electronics Hospital Medical 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Patients with diabetes who receive structured and integrated care have better control and outcomes; however, care may shift between multiple settings making coordination challenging. Outcome Measures: Number of patients engaged, resulting referrals, Navigator time per patient, and hemoglobin A1c measures across 2-years.

Primary Care 130

Primary Care Diabetes Referral Integrated Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: While hypertension is the most common chronic disease cared for during adult primary care visits, it is challenging to know which hypertensive patients have the highest risk of cardiovascular complications in the future. A total of 269,411 patients were used for model training.

Hypertension 130

Hypertension Primary Care Primary Care Physician Chronic Disease 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: American Indian/Alaskan Native (AI/AN) patients are disproportionately affected by deleterious health outcomes for many preventable disease when compared to their non-indigenous counterparts. Population Studied: AI/AN patients residing in the USA. Results: All hypotheses were supported.

Primary Care 130

Primary Care Utilities Community Preventive Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Gender affirming medical care is associated with long term benefits for transgender and non-binary patients but access to such care does not meet the current need. Many practicing providers receive no training in gender affirming hormone care, working competently with gender diverse patients, or ensuring an affirming care environment.

Education 130

Education Primary Care Provider Community 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context In the post-discharge period from hospital acute inpatient care, the older patient is at risk from a lack of joined-up care. Hospitals write discharge summaries to family medicine providers. Though patients/carers are often copied in, they seldom get a plain English version or space to discuss its contents.

GP 130

GP Hospital Family Medicine DO 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective To examine utilization of the screening, and prevalence of FI at two time points in a pediatric clinic an urban pediatric practice that has implemented universal FI screening and response. Comparison of FI for paired patients in 2022 and 2023. 73% of FI families had a FI ICD-10 code documented (Table 1).

Primary Care 130

Primary Care Screening Referral Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Little is known about how patients’ social needs (i.e. Objective To understand how patient-reported social needs are associated with cervical cancer screening in a fully insured population. Dataset Utilized data from a large integrated health system. Results Over 30% of patients reported at least one social need.

Screening 130

Screening Relationship Insurance Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

Study Design and Analysis: Formative research included depth interviews with primary care/oncology clinicians, patient advocates, and policy influencers (n=40), and two Delphi panels (1-national survivorship experts; 1-local primary care clinicians) to identify/prioritize strategies for breast cancer survivorship care.

Primary Care 130

Primary Care Referral Electronics Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context A number of patients have complex care needs that arise from interactions among multiple factors, such as multimorbidity, mental health issues, and social vulnerability. Shared decision-making (SDM), a collaborative process between patients and professionals, is known to improve the quality of the decision-making process.

Mental Health 130

Mental Health Chronic Condition Consulting Healthcare 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective The PORTRAIT Registry tracked 797 patients with new or worsening PAD symptoms at vascular specialty clinics and highlighted the underutilization of prevention services and significant disparities in quality of life among women, non-white patients, and those with financial barriers.

Community 130

Community Patient-Centered Utilities Diagnosis 130

Annals of Family Medicine

NOVEMBER 20, 2024

Background: Hypertension and depression frequently co-occur, complicating patient management and worsening outcomes. Delivery methods varied, with most interventions being face-to-face, while a few utilized digital platforms such as mobile apps and telephone support.

Hypertension 130

Hypertension Management Individual Clinical Practice 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Efforts to understand patient spirituality and implement spiritual history-taking tools have yet to consider the specific needs of refugee populations. For example, many Burmese immigrants and refugees have faced religious persecution, which may affect the process of spiritual history-taking for enhancing patient care.

Primary Care 130

Primary Care Physicals Appointment Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

However, poor treatment compliance among thalassemia patients remains a challenge, leading to less successful outcomes and negative perceptions of the disease. The study aimed to explore the lived experiences of thalassemia patients in Eastern India and examined how social relationships impacted treatment adherence. were males and 45.4%

Individual 130

Individual Relationship Community Families 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Project ECHO (Extension for Community Healthcare Outcomes) is a virtually-delivered health professions education model, designed to improve patient care by enhancing primary care capacity in specialty topics. Clinicians from rural and Northern Ontario particularly benefited as access to specialists in their areas was sparse to none.

Primary Care 130

Primary Care Management Diagnose Clinical Practice 130

Annals of Family Medicine

NOVEMBER 20, 2024

In terms of qualitative findings, clinicians were highly satisfied with ECHO Concussion, sharing that the program helped them stay on top of current evidence and better utilize resources and guidelines. Conclusion Concussion management is complex and ECHO Concussion can be beneficial for frontline clinicians.

Management 130

Management Education Illness Chronic Condition 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Building patients’ and health professionals’ trust in health research includes responsibly sharing health information.

Community 130

Community Healthcare Electronics Patient-Centered 130