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Health Care Transformation Among Small Urban Practices Serving the Underserved

小型城市实践中的医疗保健转型，为服务不足的人群提供服务

基本信息

批准号：
8385730
负责人：
Carolyn Anne Berry
金额：
$ 30万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-30 至 2013-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8385730
关键词：
Health Care Transformation Among Small

项目摘要

DESCRIPTION (provided by applicant): The proposed collaboration among the Center For Health Care Strategies (CHCS), The Robert F. Wagner Graduate School for Public Service of New York University (NYU) and the Primary Care Information Project (PCIP) of the New York City Department of Health and Mental Hygiene (NYCDOHMH) will capitalize on the ongoing efforts of PCIP to transform primary care practices in New York City and the extensive amount of available data describing these practices. The proposed study will focus on a diverse set of small urban practices (< 5 providers) with high volumes of Medicaid and/or uninsured patients that have been engaged in multiple transformation processes under the auspices of the PCIP for at least one year. The main goals of the study are to: 1) Utilize secondary data for a large number (N=105+) of small, urban primary care practices that have undergone transformation processes for at least one year to understand changes in management/transformation processes, status and changes in health care processes, and status and changes in patient outcomes and the interrelationships among these variables; 2) Utilize mixed methods, including a provider survey and key informant interviews with patients, to assess the effects of practice transformation activities on health care providers and their patients; 3) Use a detailed practice assessment, site visits, and key informant interviews to examine in depth the implementation of transformation components with attention to the organizational and contextual factors that affected implementation and success in 40 selected practices; and 4) Disseminate the findings from this study widely via presentations at conferences and meetings of professional organizations and medical societies, a web based "tool kit" of best practices, and peer-reviewed journal articles. PUBLIC HEALTH RELEVANCE: The proposed study will inform primary care providers, payers, health services researchers, and policy-makers about methods to achieve primary care practice transformation in small practices with high volumes of Medicaid and uninsured patients. In a time of increasing resource constraints, rising medical need, and a projected shortage of primary care providers, such information will be critical to ensuring patient-centered primary medical care for all patients in the US, particularly the most vulnerable.

描述（由申请人提供）：卫生保健战略中心（CHCS），罗伯特F。纽约大学（NYU）的瓦格纳公共服务研究生院和纽约市卫生和心理卫生部（NYCDOHMH）的初级保健信息项目（PCIP）将利用PCIP正在进行的努力，以改变纽约市的初级保健做法和大量描述这些做法的可用数据。拟议的研究将侧重于一组多样化的小型城市实践（< 5个提供者），这些实践具有大量的医疗补助和/或未投保的患者，这些患者在PCIP的主持下参与了多个转型过程至少一年。本研究的主要目的是：1）利用大量（N=105+）经历了至少一年转型过程的小型城市初级保健实践的二级数据，了解管理/转型过程的变化，医疗保健过程的状态和变化，以及患者结局的状态和变化以及这些变量之间的相互关系; 2）利用混合方法，包括提供者调查和与患者的关键知情人访谈，以评估实践转变活动对卫生保健提供者及其患者的影响; 3）使用详细的实践评估，现场访问，和关键的线人访谈，以深入检查转型组件的实施情况，并关注影响转型的组织和环境因素。4）通过在专业组织和医学协会的会议上的介绍、基于网络的最佳做法“工具包”以及同行评审的期刊文章，广泛传播本研究的结果。公共卫生相关性：拟议的研究将告知初级保健提供者，支付者，卫生服务研究人员和政策制定者关于在具有大量医疗补助和无保险患者的小型实践中实现初级保健实践转型的方法。在资源日益紧张、医疗需求不断上升以及预计初级保健提供者短缺的情况下，这些信息对于确保美国所有患者，特别是最脆弱患者以患者为中心的初级医疗保健至关重要。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Patient-centered medical home and quality measurement in small practices.

以患者为中心的医疗之家和小型诊所的质量测量。

DOI：
发表时间：
2014
期刊：
The American journal of managed care
影响因子：
0
作者：
Wang,JasonJ;Winther,ChloeH;Cha,Jisung;McCullough,ColleenM;Parsons,AmandaS;Singer,Jesse;Shih,SarahC
通讯作者：
Shih,SarahC

Small practices' experience with EHR, quality measurement, and incentives.

小型诊所在 EHR、质量衡量和激励方面的经验。

DOI：
发表时间：
2013
期刊：
The American journal of managed care
影响因子：
0
作者：
Begum,Rohima;SmithRyan,Mandy;Winther,ChloeH;Wang,JasonJ;Bardach,NaomiS;Parsons,AmandaH;Shih,SarahC;Dudley,RAdams
通讯作者：
Dudley,RAdams

Quality measure performance in small practices before and after electronic health record adoption.

质量衡量采用电子健康记录之前和之后小型诊所的绩效。