scholarly journals The success of behavioral economics in improving patient retention within an intensive primary care practice

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Phillip Groden ◽  
Alexandra Capellini ◽  
Erica Levine ◽  
Ania Wajnberg ◽  
Maria Duenas ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Economics ◽  
Patient Outcomes ◽  
Primary Care Clinic ◽  
Care Practice ◽  
Missed Appointments ◽  
Care Clinic ◽  
Visit Adherence ◽  
Patient Retention

Abstract Background A minority of the U.S. population comprises a majority of health care expenses. Health system interventions for high-cost populations aim to improve patient outcomes while reducing costly over-utilization. Missed and inconsistent appointments are associated with poor patient outcomes and increased health care utilization. PEAK Health— Mount Sinai’s intensive primary care clinic for high-cost patients— employed a novel behavioral economics-based intervention to reduce the rate of missed appointments at the practice. Behavioral economics has accomplished numerous successes across the health care field; the effect of a clinic-based behavioral economics intervention on reducing missed appointments has yet to be assessed. Methods This was a single-arm, pre-post trial conducted over 1 year involving all active patients at PEAK Health. The intervention consisted of: a) clinic signage, and b) appointment reminder cards containing behavioral economics messaging designed to increase the likelihood patients would complete their subsequent visit; appointment cards (t1) were transitioned to an identical EMR template (t2) at 6 months to boost provider utilization. The primary objective, the success of scheduled appointments, was assessed with visit adherence: the proportion of successful over all scheduled appointments, excluding those cancelled or rescheduled. The secondary objective, the consistency of appointments, was assessed with a 2-month visit constancy rate: the percentage of patients with at least one successful visit every 2 months for 1 year. Both metrics were assessed via a χ2 analysis and together define patient retention. Results The visit adherence rate increased from 74.7% at baseline to 76.5% (p = .22) during t1 and 78.0% (p = .03) during t2. The 2-month visit constancy rate increased from 59.5% at baseline to 74.3% (p = .01) post-intervention. Conclusions A low-resource, clinic-based behavioral economics intervention was capable of improving patient retention within a traditionally high-cost population. A renewed focus on patient retention— employing the metrics described here— could bolster chronic care efforts and significantly improve the outcomes of high-cost programs by reducing the deleterious effects of missed and inconsistent appointments.

scholarly journals The Success Of Behavioral Economics In Improving Patient Retention Within An Intensive Primary Care Practice

2021 ◽  
Author(s):  
Phillip Groden ◽  
Alexandra Capellini ◽  
Erica Levine ◽  
Ania Wajnberg ◽  
Maria Duenas ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Economics ◽  
Patient Outcomes ◽  
Care Practice ◽  
Missed Appointments ◽  
Care Clinic ◽  
Visit Adherence ◽  
One Year ◽  
Patient Retention

Abstract BackgroundA minority of the U.S. population comprises a majority of health care expenses. Health system interventions for high-cost populations aim to improve patient outcomes while reducing costly over-utilization. Missed and inconsistent appointments are associated with poor patient outcomes and increased health care utilization. PEAK Health— Mount Sinai’s intensive primary care clinic for high-cost patients— employed a novel behavioral economics-based intervention to reduce the rate of missed appointments at the practice. Behavioral economics has accomplished numerous successes across the health care field; the effect of a clinic-based behavioral economics intervention on reducing missed appointments has yet to be assessed.MethodsThis was a single-arm, pre-post trial conducted over one year involving all active patients (286) at PEAK Health. The intervention consisted of: a) clinic signage, and b) appointment reminder cards containing behavioral economics messaging designed to increase the likelihood patients would complete their subsequent visit; appointment cards (t1) were transitioned to an identical EMR template (t2) at 6 months to boost utilization of this component. The primary objective, the success of scheduled appointments, was assessed with visit adherence: the proportion of successful over all scheduled appointments, excluding those cancelled or rescheduled. The secondary objective, the consistency of appointments, was assessed with a 2-month visit constancy rate: the percentage of patients with at least one successful visit every two months for one year. Both metrics were assessed via a χ² analysis and together define patient retention. ResultsThe visit adherence rate increased from 74.7% at baseline to 76.5% (p= .22) during t1 and 78.0% (p= .03) during t2. The 2-month visit constancy rate increased from 59.5% at baseline to 74.3% (p= .01) post-intervention.ConclusionsA low-resource, clinic-based behavioral economics intervention was capable of improving patient retention within a traditionally high-cost population. A renewed focus on patient retention— employing the metrics described here— could bolster chronic care efforts and significantly improve the outcomes of high-cost programs by reducing the deleterious effects of missed and inconsistent appointments.

scholarly journals Effect of crew resource management on diabetes care and patient outcomes in an inner-city primary care clinic

2007 ◽  
Vol 16 (4) ◽  
pp. 244-247 ◽  
Author(s):  
C. R Taylor ◽  
J. T Hepworth ◽  
P. I Buerhaus ◽  
R. Dittus ◽  
T. Speroff
Keyword(s):  
Primary Care ◽  
Resource Management ◽  
Inner City ◽  
Patient Outcomes ◽  
Diabetes Care ◽  
Primary Care Clinic ◽  
Crew Resource Management ◽  
Care Clinic

scholarly journals A GWEP COLLABORATION: IMPLEMENTING THE AWV IN A RURAL PRIMARY CARE CLINIC

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S393-S393
Author(s):  
Christine McKibbin
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Primary Care Clinic ◽  
Lessons Learned ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Rural Primary Care

Abstract This presentation will focus on the collaboration with the Dartmouth GWEP to implement the AWV in a rural primary care clinic. The challenges of practice transformation in busy primary care clinics will be discussed along with lessons learned on a successful GWEP partnership to achieve improved patient outcomes in primary care.

Collaboration between the family nurse and family doctor from the perspective of patients: a qualitative study

2019 ◽  
Author(s):  
Ewa Taranta ◽  
Ludmila Marcinowicz
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Dominant Role ◽  
Family Doctor ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
The North ◽  
Primary Health ◽  
The Family

Abstract Background There is increasing focus on collaboration in primary health care, but there is insufficient patient perspective on collaboration between the family nurse and family doctor. Objective To explore how patients perceive collaboration between the family nurse and family doctor in primary health care in Poland. Methods A qualitative approach and an inductive, naturalistic inquiry strategy were used. Thirty-seven patients from eight general practice clinics in the north-eastern part of Poland participated in semi-structured, face-to-face interviews. The qualitative data were examined by means of thematic analysis. The study was reported according to the consolidated criteria for reporting qualitative research (COREQ) checklist. Results Four subthemes emerged in the context of nurse–doctor collaboration, namely: (i) carrying out the doctor’s orders; (ii) visit preparation; (iii) the family nurse as a source of information and (iv) participants’ perceptions of the status of the family nurse. Nurses performing instrumental activities connected with a doctor’s orders was understood by the participants to be collaboration and prevailed in their responses. Conclusion The perception of collaboration (or lack thereof) between the family nurse and family doctor results from patients’ varied experiences and observations during their visits to a primary care clinic. The traditional model of nursing care and the hierarchical relationship, in which the doctor has the dominant role, are evident in the patients’ remarks. The autonomy of nursing could be strengthened by expanding, and highlighting, the primary care activities that a nurse can perform on her own.

scholarly journals Urinary tract bleeding from a urethral caruncle mimicking genital tract bleeding

2019 ◽  
Vol 12 (2) ◽  
pp. e225540
Author(s):  
Kento Sonoda ◽  
Rika Kato ◽  
Hajime Kojima ◽  
Yasuharu Tokuda
Keyword(s):  
Primary Care ◽  
Genital Tract ◽  
Vaginal Bleeding ◽  
Primary Care Clinic ◽  
Final Diagnosis ◽  
Japanese Woman ◽  
Care Practice ◽  
Care Clinic ◽  
Palpable Mass ◽  
Mri Scans

A 69-year-old Japanese woman with a post-hysterectomy status came to our primary care clinic. She presented with vaginal bleeding for the past 3 days which had developed after defecation. There was a palpable mass measuring approximately 2 cm on pelvic exam; however, heavy bleeding prevented in-depth observation. CT and MRI scans revealed that the mass was inside the urethral meatus and not in the vagina. She underwent surgical resection of the urethral tumour, and the pathological report showed no malignancy. A final diagnosis of urethral caruncle was made. Vaginal bleeding is commonly encountered in the primary care practice and is usually attributed to gynaecological diseases. However, patients and physicians may falsely regard urinary or gastrointestinal tract bleeding as one involving the genital tract. We present a case wherein vaginal bleeding was initially considered but was later identified to be due to a urethral caruncle.

scholarly journals Embedded Maternal Mental Health Care in a Pediatric Primary Care Clinic: A Qualitative Exploration of Mothers’ Experiences

2019 ◽  
Vol 19 (8) ◽  
pp. 934-941 ◽  
Author(s):  
Chelsea Anne Young ◽  
Honora Burnett ◽  
Alexandra Ballinger ◽  
Gloria Castro ◽  
Shay Steinberg ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Maternal Mental Health ◽  
Primary Care Clinic ◽  
Pediatric Primary Care ◽  
Care Clinic ◽  
Qualitative Exploration ◽  
Mothers Experiences
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