The Nurse-Managed Health Center Safety Net: a Policy Solution to Reducing Health Disparities

2005 ◽  
Vol 40 (4) ◽  
pp. 729-738 ◽  
Author(s):  
Tine Hansen-Turton
2007 ◽  
Vol 122 (5) ◽  
pp. 592-601 ◽  
Author(s):  
Christine A. Riedy ◽  
Kiet A. Ly ◽  
Vickie Ybarra ◽  
Peter Milgrom

Federally Qualified Health Centers (FQHCs) contribute greatly to reducing health disparities by providing care to underserved communities. Yet these safety-net clinics face chronic manpower shortages and turnover. Practice-Based Research Networks aid in translating medical science from bench to clinical practice. These networks have been used to understand and improve health-care delivery and reduce disparities. Initiatives to strengthen lagging translational research in dentistry have begun, but there is no FQHC research network that addresses oral health. This article reviews the potential for, and outlines a model of, an Oral Health FQHC Research Network. It characterizes the needs for an FQHC research network, describes a successful FQHC research-oriented program, and outlines an Oral Health FQHC Research Network conceptual model. It argues that strengthening FQHCs through involvement of their dental staff in clinical research may enhance their jobs, draw staff closer to the community, and strengthen their ability to reduce health disparities.


Author(s):  
David Hartzband ◽  
Feygele Jacobs

To better understand existing capacity and help organizations plan for the strategic and expanded uses of data, a project was initiated that deployed contemporary, Hadoop-based, analytic technology into several multi-site community health centers (CHCs) and a primary care association (PCA). An initial data quality exercise was carried out after deployment, in which a number of analytic queries were executed using both the existing electronic health record (EHR) applications and in parallel, the analytic stack. Each organization carried out the EHR analysis using the definitions typically applied for routine reporting. The analysis using the analytic stack was carried out using those common definitions established for the Uniform Data System (UDS) by the Health Resources and Service Administration.  In addition, interviews with health center leadership and staff were completed to understand the context for the findings.The analysis uncovered many challenges and inconsistencies with respect to the definition of core terms (patient, encounter, etc.), data formatting, and missing, incorrect and unavailable data. At a population level, apparent underreporting of a number of diagnoses, specifically obesity and heart disease, was also evident in the results of the data quality exercise, for both the EHR-derived and stack analytic results.Data awareness, that is, an appreciation of the importance of data integrity, data hygiene and the potential uses of data, needs to be prioritized and developed by health centers and other healthcare organizations if analytics are to be used in an effective manner to support strategic objectives. While this analysis was conducted exclusively with community health center organizations, its conclusions and recommendations may be more broadly applicable. 


2017 ◽  
Vol 5 (2) ◽  
pp. 154 ◽  
Author(s):  
Muhammad Arsyad ◽  
Yoshio Kawamura ◽  
Syarifuddin Yusuf ◽  
Muh. Hatta Jamil ◽  
Andi Nuddin ◽  
...  

Poverty in agricultural sector is still becomes a serious issue in developing country, and Indonesia is no exception. Our previous study was focusing on poverty and income (income poverty). This paper, however, deals with a substantive question, can access to social facility (non-income) help poverty reduction in agriculture? The study (also) utilized previous model of Dimensionality Test, Factor and Path Analysis to answer the question. The results show that the higher government transfer source income in terms of Social safety Net Program, the more money for smallholders will be. This leads us to argue that transfer income from the government to the smallholder community can be still considered in maintaining smallholders’ daily life, means helping them move out poverty. The better access to social services such as primary public health center (called PUSKESMAS), clean water supplied by PDAM (Local Government Division for Drinking Water Affairs) and secondary school is, the higher the household income will be. Thus, if PUSKESMAS, primary and secondary schools as well as clean water sources are nearer, the less time and money will be spent to travel, then the more household income at hand will be saved. In other words, distance and degree of utilization appear to be a crucial part of these interpretations above. Therefore, it is reasonable to say that the better the access to social services such as public health center, schools and public clean water, the more household income will be and in turn it will alleviate the poverty of smallholders. It is clear that providing better access to social facility can help poverty reduction in agricultural sector.


2021 ◽  
Vol 2 ◽  
Author(s):  
Ingrid Glurich ◽  
Richard Berg ◽  
Aloksagar Panny ◽  
Neel Shimpi ◽  
Annie Steinmetz ◽  
...  

Introduction: Rates of diabetes/prediabetes continue to increase, with disparity populations disproportionately affected. Previous field trials promoted point-of-care (POC) glycemic screening in dental settings as an additional primary care setting to identify potentially at-risk individuals requiring integrated care intervention. The present study observed outcomes of POC hemoglobin A1c (HbA1c) screening at community health center (CHC) dental clinics (DC) and compliance with longitudinal integrated care management among at-risk patients attending dental appointments.Materials and Methods: POC HbA1c screening utilizing Food and Drug Administration (FDA)-approved instrumentation in DC settings and periodontal evaluation of at-risk dental patients with no prior diagnosis of diabetes/prediabetes and no glycemic testing in the preceding 6 months were undertaken. Screening of patients attending dental appointments from October 24, 2017, through September 24, 2018, was implemented at four Wisconsin CHC-DCs serving populations with a high representation of disparity. Subjects meeting at-risk profiles underwent POC HbA1c screening. Individuals with measures in the diabetic/prediabetic ranges were advised to seek further medical evaluation and were re-contacted after 3 months to document compliance. Longitudinal capture of glycemic measures in electronic health records for up to 2 years was undertaken for a subset (n = 44) of subjects with available clinical, medical, and dental data. Longitudinal glycemic status and frequency of medical and dental access for follow-up care were monitored.Results: Risk assessment identified 224/915 (24.5%) patients who met inclusion criteria following two levels of risk screening, with 127/224 (57%) qualifying for POC HbA1c screening. Among those tested, 62/127 (49%) exhibited hyperglycemic measures: 55 in the prediabetic range and seven in the diabetic range. Moderate-to-severe periodontitis was more prevalent in patients with prediabetes/diabetes than in individuals with measures in the normal range. Participant follow-up compliance at 3 months was 90%. Longitudinal follow-up documented high rates of consistent access (100 and 89%, respectively), to the integrated medical/DC environment over 24 months for individuals with hyperglycemic screening measures.Conclusion: POC glycemic screening revealed elevated HbA1c measures in nearly half of at-risk CHC-DC patients. Strong compliance with integrated medical/dental management over a 24-month interval was observed, documenting good patient receptivity to POC screening in the dental setting and compliance with integrated care follow-up by at-risk patients.


Author(s):  
Thomas P. O’Toole

In many ways homelessness is both a health issue and a reflection of the viability of our social safety net and health care system. Despite advances made in our understanding of how to best provide care and assist homeless persons, significant health disparities and gaps in care persist, as does the conundrum of chronic and persistent homelessness. Primary care tailored to homeless persons provides a unique opportunity to address some of these health disparities and vulnerabilities as well as the platform on which to engage them in an array of additional services over a continuum of time and need. Core tenets of the most successful models capture several key elements: (1) availability of care based on an open-access, on-demand, and non-contingent model; (2) one-stop, wrap-around services that are integrated and coordinated; (3) capacity for intensive, longitudinal and community/social service–linked case management; (4) high-quality, evidence-based, and culturally sensitive care that both destigmatizes seeking care and supports professionalism among the providers delivering that care; and (5) accountability to specific measurable goals and outcomes. However, it will not happen without deliberate planning and organization and a commitment to the capacity needed to bring services to scale.


Sign in / Sign up

Export Citation Format

Share Document