A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity

Author(s):  
James W. Begun ◽  
Linda M. Kahn ◽  
Brooke A. Cunningham ◽  
Jan K. Malcolm ◽  
Sandra Potthoff
2021 ◽  
Vol 24 (3) ◽  
pp. 336-343
Author(s):  
Silvia Rodríguez-Mireles ◽  
Beatriz G. López-Valcárcel ◽  
Lluís Serra-Majem

2019 ◽  
pp. 101-108
Author(s):  
Julie Wood ◽  
Kevin Grumbach

This chapter looks at the role of primary health care in community health. Primary care, it argues, has built on its historical roots of holistic family-centered care to embrace the broader concept of population health. The chapter looks at the evolution of care models from patient/family-centered to panel management (the sum of patients being cared for by a primary care practice), to community health management. This broader concept of health necessitates collaboration with partners outside the clinical practice, including public health professionals, policymakers, schools, housing, parks and recreation, law enforcement, transportation, and food systems. The chapter describes the population and community framework and its historical role in the development of primary care, and then turns to the proposal of pragmatic approaches that busy primary care clinicians and care teams can use to integrate population health approaches into their practices.


2016 ◽  
Vol 34 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Robin Evans-Agnew ◽  
David Reyes ◽  
Janet Primomo ◽  
Karen Meyer ◽  
Corrie Matlock-Hightower

2005 ◽  
Vol 11 (2) ◽  
pp. 45 ◽  
Author(s):  
Peter Harvey

This paper provides a review of recent developments in population-based approaches to community health and explores the origins of the population health concept and its implications for the operation of health service management. There is a growing perception among health professionals that the key to improving health outcomes will be the implementation of integrated and preventive population-based resource management rather than investment in systems that respond to crises and health problems at the acute end of the service provision spectrum only. That is, we will need increasingly to skew our community health and welfare investments towards preventive care, education, lifestyle change, self-management and environmental improvement if we are to reduce the rate of growth in the incidence of chronic disease and mitigate the impact of these diseases upon the acute health care system. While resources will still need to be devoted to the treatment and management of physical trauma, infectious diseases, inherited illness and chronic conditions, it is suggested we could reduce the rate at which demand for these services is increasing at present by managing our environment and communities better, and through the implementation of more effective early intervention programs across particular population groups. Such approaches are known generally as population health management, as opposed to individual or illness - based health management' or even public health - and suggest that health systems might productively focus in the future on population level causation and not just upon disease-specific problems or illness management after the fact. Population health approaches attempt to broaden our understanding of causation and manage health through an emphasis on the health of whole populations and by building healthy communities rather than seeing "health care" as predominantly about illness management or responses to health crises. The concept also presupposes the existence of cleaner and healthier environments, clean water and food, and the existence of vibrant social contexts in which individuals are able to work for the overall good of communities and, ultimately, of each other.


Author(s):  
Eva Graham ◽  
Norbert Schmitz ◽  
Laura Rosella

IntroductionDepression has consistently been associated with an increased risk of diabetes in recent meta-analyses. However, depression is a highly heterogeneous construct and people with specific symptoms of depression, such as weight gain and increased sleep, may be at a higher risk of diabetes. Objectives and ApproachThis work will compare incident diabetes in Ontario adults with recent depressive episodes that included symptoms of weight gain, weight loss, or no weight change and in those with no recent depressive episodes. Participants will be drawn from several waves of the Canadian Community Health Survey and the National Population Health Survey. Past 12-month depressive episodes and weight change during most recent or worst episodes was measured using the CIDI/CIDI short form. Time to incident diabetes will be ascertained through linkage with the Ontario Diabetes Database. Cox proportional hazards regression will assess diabetes incidence by depression and weight change characteristics. ResultsThis study will include 106 084 Ontario adults who participated in the Canadian Community Health Survey (2000/2001, 2002, 2003, 2012) and the National Population Health Survey (1996). Follow-up time will range from 4 to 19 years (until March 2017). Study covariates will include demographic and lifestyle factors, comorbidities, and health care use and will be extracted from the surveys above and from administrative health data. The dataset for this study is currently being prepared by the Institute for Clinical Evaluative Sciences (ICES) and the findings of this analysis will be presented at this conference. Conclusion/ImplicationsThe results of this work will provide insight into who, among those with depression, is at highest risk of new-onset diabetes. These results will be relevant to the development of both personalized and population-level diabetes screening and prevention strategies.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S158-S159
Author(s):  
Martin Brenneman ◽  
Brian C Bohn ◽  
Sarah E Moore ◽  
Ashley Wilde ◽  
Ashley Wilde ◽  
...  

Abstract Background The Infectious Diseases Society of America asymptomatic bacteriuria (ASB) guidelines recommend against screening for or treating ASB in most patients without symptoms of a urinary tract infection (UTI). The purpose of this study was to characterize current urine testing practices and their potential impact on identification and treatment of asymptomatic bacteriuria on hospitalized adults. Methods This retrospective, point prevalence study conducted at a 4 hospital community health-system that included all inpatients ≥ 18 years old present on November 13th, 2019. Patients were excluded if they were admitted or transferred to either a labor & delivery or mother-baby unit. A chart review was performed for a sub-group of patients with abnormal urine testing, with a target sample size of 200 (n=50 from each hospital). The primary outcome was the prevalence of patients with a urinalysis, urine culture, or both performed during their admission. Secondary outcomes included abnormal urine testing in the overall cohort and symptomatology and antibiotic use in the sub-group (Figure 1). Results 947 patients met inclusion criteria. Of those patients, 516 (54%) had urine testing performed during their admission. 322 (34%) patients had abnormal urine testing results (Table 1). In the sub-group, 192 patients with abnormal urine tests were included. Antibiotics with a documented indication of UTI were administered to 66 (34%) patients. Of those given antibiotics with a UTI indication, 49/66 (74%) did not have documented signs or symptoms of a UTI (Figure 2). Conclusion Urine testing was performed on the majority of admitted adult patients. Unnecessary testing likely contributes to guideline discordant screening and treatment of ASB. Future studies are needed to identify effective diagnostic stewardship interventions to decrease screening and treatment of ASB. Disclosures Ashley Wilde, PharmD, BCPS-AQ ID, Nothing to disclose


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