scholarly journals Patient Experience in Primary Care: A Systematic Review of CG-CAHPS Surveys

2018 ◽  
Vol 6 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Jeana M Holt
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Patient Experience ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Empirical Literature ◽  
Patient Reports ◽  
Care System

The National Academy of Medicine’s (NAM) vision for 21st-century health care underscored the need for increased patient engagement and charged health-care researchers to develop tools to evaluate patient experience. The most widely studied patient experience tools are the Consumer Assessments of Healthcare Providers and Systems (CAHPS) surveys. The Clinician and Group (CG)-CAHPS survey is the preferred patient experience survey for primary care, and thus a systematic review of patient reports from the CG-CAHPS empirical literature is ideal to appreciate the voice of health-care consumers. This systematic review revealed patient subjective reports regarding the acceptability of health-care delivery models, the effectiveness of interventions, the timeliness of care in different practice climates, and their responses to quality improvement initiatives. The synthesized results inform clinicians, organizations, and the health-care system where to prioritize and how to adapt services to efficiently provide equitable care, achieving the NAM’s vision for a patient-centered US health-care system.

Health Care System Changes to Improve Adherence and Long-Term Outcomes for Depressed Patients

CNS Spectrums ◽  
2007 ◽  
Vol 12 (S13) ◽  
pp. 17-25
Author(s):  
Wayne J. Katon
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Treatment Adherence ◽  
Health Care System ◽  
Structural Changes ◽  
Care Delivery ◽  
The United States ◽  
Chronic Illnesses ◽  
Depressed Patients ◽  
Care System

Depression, which is increasingly regarded as a chronic condition, is associated with significant suffering, social and functional impairment, and an estimated $44 billion in direct and indirect costs annually in the United States. Despite this severe burden on the health care system, the management of depression remains suboptimal in primary care, where many depressed patients fail to receive adequate dosage and duration of treatment. Adherence to evidence-based guidelines, essential to improving outcomes, requires key structural changes to the US health care delivery system. Several health care models aimed at improving treatment adherence in patients with chronic illnesses have been evaluated in primary care settings with promising results. Those approaches that have been found to be effective advocate multifaceted collaborative interventions that target patients, families, physicians, and the organization of the health care system to improve adherence and depression outcomes. Enhancing education and the active participation of patients and their families are now considered important elements of interventions to improve adherence to the treatment of chronic illnesses, including depression.

Primary-Care Visits and Hospitalizations for Ambulatory-Care–Sensitive Conditions in an Inner-City Health Care System

2003 ◽  
Vol 3 (6) ◽  
pp. 324-328 ◽  
Author(s):  
John F. Steiner ◽  
Patricia A. Braun ◽  
Paul Melinkovich ◽  
Judith E. Glazner ◽  
Vijayalaxmi Chandramouli ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Inner City ◽  
Ambulatory Care ◽  
Health Care System ◽  
Ambulatory Care Sensitive Conditions ◽  
Care System ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Modern Western Science as a Standard for Traditional Chinese Medicine: A Critical Appraisal

2003 ◽  
Vol 31 (2) ◽  
pp. 213-221 ◽  
Author(s):  
Ruiping Fan
Keyword(s):  
Health Care ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Health Care System ◽  
Care Delivery ◽  
World Health ◽  
Scientific Medicine ◽  
Integrative Health ◽  
Integrative Health Care ◽  
Care System

It is generally recognized that China, while attempting to develop modern scientific medicine in carrying out its national policy for modernization, has also made significant efforts to integrate traditional Chinese medicine into its health care system. For instance, the World Health Organization's first global strategy on traditional and alternative medicine (released in May 2002) lists China as one of only four of its member states to have attained an integrative health care system. However, medical integration can take many different forms and involve quite different health care standards. A health care standard is a set of mechanisms by which distinct diagnostic and therapeutic practices and products are validated or accredited for use in health care delivery. Traditional Chinese medicine and modern scientific medicine adopt different sets of such mechanisms and thereby engage different health care standards. Accordingly, in appraising the Chinese integrative health care system, it is important to investigate which health care standard has been appealed to.

Patient Experiences, Trust, and Preferences for Health Data Sharing

2021 ◽  
Author(s):  
Rochelle D. Jones ◽  
Chris Krenz ◽  
Kent A. Griffith ◽  
Rebecca Spence ◽  
Angela R. Bradbury ◽  
...  
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Health Care System ◽  
Lived Experiences ◽  
Care Delivery ◽  
Group Discussion ◽  
Final Analysis ◽  
Secondary Use ◽  
The Impact ◽  
Care System

PURPOSE: Scholars have examined patients' attitudes toward secondary use of routinely collected clinical data for research and quality improvement. Evidence suggests that trust in health care organizations and physicians is critical. Less is known about experiences that shape trust and how they influence data sharing preferences. MATERIALS AND METHODS: To explore learning health care system (LHS) ethics, democratic deliberations were hosted from June 2017 to May 2018. A total of 217 patients with cancer participated in facilitated group discussion. Transcripts were coded independently. Finalized codes were organized into themes using interpretive description and thematic analysis. Two previous analyses reported on patient preferences for consent and data use; this final analysis focuses on the influence of personal lived experiences of the health care system, including interactions with providers and insurers, on trust and preferences for data sharing. RESULTS: Qualitative analysis identified four domains of patients' lived experiences raised in the context of the policy discussions: (1) the quality of care received, (2) the impact of health care costs, (3) the transparency and communication displayed by a provider or an insurer to the patient, and (4) the extent to which care coordination was hindered or facilitated by the interchange between a provider and an insurer. Patients discussed their trust in health care decision makers and their opinions about LHS data sharing. CONCLUSION: Additional resources, infrastructure, regulations, and practice innovations are needed to improve patients' experiences with and trust in the health care system. Those who seek to build LHSs may also need to consider improvement in other aspects of care delivery.

The Education of Pediatricians for Primary Care: The Score After Two Score Years

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 270-272
Author(s):  
Evan Charney
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care System ◽  
Medical Profession ◽  
Primary Care System ◽  
Educational Structure ◽  
Task Forces ◽  
Do So ◽  
Care System

In a 1973 monograph on the education of physicians for primary care, Joel Alpert and I wrote, "There are two interrelated and serious problems in our present educational structure—not enough physicians enter primary care and those who do so are not adequately prepared for the job."1 Twenty years and many task forces and exhortatory editorials later, much the same could be said. But that conclusion would not be entirely fair: changes have indeed occurred in the subsequent two score years. There is now clear consensus that a strong primary care system should be the linchpin of our nation's health care system, with 50 to 60% of physicians as generalists, 2,3 and the medical profession has at least professed to agree with that strategy.4

A Principled Approach to Essential Health-Care Delivery System Reforms

2017 ◽  
pp. 159-201
Author(s):  
Gunnar Almgren
Keyword(s):  
Health Care ◽  
Population Health ◽  
Health Care System ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Right To Health Care ◽  
Competing Interests ◽  
Political Feasibility ◽  
Future Health Care ◽  
Care System

The basic premise of this chapter is that we have at our disposal a wealth of evidence-based knowledge of critical health care delivery strategies that would, if implemented on a large scale, yield both a social right to health care for all citizens and favorable population health care outcomes at lower cost. This chapter provides a synthesis of this knowledge, and then identifies a limited set of very specific health care system delivery reforms that meet three evaluative criteria: equity, sustainability, and political feasibility. Equity refers to the extent to which any particular health care system delivery reform achieves a fair balance between the competing interests of different segments of the patient population and society at large. Sustainability refers to the extent to which a health care system delivery reform initiative yields favorable impacts on population health while realizing large reductions in immediate and future health care costs. Finally, political feasibility refers to the likelihood of a given health care system delivery reform in view of the competing interests of different stakeholder groups affected. This chapter offers a principled and empirically justified blueprint for the most promising health care system delivery reforms towards the fulfillment of these three ends.

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