scholarly journals Effect of a Digital Precision Public Health Intervention for Care Coordination During Covid-19 Pandemic in Australia: A Real World Study

2021 ◽  
Author(s):  
Andre Q Andrade ◽  
Jean-Pierre Calabretto ◽  
Nicole L Pratt ◽  
Lisa M Kalisch-Ellett ◽  
Vanessa T LeBlanc ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Continuity Of Care ◽  
Care Coordination ◽  
Real World ◽  
Primary Care Providers ◽  
Patient Specific ◽  
Specific Information ◽  
Care Providers ◽  
Precision Public Health

Abstract Background: Emergencies disproportionally affect vulnerable populations. The COVID-19 pandemic affected older patients with co-morbidities both directly due to more severe infection and indirectly by affecting care provision. To promote continuity of care, public health professionals require tools to quickly and precisely coordinate with primary care providers. This study evaluated whether digital interventions powered by current existing infrastructure are more effective than conventional interventions in promoting primary care appointments during the COVID-19 pandemic. Methods: We developed a digital intervention delivered by secure messaging and compared it to a post delivered intervention to promote continuity of care for vulnerable veterans during COVID-19 in a real world, non-randomised, interventional study. The study was implemented as part of the Veterans’ MATES program, an Australian Government Department of Veterans’ Affairs program to promote improvements in health care for veterans. The intervention provided patient specific information to general practitioners (GPs) to support continuity of care, alongside mailed education to veterans. The intervention key messages were to maintain regular contact with care providers and to continue to adhere to health plans. The intervention took place in April 2020, during the first weeks of COVID-19 social distancing rules in Australia. The main outcome was time to first appointment with the primary general practitioner (GP) measured using a Cox proportional hazards model.Results: GPs received digital messaging for 51,052 veterans and post messaging for 26,859 veterans. The proportion of patients seeing their primary GP during the three months following intervention was higher in the digital group (77.8%) than the post group (61.5%) (p<0.01). Being in the digital group was associated with earlier appointments. Conclusion: Current infrastructure coupled with innovative solutions is effective in promoting care coordination at scale during national emergencies, opening up new perspectives for precision public health initiatives.

scholarly journals Linkage to primary-care public health facilities for cardiovascular disease prevention: a community-based cohort study from urban slums in India

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045997
Author(s):  
Abhijit Pakhare ◽  
Ankur Joshi ◽  
Rasha Anwar ◽  
Khushbu Dubey ◽  
Sanjeev Kumar ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Multivariate Analysis ◽  
Urban Slum ◽  
Primary Care Providers ◽  
Health Facilities ◽  
Care Providers ◽  
Community Based ◽  
Public Health Facilities ◽  
Care Facilities

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.

"Team Dynamics, Clinical Work Satisfaction, and Care Coordination Between Primary Care Providers"

2015 ◽  
Vol 2015 (1) ◽  
pp. 13538
Author(s):  
Hummy Song ◽  
Molly Ryan ◽  
Shalini A Tendulkar ◽  
Alyna T Chien ◽  
Josephine Fisher ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Coordination ◽  
Work Satisfaction ◽  
Clinical Work ◽  
Primary Care Providers ◽  
Team Dynamics ◽  
Care Providers

Evaluation of coordination of cancer care between designated cancer hospitals and primary care providers: Results from a nationwide survey in Japan.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 84-84
Author(s):  
Taro Tomizuka ◽  
Tomone Watanabe ◽  
Satoru Kamitani ◽  
Takahiro Higashi
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Care Coordination ◽  
Cancer Care ◽  
Critical Path ◽  
Primary Care Providers ◽  
Care Providers ◽  
Follow Up Care ◽  
Cancer Specialist

84 Background: To improve coordination of cancer care between cancer specialist hospitals and primary care providers (PCPs), the Japanese government accredited cancer specialist hospitals, so called “designated cancer care hospitals (DCCHs)” and introduced “Cancer care coordination instruction fee” which PCPs can receive if they share a cancer critical path (Japanese version of Survivorship Care Plans) of each cancer patient with DCCHs. We sought to assess the current status of coordination of cancer care in Japan and communication between DCCHs and PCPs from PCPs’ point of view. Methods: A cross-sectional mail survey was administered to randomly selected clinic-based PCPs (4,000 clinics) from a nation-wide database of medical institutions authorized by Ministry of Health, Labour and Welfare Japan to treat patients with health insurance (87,869 clinics). The survey evaluated how much PCPs provided cancer follow-up care and how well DCCHs coordinated care and communicated with PCPs in cancer survivorship. Results: 1,873 PCPs returned the questionnaire (response rate: 46.8%). 1,223 (65.3%) answered to provide cancer follow-up care in outpatient setting. Most of the PCPs which provided cancer follow-up care evaluated the care coordination and support by DCCHs were satisfactory (946, 77.4%) but the degree of good evaluation varied by region (highest: 91.3%, lowest: 45.8%). In regression analysis, provision of palliative care by PCPs (OR 1.52 95%CI 1.05-2.17) and use of cancer critical path (OR 2.10 95%CI 1.63-2.71) were significantly correlated with better evaluation of communication and care coordination. Conclusions: DCCHs communicated well with PCPs and PCPs were satisfied with the communication and care coordination by DCCHs. Provision of palliative care by PCPs and use of cancer critical path are likely to lead good care coordination in cancer care.

scholarly journals Public Health Detailing of Primary Care Providers: New York City’s Experience, 2003–2010

2012 ◽  
Vol 102 (S3) ◽  
pp. S342-S352 ◽  
Author(s):  
Michelle G. Dresser ◽  
Leslie Short ◽  
Laura Wedemeyer ◽  
Victoria Lowerson Bredow ◽  
Rachel Sacks ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
New York ◽  
Primary Care Providers ◽  
Care Providers

scholarly journals Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Jinhee Lee ◽  
Thomas F. Kresina ◽  
Melinda Campopiano ◽  
Robert Lubran ◽  
H. Westley Clark
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Opioid Dependence ◽  
Alcohol Use Disorders ◽  
Primary Care Providers ◽  
Care Providers ◽  
Addictive Disorders ◽  
Care And Treatment

Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

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