The Impact on Patient Health Outcomes of Interventions Targeting the Patient-Physician Relationship

Over the past two decades, we have seen an increase in the use of medical-legal partnerships (MLPs) in health-care and/or legal settings to address health disparities affecting vulnerable populations. MLPs increase medical teams' capacity to address social and environmental threats to patients' health, such as unsafe housing conditions, through partnership with legal professionals. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we systematically reviewed observational studies published from January 1993-January 2016 to investigate the capacity of MLPs to address legal and health disparities. We identified 13 articles for qualitative analysis from an initial pool of 355 records. The resulting pool of 13 articles revealed more information regarding the capacity of MLPs to address legal outcomes than their capacity to address health outcomes; only 4 studies directly addressed the impact of MLP intervention on patient wellbeing and/or patient utilization of healthcare services. We call for further evaluation/longitudinal studies that specifically address MLPs' short and long term effects upon patient health disparities. Finally, given the demonstrated capacity of MLPs to address unmet legal needs, and their evident potential in regards to improving health outcomes, we present the MLP model as a framework to address HIV-related legal and health disparities.

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Understanding Hospital-Based Nurses’ Experiences of Structurational Divergence

The Qualitative Report ◽

10.46743/2160-3715/2015.2107 ◽

2015 ◽

Author(s):

LaKesha Anderson

Keyword(s):

Health Outcomes ◽

Organizational Communication ◽

Future Research ◽

Narrative Approach ◽

Patient Health ◽

The Impact ◽

Organizational Conflicts

This study examined hospital-based nurses’ experiences of structurational divergence. I used a semi-structured narrative approach to interview 10 hospital-based nurses and data was analyzed using phenomenological methods. This resulted in the identification of the following three themes, which capture instances of structurational divergence and resulting interpersonal, intrapersonal, and organizational conflicts: Managing Overload, Identifying and Negotiating Boundaries, and Substituting and Advocating. I also discovered an additional theme, Eating their Young.. Results have implications for future research in health and organizational communication and reflect the importance of research into the communication between and amongst nurses, patients, and physicians and the impact of that communication on patient health outcomes.

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The Impact of Hospital Advertising on Patient Demand and Health Outcomes

Marketing Science ◽

10.1287/mksc.2019.1153 ◽

2020 ◽

Vol 39 (3) ◽

pp. 612-635 ◽

Cited By ~ 4

Author(s):

Tongil “TI” Kim ◽

Diwas KC

Keyword(s):

Health Outcomes ◽

Hospital Readmissions ◽

Patient Choice ◽

Significant Heterogeneity ◽

Demand Model ◽

Readmission Rates ◽

Patient Response ◽

Individual Patient Level ◽

Patient Health ◽

The Impact

Does hospital advertising influence patient choice and health outcomes? We examine more than 220,000 individual patient-level visits over 24 months in Massachusetts to answer this question. We find that patients are positively influenced by hospital advertising; seeing a television advertisement for a given hospital makes a patient more likely to select that hospital. We also observe significant heterogeneity in patient response depending on insurance status, medical conditions, and demographic factors, like age, gender, and race. For example, patients with more restrictive forms of insurance are less sensitive to advertisements. Our demand model allows us to study the impact of a ban on hospital advertising, which has been recently considered by policy makers. We find that banning hospital advertising can hurt patient health outcomes through increased hospital readmissions. This is because hospital advertisements drive patients to higher-quality hospitals, which tend to advertise more and have lower readmission rates. However, we do not find a significant change in the overall mortality rate.

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Effects on patients of variations in the implementation of a cardiometabolic risk intervention program in Montréal

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.38.2.03 ◽

2018 ◽

Vol 38 (2) ◽

pp. 64-77 ◽

Cited By ~ 2

Author(s):

Marie-Ève Beauregard ◽

Sylvie Provost ◽

Raynald Pineault ◽

Dominique Grimard ◽

José Pérez ◽

...

Keyword(s):

Health Outcomes ◽

Program Implementation ◽

Intervention Program ◽

Cardiometabolic Risk ◽

Propensity Scores ◽

Health Indicators ◽

Patient Health ◽

Services Sociaux ◽

The Impact

Introduction In 2011, the Agence de la santé et des services sociaux de Montréal (ASSSM), in partnership with the region’s Centres de santé et de services sociaux (CSSS), coordinated the implementation of a program on cardiometabolic risk based on the Chronic Care Model. The program, intended for patients suffering from diabetes or hypertension, involved a series of individual follow-up appointments, group classes and exercise sessions. Our study assesses the impact on patient health outcomes of variations in the implementation of some aspects of the program among the six CSSSs taking part in the study. Methods The evaluation was carried out using a quasi-experimental “before and after” design. Implementation variables were constructed based on data collected during the implementation analysis regarding resources, compliance with the clinical process set out in the regional program, the program experience and internal coordination within the care team. Differences in differences using propensity scores were calculated for HbA1c results, achieving the blood pressure (BP) target, and two lifestyle targets (exercise level and carbohydrate distribution) at the 6- and 12-month follow-ups, based on greater or lesser patient exposure to the implementation of various aspects of the program under study. Results The results focus on 1185 patients for whom we had data at the 6-month follow- up and the 992 patients from the 12-month follow-up. The difference in differences analysis shows no clear association between the extent of implementation of the various aspects of the program under study and patient health outcomes. Conclusion The program produces effects on selected health indicators independent of variations in program implementation among the CSSSs taking part in the study. The results suggest that the effects of this type of program are more highly dependent on the delivery of interventions to patients than on the organizational aspects of its implementation.

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