scholarly journals Medicaid-serving Health Maintenance Organization-Federally Qualified Health Center (HMO-FQHC)-School of Public Health Collaboration to Provide After-Hours Pediatric Urgent Care: A One Year Demonstration Project

2018 ◽  
Vol 27 (5) ◽  
pp. 1-15
Author(s):  
L. S. Fischer ◽  
C. E. Begley ◽  
S. Azadeh ◽  
A. M. Dangre ◽  
A. P. Giardino
2009 ◽  
Vol 7 (2) ◽  
pp. 39
Author(s):  
Sinan Khan, MPH, MA ◽  
Anke Richter, PhD

Objective: To comply with the Center for Disease Control’s mass prophylaxis mandates, many public health jurisdictions must supplement their existing Points of Dispensing (POD)-based system. Because of limited budgets and personnel availability, only one or two alternatives out of the many potential options can be implemented.Design: Multicriteria decision analysis is a powerful tool that allows public health officials to assess the relative effectiveness of alternate modes of dispensing while incorporating the opinions of their multidisciplinary emergency response planning teams.Setting: This process was utilized to analyze the effectiveness of alternate modes of dispensing that could be used to supplement the existing POD system within the Los Angeles County (LAC) Department of Public Health (DPH).Results: The top two options for LAC were prepositioning for civil service and partnership with a major Health Maintenance Organization. These choices were stable under a variety of sensitivity analyses, and the differences in opinion between the agencies and other stakeholders do not change them.Conclusions: The transparency of the model and analysis may allow decision makers and planners in the LAC DPH to garner support for their alternate modes of dispensing plans. By making the decision criteria clear and demonstrating the robustness of the results in the sensitivity analyses, public health partners gain a deeper understanding of the issues and their potential roles. The process can be repeated by any jurisdiction, but definition of “best” will rely on the issues and gaps that are identified with the jurisdiction’s POD plan for mass prophylaxis.


2020 ◽  
Author(s):  
Iman Sharif ◽  
Shae Patel ◽  
Melissa Shafer ◽  
Laura Longman ◽  
Laura Longman

BACKGROUND In contrast to the current broad dissemination of telemedicine across medical specialties, previous research focused on the effectiveness of telemedicine in special populations and for behavioral health encounters; demonstrating that both physician and patient factors impact the efficacious use of telemedicine. OBJECTIVE We evaluated physician perceptions of the appropriateness of telemedicine for patients attending the primary care practices of a federally qualified health center in New York City. METHODS Anonymous cross-sectional survey including closed and open-ended questions. We used chi-square to test whether providers from certain specialties were more likely to state they would use telemedicine in the future. We used t-test to compare age between those who would vs. would not use telemedicine. Then, we used logistic regression to test whether age and specialty were both correlated with desire to use telemedicine in the future. We used thematic content analysis to describe the reasons providers felt they would not want to use telemedicine in the future, and to describe the situations for which they felt telemedicine would be appropriate. RESULTS Of 272 FHC providers who were sent the electronic survey, 159(58%) responded within the 2-week survey time frame. Mean age of providers was 45 years (range 28-75). Overall, 81% stated they would use telemedicine in the future. Compared to the Family Medicine, Internal Medicine, Behavioral Health, Dental, and OB/GYN specialties, providers from Pediatrics, Med-Peds, Subspecialties and Surgery [Pro-telemedicine specialties] were more likely to believe telemedicine would be useful post pandemic (94% vs. 72%, p<0.05). Providers who reported they would use telemedicine in the future were younger [mean age 44(42-46) vs. 50(46-55), p<0.01). In regression analysis, both pro-telemedicine specialties and age were significantly associated with odds of reporting they would use telemedicine in the future [specialties: 5.2(1.7-16.2); age: 0.95(0.92-0.99)]. Providers who did not want to use telemedicine in the future cited concerns about inadequate patient care, lack of physical patient interaction, technology issues, and lack of necessity. Providers who felt telemedicine would be useful cited the following situations: follow up visits, medication refills, urgent care, patient convenience, and specific conditions such has behavioral health, dermatology visits, and chronic care management. CONCLUSIONS The majority of health providers in this resource poor setting in a federally qualified health center believed that telemedicine would be useful for providing care after the pandemic is over.


1998 ◽  
Vol 20 (2) ◽  
pp. 17-18 ◽  
Author(s):  
Dana Baldwin

I am part of a multi-disciplinary team composed of researchers from Kaiser Permanente, the country's largest staff model Health Maintenance Organization (HMO) and the Los Angeles chapter of the Alzheimer's Disease and Related Disorders Association. This team has designed a demonstration service delivery system to enhance the quality of care given to dementia patients and their care givers. If the demonstration project is successful, it may be expanded throughout the Kaiser system. After completing my Ph.D. in medical anthropology at UCLA, I worked as a consultant at the Rand Corporation then held a post-doctoral fellowship in addictions through the National Institute on Drug Addiction. With this track record, and my experience with both qualitative and quantitative survey methods, I was hired at Kaiser as an internal health care service and organizational researcher. They did not hire me because I was an anthropologist. As an anthropologist, however, I have brought some of the discipline's perspectives to bear on the formative stages of the dementia demonstration project.


Bone ◽  
2008 ◽  
Vol 43 (6) ◽  
pp. S131
Author(s):  
M. Diehl ◽  
A. Beratarrechea ◽  
J. Saimovici ◽  
N. Pace ◽  
S. Figar ◽  
...  

2019 ◽  
Vol 13 (2) ◽  
pp. 1-18
Author(s):  
Yeni Suryamah

Diarrhea disease is still a public health problem in developing countries such as Indonesia because of morbidity and mortality which is still high. On Cimahi City in 2013 the incidence of diarrhea was on third place (10.69%) after acute respiratory infection and acute nasopharyngitis on patients age group 0 to less than one year. Number of less-one-year infants with diarrhea disease who came to the public health center in Cimahi City was 19.53% and the number of 1-4 years old toddlers was 13.41% in 2014.. Many factors play an important role against children under five's illness especially diarrhea which among its are breastfeeding (breast milk). Some ways of breastfeeding are by giving directly to the baby or give it indirectly through expressed breast milk. The purpose of this study was to determine the relationship between the way of breastfeeding and the incidence of diarrhea in infants 6-11 months in public health centers Cimahi City in 2015 before and after controlling for variables maternal education, maternal occupation, socio economic status, hygiene of food and drink, sex, age infant, complementary feeding, and nutritional status. The study design using case-control study in which cases were infants aged 6-11 months who come to the public health center and was diagnosed as a case of diarrhea while control is taken at the same public health center and in the same week and do not suffer from diarrhea or infants who visit for immunizations. Case control comparative is 1: 1 with 154 chosen samples from each group. Multivariate analysis using logistic regression. The survey results revealed significant correlation between expressed breast milk with the incidence of diarrhea in infants (p = 0.019). The expressed breast milk has a protective effect 0.546 times less protection against diarrhea compared with infants fed breast milk directly. While the not breast milk / formula milk is known that there are no significant relationship with the occurrence of diarrhea (p = 0.858). There was no significant relationship between how breastfeeding by the incidence of diarrhea in infants after the controlled variable hygiene of food and drinks with p value of 0.055 (95% CI 0.360-1.011) and 0.875 (95% CI 0.360-1.011). It is hoped that the department of health and public health centers can increase promotional efforts to expectant mothers and mothers of infants, especially on hygiene of food and drink for use by infants including handwashing, increased promotional efforts health on complementary feeding, and the need for socialization of giving expressed breast milk to the baby to support the movement of breastfeeding until the age of two years


1992 ◽  
Vol 26 (11) ◽  
pp. 1441-1446 ◽  
Author(s):  
L. Douglas Ried ◽  
Richard E. Johnson

OBJECTIVE: To assess the reliability and validity of a proposed new standard of drug-use intensity, the minimum marketed dose (MMD), using anxiolytic drugs as models. DESIGN: Retrospective, cohort design. SETTING: Staff model, nonprofit health maintenance organization. PATIENTS/PARTICIPANTS: Eighty-five patients who obtained one or more prescriptions for an anxiolytic, antidepressant, or sedative-hypnotic drug during three consecutive one-year time periods. Fifty-nine patients had a prescription filled during the year before the study. RESULTS: For anxiolytic drugs, the magnitude of the average correlation for the MMD measure of drug-use intensity was greater than the total number of prescriptions and the total number of dosage units. Discriminant validity was demonstrated because the MMD was not correlated with measures in unrelated therapeutic categories. Summed MMD units were shown to significantly predict physical impairment (criterion validity). CONCLUSIONS: The MMD measure of drug-use intensity was reliable and valid for anxiolytic drugs. These findings suggest that information gathered from automated prescription records may be a useful indicator of drug-use intensity in pharmacoepidemiologic studies.


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