Update to Internet-only Tables: NAMCS Community Health Centers

This report provides estimates of ambulatory care visits made to both physicians and nonphysician clinicians at community health centers in the United States.

Update to Internet-only Tables: NAMCS Community Health Centers

This report provides estimates of ambulatory care visits made to both physicians and nonphysician clinicians at community health centers in the United States.

Project COALESCE—An Example of Academic Institutions as Conveners of Community-Clinic Partnerships to Improve Cancer Screening Access

In Virginia, 56% of colorectal cancers (CRC) are diagnosed late, making it one of three enduring CRC mortality hotspots in the US. Cervical cancer (CCa) exhibits a similar pattern, with 48% late-stage diagnosis. Mortality for these cancers is worse for non-Latinx/e(nL)-Black people relative to nL-White people in Virginia, but preventable with equitable screening access and timely diagnostic follow-up. However, structural barriers, such as fractured referral systems and extended time between medical visits, remain. Because Federally Qualified Health Centers (FQHCs) care for a large proportion of racial and ethnic minorities, and underserved communities, regardless of ability to pay, they are ideal partners to tackle structural barriers to cancer screenings. We piloted a quality improvement initiative at five FQHCs in southcentral Virginia to identify and address structural, race-related barriers to CRC, as well as CCa screening and diagnostic follow-up using evidence-based approaches. Uniquely, FQHCs were paired with local community organizations in a didactic partnership, to elevate the community’s voice while together, increase support, acceptance, uptake, and intervention sustainability. We report on project development, and share preliminary data within the context of project goals, namely, to increase cancer screenings by 5–10%, improve knowledge and diagnostic follow-up processes, and build longitudinal partnerships.

Evaluating the Performance of the SIB System of Health Centers in Bojnourd and Neishabour from the Users Perspective in 2020

Introduction: Nurses and medical staff and health technologists as the largest segment of the health system are the main users of health information systems that understanding the perspective and how to use this system can be effective in improving the quality of community health. The aim of this study was to evaluate the performance of the Sib system of health centers in Bojnourd and Neishabour.Material and Methods: This is an applied study and was performed by descriptive cross-sectional method. The study population included all users of the Sib system in the health centers of Bojnourd and Neishabour who used the Sib system. Sampling was available and data were collected using a researcher-made questionnaire and data were analyzed using SPSS software version 21.Results: According to the findings of the study, the majority of users were 70% female and 30% male, 58% were in the age group of 30-39 years, and 40% of them had 5-9 years of work experience and also 63% of System users have a bachelor's degree. In the technical field, from the point of view of 40% of users, the ease of using the system is moderate.Conclusion: Based on the identified factors, by strengthening the advantages of the system and also trying to eliminate or reduce the shortcomings in it, it is possible to institutionalize and use the system more practically in order to solve health problems.

Clinical Characteristics of Vulnerable Populations Hospitalized and Diagnosed with COVID‑19 during Second Wave in Buenos Aires, Argentina.

There are a few in Argentina publications regarding the presentation of patients with COVID-19 requiring hospitalized and emergency care in vulnerable populations that compares the first and second wave, and it has few reports in developing countries. The objective is to determine whether in the care of vulnerable patients, to succeed against COVID-19, multiple public health tools and interventions necessary to minimize morbidity and mortality. The study is a prospective cohort investigation of 3028 patients during second wave with lab-confirmed COVID-19, who required any of the Health Centers response from April 1, 2021, to June 30, 2021. In a previous publication, our group analyzed the situation of hospitalized patients during the first wave in the same region, "Southeast Network" (SN), Buenos Aires Metropolitan Area (AMBA). SN with 1.8 million inhabitants residing in urban and rural areas. A total of 14 health centers with different levels of care complexity provide care to patients in the region. The information of each patient with COVID-19 evaluated by SN, was incorporated in an Epidemiological Dashboard. The investigation was designed and reported with consideration of observational studies in epidemiology. A total of 57.9% patients were men, and the mean age (SD) was 52.1 (13.5) years. Sixty four percent patients with pre-existing diseases, most frequent hypertension and diabetes, but diabetes, obesity, and cardiovascular disease presented higher risk. A total of 24.7% were hospitalized in Intensive Therapy Unit. The mortality of the cohort was 22.9%. Mortality was higher for patients aged 65 or more, and for those had some pre-existing disease. But, it was a slightly more than double that in the first wave, it is possible mainly due to the fact that more than doubled of patients in Second wave required hospitalization in ITU, compared to First wave. The patients presented greater severity of their medical condition at the time of their hospitalization. These findings were similar to those reported by other authors. Another possible cause of the high number of patients in the period studied is due to the fact that most of the hospitalized population had not been vaccinated. The health system was able to respond to the demand.

Physicians’ Behavior in Referring National Health Insurance Patients to Hospital

Physicians’ decision to refer patients in primary health care is vital in supporting the referral system. The increase of referral cases impacted the claims cost and hospital workload. This study aimed to analyze the physicians’ behavior in referring National Health Insurance (NHI) patients to hospitals. This study employed a qualitative method; 18 informants were selected using purposive sampling and analyzed using content analysis. The data were validated by triangulating method, source, and data. Physicians referred patients when the cases could not be handled; there were indications of severe disease and required further examination. The obstacles in the referral system were pressure from NHI patients that wanted to be referred and diagnosed differently from ICD 10. In referring NHI patients, physicians had followed referral procedures and criteria. High referrals were caused by patients being forced to be referred, coming with complaints of severe disease, having examined in a hospital, and some cases should not be referred to but still referred by entering a similar diagnosis into the ICD 10. It is expected that public health centers will educate NHI patients related to tiered referral procedures in health services.

Analysis of Accessibility to Family Health Centers in Antalya Using GIS

Family health centers in Turkey started to be implemented for the first time in Düzce in 2004 years within the scope of Law No. 5258. While determining the physical conditions of the places where family health centers are built, the first item in the regulation is that the building should be easily accessible. This situation shows the importance of the subject in terms of accessibility. While determining the features of the places where FHCs will be made, environmental characteristics are also taken into consideration. Environmental features are effective in determining the FHCs location in different ways. These impacts are divided into two groups: the physical features that pavements, roads and parks can include, and the social, cultural and institutional features of neighborhoods that include local social ties and collective activities. From this point of view, the importance of the location of family health centers relative to roads and houses is understood. The aim of this study is to examine the accessibility of Family Health Centers in Konyaaltı, Antalya, on a neighborhood basis using Geographic Information Systems. Konyaaltı has 21 Family Health Centers. As a result of the analyses, it was determined that most of the neighborhoods had problems in terms of accessibility, while a very few of them did not experience problems in terms of accessibility. In terms of the total number of buildings, the ratio of buildings that are 500 meters walking distance from any family health center by using highways is 35.56%. With these rates, 3,634 of the 10,2018 buildings remain within the limits of the regulation. Finally; suggestions were made to increase accessibility to these areas.