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  • NLM标题： Popul Health Manag
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  • 1.

    【2hr】Building a Culture of Health and Well-Being at Merck

    包量

    机译 在默克公司建立健康与福祉文化
    摘要：There is increasing evidence that a healthy and safe workforce can provide a competitive business advantage. This article shares the efforts and experience of a large global employer as it builds on existing corporate wellness and safety programs to develop a corporate culture of health and well-being. Starting with a comprehensive review of the current state of employee health and culture, a small team established the business case, aligned strategic partners, created an implementation plan, and engaged the C-Suite. The aim of this article is to provide a case study that others might use to design their blueprint, to gain awareness and to build a culture of health and well-being within their organization.
  • 2.

    【2hr】The Case for Patient Navigation in Lung Cancer Screening in Vulnerable Populations: A Systematic Review

    包量

    机译 弱势人群肺癌筛查中患者导航的案例：系统评价
    摘要：Patient navigation has been proposed to combat cancer disparities in vulnerable populations. Vulnerable populations often have poorer cancer outcomes and lower levels of screening, adherence, and treatment. Navigation has been studied in various cancers, but few studies have assessed navigation in lung cancer. Additionally, there is a lack of consistency in metrics to assess the quality of navigation programs. The authors conducted a systematic review of published cancer screening studies to identify quality metrics used in navigation programs, as well as to recommend standardized metrics to define excellence in lung cancer navigation. The authors included 26 studies evaluating navigation metrics in breast, cervical, colorectal, prostate, and lung cancer. After reviewing the literature, the authors propose the following navigation metrics for lung cancer screening programs: (1) screening rate, (2) compliance with follow-up, (3) time to treatment initiation, (4) patient satisfaction, (5) quality of life, (6) biopsy complications, and (7) cultural competency.
  • 3.

    【2hr】Health Care Access Barriers Bring Children to Emergency Rooms More Frequently: A Representative Survey

    包量

    机译 一项代表性调查显示，医疗保健进入壁垒将儿童更频繁地带到急诊室
    摘要：Children may visit the emergency department (ED) regularly in part because they and their caregivers may be experiencing barriers to appropriate and timely pediatric care. However, assessing the wide range of potential barriers to access to care that children and their caregivers may experience is often a challenge. The objective of this study was to assess the barriers to pediatric health care reported by caregivers and to examine the association between those reported barriers to care with the frequency of children's ED visits in the past 12 months. Assessment of ED utilization and access to care barriers was made through a telephone interview survey conducted as part of a broader Community Health Needs Assessment in 2015. A weighted community sample of adult caregivers (N = 1057) of children between the ages of 0–17 residing in Miami-Dade, Broward, and Palm Beach counties, Florida were contacted. This study found that multiple ED visits (≥2 vs. 0) in the past 12 months by a child were most strongly associated with access to care barriers attributed to language and culture (relative risk [RR] = 2.51), trouble finding a doctor (RR = 1.86), scheduling an appointment (RR = 1.68), and transportation access (RR = 1.73). These findings suggest that access to care barriers experienced by households may exacerbate the risk of a child experiencing repeated visits to the ED in a year. Findings are discussed further in the context of actionable population health management strategies to reduce risk of frequent ED utilization by children.
  • 4.

    【2hr】Optimizing Clinical and Cost Outcomes for Patients on Enteral Nutrition Support for Treatment of Exocrine Pancreatic Insufficiency: Proceedings from an Expert Advisory Board Meeting

    包量

    机译 肠内营养支持治疗外分泌性胰腺功能不全的患者的临床和费用结果优化：专家顾问委员会会议的记录
    摘要：
  • 5.

    【2hr】Population Health Could Do Far More to Mitigate Health Disparities

    包量

    机译 人口健康可以大大减轻健康差距
    摘要：
  • 6.

    【2hr】Risk Reduction Research Initiative: A National Community–Academic Framework to Improve Health and Social Outcomes

    包量

    机译 降低风险研究计划：改善健康和社会成果的国家社区学术框架
    摘要：
  • 7.

    【2hr】A Promising New Strategy to Improve Treatment Outcomes for Patients with Depression

    包量

    机译 改善抑郁症患者治疗效果的新方法
    摘要：Each year, ineffective medical management of patients with mental illness compromises the health and well-being of individuals, and also impacts communities and our society. A variety of interrelated factors have impeded the health system's ability to treat patients with behavior health conditions adequately. A key contributing factor is a lack of objective markers to help predict patient response to specific drugs that has led to patterns of “trial and error” prescribing. For many years, clinicians have sought objective data (eg, a laboratory or imaging test) to assist them in selecting appropriate treatments for individual patients. Electroencephalogram (EEG) findings coupled with medication outcomes data may provide a solution. “Crowdsourced” physician registries that reference clinical outcomes to individual patient physiology have been used successfully for cancers. These techniques are now being explored in the context of behavioral health care. The Psychiatric EEG Evaluation Registry (PEER) is one such approach. PEER is a clinical phenotypic database comprising more than 11,000 baseline EEGs and more than 39,000 outcomes of medication treatment for a variety of mental health diagnoses. Collective findings from 45 studies (3130 patients) provide compelling evidence for PEER as a relatively simple, inexpensive predictor of likely patient response to specific antidepressants and likely treatment-related side effects (including suicidal ideation).
  • 8.

    【2hr】Transforming Diabetes Care Through Artificial Intelligence: The Future Is Here

    包量

    机译 通过人工智能改变糖尿病的护理：未来就在这里
    摘要：An estimated 425 million people globally have diabetes, accounting for 12% of the world's health expenditures, and yet 1 in 2 persons remain undiagnosed and untreated. Applications of artificial intelligence (AI) and cognitive computing offer promise in diabetes care. The purpose of this article is to better understand what AI advances may be relevant today to persons with diabetes (PWDs), their clinicians, family, and caregivers. The authors conducted a predefined, online PubMed search of publicly available sources of information from 2009 onward using the search terms “diabetes” and “artificial intelligence.” The study included clinically-relevant, high-impact articles, and excluded articles whose purpose was technical in nature. A total of 450 published diabetes and AI articles met the inclusion criteria. The studies represent a diverse and complex set of innovative approaches that aim to transform diabetes care in 4 main areas: automated retinal screening, clinical decision support, predictive population risk stratification, and patient self-management tools. Many of these new AI-powered retinal imaging systems, predictive modeling programs, glucose sensors, insulin pumps, smartphone applications, and other decision-support aids are on the market today with more on the way. AI applications have the potential to transform diabetes care and help millions of PWDs to achieve better blood glucose control, reduce hypoglycemic episodes, and reduce diabetes comorbidities and complications. AI applications offer greater accuracy, efficiency, ease of use, and satisfaction for PWDs, their clinicians, family, and caregivers.
  • 9.

    【2hr】Retraction of: “Using the Healthy Days Measure to Assess Factors Associated with Poor Health-Related Quality of Life for Patients with Metastatic Breast, Lung, or Colorectal Cancer Enrolled in a Medicare Advantage Health Plan,” by Casebeer AW, et al. Popul Health Manag [e-pub; doi: 10.1089/pop.2018.0024]

    包量

    机译 撤回：Casebeer AW等人“使用健康天数评估来评估纳入Medicare Advantage健康计划的转移性乳腺癌，肺癌或结直肠癌患者与健康不良生活质量相关的因素”。 Popul Health Manag [e-pub; doi：10.1089 / pop.2018.0024]
    • 作者：
    • 刊名：Population Health Management
    • 2019年第2期
    摘要：
  • 10.

    【2hr】Purchasing Population Health – Revisited

    包量

    机译 购买人口健康
    摘要：
  • 11.

    【2hr】Nursing Home Compare Star Rankings and the Variation in Potentially Preventable Emergency Department Visits and Hospital Admissions

    包量

    机译 疗养院比较星级和可能预防的急诊就诊和住院人数的变化
    摘要：Measurement of the quality of US health care increasingly emphasizes clinical outcomes over clinical processes. Nursing Home Compare Star Ratings are provided by Medicare to help select better nursing home care. The authors determined the rates and types of 2 important clinical outcomes–potentially preventable hospital admissions and potentially preventable emergency department (ED) visits–for a subset of 439,011 long-term nursing homes residents residing in 12,883 nursing homes throughout the United States over a 2-year period (2010–2011) and compared them with the Star Rating system. This study found that (1) the likelihood of potentially preventable events increases with increasing burden of chronic illness, (2) the principle reasons for hospital admissions and ED visits (eg, septicemia, pneumonia, confusion, gastroenteritis) are not part of existing nursing home quality measures, (3) the rate of potentially preventable admissions and ED visits for nursing homes residents varies greatly both across and within states, with 5 states having in excess of 20% more than the national average for both, and (4) the Nursing Home Compare Stars measure has limited correlation with rates of these potentially preventable events. Nursing Home Compare Star rankings could benefit by incorporating outcomes measures such as preventable hospitalizations and ED visits, and by comparing nursing home performance on results drawn from across states rather than within them. Such reform could better help users find nursing homes of higher quality and stimulate homes to improve quality in ways that benefit residents.
  • 12.

    【2hr】Utilizing Community Health Needs Assessments (CHNAs) in Nonprofit Hospitals to Guide Population-Centered Outcomes Research for Pediatric Patients: New Recommendations for CHNA Reporting

    包量

    机译 利用非营利医院的社区健康需求评估（CHNA）指导小儿患者以人群为中心的结果研究：CHNA报告的新建议
    摘要：Currently, Community Health Needs Assessment (CHNA) reports lack a standard structure, making it difficult to derive meaningful information. However, they have the potential to be a useful tool for analyzing pediatric outcomes, guiding resource allocation, and linking to Patient-Centered Outcomes Research Institute priorities. The objective was to evaluate the utility of CHNA for informing future pediatric, patient-centered outcomes research. The authors analyzed CHNA documents, published before July 1, 2016 by 61 nonprofit hospitals, focusing on 4 metropolitan areas in Florida: Miami, Orlando, Tampa, and Jacksonville. Out of 18 health priorities identified, access to care and obesity were universally recognized as the most urgent pediatric health needs across all hospital types and metropolitan regions. This analysis also yielded insights into key regional differences. The authors advocate that a major change in the CHNA format be implemented using a common set of domains to produce meaningful, interpretable, and comparable results that inform and guide patient-centered health outcomes research.
  • 13.

    【2hr】Underutilization of Statin Therapy for Secondary Prevention of Cardiovascular Disease Among Older Adults

    包量

    机译 他汀类药物疗法的未充分利用对老年人心血管疾病的二级预防
    摘要：Secondary cardiovascular disease (CVD) clinical trials have demonstrated that higher intensity levels of statin therapy are more effective than lower levels in reducing mortality rates. Despite updated treatment guidelines, statin therapy may be underutilized, with evidence that females are treated less aggressively than males. The primary objective of this study was to determine the prevalence of statin utilization by varying therapy intensity by sex. The secondary objective was to document the benefits of statin therapy intensity levels on all-cause mortality for males and females. A 25% random sample of adults ≥65 years was utilized to identify those with established CVD. Inclusion criteria included: (1) 12-month pre period and (2) up to 30 months post period. Five categories of statin utilization were established: adherent to high-, moderate-, or low-intensity statin therapy, nonadherent, and no statins. Among eligible insureds (N = 49,530 males; N = 44,710 females), 20% of males and 12% of females were identified as high-intensity statin users. Mortality rates significantly increased similarly for males and females as statin therapy intensity decreased. Likewise, mortality hazard ratios indicated the most benefit from high-intensity statin therapy compared to all other categories. Statin therapy for secondary prevention of CVD is beneficial in reducing mortality for males and females but is underutilized, especially among females. Education programs among patients to increase heart health awareness and among physicians to promote the benefits of updated statin guidelines should be encouraged.
  • 14.

    【2hr】Prioritizing Population Approaches: A Qualitative Evaluation of Policy, Systems, and Environmental Change Initiatives in Cancer Prevention and Control

    包量

    机译 优先考虑人口方法：对癌症预防和控制中的政策，系统和环境变化计划的定性评估
    摘要：IntroductionThe development and implementation of policy, systems and environmental (PSE) change is a commonly used public health approach to reduce disease burden. CDC’s National Comprehensive Cancer Control Program conducted a demonstration with 13 programs to determine whether and to what extent dedicated resources would enhance the adoption of PSE strategies. This paper describes results of the qualitative portion of a longitudinal, mixed-methods evaluation of this demonstration.
  • 15.

    【2hr】Expenditure Reductions Associated with a Social Service Referral Program

    包量

    机译 与社会服务推荐计划相关的支出减少
    摘要：Recent health system innovations provide encouraging evidence that greater coordination of medical and social services can improve health outcomes and reduce health care expenditures. This study evaluated the savings associated with a managed care organization's call center-based social service referral program that aimed to assist participants address their social needs, such as homelessness, transportation barriers, and food insecurity. The program evaluation linked social service referral data with health care claims to analyze expenditures in 2 annual periods, before and after the first social service referral. Secondary data analysis estimated the change in mean expenditures over 2 annual periods using generalized estimating equations regression analysis with the identity link. The study compared the change in mean health care expenditures for the second year for those reporting social needs met versus the group whose needs remained unmet. By comparing the difference between the first and second year mean expenditures for both groups, the study estimated the associated savings of social services, after controlling for group differences. These results showed that the decrease in second year mean expenditures for the group of participants who reported all of their social needs met was $2443 (10%) greater than the decrease in second year mean expenditures for the group who reported none of their social needs met, after controlling for group differences. Organizations that integrate medical and social services may thrive under policy initiatives that require financial accountability for the total well-being of patients.
  • 16.

    【2hr】Quality of Care Improves for Patients with Diabetes in Medicare Shared Savings Accountable Care Organizations: Organizational Characteristics Associated with Performance

    包量

    机译 在医疗保险中，糖尿病患者的医疗质量得到了提高，共有储蓄的责任医疗组织：与绩效相关的组织特征
    摘要：Accountable care organizations (ACOs), a primary care-centric delivery and payment model, aim to promote integrated population health, which may improve care for those with chronic conditions such as diabetes. Research has shown that, overall, the ACO model is effective at reducing costs, but there is substantial variation in how effective different types of ACOs are at impacting costs and improving care delivery. This study examines how ACO organizational characteristics – such as composition, staffing, care management, and experiences with health reform – were associated with quality of care delivered to patients with diabetes. Secondary data were analyzed retrospectively to examine Medicare Shared Savings Program (MSSP) ACOs' performance on diabetes metrics in the first 2 years of ACO contracts. Ordinary least squares was used to analyze 162 MSSP ACOs with publicly available performance data and the National Survey of ACOs. ACOs improved performance significantly for patients with diabetes between contract years 1 and 2. In year 1, also having a private payer contract and an increased number of services within the ACO were positively associated with performance, while having a community health center or a hospital were negatively associated with performance. Better performance in year 1 was negatively associated with improved performance in year 2. This study found that ACOs substantively improved diabetes management within initial contract years. ACOs may need different types of support throughout their contracts to ensure continued improvements in performance.
  • 17.

    【2hr】Comparing the Health of Populations: Methods to Evaluate and Tailor Population Management Initiatives in the Netherlands

    包量

    机译 比较人口健康：荷兰的人口管理举措评估和定制方法
    摘要：Health care no longer focuses solely on patients and increasingly emphasizes regions and their populations. Strategies, such as population management (PM) initiatives, aim to improve population health and well-being by redesigning health care and community services. Hence, insight into population health is needed to tailor interventions and evaluate their effects. This study aims to assess whether population health differs between initiatives and to what extent demographic, personal, and lifestyle factors affect these differences. A population health survey that included the Short Form 12 version 2 (SF12, physical and mental health status), Patient Activation Measure 13 (PAM13), and demographic, personal, and lifestyle factors was administered in 9 Dutch PM initiatives. Potential confounders were determined by comparing these factors between PM initiatives using analyses of variance and chi-square tests. The influence of these potential confounders on the health outcomes was studied using multivariate linear regression. Age, education, origin, employment, body mass index, and smoking were identified as potential confounders for differences found between the 9 PM initiatives. Each had a noteworthy influence on all of the instruments' scores. Not all health differences between PM initiatives were explained, as the SF12 outcomes still differed between PM initiatives once corrected. For the PAM13, the differences were no longer significant. Demographic and lifestyle factors should be included in the evaluation of PM initiatives and population health differences found can be used to tailor initiatives. Other factors beyond health care (eg, air quality) should be considered to further refine the tailoring and evaluation of PM initiatives.
  • 18.

    【2hr】How to Measure Population Health: An Exploration Toward an Integration of Valid and Reliable Instruments

    包量

    机译 如何衡量人口健康：有效和可靠工具整合的探索
    摘要：Population health management initiatives are introduced to transform health and community services by implementing interventions that combine various services and address the continuum of health and well-being of populations. Insight is required into a population's health to evaluate implementation of these initiatives. This study aims to determine the performance of commonly used instruments for measuring a population's experienced health and explores the assessed concepts of population health. Survey-based Short Form 12, version 2 (SF12, health status), Patient Activation Measure 13 (PAM13), and Kessler 10 (K10, psychological distress) data of 3120 respondents was used. Floor/ceiling effects were studied using descriptive statistics. Validity was assessed using factor and discriminant analyses, and reliability was assessed using Cronbach α. Finally, to study covered concepts, exploratory factor analyses (EFAs) were conducted, which included additional surveyed characteristics. The SF12 and PAM13 sum scores showed acceptable averages and distributions, while results of the K10 indicated a floor effect. SF12 and K10 measured their expected constructs, while PAM13 did not. The EFA of PAM13 displayed 1 instead of the expected 4 constructs. Reliability was good for all instruments (α 0.89–0.93). The overall EFA identified 4 concepts: mental, physical ability, lifestyle, and self-management. SF12 and PAM13, combined with lifestyle characteristics, are shown to provide insightful information to measure the physical, mental, lifestyle, and self-management concepts of population health. Future research should include additional instruments that cover new aspects introduced by recent definitions of health.
  • 19.

    【2hr】Trends in US Hospital Provision of Health Promotion Services, 1996–2014

    包量

    机译 1996–2014年美国医院提供健康促进服务的趋势
    摘要：Hospitals have long played important roles in the provision of health promotion services (HPS) in local communities, defined as activities that enable people to increase control over and improve their health, including programs such as disease prevention and wellness. Nearly 2 decades ago, researchers cross-sectionally documented the provision of HPS by hospitals, but little research has been done to update this work or document how HPS have changed over time. This study assessed changes in the provision of HPS among US hospitals between 1996 and 2014. Relationships were assessed using random effects Poisson regression models. The overall number of HPS reported by hospitals was relatively modest (approximately half of all possible services, on average). The number of services increased modestly over time, although the rate of increase became less positive over time. The findings highlight a number of opportunities to improve hospital provision of HPS.
  • 20.

    【2hr】Use of International Classification of Diseases, Ninth Revision Codes for Obesity: Trends in the United States from an Electronic Health Record-Derived Database

    包量

    机译 国际疾病分类的使用，第九版肥胖症修订代码：电子病历衍生数据库中的美国趋势
    摘要：Obesity is a potentially modifiable risk factor for many diseases, and a better understanding of its impact on health care utilization, costs, and medical outcomes is needed. The ability to accurately evaluate obesity outcomes depends on a correct identification of the population with obesity. The primary objective of this study was to determine the prevalence and accuracy of International Classification of Diseases, Ninth Revision (ICD-9) coding for overweight and obesity within a US primary care electronic health record (EHR) database compared against actual body mass index (BMI) values from recorded clinical patient data; characteristics of patients with obesity who did or did not receive ICD-9 codes for overweight/obesity also were evaluated. The study sample included 5,512,285 patients in the database with any BMI value recorded between January 1, 2014, and June 30, 2014. Based on BMI, 74.6% of patients were categorized as being overweight or obese, but only 15.1% of patients had relevant ICD-9 codes. ICD-9 coding prevalence increased with increasing BMI category. Among patients with obesity (BMI ≥30 kg/m2), those coded for obesity were younger, more often female, and had a greater comorbidity burden than those not coded; hypertension, dyslipidemia, type 2 diabetes mellitus, and gastroesophageal reflux disease were the most common comorbidities. Key findings: US outpatients with overweight or obesity are not being reliably coded, making ICD-9 codes undependable sources for determining obesity prevalence and outcomes. BMI data available within EHR databases offer a more accurate and objective means of classifying overweight/obese status.
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