These recent journal articles, selected by our team of researchers, highlight important issues related to socioeconomic status, medical homes, health equity, and population health.
Socioeconomic Status (SES)
Patient-Centered Community Health Worker Intervention to Improve Posthospital Outcomes: A Randomized Clinical Trial JAMA Internal Medicine (subscription required)
Sociodemographic factors and socioeconomic status can influence health outcomes, but hospital personnel often lack the time, skills, and knowledge of the community to address these factors. In a randomized trial, researchers sought to determine whether a targeted community health worker intervention would improve posthospital outcomes for patients with low socioeconomic status. The study found that the intervention improved access to primary care and quality of discharge and controlled recurrent readmissions in a high-risk population.
For more on SES, check out this extensive list of resources collected by our staff.
Total Cost of Care Lower among Medicare Fee-for-Service Beneficiaries Receiving Care from Patient-Centered Medical Homes Health Services Research (subscription required)
In 2008, the National Committee for Quality Assurance (NCQA) developed a program for formally recognizing medical practices as primary care medical homes (PCMHs), but there is limited evidence about the effectiveness of the PCMH model. Researchers studied several data sources, including Medicare part A and B files, census data, and Medicare’s enrollment database, to compare health care utilization and payments between practices with PCMH recognition and those without the recognition. The study, published in Health Services Research, found that total Medicare payments, acute care payments, and the number of emergency department visits declined after practices received NCQA PCMH recognition.
America’s Essential Hospitals member Cambridge Health Alliance established an accountable care organization after the passage of health care reform in Massachusetts. This case study, published by The Commonwealth Fund, explores the successes and challenges of the hospital’s strategies.
Introducing Sexual Orientation and Gender Identity into the Electronic Health Record: One Academic Health Center’s Experience Academic Medicine
In a step to reduce lesbian, gay, bisexual, and transgender health disparities, the University of California, Davis Health System became the first U.S. academic health center to formally introduce patient sexual orientation and gender identity data into its electronic health record. This study, published in the August edition of Academic Medicine, describes the steps the system took to implement an institutional culture change.
Trends in Cancer Screening by Citizenship and Health Insurance, 2000 – 2010 Journal of Immigrant and Minority Health (subscription required)
Early detection screenings for breast, cervical, and colorectal cancer are essential for improving the odds of cancer survival, but they are not evenly used across class, race, ethnicity, or nativity lines. Immigrants, who have lower rates of health insurance coverage, are often at a disadvantage for being screened. This study, published in the Journal of Immigrant and Minority Health, found higher screening rates among citizens compared to noncitizens and also found that uninsured noncitizens sometimes have higher screening rates than uninsured natives. Researchers suggested that policies to reduce disparities in cancer screening take into account nativity, citizenship, and access to health insurance.
What Can Providers Learn from Childhood Body Mass Index Trajectories: A Study of a Large, Safety Net Clinical Population Academic Pediatrics (subscription required)
Though recent national data and local studies show a plateau or decrease in childhood obesity rates, Colorado was one of three states where obesity among low-income preschoolers increased between 2008 and 2011. In a retrospective cohort study, researchers studied data for children seen at Denver Health outpatient clinics between 2006 and 2013. The study found that the entire population showed increasing average body mass index scores and that many obese children were already obese by age 3. In the results, published in Academic Pediatrics, researchers suggest that intervention before age 3 may be essential to curbing childhood obesity.