Article
Health Care Sciences & Services
Mary Patzel, Chrystal Barnes, NithyaPriya Ramalingam, Rose Gunn, Erin S. Kenzie, Sarah S. Ono, Melinda M. Davis
Summary: The MISSION Act aimed to improve rural veteran access to care by expanding coverage for services in the community. However, this solution relies on clinics willing to navigate VA administrative processes, posing challenges and opportunities for high-quality, equitable care access and delivery.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Health Care Sciences & Services
Kate L. Sheahan, Karen M. Goldstein, Claire T. Than, Bevanne Bean-Mayberry, Catherine C. Chanfreau, Megan R. Gerber, Danielle E. Rose, Julian Brunner, Ismelda A. Canelo, Jill E. Darling Mshs, Sally Haskell, Alison B. Hamilton, Elizabeth M. Yano
Summary: The study surveyed 1,391 women Veterans who routinely use VA primary care, finding that they have significant multimorbid physical and mental health conditions and trauma histories, requiring continued investment in woman-centered primary care and emphasis on trauma-informed, age-specific care.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Computer Science, Information Systems
Brian E. Dixon, Kimberly M. Judon, Ashley L. Schwartzkopf, Vivian M. Guerrero, Nicholas S. Koufacos, Justine May, Cathy C. Schubert, Kenneth S. Boockvar
Summary: In older adult healthcare, the use of event notification service (ENS) alerts can increase the likelihood of timely follow-up after non-VA acute care encounters, but does not significantly affect 30-day readmission rates.
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
(2021)
Article
Health Care Sciences & Services
Erin M. Staab, Wen Wan, Amanda Campbell, Stacey Gedeon, Cynthia Schaefer, Michael T. Quinn, Neda Laiteerapong
Summary: The study found that PCPs who had access to behavioral health treatment plans, depression tracking systems, screening protocols, and an adequate number of psychiatrists were more confident in identifying and managing depression. However, there were disparities based on poverty and race that may affect PCPs' confidence levels.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Public, Environmental & Occupational Health
Linda Baier Manwell, Melissa McNeil, Megan R. Gerber, Samina Iqbal, Sarina Schrager, Catherine Staropoli, Roger Brown, Laure Veet, Sally Haskell, Patricia Hayes, Molly Carnes
Summary: The training program successfully improved primary care providers' comfort in providing care for women Veterans, empowering them to implement institutional changes and enhance their provision of care to women.
JOURNAL OF WOMENS HEALTH
(2022)
Article
Public, Environmental & Occupational Health
Jena Wallander Gemkow, David T. Liss, Ta-Yun Yang, Roxane Padilla, Patricia Lee King, Susan Pereyra, Stephanie Cox-Batson, Sandi Tenfelde, Lisa Masinter
Summary: This study found that postpartum patients at federally qualified health centers transitioned to primary care at low rates and insurance loss was identified as a significant barrier to care. Strategies to increase continuity, such as improving insurance access, should be studied further.
AMERICAN JOURNAL OF PREVENTIVE MEDICINE
(2022)
Article
Public, Environmental & Occupational Health
Hua Jin, Zhaoxin Wang, Leiyu Shi, Chen Chen, Yongyan Huo, Wuquan Huang, Yi Zhang, Yuan Lu, Xuhua Ge, Jianwei Shi, Dehua Yu
Summary: The study found that community health centers in Shanghai, China have provided better primary care experiences for patients with multimorbidity in certain quality domains, including first contact-utilization, accessibility, and ongoing care, but there is still room for improvement in care coordination and family-centeredness.
FRONTIERS IN PUBLIC HEALTH
(2021)
Article
Geriatrics & Gerontology
Samuel T. Edwards, Allison O'Neill, Meike Niederhausen, Apoorva Salvi, Avery Laliberte, Somnath Saha, Denise M. Hynes, Steven Pizer, Bruce Kinosian
Summary: Veterans Affairs home-based primary care provides comprehensive care for patients with complex chronic disease. This study examines the care trajectories of newly enrolled patients in VA HBPC, finding variable trajectories with overall reductions in acute care use and a majority of time spent in non-institutional settings.
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
(2023)
Article
Health Care Sciences & Services
Eliana Sullivan, Whitney E. Zahnd, Jane M. Zhu, Erin Kenzie, Mary Patzel, Melinda Davis
Summary: Based on the 2018 MISSION Act, rural veterans have less spatial access in terms of clinic number (supply) compared to urban veterans, but have more access when considering both clinic number and population size (supply and demand).
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Review
Health Care Sciences & Services
Jack Tsai, John Havlik, Benjamin A. Howell, Erin Johnson, David Rosenthal
Summary: This narrative review examined the impact of the HPACT model on the health and healthcare outcomes of homeless veterans. The review found that HPACT is associated with reductions in emergency department utilization and improvements in primary care utilization and patient engagement. However, the methodological rigor of the included studies was low.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Public, Environmental & Occupational Health
Saul J. Weiner, Alan Schwartz, Amy Binns-Calvey, Benjamin Kass, Timothy D. Underwood, Vincent Kane
Summary: The study utilized actors incognito portraying homeless veterans to identify barriers in accessing services at community-based organizations, leading to improved access to a range of services over the study period. This demonstrates the effectiveness of audit and feedback programs based on direct covert observation for vulnerable populations.
JOURNAL OF PUBLIC HEALTH
(2022)
Article
Public, Environmental & Occupational Health
Hui Sang, Claudia Gonzalez-Vallejo, Jing Zhao, Rui Long
Summary: In urban China, the utilization rate of community health centers (CHCs) remains low despite their potential benefits. A study in Shanghai found that while low cost did not strongly influence the choice of CHCs, factors such as older age, perceived susceptibility to common diseases, and benefits of individualized care greatly increased the likelihood of using primary care services. Conversely, perceived low competencies of medical personnel and outdated medical facilities had significant negative relationships with the intention of choosing CHCs.
HEALTH & SOCIAL CARE IN THE COMMUNITY
(2021)
Article
Social Sciences, Interdisciplinary
Sara E. Golden, Megan Lafferty, Anna Tyzik, Diana Govier, Jennifer Barton, Alan R. Teo, Samuel T. Edwards, Sarah S. Ono, Denise M. Hynes, Christopher G. Slatore
Summary: This study conducted interviews with clinicians and staff to evaluate their experiences with Veterans' decisions on healthcare and identify areas for improvement. Insufficient time and knowledge were found to be barriers to assisting Veterans in making decisions about community care. Concerns about quality of community care and lack of patient understanding also emerged. Clinicians need decision support that integrates informational needs, referral process clarity, and improved quality measurement and description methods. While new initiatives have been established, the rollout is complex and ongoing.
Article
Public, Environmental & Occupational Health
Aazam Hosseinnejad, Maryam Rassouli, Simin Jahani, Nasrin Elahi, Shahram Molavynejad
Summary: The aim of this study was to examine the stakeholders' perception of the requirements for establishing a position for community health nursing in the Iranian primary health care system. Through analysis of interviews, 6 main categories were identified, along with their strengths, weaknesses, opportunities, and threats. The findings suggest that implementing these strategies in accordance with the cultural context can help address challenges and promote the role of community health nursing in the health system.
FRONTIERS IN PUBLIC HEALTH
(2022)
Article
Health Care Sciences & Services
Mayuree Rao, Liberty Greene, Karin Nelson, Matthew L. L. Maciejewski, Donna M. M. Zulman
Summary: Social risks are associated with poorer health outcomes and may affect access to primary care services for patients with complex medical needs. Unemployment and low medical literacy are associated with fewer encounters with primary care teams, while low social support is associated with higher odds of social work encounters. However, utilization of social work services is low among patients with social risks, indicating a need to understand barriers to accessing these services.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)