Development of a survey instrument to measure patient experience of integrated care.

Background: Healthcare systems are working to move towards more integrated, patient-centered care. This study describes the development and testing of a multidimensional self-report measure of patients' experiences of integrated care.

Methods: Random-digit-dial telephone survey in 2012 of 317 adults aged 40 years or older in the San Francisco region who had used healthcare at least twice in the past 12 months.

Patient and clinician views on comparative effectiveness research and engagement in research.

Aims: Describe and compare patient and primary care clinician attitudes about comparative effectiveness research (CER) and inclusion of patients and clinicians as partners in clinical research.

Materials & Methods: Online survey of patients (n = 900) and primary care clinicians (n = 750) from opt-in survey panels.

Results: Nearly half (45%) of clinicians were not familiar with CER, but after reviewing a definition of CER, most (76%) agreed that it can improve patient care.

Patient perceptions of integrated care: confused by the term, clear on the concept.

Purpose: Health care reform in the US has introduced terms such as 'the patient-centered medical home' and 'integrated care' that are often unclear and unfamiliar to patients. This study explored patient experiences with the functional domains of integrated care.

Theory And Methods: Patients first wrote their definitions of integrated care and then participated in focus group discussions about their experiences with the health care system.

How the Patient-Centered Outcomes Research Institute is engaging patients and others in shaping its research agenda.

Clinical research has been driven traditionally by investigators, from generating research questions and outcomes through analysis and release of study results. Building on the work of others, the Patient-Centered Outcomes Research Institute (PCORI) is tapping into its broad-based stakeholder community--especially patients, caregivers, and their clinicians--to generate topics for research, help the institute prioritize those topics, select topics for funding, and ensure patients' involvement in the design of research projects. This article describes PCORI's approach, which is emblematic of the organization's mandate under the Affordable Care Act to seek meaningful ways to integrate the patient's voice into the research process, and describes how it is being used in selection of research that PCORI will fund.

The association among specialty, race, ethnicity, and practice location among California physicians in diverse specialties.

Background: Minority physicians are more likely than their counterparts to work in underserved communities and care for minority, poor, and uninsured patients, but much of this research has examined primary care physicians alone. Few have investigated whether non-primary care specialists of minority backgrounds are more likely to serve the underserved than nonminority specialists.

Objective: We examined whether underrepresented minority (URM) physicians from a wide variety of specialties are more likely than non-URM physicians to practice in underserved communities.

Effect of closure of a local safety-net hospital on primary care physicians' perceptions of their role in patient care.

PURPOSE We examined how the closure of a large safety-net hospital in Los Angeles County, California, affected local primary care physicians. METHODS We conducted semistructured interviews with 42 primary care physicians who practiced in both underserved and nonunderserved settings in Los Angeles County. Two investigators independently reviewed and coded transcripts.

Increased patient delays in care after the closure of Martin Luther King Hospital: implications for monitoring health system changes.

Background: The safety net system remains an important part of the health care system for uninsured and minority populations, however, the closure of safety net hospitals changes the availability of care. Using community-based participatory research methods, we explored the impact of hospital closure among late middle aged and elderly racial/ethnic minorities in South Los Angeles.

Methods: Telephone survey of participants in both 2008, after hospital closure, and 2003, before hospital closure, who self-identified as African American or Latino, were over the age of 50 and lived in zip codes of South Los Angeles.

The vulnerability of middle-aged and older adults in a multiethnic, low-income area: contributions of age, ethnicity, and health insurance.

This community-partnered study was developed and fielded in partnership with key community stakeholders and describes age- and race-related variation in delays in care and preventive service utilization between middle-aged and older adults living in South Los Angeles. The survey sample included adults aged 50 and older who self-identified as African American or Latino and lived in ZIP codes of South Los Angeles (N=708). Dependent variables were self-reported delays in care and use of preventive services.

Do physicians with self-reported non-English fluency practice in linguistically disadvantaged communities?

Background: Language concordance between physicians and patients may reduce barriers to care faced by patients with limited English proficiency (LEP). It is unclear whether physicians with fluency in non-English languages practice in areas with high concentrations of people with LEP.

Objective: To investigate whether physician non-English language fluency is associated with practicing in areas with high concentrations of people with LEP.

Recruiting and retaining primary care physicians in urban underserved communities: the importance of having a mission to serve.

Objectives: We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas.

Methods: We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, stratified by race/ethnicity (African American, Latino, and non-Latino White) and practice location (underserved vs nonunderserved area). We reviewed transcriptions and coded them into themes by using standard qualitative methods.

Self-reported fluency in non-english languages among physicians practicing in California.

Background And Objectives: With increasing numbers of people with limited English proficiency in the United States, there is growing concern about the potential adverse effect of language barriers on patient care. We sought to compare the non-English language fluency of practicing physicians by physician race/ethnicity and location of medical school education.

Methods: We used cross-sectional analyses of California Medical Board Survey (2007) data of 61,138 practicing physicians.

The impact of public hospital closure on medical and residency education: implications and recommendations.

Background: Challenges around safety-net hospital closure have impacted medical student and resident exposure to urban public healthcare sites that may influence their future practice choices.

Objective: To assess the impact of the closure of a public safety-net teaching hospital for the clinical medical education of Charles Drew University medical students and residents.

Method: Retrospective cohort study of medical students' and residents' and clinical placement into safety-net experiences after the closure of the primary teaching hospital.