The association between specific narrative elements and patient perspectives on acute pain treatment.

Background: Narratives are effective tools for communicating with patients about opioid prescribing for acute pain and improving patient satisfaction with pain management. It remains unclear, however, whether specific narrative elements may be particularly effective at influencing patient perspectives.

Methods: This study was a secondary analysis of data collected for Life STORRIED, a multicenter RCT.

Personalized risk communication and opioid prescribing in association with nonprescribed opioid use: A secondary analysis of a randomized controlled trial.

Background: To determine the impact of personalized risk communication and opioid prescribing on nonprescribed opioid use, we conducted a secondary analysis of randomized controlled trial participants followed prospectively for 90 days after an emergency department (ED) visit for acute back or kidney stone pain.

Methods: A total of 1301 individuals were randomized during an encounter at four academic EDs into a probabilistic risk tool (PRT) arm, a narrative-enhanced PRT arm, or a general risk information arm (control). In this secondary analysis, both risk tool arms were combined and compared with the control arm.

"Community engagement via restorative justice to build equity-oriented crisis standards of care".

The COVID-19 (SARS-CoV-2) Pandemic has revealed multiple structural inequities within the United States (US), with high social vulnerability index communities shouldering the brunt of death and disability of this pandemic. BIPOC/Latinx people have undergone hospitalizations and death at magnitudes greater than White people in the US. The untold second casualties are health care workers that are suffering from increased risk of infection, death, and mental health crisis.

A Multicentered Randomized Controlled Trial Comparing the Effectiveness of Pain Treatment Communication Tools in Emergency Department Patients With Back or Kidney Stone Pain.

To compare the effectiveness of 3 approaches for communicating opioid risk during an emergency department visit for a common painful condition. This parallel, multicenter randomized controlled trial was conducted at 6 geographically disparate emergency department sites in the United States. Participants included adult patients between 18 and 70 years of age presenting with kidney stone or musculoskeletal back pain.

Disparities in Primary Care Wait Times in Medicaid versus Commercial Insurance.

Background: Timely access to primary care is important, particularly among patients with acute conditions and patients seeking gateways to specialty care. Due to concerns that expanded Medicaid eligibility would compromise access to primary care among new Medicaid beneficiaries, an experimental study was conducted to test the ability to obtain timely appointments. Although access to primary care appointments for simulated Medicaid patients significantly increased, wait times also increased.

Stories to Communicate Individual Risk for Opioid Prescriptions for Back and Kidney Stone Pain: Protocol for the Life STORRIED Multicenter Randomized Clinical Trial.

Background: Prescription opioid misuse in the United States is a devastating public health crisis; many chronic opioid users were originally prescribed this class of medication for acute pain. Video narrative-enhanced risk communication may improve patient outcomes, such as knowledge of opioid risk and opioid use behaviors after an episode of acute pain.

Objective: Our objective is to assess the effect of probabilistic and narrative-enhanced opioid risk communication on patient-reported outcomes, including knowledge, opioid use, and patient preferences, for patients who present to emergency departments with back pain and kidney stone pain.

Video or Telephone? A Natural Experiment on the Added Value of Video Communication in Community Paramedic Responses.

Study Objective: The objective of this study was to determine the effect of video versus telephonic communication between community paramedics and online medical control physicians on odds of patient transport to a hospital emergency department (ED).

Methods: This was a retrospective analysis of data from a telemedicine-capable community paramedicine program operating within an advanced illness management program that provides home-based primary care to approximately 2,000 housebound patients per year who have advanced medical illness, multiple chronic conditions, activities of daily living dependencies, and past-year hospitalizations. Primary outcome was difference in odds of ED transport between community paramedicine responses with video communication versus those with telephonic communication.

Critical Care And Emergency Department Response At The Epicenter Of The COVID-19 Pandemic.

New York City has emerged as the global epicenter for the coronavirus disease 2019 (COVID-19) pandemic. The city's public health system, New York City Health + Hospitals, has been key to the city's response because its vulnerable patient population is disproportionately affected by the disease. As the number of cases rose in the city, NYC Health + Hospitals carried out plans to greatly expand critical care capacity.

Improving Psychiatric Access for Students in Crisis: An Alternative to the Emergency Department.

School behavioral health crisis referrals have emerged as a significant driver of avoidable emergency department (ED) visits. However, few resources exist to divert students to more appropriate settings. This article examines the effectiveness of an ambulatory behavioral health urgent care pilot project in reducing ED visits and improving collaborations with schools in the local community.

"We just get paid for 12 hours a day, but we work 24": home health aide restrictions and work related stress.

Background: Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research conducted regarding the effect of MLTC challenges on beneficiaries, the impact of MLTC regulatory changes on home health aides has not been explored.

Methods: Qualitative interviews were conducted with formal caregivers, defined as paid home health aides (HHAs) (n = 13) caring for patients in a home-based primary care program in the New York City metropolitan area.

Care Team Perspectives and Acceptance of Telehealth in Scaling a Home-Based Primary Care Program: Qualitative Study.

Background: Novel and sustainable approaches to optimizing home-based primary care (HBPC) programs are needed to meet the medical needs of a growing number of homebound older adults in the United States. Telehealth may be a viable option for scaling HBPC programs.

Objective: The purpose of this qualitative study was to gain insight into the perspectives of HBPC staff regarding adopting telehealth technology to increase the reach of HBPC to more homebound patients.

Coercive Control in Intimate Partner Violence: Relationship with Women's Experience of Violence, Use of Violence, and Danger.

Objective: The objective of this study was to better understand the experience of coercive control as a type of IPV by examining associations between coercive control and women's experiences of particular forms of violence, use of violence, and risk of future violence.

Method: As part of a larger research study, data were collected from 553 women patients at two hospital emergency departments who had experienced recent IPV and unhealthy drinking. Baseline assessments, including measures of coercive control, danger, and experience and use of psychological, physical, and sexual forms of IPV in the prior three months were analyzed.

Changes in primary care access at community health centers between 2012/2013 and 2016.

Objective: To compare access at community health centers (CHCs) vs private offices (non-CHCs) under the Affordable Care Act.

Data Source: Ten state primary care audit conducted in 2012/2013 and 2016.

Study Design: CHCs and non-CHCs were called.

"It's Really Overwhelming": Patient Perspectives on Care Coordination.

Purpose: Failures of care coordination among health care providers are known to lead to poorer health outcomes for patients with complex medical needs. However, there has been limited research into the perspectives of patients who receive care from a variety of health care providers. This qualitative study sought to characterize the factors leading to emergency department (ED) patient satisfaction and dissatisfaction with their care coordination.

Impact of a medical home model on costs and utilization among comorbid HIV-positive Medicaid patients.

Objectives: The Pennsylvania Chronic Care Initiative (CCI) was a statewide patient-centered medical home (PCMH) initiative implemented from 2008 to 2011. This study examined whether the CCI affected utilization and costs for HIV-positive Medicaid patients with both medical and behavioral health comorbidities.

Study Design: Nonrandomized comparison of 302 HIV-positive Medicaid patients treated in 137 CCI practices and 2577 HIV-positive Medicaid patients treated elsewhere.

Acuity-based Scheduling in Primary Care.

Objectives: Triage algorithms are ubiquitous in emergency care settings, but the extent of their use in primary care is unknown. This study asks whether primary care practices prioritize patients with more acute service needs.

Methods: We used an audit study in which simulated patients were randomized to 2 clinical scenarios-a new patient seeking a routine check-up or a new patient seeking treatment for newly diagnosed hypertension-and attempted to schedule appointments with thousands of randomly selected primary care physicians across 10 states.

Most Primary Care Physicians Provide Appointments, But Affordability Remains A Barrier For The Uninsured.

The US uninsurance rate has nearly been cut in half under the Affordable Care Act, and access to care has improved for the newly insured, but less is known about how the remaining uninsured have fared. In 2012-13 and again in 2016 we conducted an experiment in which trained auditors called primary care offices, including federally qualified health centers, in ten states. The auditors portrayed uninsured patients seeking appointments and information on the cost of care and payment arrangements.

National disparities in treatment package time for resected locally advanced head and neck cancer and impact on overall survival.

Background: The purpose of this study was to determine national disparities in head and neck cancer treatment package time (the time interval from surgery through the completion of radiation) and the associated impact on survival.

Methods: We conducted an observational cohort study using the National Cancer Database of 15 234 patients with resected head and neck cancer who underwent adjuvant radiotherapy from 2004-2012. Predictors of prolonged package time were identified by multivariable linear regression.