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Organizational Determinants to Hypertension Management: Adapting a Health Equity Framework to Examine Processes at Two Academic Health Systems.
J Gen Intern Med
January 2025
Center for Health System Sciences, Atrium Health, Charlotte, NC, USA.
Background: Hypertension management is a national priority. However, hypertension control rates are suboptimal and vary across clinics, even among those in the same health system and geographic region.
Objective: To identify organizational barriers and facilitators that impact hypertension management at the provider, clinic, and health system level.
Acceptability of the Fit2ThriveMB mHealth physical activity promotion intervention in women with metastatic breast cancer.
Support Care Cancer
January 2025
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA.
Purpose: Increasing physical activity (PA) is safe and associated with improved health outcomes in patients with metastatic breast cancer (MBC). Mobile health (mHealth) PA interventions that allow for remote monitoring and tailoring to abilities may be particularly useful for MBC patients. However, limited data exist on the acceptability of these interventions for MBC patients.
View Article and Find Full Text PDFBackground: Cork University Hospital, Ireland's largest teaching hospital, faced challenges in maintaining consistent handover processes in its Acute Mental Health Unit (AMHU). Prior to 2019, handovers relied on informal methods, risking information loss and compromising patient care. This quality improvement (QI) initiative aimed to standardise handover practices using an electronic tool integrated with the ISBAR communication protocol.
View Article and Find Full Text PDFUse Of Patient Health Survey Data For Risk Adjustment To Limit Distortionary Coding Incentives In Medicare.
Health Aff (Millwood)
January 2025
Michael E. Chernew, Harvard University.
A core problem with the current risk-adjustment system in Medicare Advantage and accountable care organization (ACO) programs-the Hierarchical Condition Categories (HCC) model-is that the inputs (coded diagnoses) can be influenced for gain by risk-bearing plans or providers. Using existing survey data on health status (which provide less manipulable inputs), we found that the use of a hybrid risk score drawing from survey data and a scaled-back set of HCCs would, in addition to mitigating coding incentives, modestly lessen risk-selection incentives, strengthen payment incentives to deliver efficient care, allocate payment across ACOs more efficiently according to markers of population health that are not as affected by practice patterns or coding efforts, and redistribute payment in a manner that supports equity goals. Although sampling error and survey nonresponse present challenges, analyses suggest that these should not be prohibitive.
View Article and Find Full Text PDFThe purpose of this research is to describe the factors affecting hazardous chemotherapy exposure and strategies to foster chemotherapy safety among oncology nurses. Fifteen oncology nurses and 5 oncology nurse managers were recruited from 2 medical centers in the Midwest United States through convenience purposive sampling. A qualitative descriptive approach was employed.
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