Background: Little is known about the impact of accountable care organization (ACO) on US adults aged 18-64.
Objectives: To examine whether having a usual source of care (USC) provider participating in an ACO affects receipt of preventive care services, patient experiences, and health care expenditures among nonelderly Americans.
Research Design: A cross-sectional analysis of the 2015 Medical Organizations Survey linked with the Medical Expenditure Panel Survey.
Subjects: Survey respondents aged 18-64 with an identified USC and continuous health insurance coverage during 2015.
Measures: Preventative care services (routine checkup, flu vaccination, and cancer screening), patient experiences with health care (access to care, interaction quality with providers, and global satisfaction), and health care expenditures (total and out-of-pocket expenditures) for respondents with USC by ACO and non-ACO provider groups.
Results: Among 1563, nonelderly Americans having a USC, we found that nearly 62.7% [95% confidence interval (CI), 58.6%-66.7%; representing 15,722,208 Americans] were cared for by ACO providers. Our analysis showed no significant differences in preventive care services or patient experiences between ACO and non-ACO groups. Adjusted mean total health expenditures were slightly higher for the ACO than non-ACO group [$7016 (95% CI, $4949-$9914) vs. $6796 (95% CI, $4724-$9892)]; however, this difference was not statistically significant (P=0.250).
Conclusions: Our findings suggest that having a USC provider participating in an ACO is not associated with preventive care services use, patient experiences, or health care expenditures among a nonelderly population.
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http://dx.doi.org/10.1097/MLR.0000000000000935 | DOI Listing |
JMIR Res Protoc
January 2025
Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Background: To successfully design, develop, implement, and deliver digital health services that provide value, they should be cocreated with patients. However, occasionally, the value may also be codestructed. In the field of health care, the concepts of value cocreation and codestruction still need to be better established within emerging digital health services.
View Article and Find Full Text PDFJ Trauma Nurs
January 2025
Author Affiliations: Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal (Dr Mota); Health School, Polytechnic Institute of Viseu, Viseu, Portugal (Drs Mota, Santos, and Cunha); Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal (Drs Mota and Cunha); CINTESIS@RISE - Center for Health Technology and Services Research, University of Porto, Porto, Portugal (Drs Mota and Santos); Academic Clinical Centre of Beiras, Covilhã, Portugal (Drs Mota and Cunha); Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal (Drs Melo and Santos); Portugal Centre for Evidence-Based Practice: A Joanna Briggs Institute Centre of Excellence, Coimbra, Portugal (Dr Santos); Hospital São Teotónio, Tondela Viseu Hospital Centre, Viseu, Portugal (Dr Abrantes); Santa Casa da Misericórdia de Seia, Seia, Portugal (Dr Monteiro); and Nursing School of Porto, Porto, Portugal (Dr Santos).
Background: Spinal immobilization, a widely used trauma prehospital intervention, is known to cause discomfort, yet little is known about interventions to reduce this discomfort.
Objective: This scoping review aims to evaluate prehospital interventions to reduce discomfort from spinal immobilization in adult trauma patients.
Method: This scoping review assessed prehospital pharmacological and nonpharmacological interventions to address discomfort from spinal immobilization in adult trauma patients.
J Trauma Nurs
January 2025
Author Affiliations: Penn Medicine, Department of Advanced Practice & Trauma Surgical Critical Care (Dr Saucier), Biostatistics, Hearing, & Speech, Ingram Cancer Center, Vanderbilt University School of Medicine (Dr Dietrich), School of Nursing, Vanderbilt University (Drs Maxwell and Minnick), Nashville, Tennessee; David E. Longnecker Associate Professor of Anesthesiology and Critical Care (Dr Lane-Fall), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Surgical Service Line (Dr Messing), Inova Health System, Falls Church, Virginia.
Background: Patient transitions in critical care require coordination across provider roles and rely on the quality of providers' actions to ensure safety. Studying the behavior of providers who transition patients in critical care may guide future interventions that ultimately improve patient safety in this setting.
Objective: To establish the feasibility of using the Theory of Planned Behavior in a trauma environment and to describe provider behavior elements during trauma patient transfers (de-escalations) to non-critical care units.
J Trauma Nurs
January 2025
Author Affiliations: Trauma Prevention Program, UC Davis Medical Center, University of California Davis, Sacramento, California (Dr Adams); Department of Pediatrics, School of Medicine, University of California Davis, Sacramento, California (Dr Tancredi); Betty Irene Moore School of Nursing, University of California Davis, Sacramento, California (Drs Bell and Catz); and Division of General Internal Medicine, School of Medicine and Center for Healthcare Policy and Research, University of California Davis, Sacramento, California (Dr Romano).
Background: Acute care hospitalization has been associated with older adult home falls after discharge, but less is known about the effects of hospital- and patient-related factors on home fall risk.
Objectives: This study compares the effects of hospital length of stay, medical condition, history of falls, and home health care on period rates of home falls after discharge from acute care hospitalization.
Methods: This was a retrospective cohort study comparing period rates of home injury falls among older adults (age ≥ 65) occurring after discharge from an acute care hospitalization.
J Public Health Manag Pract
November 2024
Author Affiliations: Office of Epidemiology, Missouri Department of Health and Senior Services, Jefferson City, Missouri (Mr Quay, Ms Harbert, and Dr Garikapaty); and Bureau of Health Care Analysis and Data Dissemination, Missouri Department of Health and Senior Services, Jefferson City, Missouri (Mr Schramm).
There are multiple surveillance systems working to address the issue of maternal mortality in Missouri. These surveillance systems have key methodological differences in their definitions, terminology, inclusion criteria, and purpose. This study aims to provide an understanding of the practical effects of these programmatic differences regarding what cases are included and how this can impact the interpretations of the data and influence policy decisions.
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