Annals of family medicine
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Annals of family medicine · Jul 2020
Participation in the Comprehensive Primary Care Plus Initiative.
Comprehensive Primary Care Plus (CPC+) is the largest test of primary care payment and delivery reform. This program aims to strengthen primary care via enhanced and alternative payment, data feedback, learning, and health information technology support for practice transformation for more than 3,000 practices. We analyzed participation rates and how CPC+ practices differ from other primary care practices in CPC+ regions. ⋯ Participants in CPC+ are diverse but not representative of all primary care practices, underscoring the need to further engage practices that are small, independent, in rural areas, and lack experience with practice and payment transformation models, as well as the need to extrapolate evaluation results carefully.
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Annals of family medicine · Jul 2020
Redesigning Primary Care to Address the COVID-19 Pandemic in the Midst of the Pandemic.
During a pandemic, primary care is the first line of defense. It is able to reinforce public health messages, help patients manage at home, and identify those in need of hospital care. In response to the COVID-19 pandemic, primary care scrambled to rapidly transform itself and protect clinicians, staff, and patients while remaining connected to patients. ⋯ Throughout, practices bore tremendous financial burden, laying off staff or even closing at a time when most needed. Primary care must learn from this experience and be ready for the next pandemic. Policymakers and payers cannot fail primary care during their next time of need.
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Annals of family medicine · Jul 2020
ReviewUnderstanding Barriers to and Facilitators of Case Management in Primary Care: A Systematic Review and Thematic Synthesis.
Despite evidence on the benefits of case management for the care of patients with complex needs in primary care, implementing the program-necessary to achieve its benefits-has been challenging worldwide. Evidence on factors affecting implementation remains disparate. Accordingly, the objective of this systematic review was to identify barriers to and facilitators of case management, from the perspectives of health care professionals, in primary care settings around the world. ⋯ Our study's findings show that multiple factors influence case management implementation. These findings have implications for researchers, clinicians, and policy makers who strive to implement or reform case management programs in local or larger primary care settings.
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Annals of family medicine · Jul 2020
Multicenter StudyTransforming Primary Care for Lesbian, Gay, Bisexual, and Transgender People: A Collaborative Quality Improvement Initiative.
Lesbian, gay, bisexual, and transgender (LGBT) people experience multiple disparities in access to care and health outcomes. We developed a quality improvement initiative, Transforming Primary Care for LGBT People, to enhance the capacity of federally qualified health centers (FQHCs) to provide culturally affirming care for this population. ⋯ FQHCs participating in this initiative reported improved capacity to provide culturally affirming care and targeted screening for LGBT patients.
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Annals of family medicine · Jul 2020
Prevalence of Intimate Partner Violence and Beliefs About Partner Violence Screening Among Young Men.
Few clinical guidelines focus on how physicians can identify intimate partner violence (IPV) perpetration or victimization among male patients, and little is known of men's experiences and beliefs regarding screening in health care settings. Our objective was to determine prevalence of men's experiences with IPV screening in health care settings and associations with men's beliefs regarding health care clinician identification of IPV. ⋯ Among young US men, 9 in 10 support IPV identification by health care clinicians, nearly 1 in 5 report using IPV, but only about 1 in 10 report health care clinicians asking about IPV. These represent missed opportunities for health care IPV identification. Beliefs and experiences regarding health care IPV identification vary by race, education, and men's IPV perpetration and victimization. These disparities can inform tailored health care identification approaches.