Journal of general internal medicine
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Unless implementation of systematic depression screening is associated with timely treatment, quality measures based on screening are unlikely to improve outcomes. ⋯ Implementing systematic depression screening within a large health care system led to high rates of screening and increased rates of depression diagnosis and treatment.
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The Agency for Healthcare Research and Quality (AHRQ) could devote resources to collate and assess quality improvement studies to support learning health systems (LHS) but there is no reliable data on the consistency of data extraction for important criteria. ⋯ Creating explicit instructions for extracting data for quality improvement studies helps enhance the consistency of data extraction. This is important because it is difficult for LHS to vet these quality improvement studies on their own and they would value AHRQ's support in that regard.
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Several population health big data projects have been initiated in the USA recently. These include the County Health Rankings & Roadmaps (CHR) initiated in 2010, the 500 Cities Project initiated in 2016, and the City Health Dashboard project initiated in 2017. Such projects provide data on a range of factors that determine health-such as socioeconomic factors, behavioral factors, health care access, and environmental factors-either at the county or city level. ⋯ Census Bureau. This resulted in a large extent of similarity among different datasets and a potential waste of resources. This perspective article aims to elaborate on the diminishing returns of creating more population health datasets and propose potential ways to integrate with clinical care and research, driving insights bidirectionally, and utilizing advanced analytical tools to improve value in population health big data.
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The patient-centered medical home (PCMH) model aims to improve primary health care using a patient-centered approach. Little qualitative research has investigated how the PCMH model affects patient experience with care. ⋯ Most participants had positive experiences with their care. Opportunities exist, however, to improve care for Medicaid and dually eligible beneficiaries, and enhance patient awareness of and involvement in PCMH practice transformation.
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Understanding the impact of the COVID-19 pandemic on healthcare workers (HCW) is crucial. ⋯ In a large healthcare system, HCW had similar odds for testing SARS-CoV-2 positive, but lower odds of hospitalization compared to non-HCW. Patient-facing HCW had higher odds of a positive test. These results are key to understanding HCW risk mitigation during the COVID-19 pandemic.