The American journal of managed care
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The introduction of the American physician assistant/associate (PA) was predicated on the belief that the nation's health care needs had outpaced the supply of physicians. The notion that the medical experience of veterans could be utilized in the civilian sector was at the forefront of discussion. From 1965 to the third decade of the new century, the PA has become established in this role and has become an integrated part of society. ⋯ In 2021, at least 11,000 PAs graduated from 277 accredited programs. This graduation rate is increasing, with 20 more programs in development. Predictive modeling by the Bureau of Labor Statistics suggests that the employment growth of PAs will continue beyond 2030.
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HealthPartners developed a checklist, the School Environment Index (SEI), that it uses to help elementary schools identify opportunities to improve student nutrition and increase physical activity. The objective in this pilot study was to assess whether the SEI, as administered, can be used to measure the progress of these programs. ⋯ The SEI shows adequate internal consistency and sensitivity to change in this pilot evaluation. It is also feasible and useful to identify opportunities to improve practices and policies related to student nutrition and physical activity in partnership with the participating elementary schools. However, it lacks reliability as used. Increasing the number of respondents per school might moderate the impact of individual respondents and thereby increase reliability.
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Therapeutic/clinical inertia is thought to be responsible for up to 80% of cardiovascular events. This study was conducted as a comprehensive scoping and bibliometric analysis of peer-reviewed scholarly documents reporting on factors associated with therapeutic/clinical inertia in caring for patients with hypertension. Additionally, this study identified the factors associated with therapeutic/clinical inertia in hypertension. ⋯ This scoping and bibliometric study provides insights into the width and depth of scholarly peer-reviewed documents on factors associated with therapeutic/clinical inertia in caring for patients with hypertension. Findings of this study could be helpful in shaping future directions of research into therapeutic/clinical inertia in hypertension.
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We evaluated the effects of acquiring a flash continuous glucose monitoring (CGM) system in the population with type 2 diabetes (T2D) treated with basal or noninsulin therapy. ⋯ Acquisition of the flash CGM system was associated with significant reductions in outpatient and inpatient ADEs and ACHs. These findings provide compelling evidence that use of flash CGM in patients with T2D treated with basal insulin therapy or noninsulin therapy improves clinical outcomes and potentially reduces costs.
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In April 2018, CMS began reimbursing both clinical and community settings for providing the CDC-recognized Diabetes Prevention Program (DPP) to eligible Medicare beneficiaries. To better understand the process of offering the program to Medicare beneficiaries, we interviewed relevant stakeholders in a large, integrated health care delivery system. ⋯ Although the reimbursement of DPP for Medicare beneficiaries was a landmark decision, the current structure and requirements make it difficult for health systems and community-based providers to implement and promote this benefit. This study highlights the challenges that even integrated health systems are facing to implement MDPP, as well as potential strategies to overcome these barriers and expand the reach of the program. Medicare should seek ways to increase the financial incentives and decrease the barriers associated with implementing MDPP.