LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 34

Search options

  1. Article ; Online: Interaction between Legal and Social Needs in Their Association with Self-rated Health in a National Sample of Veterans.

    Griesemer, Ida / Li, Mingfei / Tsai, Jack / Harvey, Kimberly / Hausmann, Leslie R M / Linsky, Amy M / Mohr, David C / Gurewich, Deborah

    Journal of health care for the poor and underserved

    2024  Volume 34, Issue 4, Page(s) 1221–1233

    Abstract: Many health-related social needs, such as financial insecurity, are interconnected with legal needs. However, little is known about which social needs are more likely to be associated with legal needs, or whether legal and other needs interact to affect ... ...

    Abstract Many health-related social needs, such as financial insecurity, are interconnected with legal needs. However, little is known about which social needs are more likely to be associated with legal needs, or whether legal and other needs interact to affect health. Using data from a 2020 national mailed survey assessing social needs among Veterans who had or were at risk for cardiovascular disease (N=2,801) and linked administrative data, linear regression models tested interactions between legal and other social needs, and their associations with self-rated health. In a model examining the interaction of financial and legal needs, experiencing financial but not legal needs was as strongly associated with worse health (b=-0.58, 95% CI -0.69, -0.46) as experiencing both financial and legal needs (b= -0.55, 95% CI -0.70, -0.40). Financial needs are important to Veterans' health and further research is needed to determine how financial and legal needs should be triaged by providers.
    MeSH term(s) Humans ; Male ; Female ; Middle Aged ; United States ; Veterans/statistics & numerical data ; Veterans/psychology ; Aged ; Health Status ; Adult ; Cardiovascular Diseases/epidemiology ; Self Report
    Language English
    Publishing date 2024-04-25
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1142637-8
    ISSN 1548-6869 ; 1049-2089
    ISSN (online) 1548-6869
    ISSN 1049-2089
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 3605: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 493: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Disparities in Wait Times for Care Among US Veterans by Race and Ethnicity.

    Gurewich, Deborah / Beilstein-Wedel, Erin / Shwartz, Michael / Davila, Heather / Rosen, Amy K

    JAMA network open

    2023  Volume 6, Issue 1, Page(s) e2252061

    Abstract: Importance: Prior studies indicate that Black and Hispanic vs White veterans wait longer for care. However, these studies do not capture the COVID-19 pandemic, which caused care access disruptions, nor implementation of the US Department of Veterans ... ...

    Abstract Importance: Prior studies indicate that Black and Hispanic vs White veterans wait longer for care. However, these studies do not capture the COVID-19 pandemic, which caused care access disruptions, nor implementation of the US Department of Veterans Affairs (VA) Maintaining Internal Systems and Strengthening Integrated Outside Networks Act (MISSION), which is intended to improve care access by increasing veterans' options to use community clinicians.
    Objective: To determine whether wait times increased differentially for Black and Hispanic compared with White veterans from the pre-COVID-19 to COVID-19 periods given concurrent MISSION implementation.
    Design, setting, and participants: This cross-sectional study used data from the VA's Corporate Data Warehouse for fiscal years 2019 to 2021 (October 1, 2018, to September 30, 2021). Participants included Black, Hispanic, and White veterans with a new consultation for outpatient cardiology and/or orthopedic services during the study period. Multivariable mixed-effects models were used to estimate individual-level adjusted wait times and a likelihood ratio test of the significance of wait time disparity change over time.
    Main outcomes and measures: Overall mean wait times and facility-level adjusted relative mean wait time ratios.
    Results: The study included 1 162 148 veterans (mean [SD] age, 63.4 [14.4] years; 80.8% men). Significant wait time disparities were evident for orthopedic services (eg, Black veterans had wait times 2.09 [95% CI, 1.57-2.61] days longer than those for White veterans) in the pre-COVID-19 period, but not for cardiology services. Mean wait times increased from the pre-COVID-19 to COVID-19 periods for both services for all 3 racial and ethnic groups (eg, Hispanic wait times for cardiology services increased 5.09 [95% CI, 3.62-6.55] days). Wait time disparities for Black veterans (4.10 [95% CI, 2.44-5.19] days) and Hispanic veterans (4.40 [95% CI, 2.76-6.05] days) vs White veterans (3.75 [95% CI, 2.30-5.19] days) increased significantly from the pre-COVID-19 to COVID-19 periods (P < .001). During the COVID-19 period, significant disparities were evident for orthopedic services (eg, mean wait times for Hispanic vs White veterans were 1.98 [95% CI, 1.32-2.64] days longer) but not for cardiology services. Although there was variation in wait time ratios across the 140 facilities, only 6 facility wait time ratios were significant during the pre-COVID-19 period and 26 during the COVID-19 period.
    Conclusions and relevance: These findings suggest that wait time disparities increased from the pre-COVID-19 to COVID-19 periods, especially for orthopedic services for both Black and Hispanic veterans, despite MISSION's goal to improve access. Facility-level analyses identified potential sites that could be targeted to reduce disparities.
    MeSH term(s) Male ; Humans ; Middle Aged ; Female ; Ethnicity ; Waiting Lists ; Veterans ; Cross-Sectional Studies ; Pandemics ; COVID-19
    Language English
    Publishing date 2023-01-03
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.52061
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  3. Article ; Online: Using the Kitagawa Decomposition to Measure Overall-and Individual Facility Contributions to-Within-facility and Between-facility Differences: Analyzing Racial and Ethnic Wait Time Disparities in the Veterans Health Administration.

    Shwartz, Michael / Rosen, Amy K / Beilstein-Wedel, Erin / Davila, Heather / Harris, Alex Hs / Gurewich, Deborah

    Medical care

    2023  Volume 61, Issue 6, Page(s) 392–399

    Abstract: Background: Identifying whether differences in health care disparities are due to within-facility or between-facility differences is key to disparity reductions. The Kitagawa decomposition divides the difference between 2 means into within-facility ... ...

    Abstract Background: Identifying whether differences in health care disparities are due to within-facility or between-facility differences is key to disparity reductions. The Kitagawa decomposition divides the difference between 2 means into within-facility differences and between-facility differences that are measured on the same scale as the original disparity. It also enables the identification of facilities that contribute most to within-facility differences (based on facility-level disparities and the proportion of patient population served) and between-facility differences.
    Objectives: Illustrate the value of a 2-stage Kitagawa decomposition to partition a disparity into within-facility and between-facility differences and to measure the contribution of individual facilities to each type of difference.
    Subjects: Veterans receiving a new outpatient consult for cardiology or orthopedic services during fiscal years 2019-2021.
    Measures: Wait time for a new-patient consult.
    Methods: In stage 1, we predicted wait time for each Veteran from a multivariable model; in stage 2, we aggregated individual predictions to determine mean adjusted wait times for Hispanic, Black, and White Veterans and then decomposed differences in wait times between White Veterans and each of the other groups.
    Results: Noticeably longer wait times were experienced by Hispanic Veterans for cardiology (2.32 d, 6.8% longer) and Black Veterans for orthopedics (3.49 d, 10.3% longer) in both cases due entirely to within-facility differences. The results for Hispanic Veterans using orthopedics illustrate how positive within-facility differences (0.57 d) can be offset by negative between-facility differences (-0.34 d), resulting in a smaller overall disparity (0.23 d). Selecting 10 facilities for interventions in orthopedics based on the largest contributions to within-in facility differences instead of the largest disparities resulted in a higher percentage of Veterans impacted (31% and 12% of Black and White Veterans, respectively, versus 9% and 10% of Black and White Veterans, respectively) and explained 21% of the overall within-facility difference versus 11%.
    Conclusions: The Kitagawa approach allows the identification of disparities that might otherwise be undetected. It also allows the targeting of interventions at those facilities where improvements will have the largest impact on the overall disparity.
    MeSH term(s) Humans ; Black or African American ; Healthcare Disparities ; Racial Groups ; United States ; Veterans ; Veterans Health ; Waiting Lists ; White ; Hispanic or Latino
    Language English
    Publishing date 2023-04-17
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 411646-x
    ISSN 1537-1948 ; 0025-7079
    ISSN (online) 1537-1948
    ISSN 0025-7079
    DOI 10.1097/MLR.0000000000001849
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.B 518: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 63: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article ; Online: Addressing Social Determinants of Health Within Healthcare Delivery Systems: a Framework to Ground and Inform Health Outcomes.

    Gurewich, Deborah / Garg, Arvin / Kressin, Nancy R

    Journal of general internal medicine

    2020  Volume 35, Issue 5, Page(s) 1571–1575

    Abstract: Social determinants of health (SDoH) are the conditions in which people live and work that shape access to essential social and economic resources. Calls for healthcare systems to intervene on unmet social needs have stimulated several large-scale ... ...

    Abstract Social determinants of health (SDoH) are the conditions in which people live and work that shape access to essential social and economic resources. Calls for healthcare systems to intervene on unmet social needs have stimulated several large-scale initiatives across the country. Yet, such activities are underway in the absence of a unifying conceptual framework outlining the potential mechanisms by which healthcare-based unmet social need interventions can improve health outcomes. Drawing on theoretical foundations and empirical evidence about the relationship between unmet social needs and health, the authors developed the OASIS (Outcomes from Addressing SDoH in Systems) conceptual framework to map the known and hypothesized pathways by which unmet social need screening and referral interventions may impact outcomes. The OASIS framework may help guide policy makers, healthcare system leaders, clinicians, and researchers to utilize a more unified approach in their efforts to implement and evaluate unmet social need interventions and thus foster the development of an evidence base to inform healthcare systems to more effectively mitigate the consequences of unmet social needs. Adopting an overarching conceptual framework for addressing unmet social needs by healthcare systems holds promise for better achieving health equity and promoting health at the individual and population levels.
    MeSH term(s) Delivery of Health Care ; Health Equity ; Humans ; Outcome Assessment, Health Care ; Social Determinants of Health
    Language English
    Publishing date 2020-02-19
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 639008-0
    ISSN 1525-1497 ; 0884-8734
    ISSN (online) 1525-1497
    ISSN 0884-8734
    DOI 10.1007/s11606-020-05720-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 2205: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article ; Online: Medicaid Expansion and Change in Federally Qualified Health Center Accessibility From 2008 to 2016.

    Evans, Leigh / Fabian, M Patricia / Charns, Martin P / Gurewich, Deborah / Stopka, Thomas J / Cabral, Howard J

    Medical care

    2022  Volume 60, Issue 10, Page(s) 743–749

    Abstract: Background: The Affordable Care Act expanded health coverage for low-income residents through Medicaid expansion and increased funding for Health Center Program New Access Points from 2009 to 2015, improving federally qualified health center (FQHC) ... ...

    Abstract Background: The Affordable Care Act expanded health coverage for low-income residents through Medicaid expansion and increased funding for Health Center Program New Access Points from 2009 to 2015, improving federally qualified health center (FQHC) accessibility. The extent to which these provisions progressed synergistically as intended when states could opt out of Medicaid expansion is unknown.
    Objective: To compare change in FQHC accessibility among census tracts in Medicaid expansion and nonexpansion states.
    Research design: Tract-level FQHC accessibility scores for 2008 and 2016 were estimated applying the 2-step floating catchment area method to American Community Survey and Health Resources and Services Administration data. Multivariable linear regression compared changes in FQHC accessibility between tracts in Medicaid expansion and nonexpansion states, adjusting for sociodemographic and health system factors and accounting for state-level clustering.
    Subjects: In total, 7058 census tracts across 10 states.
    Results: FQHC accessibility increased comparably among tracts in Medicaid expansion and nonexpansion states (coef: 0.3; 95% CI: -0.3, 0.8; P -value: 0.36). FQHC accessibility increased more in tracts with higher poverty and uninsured rates, and those with lower proportions of non-English speakers and Black or African American residents.
    Conclusion: Similar gains in FQHC accessibility across Medicaid expansion and nonexpansion states indicate improvements progressed independently from Medicaid expansion, rather than synergistically as expected. Accessibility increases appeared consistent with HRSA's goal to improve access for individuals experiencing economic barriers to health care but not for those experiencing cultural or language barriers to health care.
    MeSH term(s) Health Services Accessibility ; Humans ; Insurance Coverage ; Insurance, Health ; Medicaid ; Medically Uninsured ; Patient Protection and Affordable Care Act ; United States
    Language English
    Publishing date 2022-08-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 411646-x
    ISSN 1537-1948 ; 0025-7079
    ISSN (online) 1537-1948
    ISSN 0025-7079
    DOI 10.1097/MLR.0000000000001762
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.B 518: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 63: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article ; Online: Relationship Between Unmet Social Needs and Care Access in a Veteran Cohort.

    Gurewich, Deborah / Linsky, Amy M / Harvey, Kimberly L / Li, Mingfei / Griesemer, Ida / MacLaren, Risette Z / Ostrow, Rory / Mohr, David

    Journal of general internal medicine

    2023  Volume 38, Issue Suppl 3, Page(s) 841–848

    Abstract: Background: The association between unmet social needs (e.g., food insecurity) and adverse health outcomes is well-established, especially for patients with and at risk for cardiovascular disease (CVD). This has motivated healthcare systems to focus on ... ...

    Abstract Background: The association between unmet social needs (e.g., food insecurity) and adverse health outcomes is well-established, especially for patients with and at risk for cardiovascular disease (CVD). This has motivated healthcare systems to focus on unmet social needs. Yet, little is known about the mechanisms by which unmet social needs impact health, which limits healthcare-based intervention design and evaluation. One conceptual framework posits that unmet social needs may impact health by limiting care access, but this remains understudied.
    Objective: Examine the relationship between unmet social needs and care access.
    Design: Cross-sectional study design using survey data on unmet needs merged with administrative data from the Veterans Health Administration (VA) Corporate Data Warehouse (September 2019-March 2021) and multivariable models to predict care access outcomes. Pooled and separate rural and urban logistic regression models were utilized with adjustments from sociodemographics, region, and comorbidity.
    Subjects: A national stratified random sample of VA-enrolled Veterans with and at risk for CVD who responded to the survey.
    Main measures: No-show appointments were defined dichotomously as patients with one or more missed outpatient visits. Medication non-adherence was measured as proportion of days covered and defined dichotomously as adherence less than 80%.
    Key results: Greater burden of unmet social needs was associated with significantly higher odds of no-show appointments (OR = 3.27, 95% CI = 2.43, 4.39) and medication non-adherence (OR = 1.59, 95% CI = 1.19, 2.13), with similar associations observed for rural and urban Veterans. Social disconnection and legal needs were especially strong predictors of care access measures.
    Conclusions: Findings suggest that unmet social needs may adversely impact care access. Findings also point to specific unmet social needs that may be especially impactful and thus might be prioritized for interventions, in particular social disconnection and legal needs.
    MeSH term(s) Humans ; Veterans ; Health Services Accessibility ; Cross-Sectional Studies ; Surveys and Questionnaires ; Cardiovascular Diseases
    Language English
    Publishing date 2023-06-20
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 639008-0
    ISSN 1525-1497 ; 0884-8734
    ISSN (online) 1525-1497
    ISSN 0884-8734
    DOI 10.1007/s11606-023-08117-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 2205: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  7. Article ; Online: Integrating Measures of Social Determinants of Health Into Health Care Encounters: Opportunities and Challenges.

    Clark, Melissa A / Gurewich, Deborah

    Medical care

    2017  Volume 55, Issue 9, Page(s) 807–809

    MeSH term(s) Social Determinants of Health
    Language English
    Publishing date 2017-07-31
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 411646-x
    ISSN 1537-1948 ; 0025-7079
    ISSN (online) 1537-1948
    ISSN 0025-7079
    DOI 10.1097/MLR.0000000000000788
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.B 518: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 63: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  8. Article ; Online: Prevalence and Determinants of Unmet Social Needs Among Rural and Urban Veterans.

    Gurewich, Deborah / Shoushtari, Sara I / Ostrow, Rory / MacLaren, Risette Z / Li, Mingfei / Harvey, Kimberly / Linsky, Amy / Mohr, David

    Journal of health care for the poor and underserved

    2023  Volume 34, Issue 1, Page(s) 275–292

    Abstract: Purpose: To examine the prevalence and determinants of nine unmet social needs among rural compared with urban Veterans.: Methods: Retrospective study using survey data collected in 2020 merged with Veterans Health Administration (VA) administrative ... ...

    Abstract Purpose: To examine the prevalence and determinants of nine unmet social needs among rural compared with urban Veterans.
    Methods: Retrospective study using survey data collected in 2020 merged with Veterans Health Administration (VA) administrative data. For each unmet need, separate logistic regression modes were run predicting the odds of rural compared with urban Veterans endorsing the need adjusting for sociodemographic characteristics and comorbidities.
    Findings: 2,801 Veterans responded to the survey (53.7% response rate). Veterans experienced high rates of need (e.g., 22% reported food insecurity). Unmet need prevalence varied minimally between rural and urban Veterans and where they did, rural Veterans were less likely to endorse the need (e.g., loneliness). For many unmet needs, Black compared with White Veterans were at higher risk. Regional unmet need disparities were also observed.
    Conclusions: As VA considers expanding unmet need interventions, tailoring interventions to the sub-populations most at risk may be warranted.
    MeSH term(s) Humans ; United States/epidemiology ; Retrospective Studies ; Veterans ; Prevalence ; Urban Population ; Surveys and Questionnaires ; Rural Population ; United States Department of Veterans Affairs
    Language English
    Publishing date 2023-07-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1142637-8
    ISSN 1548-6869 ; 1049-2089
    ISSN (online) 1548-6869
    ISSN 1049-2089
    DOI 10.1353/hpu.2023.0018
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 3605: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 493: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  9. Article ; Online: Participation of Veterans Affairs Medical Centers in veteran-centric community-based service navigation networks: A mixed methods study.

    Hausmann, Leslie R M / Goodrich, David E / Rodriguez, Keri L / Beyer, Nicole / Michaels, Zachary / Cantor, Gilly / Armstrong, Nicholas / Eliacin, Johanne / Gurewich, Deborah A / Cohen, Alicia J / Mor, Maria K

    Health services research

    2024  Volume 59, Issue 3, Page(s) e14286

    Abstract: Objective: To understand the determinants and benefits of cross-sector partnerships between Veterans Affairs Medical Centers (VAMCs) and geographically affiliated AmericaServes Network coordination centers that address Veteran health-related social ... ...

    Abstract Objective: To understand the determinants and benefits of cross-sector partnerships between Veterans Affairs Medical Centers (VAMCs) and geographically affiliated AmericaServes Network coordination centers that address Veteran health-related social needs.
    Data sources and setting: Semi-structured interviews were conducted with AmericaServes and VAMC staff across seven regional networks. We matched administrative data to calculate the percentage of AmericaServes referrals that were successfully resolved (i.e., requested support was provided) in each network overall and stratified by whether clients were also VAMC patients.
    Study design: Convergent parallel mixed-methods study guided by Himmelman's Developmental Continuum of Change Strategies (DCCS) for interorganizational collaboration.
    Data collection: Fourteen AmericaServes staff and 17 VAMC staff across seven networks were recruited using snowball sampling and interviewed between October 2021 and April 2022. Rapid qualitative analysis methods were used to characterize the extent and determinants of VAMC participation in networks.
    Principal findings: On the DCCS continuum of participation, three networks were classified as networking, two as coordinating, one as cooperating, and one as collaborating. Barriers to moving from networking to collaborating included bureaucratic resistance to change, VAMC leadership buy-in, and not having VAMCs staff use the shared technology platform. Facilitators included ongoing communication, a shared mission of serving Veterans, and having designated points-of-contact between organizations. The percentage of referrals that were successfully resolved was lowest in networks engaged in networking (65.3%) and highest in cooperating (85.6%) and collaborating (83.1%) networks. For coordinating, cooperating, and collaborating networks, successfully resolved referrals were more likely among Veterans who were also VAMC patients than among Veterans served only by AmericaServes.
    Conclusions: VAMCs participate in AmericaServes Networks at varying levels. When partnerships are more advanced, successful resolution of referrals is more likely, especially among Veterans who are dually served by both organizations. Although challenges to establishing partnerships exist, this study highlights effective strategies to overcome them.
    MeSH term(s) Humans ; United States ; United States Department of Veterans Affairs/organization & administration ; Hospitals, Veterans/organization & administration ; Patient Navigation/organization & administration ; Interviews as Topic ; Community Health Services/organization & administration ; Veterans ; Qualitative Research ; Community Networks/organization & administration ; Interinstitutional Relations
    Language English
    Publishing date 2024-01-22
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 410435-3
    ISSN 1475-6773 ; 0017-9124
    ISSN (online) 1475-6773
    ISSN 0017-9124
    DOI 10.1111/1475-6773.14286
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 582: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  10. Article ; Online: Barriers and Facilitators to Implementation of Value-Based Care Models in New Medicaid Accountable Care Organizations in Massachusetts: A Study Protocol.

    Goff, Sarah L / Gurewich, Deborah / Alcusky, Matthew / Kachoria, Aparna G / Nicholson, Joanne / Himmelstein, Jay

    Frontiers in public health

    2021  Volume 9, Page(s) 645665

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) Accountable Care Organizations ; Administrative Personnel ; Health Care Reform ; Humans ; Massachusetts ; Medicaid ; United States
    Language English
    Publishing date 2021-04-06
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2021.645665
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top