Impact on Primary Care Access Post-Disaster: A Case Study From the Rockaway Peninsula

2016 ◽  
Vol 10 (3) ◽  
pp. 492-495 ◽  
Author(s):  
Rishi K. Sood ◽  
Angelica Bocour ◽  
Supriya Kumar ◽  
Hasan Guclu ◽  
Margaret Potter ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Hurricane Sandy ◽  
Government Agencies ◽  
Care Providers ◽  
Recovery Planning ◽  
Care Access ◽  
Small Practice ◽  
Area Of Interest ◽  
Access To Primary Care

ABSTRACTObjectiveAssess Hurricane Sandy’s impact on primary care providers’ services in the Rockaways.MethodsIn-person surveys were conducted in 2014. A list of 46 health care sites in the area of interest was compiled and each site was called to offer participation in our survey. Respondents included physicians and practice administrators who remained familiar with Sandy-related operational challenges.ResultsOf the 40 sites that opted in, most had been in their current location for more than 10 years (73%) and were a small practice (1 or 2 physicians) before Hurricane Sandy (75%). All but 2 (95%) had to temporarily close or relocate. All sites experienced electrical problems that impacted landline, fax, and Internet. Less than one-quarter (n = 9) reported having a plan for continuity of services before Hurricane Sandy, and 43% reported having a plan poststorm. The majority (80%) did not report coordinating with other primary care stakeholders or receiving support from government agencies during the Sandy response.ConclusionsHurricane Sandy significantly disrupted access to primary care in the Rockaways. Severe impact to site operations and infrastructure forced many practices to relocate. Greater emergency response and recovery planning is needed, including with government agencies, to minimize disruptions of access to primary care during disaster recovery. (Disaster Med Public Health Preparedness. 2016;10:492–495)

scholarly journals An Agent-Based Model for Addressing the Impact of a Disaster on Access to Primary Care Services

2016 ◽  
Vol 10 (3) ◽  
pp. 386-393 ◽  
Author(s):  
Hasan Guclu ◽  
Supriya Kumar ◽  
David Galloway ◽  
Mary Krauland ◽  
Rishi Sood ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Hurricane Sandy ◽  
Care Providers ◽  
Agent Based Model ◽  
Agent Based ◽  
Primary Care Access ◽  
Care Access ◽  
Care Services ◽  
Primary Care Services

AbstractObjectiveHurricane Sandy in the Rockaways, Queens, forced residents to evacuate and primary care providers to close or curtail operations. A large deficit in primary care access was apparent in the immediate aftermath of the storm. Our objective was to build a computational model to aid responders in planning to situate primary care services in a disaster-affected area.MethodsUsing an agent-based modeling platform, HAZEL, we simulated the Rockaways population, its evacuation behavior, and primary care providers’ availability in the aftermath of Hurricane Sandy. Data sources for this model included post-storm and community health surveys from New York City, a survey of the Rockaways primary care providers, and research literature. The model then tested geospatially specific interventions to address storm-related access deficits.ResultsThe model revealed that areas of high primary care access deficit were concentrated in the eastern part of the Rockaways. Placing mobile health clinics in the most populous census tracts reduced the access deficit significantly, whereas increasing providers’ capacity by 50% reduced the deficit to a lesser degree.ConclusionsAn agent-based model may be a useful tool to have in place so that policy makers can conduct scenario-based analyses to plan interventions optimally in the event of a disaster. (Disaster Med Public Health Preparedness. 2016;10:386–393)

scholarly journals LO087: Emergency department patients’ connection to primary care providers: reasons for lack of connection

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S60-S60
Author(s):  
L. Krebs ◽  
S.W. Kirkland ◽  
K. Crick ◽  
C. Villa-Roel ◽  
A. Davidson ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Family Physician ◽  
Patient Characteristics ◽  
Primary Care Providers ◽  
Care Providers ◽  
Care Access ◽  
Care Services ◽  
Primary Care Services ◽  
Access To Primary Care

Introduction: Some non-urgent/low-acuity Emergency Department (ED) presentations are considered convenience visits and potentially avoidable with improved access to primary care services. This study surveyed patients who presented to the ED and explored their self-reported reasons and barriers for not being connected to a primary care provider (PCP). Methods: Patients aged 17 years and older were randomly selected from electronic registration records at three urban EDs in Edmonton, Alberta (AB), Canada. Following initial triage, stabilization, and verbal informed consent, patients completed a 47-item questionnaire. Data from the survey were cross-referenced to a minimal patient dataset consisting of ED and demographic information. The questionnaire collected information on patient characteristics, their connection to a PCP, and patients' reasons for not having a PCP. Results: Of the 2144 eligible patients, 1408 (65.7%) surveys were returned and 1402 (65.4%) were completed. The majority of patients (74.4%) presenting to the ED reported having a family physician; however, the ‘closeness’ of the connection to their family physician varied greatly among ED patients with the most recent family physician visit ranging from 1 hour before ED presentation to 45 years prior. Approximately 25% of low acuity ED patients reported no connection with a family physician. Reasons for a lack of PCP connection included: prior physician retired, left, or died (19.8%), they had never tried to find one (19.2%), they had recently moved to Alberta (18.0%), and they were unable to find one (16.5%). Conclusion: A surprisingly high proportion of ED patients (25.6%) have no identified PCP. Patients had a variety of reasons for not having a family physician. These need to be understood and addressed in order for primary care access to successfully contribute to diverting non-urgent, low acuity presentations from the ED.

scholarly journals Actionable Analysis: Toward a Jurisdictional Evaluation of Primary Care Access in the Community Context

2019 ◽  
Vol 10 ◽  
pp. 215013271989197
Author(s):  
Mary M. Ford ◽  
Kirsten Weisbeck ◽  
Bonnie Kerker ◽  
Louise Cohen
Keyword(s):  
Primary Care ◽  
Health Status ◽  
Health Care Systems ◽  
Care Facility ◽  
Primary Care Providers ◽  
City Council ◽  
Community Context ◽  
Care Providers ◽  
Primary Care Access ◽  
Care Access

Primary care is the foundation of health care systems and has potential to alleviate inequities in population health. We examined multiple measures of adult primary care access, health status, and socioeconomic position at the New York City Council District level—a unit of analysis both relevant to and actionable by local policymakers. The results showed significant associations between measures of primary care access and health status after adjustment for socioeconomic factors. We found that an increase of 1 provider per 10 000 people was associated with a 1% decrease in diabetes rates and a 5% decrease in rates of adults without an influenza immunization. Furthermore, higher rates of primary care providers in high-poverty districts accepted Medicaid and had Patient-Centered Medical Home recognition, increasing constituent accessibility. Our findings highlight the significant contribution of primary care access to community health; policies and resource allocation must prioritize primary care facility siting and provider recruitment in low-access areas.

Primer on Depression

Depression ◽  
2019 ◽  
pp. 459-474
Author(s):  
Robert S. Kinney ◽  
Radu Pop
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Access ◽  
Primary Care Providers ◽  
Depression Screening ◽  
Care Providers ◽  
Care Access ◽  
Measurement Based Care ◽  
New Guidelines ◽  
Guidelines And Recommendations

Depression is a commonly occurring illness in the general population. Existing systems for identifying and treating depression vary greatly, and the adoption of a universal, standardized method of addressing the disorder within primary care is lacking. New guidelines and recommendations by accrediting bodies have resulted in the development of some initiatives and the increased recognition of depression, yet treatments continue to rely on referrals to specialty psychiatric care providers. Given that primary care may be the only point of health care access for many individuals, this serves as an opportune setting to initiate treatment at the time that depression screening is completed. With adequate support, guidance, and a systemic approach (i.e., measurement-based care), primary care providers can be as effective as psychiatric specialty care in treating depression. This chapter providers evidence for this approach, along with direct recommendations to primary care providers.

scholarly journals Spatial access to primary care providers and colorectal cancer‐specific survival in Cook County, Illinois

2020 ◽  
Vol 9 (9) ◽  
pp. 3211-3223 ◽  
Author(s):  
Vincent L. Freeman ◽  
Keith B. Naylor ◽  
Emma E. Boylan ◽  
Benjamin J. Booth ◽  
Oksana Pugach ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Primary Care Providers ◽  
Cook County ◽  
Care Providers ◽  
Spatial Access ◽  
Cancer Specific Survival ◽  
Access To Primary Care

scholarly journals Changes to telehealth practices in primary care in New Brunswick (Canada): A comparative study pre and during the COVID-19 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258839
Author(s):  
Claire Johnson ◽  
Jérémie B. Dupuis ◽  
Pierre Goguen ◽  
Gabrielle Grenier
Keyword(s):  
Primary Care ◽  
Comparative Study ◽  
New Brunswick ◽  
Nurse Practitioners ◽  
Online Survey ◽  
Primary Care Providers ◽  
Care Providers ◽  
Timely Access ◽  
Access To Primary Care

Background During the COVID-19 pandemic, telehealth technologies were used in the primary health care setting in New Brunswick as a means to continue providing care to patients while following public health guidelines. This study aimed to measure these changes and examine if they improved timely access to primary care. A secondary goal was to identify which telehealth technologies were deemed sustainable by primary care providers. Methods This was a comparative study on the use of telehealth technology before and during the COVID-19 pandemic. Between April 2020 and November 2020, 114 active primary care providers (family physicians or nurse practitioners) responded to the online survey. Results The findings illustrated an increase in the use of telehealth technologies. The use of phone consultations increased by 122%, from 43.9% pre-pandemic to 97.6% during the pandemic (p < 0.001). The use of virtual consultation (19.3% pre-pandemic vs. 41.2% during the pandemic, p < 0.001), emails and texts also increased during the pandemic. Whereas the more structural organizational tools (electronic medical charts and reservation systems) remained stable. However, those changes did not coincide with a significant improvement to timely access to care during the pandemic. Many participants (40.1%) wanted to keep phone consultations, and 21.9% of participants wanted to keep virtual consultations as part of their long-term practice. Interpretation The observed increase in the use of telehealth technologies may be sustainable, but it has not significantly improved timely access to primary care in New Brunswick.

scholarly journals The expectations of transgender people in the face of their health-care access difficulties and how they can be overcome. A qualitative study in France

2020 ◽  
Vol 21 ◽  
Author(s):  
Emmanuel Allory ◽  
Ellie Duval ◽  
Marion Caroff ◽  
Candan Kendir ◽  
Raphaël Magnan ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Access ◽  
Primary Care Providers ◽  
Care Providers ◽  
Transgender People ◽  
Care Access ◽  
Care Services ◽  
Primary Health

Abstract Aim: Our objective was to explore the difficulties experienced by transgender people in accessing primary health-care services and their expectations towards primary care providers to improve their health-care access. Background: Because transgender people are exposed to many discriminations, their health-care access is particularly poor. Guidelines recommend greater involvement of primary care providers in the processes because of the accessibility feature of primary care services. Methods: A qualitative study using semi-directed interviews was conducted among 27 transgender people (February 2018 – August 2018). These voluntary participants were recruited through different means: local trans or LGBTI (lesbian, gay, bisexual, trans, and/or intersex) associations, primary care providers, and social networks. The data analysis was based on reflexive thematic analysis in an inductive approach. Findings: Difficulties in accessing health-care occurred at all the levels of the primary health-care system: primary care providers – transgender people interaction, access to the primary care team facility (starting with the secretariat), access to secondary care specialists, and continuity of care. Transgender people report ill-adapted health-care services as a result of gender-based identification in health-care settings. Their main expectation was depsychiatrization and self-determination. They supported mixed health network comprising primary care providers and transgender people with a coordinating role for the general practitioner. These expectations should be priorities to consider in our primary health-care system to improve access to health-care for transgender people.

scholarly journals Assessing Capacity and Disease Burden in a Virtual Network of New York City Primary Care Providers Following Hurricane Sandy

2014 ◽  
Vol 91 (4) ◽  
pp. 615-622 ◽  
Author(s):  
Kimberly Sebek ◽  
Laura Jacobson ◽  
Jason Wang ◽  
Remle Newton-Dame ◽  
Jesse Singer
Keyword(s):  
Primary Care ◽  
New York ◽  
New York City ◽  
York City ◽  
Disease Burden ◽  
Primary Care Providers ◽  
Hurricane Sandy ◽  
Virtual Network ◽  
Care Providers

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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