scholarly journals Small-area Variation in Hypertension Prevalence among Black and White Medicaid Enrollees

2016 ◽  
Vol 26 (3) ◽  
pp. 331 ◽  
Author(s):  
Kellee White ◽  
John E. Stewart ◽  
Ana Lòpez-DeFede ◽  
Rebecca C. Wilkerson
Keyword(s):  
Primary Care ◽  
South Carolina ◽  
Primary Care Physician ◽  
Small Area ◽  
Care Physician ◽  
Fiscal Year ◽  
Hypertension Prevalence ◽  
Black And White ◽  
Care Plans ◽  
Blacks And Whites

<p><strong>Objectives: </strong>To examine within-state geographic heterogeneity in hypertension prevalence and evaluate associations between hypertension prevalence and small area contextual characteristics for Black and White South Carolina Medicaid enrollees in urban vs rural areas. <strong></strong></p><p><strong>Design: </strong>Ecological <strong></strong></p><p><strong>Setting: </strong>South Carolina, United States. <strong></strong></p><p><strong>Main Outcome Measure: </strong>Hypertension prevalence </p><p><strong>Methods: </strong>Data representing adult South Carolina Medicaid recipients enrolled in fiscal year 2013 (N=409,907) and ZIP Code Tabulation Area (ZCTA)-level contextual measures (racial segregation, rurality, poverty, educational attainment, unemployment and primary care physician adequacy) were linked in a spatially referenced database. Optimized Getis-Ord hotspot mapping was used to visualize geographic clustering of hypertension prevalence. Spatial regression was performed to examine the association between hypertension prevalence and small-area contextual indicators. <strong></strong></p><p><strong>Results: </strong>Significant (alpha=.05) hotspot spatial clustering patterns were similar for Blacks and Whites. Black isolation was significantly associated with hypertension among Blacks and Whites in both urban (Black, b=1.34, P&lt;.01; White, b=.66, P&lt;.01) and rural settings (Black, b=.71, P=.02; White, b=.70, P&lt;.01). Primary care physician adequacy was associated with hypertension among urban Blacks (b=-2.14, P&lt;.01) and Whites (b=-1.74, P&lt;.01). <strong></strong></p><p><strong>Conclusions: </strong>The significant geographic overlap of hypertension prevalence hotspots for Black and White Medicaid enrollees provides an opportunity for targeted health intervention. Provider adequacy findings suggest the value of ACA network adequacy standards for Medicaid managed care plans in ensuring health care accessibility for persons with hypertension and related chronic conditions. <em>Ethn Dis. </em>2016;26(3):331-338; doi:10.18865/ed.26.3.331 </p>

scholarly journals 3164 Do cancer survivors understand their risk factors for recurrence and the value of coordinated care between an oncologist and a primary care physician? A survey of endometrial and cervical cancer patients

2019 ◽  
Vol 3 (s1) ◽  
pp. 121-121
Author(s):  
Subhjit Sekhon ◽  
Lindsay Kuroki ◽  
Graham Colditz
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Cervical Cancer ◽  
Cancer Risk ◽  
Cancer Survivors ◽  
Primary Care Physician ◽  
Care Physician ◽  
Cancer Site ◽  
Care Plans ◽  
The Impact

OBJECTIVES/SPECIFIC AIMS: To evaluate gaps in knowledge for women who are cancer survivors regarding the impact of comorbidities and lifestyle behaviors on endometrial and cervical cancer risk, and to assess prevalence of established care with a primary care physician (PCP) among patients and evaluate acceptability of referral to a PCP METHODS/STUDY POPULATION: Single institution cross-sectional study examining all women aged 18 or older with a diagnosis of cervical or endometrial cancer who present for care by a gynecologic oncologist at Barnes-Jewish Hospital/Washington University in St. Louis School of Medicine. Patients will be invited to complete a survey specific to cancer diagnosis that includes questions on participant background and sociodemographic information, knowledge of risk factors for their specific cancer site, and whether or not the patient has a primary care provider and the acceptability of referring RESULTS/ANTICIPATED RESULTS: Majority of women will be unaware of how comorbidities affect cancer risk and treatment outcomes. For women without a PCP, we anticipate that they will be accepting towards the notion of being referred to one for establishing care. DISCUSSION/SIGNIFICANCE OF IMPACT: Pilot information from this study will 1. Allow providers to improve cancer survivorship care plans by increasing collaboration between PCPs and oncologists to provide ongoing care, and 2. Afford information for providers on where gaps in knowledge exist so as to better education patients.

Integrating the primary care physician into cancer follow-up.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 102-102 ◽  
Author(s):  
Andrew L. Salner ◽  
Deborah Walker ◽  
Amanda Seltzer ◽  
SarahLena Panzer ◽  
Carrie Stricker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Primary Care Physician ◽  
Care Physician ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Plans ◽  
Follow Up Care

102 Background: After a diagnosis of breast cancer, it can be difficult for patients to understand the role their primary care physician (PCP) should play in their follow up care. Methods: 65 women (mean age 60 years, SD = 10) with breast cancer (stage 0-III) were seen by a nurse practitioner for a 60-90 minute consultative survivorship visit and received a treatment summary and personalized survivorship care plan (SCP) utilizing Carevive Care Planning Systems software. The Carevive system incorporates patient-reported and clinical data to create tailored care plans with personalized recommendations for follow up care and supportive referrals, including direction to follow up with primary care for specific care and health maintenance activities. Approximately 6 weeks following their survivorship care visit, patients completed a survey assessing their use of and satisfaction with the SCP. Patients were advised that the SCP would be mailed to their referring oncologist and primary care physician. Results: Out of 65 sent, 35 surveys have been completed to date. Survivors were diagnosed approximately 10 months prior, and all were within 6 months following completion of treatment. All patients (100%) reported that they read, or planned to read, their survivorship care plan packet carefully. While all care plans included a recommendation to follow up with their PCP, only (71%) of survivors remembered receiving this recommendation. Of those who did, most (74%) had either seen or scheduled an appointment with their PCP. Patients who reported higher anxiety at the time of the survivorship visit were more likely to report that the follow up care plan helped them take action about seeing their PCP (p = .03). Conclusions: Coordination between primary and oncology care providers has previously been shown to improve the quality of care for cancer survivors. SCPs that emphasize the importance of and activities to be undertaken in primary care may help to improve this coordination. Continuation of this research will help to better understand how to integrate the primary care physician into cancer follow up care. Updated data will be shared at time of presentation.

Survivorship Care Plans to inform the primary care physician: results from the ROGY care pragmatic cluster randomized controlled trial

2014 ◽  
Vol 8 (4) ◽  
pp. 595-602 ◽  
Author(s):  
Nicole P. M. Ezendam ◽  
Kim A. H. Nicolaije ◽  
Roy F. P. M. Kruitwagen ◽  
Johanna M. A. Pijnenborg ◽  
M. Caroline Vos ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Controlled Trial ◽  
Primary Care Physician ◽  
Controlled Trial ◽  
Care Physician ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Randomized Controlled ◽  
Cluster Randomized

Review of The fifteen minute hour: Applied psychotherapy for the primary care physician.

1988 ◽  
Vol 6 (4) ◽  
pp. 483-487
Author(s):  
Richard P. McQuellon ◽  
Guyton J. Winker
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Care Physician
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