scholarly journals Public Health Detailing of Primary Care Providers: New York City’s Experience, 2003–2010

2012 ◽  
Vol 102 (S3) ◽  
pp. S342-S352 ◽  
Author(s):  
Michelle G. Dresser ◽  
Leslie Short ◽  
Laura Wedemeyer ◽  
Victoria Lowerson Bredow ◽  
Rachel Sacks ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
New York ◽  
Primary Care Providers ◽  
Care Providers

scholarly journals Linkage to primary-care public health facilities for cardiovascular disease prevention: a community-based cohort study from urban slums in India

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045997
Author(s):  
Abhijit Pakhare ◽  
Ankur Joshi ◽  
Rasha Anwar ◽  
Khushbu Dubey ◽  
Sanjeev Kumar ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Multivariate Analysis ◽  
Urban Slum ◽  
Primary Care Providers ◽  
Health Facilities ◽  
Care Providers ◽  
Community Based ◽  
Public Health Facilities ◽  
Care Facilities

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.

“I felt useless”: a qualitative examination of COVID-19’s impact on home-based primary care providers in New York

2021 ◽  
pp. 1-15
Author(s):  
Ksenia Gorbenko ◽  
Emily Franzosa ◽  
Sybil Masse ◽  
Abraham A Brody ◽  
Orla Sheehan ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Primary Care Providers ◽  
Care Providers ◽  
Home Based Primary Care ◽  
Home Based

scholarly journals Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Jinhee Lee ◽  
Thomas F. Kresina ◽  
Melinda Campopiano ◽  
Robert Lubran ◽  
H. Westley Clark
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Opioid Dependence ◽  
Alcohol Use Disorders ◽  
Primary Care Providers ◽  
Care Providers ◽  
Addictive Disorders ◽  
Care And Treatment

Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

scholarly journals Perspectives on the HIV continuum of care among adult opioid users in New York City: a qualitative study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Babak Tofighi ◽  
Selena S. Sindhu ◽  
Chemi Chemi ◽  
Crystal Fuller Lewis ◽  
Victoria Vaughan Dickson ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
New York City ◽  
Administrative Support ◽  
Primary Care Providers ◽  
Support Networks ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Care Providers ◽  
Factors Influencing

Abstract Background Engagement in the HIV care continuum combined with office-based opioid treatment remains a cornerstone in addressing the intertwined epidemics of opioid use disorder (OUD) and HIV/AIDS. Factors influencing patient engagement with OUD and HIV care are complex and require further study. Methods In this qualitative study, in-depth interviews were conducted among 23 adult patients who use drugs (PWUD) in an inpatient detoxification program in New York City. The semi-structured interview guide elicited participant experiences with various phases of the HIV care continuum, including factors influencing access to HIV care, interactions with HIV and primary care providers, preferences around integrated care approaches for OUD and HIV, and barriers experienced beyond clinical settings which affected access to HIV care (e.g., insurance issues, transportation, cost, retrieving prescriptions from their pharmacy). Data collection and thematic analysis took place concurrently using an iterative process-based established qualitative research method. Results Respondents elicited high acceptability for integrated or co-located care for HIV and OUD in primary care. Factors influencing engagement in HIV care included (1) access to rapid point-of-care HIV testing and counseling services, (2) insurance coverage and costs related to HIV testing and receipt of antiretroviral therapy (ART), (3) primary care providers offering HIV care and buprenorphine, (4) illicit ART sales to pharmacies, (5) disruption in supplies of ART following admissions to inpatient detoxification or residential treatment programs, (6) in-person and telephone contact with peer support networks and clinic staff, (7) stigma, and (8) access to administrative support in primary care to facilitate reengagement with care following relapse, behavioral health services, transportation vouchers, and relocation from subsidized housing exposing patients to actively using peers. Conclusion These findings suggest expanding clinical and administrative support in primary care for PWUDs with patient navigators, case managers, mobile health interventions, and peer support networks to promote linkage and retention in care.

Estimating the Effect of the New York State Nurse Practitioners Modernization Act on Care Received by Medicaid Patients

2021 ◽  
pp. 152715442110181
Author(s):  
Edward Joseph Timmons ◽  
Conor Norris ◽  
Grant Martsolf ◽  
Lusine Poghosyan
Keyword(s):  
Primary Care ◽  
New York ◽  
Nurse Practitioners ◽  
New York State ◽  
Primary Care Providers ◽  
Care Providers ◽  
York State ◽  
More Care ◽  
Total Care ◽  
The Impact

The demand for primary care services may surpass the supply of primary care providers, exacerbating challenges with access, quality, and cost in the U.S. health care system. Expanding the supply of, and access to, nurse practitioner (NP) care has been proposed as one method to alleviate these challenges. New York State (NYS) changed its regulatory environment for NPs in 2015. We estimate the impact of expanded NP scope of practice (SOP) regulations in NYS on total care days received by Medicaid beneficiaries from 2015 to 2018 using a model derived from national historical data from 1999 to 2011. We used a longitudinal data policy analysis framework and a generalized difference-in-differences model to identify the effect of changes in NP SOP regulations on total care days. The model included controls for state income and unemployment rates. Our results suggest that the policy change increased total care days provided to patients, but that this difference was not statistically significant and became negligible after computing the number of days per beneficiary. In addition, our results suggest that had NYS moved to a full practice environment, more care days could have been provided to Medicaid patients, and this difference was found to be statistically significant. Our results suggest that states should adopt full NP SOP practice environments to realize measurable benefits of expanded NP SOP.

scholarly journals Addressing Patients’ Veteran Status: Primary Care Providers’ Knowledge, Comfort, and Educational Needs

2018 ◽  
Vol 50 (6) ◽  
pp. 455-459 ◽  
Author(s):  
Bonnie M. Vest ◽  
Jessica Kulak ◽  
Victoria M. Hall ◽  
Gregory G. Homish
Keyword(s):  
Primary Care ◽  
New York ◽  
Military Service ◽  
Primary Care Providers ◽  
Veterans Health ◽  
Health Administration ◽  
Care Providers ◽  
Military Population ◽  
Veteran Status ◽  
Health Related

Background and Objectives: The military population is frequently overlooked in civilian primary care due to an assumption that they are treated at the Veterans Health Administration (VA). However, less than 50% of eligible veterans receive VA treatment. Primary care providers (PCPs) may need support in addressing veterans’ needs. This regional pilot study explored the current state of practice among primary care providers as it pertains to assessing patients’ veteran status and their knowledge of and comfort with treating common conditions in this population. Methods: An electronic survey was administered to PCPs (N=102) in Western New York. Survey questions asked about assessing military status, understanding of military-related health problems, and thoughts on the priority of addressing these issues in practice. Data were analyzed using descriptive summary statistics. Results: The majority (56%; n=54) of respondents indicated they never or rarely ask their patients about military service, and only 19% (n=18) said they often or always ask. Seventy-one percent (n=68) of providers agreed or strongly agreed it was important to know if their patient was a veteran. Participants indicated limited knowledge about military stressors, resources available for military populations, and common medical conditions impacting veterans. Conclusions: Our pilot results demonstrate that in a regional sample of primary care providers, providers rarely ask patients about their military history; however, they feel it is important information for patient care. While further study is needed, it may be necessary to provide education, specifically pertaining to military culture and health-related sequelae, to address barriers that may be limiting PCPs’ provision of care for this population.

scholarly journals Effect of a Digital Precision Public Health Intervention for Care Coordination During Covid-19 Pandemic in Australia: A Real World Study

2021 ◽  
Author(s):  
Andre Q Andrade ◽  
Jean-Pierre Calabretto ◽  
Nicole L Pratt ◽  
Lisa M Kalisch-Ellett ◽  
Vanessa T LeBlanc ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Continuity Of Care ◽  
Care Coordination ◽  
Real World ◽  
Primary Care Providers ◽  
Patient Specific ◽  
Specific Information ◽  
Care Providers ◽  
Precision Public Health

Abstract Background: Emergencies disproportionally affect vulnerable populations. The COVID-19 pandemic affected older patients with co-morbidities both directly due to more severe infection and indirectly by affecting care provision. To promote continuity of care, public health professionals require tools to quickly and precisely coordinate with primary care providers. This study evaluated whether digital interventions powered by current existing infrastructure are more effective than conventional interventions in promoting primary care appointments during the COVID-19 pandemic. Methods: We developed a digital intervention delivered by secure messaging and compared it to a post delivered intervention to promote continuity of care for vulnerable veterans during COVID-19 in a real world, non-randomised, interventional study. The study was implemented as part of the Veterans’ MATES program, an Australian Government Department of Veterans’ Affairs program to promote improvements in health care for veterans. The intervention provided patient specific information to general practitioners (GPs) to support continuity of care, alongside mailed education to veterans. The intervention key messages were to maintain regular contact with care providers and to continue to adhere to health plans. The intervention took place in April 2020, during the first weeks of COVID-19 social distancing rules in Australia. The main outcome was time to first appointment with the primary general practitioner (GP) measured using a Cox proportional hazards model.Results: GPs received digital messaging for 51,052 veterans and post messaging for 26,859 veterans. The proportion of patients seeing their primary GP during the three months following intervention was higher in the digital group (77.8%) than the post group (61.5%) (p<0.01). Being in the digital group was associated with earlier appointments. Conclusion: Current infrastructure coupled with innovative solutions is effective in promoting care coordination at scale during national emergencies, opening up new perspectives for precision public health initiatives.

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