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The Role of Value-Based Payment in Promoting Innovation to Address Social Risks: A Cross-Sectional Study of Social Risk Screening by U.S. Physicians
12-01-20
One of the most important possibilities of value-based payment is its potential to spur innovation in upstream prevention, such as attention to social needs that lead to poor health. However, there is uncertainty about the conditions under which value-based payment will encourage health care...
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CIN Connections, Fall 2020: Emerging Innovations: Health Care During a Pandemic
11-16-20
The year 2020 has been unlike any other. The changes we’re now seeing in our clinics and through our screens, and the methods being used to address patient needs that we hadn’t previously considered will impact health care for years to come. This issue of CIN Connections features reflections from...
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Medical Staffing Organization and Quality of Care Outcomes in Post-acute Care Settings
11-04-20
Medical providers are significant drivers of care in post-acute long-term care (PALTC) settings, yet little research has examined the medical provider workforce and its role in ensuring quality of care. This study examined the impact of nursing home medical staffing organization (NHMSO) dimensions...
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COVID-19 and the Health Workforce
10-31-20
The health workforce has been greatly affected by COVID-19. In this commentary, we describe the articles included in this health workforce research supplement and how the issues raised by the authors relate to the COVID-19 pandemic and rapidly changing health care environment.
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Policies Matter! Factors Contributing to Nursing Home Outbreaks During the COVID-19 Pandemic
10-27-20
Between February 2020 when the COVID-19 pandemic began and August 2020, the nation has watched over 5.2 million individuals become infected and over 167,000 deaths. Unfortunately, many of the infections and deaths have been nursing home residents and staff. To date, the Centers for Medicare and...
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Tracking Oral Health in a Standardized, Evidence‐Based, Prevention‐Focused Dental Care System
10-26-20
Learning health‐care systems are foundational for measuring and achieving value in oral health care. This article describes the components of a preventive dental care program and the quality of care in a large dental accountable care organization. A retrospective study design describes and...
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Evaluation of the San Francisco Support at Home Program: Year 3 Report
10-14-20
The purpose of this report is to outline the findings from the third year (July 1, 2019-June 30, 2020) of the San Francisco Support at Home (S@H) pilot program. This report provides some background information on the program, but more information and context can be found in the Year 1 and Year 2...
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The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study
09-23-20
The objective of this study was to explore how home care workers and the agencies that employ them interact with their state’s nurse practice act in the provision of care. Using a qualitative case study approach, they selected four states with varying levels of restrictiveness in their nurse...
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Medical Care Delivery in US Nursing Homes: Current and Future Practice
09-22-20
The delivery of medical care services in US nursing homes (NH) is dependent on a workforce comprised of physicians, nurse practitioners (NP), and physician assistants (PA). Each of these disciplines operate under a unique regulatory framework while adhering to common standards of care. NH provider...
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The Relationship Between Portable School‐Based Oral Health Prevention Services and Subsequent Oral Health Treatment
08-20-20
This study examines whether a portable, school‐based, preventive oral health program was associated with reduced use of treatment services over time. They obtained encounter data from Community Health Center, Inc. (CHC) in Connecticut that operates such a program. They followed cohorts of children...
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Leveraging Big Data to Guide Better Nurse Staffing Strategies
07-27-20
A large body of research has documented a relationship between higher nurse-to-patient staffing ratios and better patient outcomes. To date, most studies have not identified an ‘optimal’ nurse staffing ratio, which creates a challenge for determining appropriate staffing levels. If increasing nurse...
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A Qualitative Assessment of Barriers and Facilitators to Implementing Recommended Infant Nutrition Practices in Mumbai, India
07-27-20
Childhood malnutrition has been a longstanding crisis in Mumbai, India. Despite national IYCF (Infant Young Child Feeding) guidelines to promote best practices for infant/toddler feeding, nearly one-third of children under age five are stunted or underweight. To improve child nutrition,...
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Nurse Practitioner Role and Practice Environment in Primary and in Nonprimary Care in California
07-23-20
The nurse practitioner (NP) role has evolved substantially from its origins in primary care, with NPs increasingly being employed in the medical and surgical specialties. Between 2008 and 2016, there was an increase in nurse practitioners in specialty care. This study explores some differences in...
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Scope-of-Practice for Nurse Practitioners and Adherence to Medications for Chronic Illness in Primary Care
06-24-20
Nonadherence to medications is costly and improving adherence is difficult, requiring multifactorial solutions, including policy solutions. The purpose of this study was to evaluate the effect of one policy strategy on medication adherence. Specifically, we examined the effect on adherence of...
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Addressing the Opioid Epidemic Amidst the COVID-19 Pandemic
05-01-20
Three of every four pharmaceutical overdose deaths in 2010 involved opioids, according to the CDC. This sobering statistic focused attention on the rapid acceleration and devastating impact of the epidemic of opioid use disorder in the United States. Throughout the country, individuals and families...
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Factors Associated with Physical Injury of Police Involvement During Incidents of Workplace Violence in Hospitals: Findings from the First Year of California’s New Standard
03-12-20
Violence against healthcare workers is a pervasive safety issue that impacts patient care and workforce stability. Workplace violence in healthcare settings is known to be a costly and often underreported problem. In California, hospitals are required to report incidents of violence towards workers...
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Constructing Matched Groups in Dental Observational Health Disparity Studies for Causal Effects
01-01-20
Electronic health record (EHR) systems provide investigators with rich data from which to examine actual impacts of care delivery in real-world settings. However, confounding is a major concern when comparison groups are not randomized. This article introduced a step-by-step strategy to construct...
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Developing and Testing Electronic Health Record-Derived Caries Indices
11-01-19
Caries indices, the basis of epidemiologic caries measures, are not easily obtained in clinical settings. This study’s objective was to design, test, and validate an automated program (Valid Electronic Health Record Dental Caries Indices Calculator Tool [VERDICT]) to calculate caries indices from...
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Supporting the Integration of Community Health Workers in Whole Person Care Pilots
10-11-19
Community health workers (CHWs) are vital contributors to high quality and equitable health services, particularly to vulnerable populations. CHWs provide a key link between community resources and the clinical team as well as advocate on behalf of communities regarding social determinants of...
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Evaluation of the San Francisco Support at Home Program: Year Two Report
09-24-19
The purpose of this report is to outline the findings from the second year of the San Francisco Support at Home (S@H) program. This report provides some background information on the program, but more information and context can be found in the preliminary report. Overall, the evaluation has two...
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The Impact of Emerging Technologies on Long-Term Care and the Health Workforce
08-01-19
New technological advances could mitigate rising health workforce demand, but will not replace the direct care workforce, according to this report. The report includes a taxonomy of currently available and emerging technology categories based on the products sold by 115 companies, in addition to...
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Envisioning an Ideal Health Workforce Data System for California
07-23-19
Seven million Californians, the majority of them Latino, African American, and Native American, live in areas experiencing shortfalls of primary care, dental care, or mental health care providers. Without accurate, robust and timely health workforce data, the state will be unable to adequately...
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Expansion of Dental Care for Low‐Income Children Through a Mobile Services Program
05-29-19
Although access to dental care has improved over time, many children still face difficulty in obtaining services. One strategy to increase access is through mobile dental services, often in collaboration with schools, Head Start programs, and school‐based health centers. This study evaluates a...
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Nurse Practitioner and Physician Assistant Waivers to Prescribe Buprenorphine and State Scope of Practice Restrictions
04-10-19
There is a shortage of clinicians authorized to prescribe medications to treat opioid use disorder. Nurse practitioners (NPs) and physician assistants (PAs) were allowed to obtain waivers to prescribe buprenorphine beginning in 2016. They investigated the proportions of NPs and PAs with waivers in...
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The Impact of Federal and State Policy on Oral Health Care Delivery in Long-Term Care Settings
11-21-18
Residents of long-term care (LTC) facilities have a significantly higher risk of poor oral health status compared with those living independently; moreover, the provision of oral health services to LTC residents is often limited. This study identifies and classifies state-level policies and funding...
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California’s Physician Assistants: How Scope of Practice Laws Impact Care
09-25-18
Physician assistants (PAs) — state-licensed health professionals who practice medicine in collaboration with physicians and other providers — provide high-quality care, and are more likely to work in rural areas and with underserved populations than are physicians. Their training enables them to...
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Evaluation of the San Francisco Support at Home Program: Year One Report
09-12-18
The purpose of this project is to conduct a two-year formative and summative evaluation of the San Francisco Support at Home program. The Support at Home program provides financial support for the purchase of home care services by adults with disabilities and older adults living in San Francisco....
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Expanding Registered Apprenticeships in Health Care
09-04-18
Registered apprenticeships (RA) – programs that have formal standards and are regulated by both federal and state agencies – have a long history in the United States. Health care-related RA programs account for a small fraction of overall apprenticeship training activity, but would seem to be a...
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Community-Based Palliative Care Leader Perspectives on Staffing, Recruitment, and Training
04-01-18
This qualitative descriptive study assesses perspectives of US community-based palliative care program leaders on staffing, recruitment, and training. Leaders from academic medical centers, large integrated and community health systems, home health and hospice organizations, and the Veterans...
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Federally Qualified Health Centers Reduce the Primary Care Provider Gap in Health Professional Shortage Counties
02-13-18
Federally qualified health centers (FQHCs) were designed to provide care in medically underserved areas and substantial and sustained federal funding has accelerated FQHC growth. This report examines changes over time in primary care provider supply and whether FQHCs have been successful in...