Research Publications

Different staffing configurations in primary and geriatric care practices could have implications for how best to deliver services that are essential for a growing population of older adults. Using data from a 2018 survey of physicians (MDs) and nurse practitioners (NPs) working in primary and…

Care coordination is a key strategy used to improve health outcomes and efficiency, yet there are limited examples in dentistry. A large dental accountable care organization piloted care coordination by retraining existing administrative staff to coordinate the care of high-risk patients. Following…

Community paramedicine, also known as mobile integrated health, is an innovative model of care that is being implemented throughout the United States. From 2014 to 2020, the California Emergency Medical Services Authority sponsored a Health Workforce Pilot Project under which specially trained…

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…

Ongoing payment reforms are pressing health systems to reorganize delivery of care to achieve greater value, improve access, integrate patient care among settings, advance population health, and address social determinants of health. Many organizations are experimenting with new ways of unleashing…

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…

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…

This document is a guide for primary care organizations and care teams working to integrate substance use disorder (SUD) treatment services. It provides proven strategies, best practices, and tools used by organizations within California to expand the capability of primary care teams in…

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…

Ensuring that Californians have timely access to substance use disorder (SUD) treatment that is appropriately linked to their physical health care represents a huge challenge and opportunity for health leaders, providers, and care teams throughout the state. This issue of CIN Connections features…

Objective To compare medication adherence, cost, and utilization in Medicare beneficiaries attributed to nurse practitioners (NP) and primary care physicians (PCP). Data Medicare Part A, B, and D claims and beneficiary summary file data, years 2009‐2013. Study Design We used propensity score‐…

Nurse practitioners are well prepared to help fill care gaps arising from shortages of primary care physicians in California. This article reports findings from a survey of California nurse practitioners that examined their employment and practice barriers. The number of nurse practitioners per…

In 2011, the Institute of Medicine (IOM, now part of the National Academy of Science, Engineering, and Medicine) released a report, “The Future of Nursing: Leading Change, Advancing Health,” which contained eight recommendations regarding how the nursing workforce can best meet health-care needs in…

This study of California nurse practitioners (NPs) and certified nurse-midwives (CNMs) was conducted in early 2017. In November 2016, there were 20,337 NPs living in California, of whom 569 also were CNMs (“dual certified”). Another 582 people had CNM-only certification. Surveys were mailed to 2,…

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…

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…

While it is difficult to know the true number of practicing geriatricians, the supply has been negatively affected by tightening certification requirements, relatively low income and negative return on investment. There appears to be consensus that clinical care by geriatricians should be reserved…

Highlights Value-based payment is leading to enhanced care coordination staffing. Sites are task shifting low-complexity care coordination to unlicensed staff. Important care coordination education gaps necessitate in-depth on-the-job training. Demonstrating the return on investment of care…

Demand for health care professionals with expertise in long-term care (LTC) and older populations is rising, due to projected growth in the older population and the increasing burden of chronic disease. One way to meet this growing LTC workforce demand may be to employ more nurse practitioners (NPs…

The aim of this study is to examine male-female earnings of nurses in Germany. Understanding and addressing differences in earnings by gender is important because differences in pay accumulate over a nurse’s career and can lead to substantial disparities between genders, especially if…

Community health workers (CHWs) and promotores de salud are playing an increasingly important role in the delivery of high quality and equitable health related services, particularly to vulnerable populations. Using a Theory of Change framework, this report connects intervention and support…

Research examining productivity, quality and outcomes of traditional pediatric dental care are generally lacking. The literature shows that education, qualifications, and roles are changing with case examples of success, but what these changes portend for patient care remains an open question…

This study describes the program requirements, workforce competencies, and barriers for dementia capable care coordination within health plans from seven states participating in the Center for Medicare and Medicaid Services demonstration programs for dually-eligible Medicare and Medicaid…

Background Childbirth is a leading reason for hospital admission in the USA, and most labor care is provided by registered nurses under physician or midwife supervision in a nurse-managed care model. Yet, there are no validated quality measures for maternity care that are thoughtful about the role…

This report updates a literature review on peer support providers prepared in 2015. Peer support workers fulfill a broad range of tasks ad job titles, in a broad range of mental health and substance use disorders recovery settings, and in various service models, although there is a lack of…

Is California prepared to meet growing demand for primary care? This report is the first in a series of three Healthforce Center at UCSF reports that will provide information to help policymakers, consumers and leaders of health care delivery organizations and educational institutions…

Community health workers (CHWs) and promotores de salud are playing an increasingly important role in community-based and clinical care settings. This research, supported by the Blue Shield of California Foundation, represents the culmination of the first phase of a two-part project aimed at…

Mobile integrated healthcare – community paramedicine (MIH-CP) is a new model of care that trains paramedics to deliver a broader range of services than traditional emergency response and transport of people to emergency departments (ED). By 2014, more than 100 emergency medical services (EMS…

A 2015 study published in JAMA found that the wage gap persists in nursing, with male nurses making $5,100 more on average per year than female colleagues in similar positions. This latest study aims to uncover the root causes of the gender pay discrepancy in nursing. …

As the Baby Boomer Generation ages into long-term care (LTC) facilities, the number of individuals requiring dental care will rise, but these systems are not set up to adequately meet their needs. The supply of dentists is projected to increase; however, enormous barriers to dental care continue to…