An Innovative Community-based Model for Improving Preventive Care in Rural Counties
| Autor: | Tracy Greever-Rice, Bhawani Mishra, Daniel Zhao, Dewey C. Scheid, Zsolt Nagykaldi |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Rural Population medicine.medical_specialty Health Information Exchange Adolescent Cost-Benefit Analysis Pilot Projects 01 natural sciences Article Young Adult 03 medical and health sciences 0302 clinical medicine Nursing Return on investment Preventive Health Services Health care Electronic Health Records Humans Revenue Medicine 030212 general & internal medicine 0101 mathematics Primary Health Care business.industry Medical record 010102 general mathematics Public Health Environmental and Occupational Health Oklahoma Health information exchange Middle Aged Quality Improvement Community-Institutional Relations Outreach Family medicine Community health Feasibility Studies Female Rural Health Services Family Practice business Health department |
| Zdroj: | The Journal of the American Board of Family Medicine. 30:583-591 |
| ISSN: | 1558-7118 1557-2625 |
| DOI: | 10.3122/jabfm.2017.05.170035 |
| Popis: | Objective This quasi-experimental pilot study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices (PCPs) located in a rural county in Oklahoma. A Wellness Coordinator (WC) working with PCPs, the county health department, the county hospital, and a health information exchange (HIE) organization helped county residents receive evidence-based preventive services. Methods The WC used a community wellness registry connected to electronic medical records via HIE and called patients at the county level based on PCP-prioritized and tailored protocols. The registry flagged patient-level preventive care gaps, tracked outreach efforts, and documented the delivery of preventive services throughout the community. Return on investment (ROI) for prioritized preventive services was estimated in participating organizations. Results Six of the 7 PCPs in the county expressed interest in the project. Three of these practices fully implemented the 1-year outreach program starting in mid 2015. The regional HIE supplied periodic data updates for 9138 county residents to help the coordinators address care gaps using the community registry. A total of 5034 outreach calls were made by the WC in the first year and 7776 prioritized recommendations were offered when care gaps were detected. Of the 5034 distinct patients who received a call, 1146 (22%) were up to date on all prioritized services, whereas 3888 (78%) were due for at least 1 of the selected services. Health care organizations in the county significantly improved the delivery of selected preventive services (mean increase, 35% across 10 services; P = .004; range, 3% to 215%) and realized a mean ROI of 80% for these services (range, 32% to 122%). The health system that employed the WC earned an estimated revenue of $52,000 realizing a 40% ROI for the coordinator position. Conclusions Although more research is needed, our pilot study suggests that it may be feasible and cost effective to implement an innovative, county-level patient outreach program for improving preventive care in rural settings. |
| Databáze: | OpenAIRE |
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