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  • 1
    Online Resource
    Online Resource
    Partial and Incremental PCMH Practice Transformation: Implications for Quality and Costs
    Wiley ; 2014
    In:  Health Services Research Vol. 49, No. 1 ( 2014-02), p. 52-74
    Details
    In: Health Services Research, Wiley, Vol. 49, No. 1 ( 2014-02), p. 52-74
    Abstract: To examine the associations between partial and incremental implementation of the Patient Centered Medical Home ( PCMH ) model and measures of cost and quality of care. Data Source We combined validated, self‐reported PCMH capabilities data with administrative claims data for a diverse statewide population of 2,432 primary care practices in M ichigan. These data were supplemented with contextual data from the Area Resource File. Study Design We measured medical home capabilities in place as of J une 2009 and change in medical home capabilities implemented between J uly 2009 and J une 2010. Generalized estimating equations were used to estimate the mean effect of these PCMH measures on total medical costs and quality of care delivered in physician practices between J uly 2009 and J une 2010, while controlling for potential practice, patient cohort, physician organization, and practice environment confounders. Principal Findings Based on the observed relationships for partial implementation, full implementation of the PCMH model is associated with a 3.5 percent higher quality composite score, a 5.1 percent higher preventive composite score, and $26.37 lower per member per month medical costs for adults. Full PCMH implementation is also associated with a 12.2 percent higher preventive composite score, but no reductions in costs for pediatric populations. Incremental improvements in PCMH model implementation yielded similar positive effects on quality of care for both adult and pediatric populations but were not associated with cost savings for either population. Conclusions Estimated effects of the PCMH model on quality and cost of care appear to improve with the degree of PCMH implementation achieved and with incremental improvements in implementation.
    Type of Medium: Online Resource
    ISSN: 0017-9124 , 1475-6773
    URL: Issue
    URL: Article
    DOI: 10.1111/hesr.2014.49.issue-1
    DOI: 10.1111/1475-6773.12085
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2078493-4
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  • 2
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    Meeting unique requirements: Community consultation and public disclosure for research in emergency setting using exception from informed consent
    Wiley ; 2021
    In:  Academic Emergency Medicine Vol. 28, No. 10 ( 2021-10), p. 1183-1194
    Details
    In: Academic Emergency Medicine, Wiley, Vol. 28, No. 10 ( 2021-10), p. 1183-1194
    Abstract: Exception from informed consent (EFIC) regulations for research in emergency settings contain unique requirements for community consultation and public disclosure. These requirements address ethical challenges intrinsic to this research context. Multiple approaches have evolved to accomplish these activities that may reflect and advance different aims. This scoping review was designed to identify areas of consensus and lingering uncertainty in the literature. Methods Scoping review methodology was used. Conceptual and empirical literature related to community consultation and public disclosure for EFIC research was included and identified through a structured search using Embase, HEIN Online, PubMed, and Web of Science. Data were extracted using a standardized tool with domains for major literature categories. Results Among 84 manuscripts, major domains included conceptual or policy issues, reports of community consultation processes and results, and reports of public disclosure processes and results. Areas of consensus related to community consultation included the need for a two‐way exchange of information and use of multiple methods. Public acceptance of personal EFIC enrollment is commonly 64% to 85%. There is less consensus regarding how to assess attitudes, what “communities” to prioritize, and how to determine adequacy for individual projects. Core goals of public disclosure are less well developed; no metrics exist for assessing adequacy. Conclusions Multiple methods are used to meet community consultation and public disclosure requirements. There remain no settled norms for assessing adequacy of public disclosure, and there is lingering debate about needed breadth and depth of community consultation.
    Type of Medium: Online Resource
    ISSN: 1069-6563 , 1553-2712
    URL: Issue
    URL: Article
    DOI: 10.1111/acem.v28.10
    DOI: 10.1111/acem.14264
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2029751-8
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  • 3
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    Online Resource
    Achieving Integration in Mixed Methods Designs—Principles and Practices
    Wiley ; 2013
    In:  Health Services Research Vol. 48, No. 6pt2 ( 2013-12), p. 2134-2156
    Details
    In: Health Services Research, Wiley, Vol. 48, No. 6pt2 ( 2013-12), p. 2134-2156
    Abstract: Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs—exploratory sequential, explanatory sequential, and convergent—and through four advanced frameworks—multistage, intervention, case study, and participatory. Integration at the methods level occurs through four approaches. In connecting, one database links to the other through sampling. With building, one database informs the data collection approach of the other. When merging, the two databases are brought together for analysis. With embedding, data collection and analysis link at multiple points. Integration at the interpretation and reporting level occurs through narrative, data transformation, and joint display. The fit of integration describes the extent the qualitative and quantitative findings cohere. Understanding these principles and practices of integration can help health services researchers leverage the strengths of mixed methods.
    Type of Medium: Online Resource
    ISSN: 0017-9124 , 1475-6773
    URL: Issue
    URL: Article
    DOI: 10.1111/hesr.2013.48.issue-6pt2
    DOI: 10.1111/1475-6773.12117
    Language: English
    Publisher: Wiley
    Publication Date: 2013
    detail.hit.zdb_id: 2078493-4
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  • 4
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    Anorexia nervosa complicated with hiatal hernia and superior mesenteric artery syndrome: A case illustrating the risk of inference observation confusion
    Wiley ; 2017
    In:  Journal of General and Family Medicine Vol. 18, No. 3 ( 2017-06), p. 144-145
    Details
    In: Journal of General and Family Medicine, Wiley, Vol. 18, No. 3 ( 2017-06), p. 144-145
    Type of Medium: Online Resource
    ISSN: 2189-7948 , 2189-7948
    URL: Issue
    URL: Article
    DOI: 10.1002/jgf2.2017.18.issue-3
    DOI: 10.1002/jgf2.26
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2886539-X
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  • 5
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    Patient perspectives on factors influencing active surveillance adherence for low‐risk prostate cancer: A qualitative study
    Wiley ; 2024
    In:  Cancer Medicine Vol. 13, No. 1 ( 2024-01)
    Details
    In: Cancer Medicine, Wiley, Vol. 13, No. 1 ( 2024-01)
    Abstract: Prostate cancer is the most common cancer among men in the United States. Treatment guidelines recommend active surveillance for low‐risk prostate cancer, which involves monitoring for progression, to avoid or delay definitive treatments and their side effects. Despite increased uptake, adherence to surveillance remains a challenge. Methods We conducted semi‐structured, qualitative, virtual interviews based on the Theoretical Domains Framework (TDF), with men (15) who were or had been on active surveillance for their low‐risk prostate cancer in 2020. Interviews were transcribed and coded under TDF's behavioral theory‐based domains. We analyzed domains related to adherence to surveillance using constructivist grounded theory to identify themes influencing decision processes in adherence. Results The TDF domains of emotion, beliefs about consequences, environmental context and resources, and social influences were most relevant to surveillance adherence‐. From these four TDF domains, three themes emerged as underlying decision processes: trust in surveillance as treatment, quality of life, and experiences of self and others. Positive perceptions of these three themes supported adherence while negative perceptions contributed to non‐adherence (i.e., not receiving follow‐up or stopping surveillance). The relationship between the TDF domains and themes provided a theoretical process describing factors impacting active surveillance adherence for men with low‐risk prostate cancer. Conclusions Men identified key factors impacting active surveillance adherence that provide opportunities for clinical implementation and practice improvement. Future efforts should focus on multi‐level interventions that foster trust in surveillance as treatment, emphasize quality of life benefits and enhance patients' interpersonal experiences while on surveillance to optimize adherence.
    Type of Medium: Online Resource
    ISSN: 2045-7634 , 2045-7634
    URL: Issue
    URL: Article
    DOI: 10.1002/cam4.v13.1
    DOI: 10.1002/cam4.6847
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2659751-2
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  • 6
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    Family physicians’ perspectives on genetics and the human genome project : FPs, genetics and the human genome project
    Wiley ; 1999
    In:  Clinical Genetics Vol. 56, No. 1 ( 1999-07), p. 28-34
    Details
    In: Clinical Genetics, Wiley, Vol. 56, No. 1 ( 1999-07), p. 28-34
    Type of Medium: Online Resource
    ISSN: 0009-9163
    URL: Article
    DOI: 10.1034/j.1399-0004.1999.560104.x
    RVK:
    WA 15000
    Language: English
    Publisher: Wiley
    Publication Date: 1999
    detail.hit.zdb_id: 2004581-5
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  • 7
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    Japanese and United States Family Medicine Resident Physicians' Attitudes about Training
    Wiley ; 2002
    In:  General Medicine Vol. 3, No. 1 ( 2002), p. 9-16
    Details
    In: General Medicine, Wiley, Vol. 3, No. 1 ( 2002), p. 9-16
    Type of Medium: Online Resource
    ISSN: 1346-0072 , 1883-6011
    URL: Article
    DOI: 10.14442/general2000.3.9
    Language: English
    Publisher: Wiley
    Publication Date: 2002
    detail.hit.zdb_id: 2934370-7
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  • 8
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    Challenging procedures used in systematic reviews by promoting a case‐based approach to the analysis of qualitative methods in nursing trials
    Wiley ; 2021
    In:  Nursing Inquiry Vol. 28, No. 2 ( 2021-04)
    Details
    In: Nursing Inquiry, Wiley, Vol. 28, No. 2 ( 2021-04)
    Abstract: This methodological discussion invites critical reflection about the procedures used to analyze the contribution of qualitative and mixed methods research to nursing trials by mounting an argument that these should rest on multiple publications produced about a project, rather than a single article. We illustrate the value‐added of this approach with findings from a qualitative, cross‐case analysis of three critical case exemplars from nursing researchers that each used a qualitative approach with a mixed method phase. The holistic lens afforded by a case‐based approach informs nursing inquiry by documenting that the critical case exemplars presented evidence of (a) a sustained commitment of resources and expertise for the qualitative methods that extended across more than one phase of the trial, (b) the impact of the qualitative methods on the trial or its aftermath, (c) deploying a theoretical or conceptual framework for a variety of purposes, and (d) integrating qualitative and quantitative data for purposes of extending explanatory power. Findings challenge the practice of linking purposes served by qualitative and mixed methods to a single trial phase.
    Type of Medium: Online Resource
    ISSN: 1320-7881 , 1440-1800
    URL: Issue
    URL: Article
    DOI: 10.1111/nin.v28.2
    DOI: 10.1111/nin.12393
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2010171-5
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  • 9
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    ‘How do you know what Aunt Martha looks like?’ A video elicitation study exploring tacit clues in doctor–patient interactions
    Wiley ; 2011
    In:  Journal of Evaluation in Clinical Practice Vol. 17, No. 5 ( 2011-10), p. 933-939
    Details
    In: Journal of Evaluation in Clinical Practice, Wiley, Vol. 17, No. 5 ( 2011-10), p. 933-939
    Abstract: Rationale and objectives  Theory suggests that tacit clues inform clinical judgements, but the prevalence and role of tacit clues during clinical interactions is unknown. This study explored whether doctors and patients identify information likely to be tacit clues or judgements based on tacit clues during health maintenance examinations. Methods  Qualitative analysis of video elicitation interview transcripts involving 18 community‐based primary care doctors and 36 patients. Outcomes were description and analysis of tacit clues and judgements based on tacit clues mentioned by participants. Results  A total of 57 references to tacit clues and 53 references to judgements based on tacit clues were identified from patient and doctor transcripts. Non‐verbal behaviours comprised the most common category of tacit clues (53% of doctor comments; 42% of patient comments). Patients mostly discussed judgements based on tacit clues that related to the doctor–patient relationship. Doctors discussed actively using non‐verbal behaviours to provide patients with tacit clues about the doctor–patient relationship. They also mentioned tacit clues that informed medical judgements and decision making. Gestalt judgements based on tacit clues were common (33% of doctor comments). Several participants identified instances in which they had difficulty articulating their rationale for specific judgements. Doctors varied widely in how frequently they mentioned tacit clues. Conclusion  During video elicitation interviews, patients and doctors identified tacit clues and judgements based on these clues as playing a role during health maintenance examinations. Future research should further elucidate the role of tacit clues in medical judgements and doctor–patient relationships.
    Type of Medium: Online Resource
    ISSN: 1356-1294 , 1365-2753
    URL: Issue
    URL: Article
    DOI: 10.1111/jep.2011.17.issue-5
    DOI: 10.1111/j.1365-2753.2010.01628.x
    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 2006772-0
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  • 10
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    The primary care provider ( PCP )‐cancer specialist relationship: A systematic review and mixed‐methods meta‐synthesis
    Wiley ; 2017
    In:  CA: A Cancer Journal for Clinicians Vol. 67, No. 2 ( 2017-03), p. 156-169
    Details
    In: CA: A Cancer Journal for Clinicians, Wiley, Vol. 67, No. 2 ( 2017-03), p. 156-169
    Abstract: Although they are critical to models of coordinated care, the relationship and communication between primary care providers (PCPs) and cancer specialists throughout the cancer continuum are poorly understood. By using predefined search terms, the authors conducted a systematic review of the literature in 3 databases to examine the relationship and communication between PCPs and cancer specialists. Among 301 articles identified, 35 met all inclusion criteria and were reviewed in‐depth. Findings from qualitative, quantitative, and disaggregated mixed‐methods studies were integrated using meta‐synthesis. Six themes were identified and incorporated into a preliminary conceptual model of the PCP‐cancer specialist relationship: 1) poor and delayed communication between PCPs and cancer specialists, 2) cancer specialists' endorsement of a specialist‐based model of care, 3) PCPs' belief that they play an important role in the cancer continuum, 4) PCPs' willingness to participate in the cancer continuum, 5) cancer specialists' and PCPs' uncertainty regarding the PCP's oncology knowledge/experience, and 6) discrepancies between PCPs and cancer specialists regarding roles. These data indicate a pervasive need for improved communication, delineation, and coordination of responsibilities between PCPs and cancer specialists. Future interventions aimed at these deficiencies may improve patient and physician satisfaction and cancer care coordination. CA Cancer J Clin 2017;67:156–169. © 2016 American Cancer Society.
    Type of Medium: Online Resource
    ISSN: 0007-9235 , 1542-4863
    URL: Issue
    URL: Article
    DOI: 10.3322/caac.v67.2
    DOI: 10.3322/caac.21385
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 603553-X
    detail.hit.zdb_id: 2018502-9
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