3篇
您的检索式：作者名="Heather Angier"
|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | A new role for primary care teams in the United States after“Obamacare:”Track and improve health insurance coverage rates显示文摘Maintaining continuous health insurance coverage is important.With recent expansions in access to coverage in the United States after“Obamacare,”primary care teams have a new role in helping to track and improve coverage rates and to provide outreach to patients.We describe efforts to longitudinally track health insurance rates using data from the electronic health record(EHR)of a primary care network and to use these data to support practice-based insurance outreach and assistance.Although we highlight a few examples from one network,we believe there is great potential for doing this type of work in a broad range of family medicine and community health clinics that provide continuity of care.By partnering with researchers through practice-based research networks and other similar collaboratives,primary care practices can greatly expand the use of EHR data and EHR-based tools targeting improvements in health insurance and quality health care. | Jennifer DeVoe Heather Angier Megan Hoopes Rachel Gold | 2016 | Family Medicine and Community Health2016，4，4： | 0 |
| 2 | New hypertension and diabetes diagnoses following the Affordable Care Act Medicaid expansion显示文摘Objective To assess the Affordable Care Act(ACA)Medicaid expansion’s impact on new hypertension and diabetes diagnoses in community health centres(CHCs).Design Rates of new hypertension and diabetes diagnoses were computed using generalised estimating equation Poisson models and we tested the difference-in difference(DID)pre-ACA versus post-ACA in states that expanded Medicaid compared with those that did not.Setting We used electronic health record data(pre-ACA:1 January 2012-31 December 2013-post-ACA:1 January 2014-31 December 2016)from the Accelerating Data Value Across a National Community Health Center Network clinical data network.We included clinics with≥50 patients contributing to person-time at risk in each study year.Participants Patients aged 19-64 with≥1 ambulatory visit in the study period were included.We then excluded patients who were pregnant during the study period(N=127530).For the hypertension outcome,we excluded individuals with a diagnosis of hypertension prior to the start of the study period,those who had a hypertension diagnosis on their first visit to a clinic or their first visit after 3 years without a visit,and those who had a diagnosis more than 3 years after their last visit(pre-ACA non-expansion N=130973;expansion N=193198;post-ACA non-expansion N=186341;expansion N=251015).For the diabetes analysis,we excluded patients with a diabetes diagnosis prior to study start,on their first visit or first visit after inactive patient status,and diagnosis while not an active patient(pre-ACA non-expansion N=145435;expansion N=198558;post-ACA non-expansion N=215039;expansion N=264644).Results In non-expansion states,adjusted hypertension diagnosis rates saw a relative decrease of 6%,while in expansion states,the adjusted rates saw a relative increase of 7%(DID 1.14,95%CI 1.11 to 1.18).For diabetes diagnosis,adjusted rates in non-expansion states experienced a significant relative increase of 28%and in expansion states the relative increase was 25%;yet these differences were not significant pre-ACA to post-ACA comparing expansion and non-expansion states(DID 0.98,95%CI 0.91 to 1.05).Conclusion There was a differential impact of Medicaid expansion for hypertension and diabetes diagnoses.Moderate increases were found in diabetes diagnosis rates among all patients served by CHCs post-ACA(both in expansion and non-expansion states).These increases suggest that ACA-related opportunities to gain health insurance(such as marketplaces and the Medicaid expansion)may have facilitated access to diagnostic tests for this population.The study found a small change in hypertension diagnosis rates from pre-ACA to post-ACA(a decrease in non-expansion and an increase in expansion states).Despite the significant difference between expansion and non-expansion states,the small change from pre-ACA to post-ACA suggests that the diagnosis of hypertension is likely documented for patients,regardless of health insurance availability.Future studies are needed to understand the impact of the ACA on hypertension and diabetes treatment and control. | Heather Angier Nathalie Huguet David Ezekiel-Herrera Miguel Marino Teresa Schmidt Beverly B Green Jennifer E DeVoe | 2020 | Family Medicine and Community Health2020，8，4： | 0 |
| 3 | Progress towards using community context with clinical data in primary care显示文摘Community-level factors have significant impacts on health.There is renewed enthusiasm for integrating these data with electronic health record(EHR)data for use in primary care to improve health equity in the USA.Thus,it is valuable to reflect on what has been published to date.Specifically,we comment on:(1)recommendations about combining community-level factors in EHRs for use in primary care;(2)examples of how these data have been combined and used;and(3)the impact of using combined data on healthcare,patient health and health equity.We found publications discussing the potential of combined data to inform clinical care,target interventions,track population health and spark community partnerships with the goal of reducing health disparities and improving health equity.Although there is great enthusiasm and potential for using these data to inform primary care,there is little evidence of improved healthcare,patient health or health equity. | Heather Angier Elizabeth A Jacobs Nathalie Huguet Sonja Likumahuwa-Ackman Stephanie Robert Jennifer E DeVoe | 2019 | Family Medicine and Community Health2019，7，1： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员