Background: The patient-centered medical home (PCMH) is promoted as a way to improve access to care, health care outcomes, and control costs. The organizational, environmental, and patient characteristics associated with school-based health centers (SBHCs) obtaining PCMH recognition is currently unknown. A multitheoretical approach was used to…

The breakdown of care transitions between various healthcare facilities, providers, and services is a major issue in healthcare, and accounts for over US$15 billion in healthcare expenditures annually. The transition between inpatient care and home care is a very delicate period where, too often, chronically ill patients get worse and wind up back…

Background: The Affordable Care Act (ACA) was introduced, in part, to increase access to primary care, which has been shown to provide patients with myriad health benefits. Objective: To increase primary care usage by understanding the beliefs about primary and emergency care most salient to those whose healthcare-seeking practices may be impacted…

Introduction: Knowledge translation (KT) initiatives have the potential to improve prescribing quality and produce savings that exceed the cost of the KT program itself, including the cost of evaluation using pragmatic study methods. Our objective was to measure the impact and estimated savings resulting from the distribution of individualized…

Although primary care practices and schools are major venues for the delivery of mental health services to children, these systems are disconnected, contributing to fragmentation in service delivery. This paper describes barriers to collaboration across the primary care and school systems, including administrative and fiscal pressures, conceptual…

Background: Families supporting children with complex needs are significantly more distressed and economically disadvantaged than families of children without disability and delay. What is not known is the associations and costs of parental psychiatric distress within a multi-diagnosis group of special needs children. Methods: In this…

Evaluated economic costs for nursing home patients and elderly living in their own homes. Using time records compiled by nurses or family members, the costs incurred annually in caring for a senile demented elderly person at home were estimated to average $11,735, and in a nursing home, $22,458. (Author/BL)

The academic medical center is being affected by changes in the national health care delivery system, including the rapid growth in prepaid health plans, the emerging surplus of physicians, and the continued escalation of health care costs. (Author/MLW)

Two surveys show that the use of prepaid health care plans for educational purposes is rising. A review of published studies that have examined the costs of such training is included. (Author/MLW)

The comprehensive medical care system being utilized in China is described. Topics discussed include: the availability of medical care, training of physicians, medical care costs, and the political and social implications of the Chinese system. Lessons the United States can learn from the Chinese experience are presented. (BT)

Experience with the Computer Stored Ambulatory Record (COSTAR), a computerized medical records system, installed at a large primary care clinic at a university medical center is reported. Use of the system was terminated because clinic revenues could not cover operating costs. (Author/MLW)

This pilot study provides information on the effort required to conduct a telephone survey on access to care of persons with angina. Allowing for noncontact calls, refusal to participate, and ineligibility, the response rate for whites was 23.4% (2,724 of 11,559), and that of African Americans was 24.3% (2,003 of 8,242). (SLD)

Three factors that will have major effects on the medical cost quality debate are: industrial and governmental policy in regard to health-related expenditures, an aging population, and societal attitudes towards competition in the health care system. Approaches to conflict resolution are offered. (MLW)

A questionnaire was administered to 339 graduating senior medical students at the Medical College of Georgia to determine different potential sources of influence on career choice. Indebtedness may be associated with the choice of a non-primary care specialty with greater remuneration than primary care specialty. (MLW)

Women have a higher prevalence of depressive disorders compared to men. The current system of care for women with depressive disorders provides significant financial barriers for patients with lower incomes to access mental health services. Primary care systems are used extensively by women and have the potential to diagnose patients at early…