Abstract:
:In the face of severe financial challenges and demands to improve quality and service to patients, many community health centers (CHCs) have aligned or integrated with other CHCs, physician groups, or hospitals. Yet the nature of and rationale for these organizational decisions are not well understood. Our research applied an organizational theoretical framework to test whether strategic adaptation theory or institutional theory best describes the integration activity of CHCs in Ohio. We collected primary data from case studies of seven CHCs selected for geographic representation and studied December 2000-January 2001. Semi-structured interviews and a case study database supported our chain of evidence. We found that CHC integration activity was substantial (five of seven CHCs integrated) and extremely varied. Consistent with strategic adaptation theory, we determined that CHC integration actions were predominantly center-specific, rational responses to environmental challenges and were initiated to improve operations or financial performance. Rarely did CHCs initiate major organizational change merely to mimic other CHC actions, as might have been expected of highly institutionalized organizations. Understanding the basis for CHCs' strategic decisions while monitoring financial health will remain critical as lawmakers and administrators work to develop policies that both maintain progress made and improve primary care access for the poor, the uninsured, and those with special health care needs served by these important safety net providers.
journal_name
J Health Care Poor Underservedjournal_title
Journal of health care for the poor and underservedauthors
McAlearney JS,McAlearney ASdoi
10.1353/hpu.2006.0030keywords:
subject
Has Abstractpub_date
2006-02-01 00:00:00pages
55-64issue
1eissn
1049-2089issn
1548-6869pii
S1548686906100558journal_volume
17pub_type
杂志文章,多中心研究abstract::Serious mental illness is highly prevalent in jails and prisons, and treatment with psychiatric medications is often required. However, operational factors and patient characteristics make prescribing in correctional settings uniquely challenging. The American Academy of Psychiatry and the Law has approved the formati...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0055
更新日期:2016-01-01 00:00:00
abstract::Detainees of large urban jails have may health risks including injuries related to violence and firearms. A survey of 582 randomly selected detainees entering the Cook County Department of Corrections during the summer of 1994 found that 51 percent had previously entered hospitals for violence-related injuries, and 26...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章,评审
doi:10.1353/hpu.2010.0640
更新日期:1995-01-01 00:00:00
abstract::The objective of this study was to assess the factorial invariance and convergent validity of the Group-Based Medical Mistrust Scale (GBMMS) across gender (male and female) and ethnoracial identity (Latino and Black). Minority students (N = 686) attending a southeastern university were surveyed in the fall of 2011. Ps...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2017.0011
更新日期:2017-01-01 00:00:00
abstract::Poor communication of medical information during care transitions can lead to medication errors, adverse drug events, and increased health care costs. The crucial pharmacist's role sometimes requires efforts to improve documentation. Here, we describe our experience integrating a pharmacist into a medical team at a fe...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2013.0045
更新日期:2013-02-01 00:00:00
abstract::Homicide is the number one cause of death among African American youth, both male and female. Largely to blame for Black-on-Black violence is the sense of alienation our youth feel from society. To counter this phenomenon of violence it is essential to empower youth. Through education and community-based programs we c...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2010.0612
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVES:To test whether foreign-born status confers a protective effect against low birth weight (LBW) outcomes among Mexican-origin women in Colorado. METHODS:Retrospective cohort study utilizing Colorado birth records from 1989-2004 for multivariate logistic regression analysis. The study population was 66,422 U....
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2012.0065
更新日期:2012-05-01 00:00:00
abstract::This report describes an innovative approach to implementing the Office-Based Opioid Treatment (OBOT) model in underserved, community-based settings. Although numerous resources are available to physicians interested in offering medication-assisted treatment (MAT), there is little guidance on how to integrate and oper...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2020.0080
更新日期:2020-01-01 00:00:00
abstract::The documented high incidence of mental health disorders among individuals in substance abuse treatment argues for the importance of studying the provision of mental health services to this population. This survey documents how the Linkage Programs assembled an array of mental health services based on the assessed hea...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章,多中心研究
doi:10.1353/hpu.2010.0377
更新日期:1995-01-01 00:00:00
abstract::Current estimates of homelessness in the U.S. are biased toward counts of sheltered or visibly unsheltered individuals. Those who remain out of sight during counts and/or live in places or circumstances that elude the United States Department of Housing and Urban Development's (HUD) definition of homelessness remain u...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0122
更新日期:2016-01-01 00:00:00
abstract::This article describes the implementation of a pharmaceutical Patient Assistance Program in a free clinic, including issues such as navigating complicated pharmaceutical company requirements, obtaining documentation for income verification, engaging healthcare providers, tracking and re-ordering medications, and devel...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0148
更新日期:2016-01-01 00:00:00
abstract::Abstract:Background. Understanding condom-use patterns and the reasons that women have for choosing not to use condoms with their sexual partners, (both steady and non-steady), is important to the development and implementation of targeted, culturally appropriate interventions that can promote condom u...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2011.0160
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:This study analyzed the impact of sociodemographic characteristics, patient comorbidities, risk factors for critical limb ischemia and hospital characteristics on racial disparities in amputation rates for Native American patients with peripheral artery disease (PAD). METHODS:The study used the Healthcare...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2018.0058
更新日期:2018-01-01 00:00:00
abstract::This commentary examines Genesee County (Flint) Michigan to explore whether a well-structured safety net system is able to provide low-income uninsured people adequate access to care at a reasonable cost. Genessee County is one of the more economically challenged communities in the country. This commentary explores th...
journal_title:Journal of health care for the poor and underserved
pub_type: 评论,杂志文章
doi:10.1353/hpu.2012.0025
更新日期:2012-02-01 00:00:00
abstract::Precision medicine is an approach in which the characteristics of patients as well as their diseases are used to identify optimal therapy; it links researchers, patients, health care providers, and clinical laboratories. In precision medicine, specific molecular characteristics of an untreatable cancer can be targeted...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2019.0117
更新日期:2019-01-01 00:00:00
abstract::This study examines travel patterns for hospitalization among elderly patients to address whether there are differences by age and race/ethnicity, and whether the differences persist even when a severe illness occurs. Using the Healthcare Cost and Utilization Project (HCUP) State Inpatient database (SID) of the Agency...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2005.0023
更新日期:2005-05-01 00:00:00
abstract::While the goals of President Clinton's health care reform plan--to expand access to health care by the underserved and reduce the unacceptably high cost of care--are important, his proposed mechanisms for doing so include provisions that are counterproductive. Blacklisting certain drugs from the Medicare program, impo...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2010.0081
更新日期:1994-01-01 00:00:00
abstract::Compared with youth of other races/ethnicities, Native American youth (ages 15-19 years) are more likely to have participated in sexual intercourse, thus placing them at greater risk for sexually transmitted diseases (STDs) and unintended pregnancies. This study's purpose was to investigate relationships among protect...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2006.0133
更新日期:2006-11-01 00:00:00
abstract::The goals of the United States' National HIV/AIDS Strategy are reducing HIV infections, increasing linkage to care, and reducing health disparities. To accomplish these, it is imperative to have accurate data about HIV prevalence, especially in high-burden populations, including immigrants, ethnic/racial minorities an...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0128
更新日期:2016-01-01 00:00:00
abstract::Family engagement may improve disease management, yet little is known about this topic as it relates to underrepresented minorities who receive care in low-resource primary care settings. This study aimed to explore family engagement in diabetes and hypertension management at an Urban Indian Health Organization to ide...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2020.0063
更新日期:2020-01-01 00:00:00
abstract::Booster seats protect child occupants between 4 and 8 years of age. The objective of this study was to determine barriers and facilitators for booster seat use among Latino families. We conducted one-to-one elicitation interviews with 56 mothers and 35 fathers of booster-eligible Latino children in an urban county and...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2006.0058
更新日期:2006-05-01 00:00:00
abstract::Mexican American women have the highest incidence of metabolic syndrome among all U.S. demographic groups. This paper details an innovative approach to reducing the risks for metabolic syndrome among Hispanic families in rural Idaho. Compañeros en Salud (CeS) is a promotora-led wellness program and community-based par...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2013.0106
更新日期:2013-01-01 00:00:00
abstract::This study assessed links between racism and oral health outcomes among pregnant Canadian Aboriginal women. Baseline data were analyzed for 541 First Nations (94.6%) and Métis (5.4%) women in an early childhood caries preventive trial conducted in urban and on-reserve communities in Ontario and Manitoba. One-third of ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2016.0030
更新日期:2016-01-01 00:00:00
abstract::Hepatitis C virus (HCV) is the most common blood-borne chronic viral infection in the United States and it is over represented in incarcerated populations. This study estimates if in prison tattooing is associated with self reported HCV infection in a probabilistic sample of 1,331 sentenced inmates in Puerto Rico pris...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2011.0084
更新日期:2011-08-01 00:00:00
abstract::Screening for colorectal cancer (CRC) is underutilized among ethnic minority groups, particularly among Korean American immigrants. To explore the role of cultural and health beliefs in CRC screening, a structured questionnaire was administered to 281 Korean American immigrants aged between 50 and 88 in the New York m...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2013.0087
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Vision problems in homeless children can decrease educational achievement and quality of life. PURPOSE:To estimate the prevalence and specific diagnoses of vision problems in children in an urban homeless shelter. METHODS:A prospective series of 107 homeless children and teenagers who underwent screening w...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2015.0072
更新日期:2015-08-01 00:00:00
abstract::In this study, we examined the treatment and outcomes of pancreatic adenocarcinoma in New Mexico Native Americans (NA). METHODS:A retrospective review of patients treated for pancreatic adenocarcinoma at a university cancer center from 2002-2016 comparing demographic characteristics, disease presentation, treatment, ...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2019.0045
更新日期:2019-01-01 00:00:00
abstract::Only 43% of Americans with HIV are virally suppressed; the rate is lower for African Americans, even among insured populations. This study uses 2010 Medicare and Medicaid data for HIV-positive Californians to examine how antiretroviral treatment (ART) relates to patient and provider characteristics. Logistic regressio...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2017.0031
更新日期:2017-01-01 00:00:00
abstract::While African Americans are at a significantly higher risk for developing certain cancers, they also have low rates of participation in cancer research, particularly clinical trials. This study assessed both African American men's and African American women's (1) knowledge of and participation in cancer-related clinic...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2013.0187
更新日期:2013-11-01 00:00:00
abstract::Patient activation describes an individual's readiness to participate in their health care. Lower levels of activation that may contribute to poor health outcomes have been documented in Latino patients. We administered a brief activating intervention directed at Spanish-speakers that sought to improve and encourage q...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2014.0110
更新日期:2014-05-01 00:00:00
abstract::Miami-Dade and Broward counties remain an epicenter of the HIV/AIDS epidemic in the U.S. This report from the field describes the implementation of a SAMHSA-funded, campus-based initiative to address HIV prevention and testing for young minority men who have sex with men. Outcome criteria are clearly delineated and be...
journal_title:Journal of health care for the poor and underserved
pub_type: 杂志文章
doi:10.1353/hpu.2017.0048
更新日期:2017-01-01 00:00:00