Abstract：
:Community health centers (CHCs) provide primary care for underserved children and adults. The Patient Protection and Affordable Care Act (ACA) aimed to strengthen the CHC network by increasing federal funds and expanding Medicaid eligibility. The ACA also aimed to boost preventive and mental health services and to reduce health and healthcare disparities. Here, we summarize our results to-date as experts in investigating the impact of ACA Medicaid expansion on CHCs and the patients they serve. We found the ACA Medicaid expansion increased access to care and preventive services, primarily in Medicaid expansion states. Rates of physical and mental health conditions rose substantially from pre- to post-ACA in expansion states, suggesting underdiagnosis pre-ACA. Disparities in health insurance coverage by race/ethnicity decreased at CHCs, yet some remain. These findings indicate that the ACA Medicaid expansion significantly helped CHCs and patients. Insurance expansion buoyed CHCs' financial viability by increasing reimbursement. Therefore, the ACA Medicaid expansion enhanced the health of underserved patients and repeal would jeopardize these advances for CHCs and their patients.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Tilhou AS,Huguet N,DeVoe J,Angier Hdoi
10.1007/s11606-019-05571-wsubject
Has Abstractpub_date
2020-04-01 00:00:00pages
1292-1295issue
4eissn
0884-8734issn
1525-1497pii
10.1007/s11606-019-05571-wjournal_volume
35pub_type
杂志文章abstract：:The lack of effective and consistent research mentorship and research mentor training in both undergraduate medical education (UME) and graduate medical education (GME) is a critical constraint on the development of innovative and high quality medical education research. Clinical research mentors are often not familia...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-015-3295-5
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:Limitations in instrumental activities of daily living (IADL) hinder a person's ability to live independently in the community and self-manage their conditions, but its impact on hospital readmission has not been firmly established. OBJECTIVE:To test the importance of IADL dependency as a predictor of 30-da...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05982-0
更新日期：2020-10-01 00:00:00
abstract：OBJECTIVE:Routine screening for prostate cancer is controversial because of frequent false-positive results, the potential for slow, non-life-threatening growth of untreated cancer, the uncertainty regarding whether treatment can extend life, and the potential for treatment complications. This study examines how inform...
journal_title：Journal of general internal medicine
pub_type： 临床试验,杂志文章
doi：10.1007/BF02600045
更新日期：1996-06-01 00:00:00
abstract：OBJECTIVE:Methods of assessing humanism in internal medicine residents have not been completely designed or evaluated. This study used patient satisfaction as a measure of humanism, and assessed the validity of using faculty physicians to evaluate residents' humanistic behavior. Residents' ability to assess themselves ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599551
更新日期：1989-11-01 00:00:00
abstract：BACKGROUND:Despite compelling reasons to draw on the contributions of under-represented minority (URM) faculty members, US medical schools lack these faculty, particularly in leadership and senior roles. OBJECTIVE:The study's purpose was to document URM faculty perceptions and experience of the culture of academic med...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1478-7
更新日期：2010-12-01 00:00:00
abstract：BACKGROUND:Treatment decisions about menopause are predicated on a transient duration of vasomotor symptoms. However, evidence supporting a specific duration is weak. OBJECTIVE:To estimate the natural progression of vasomotor symptoms during the menopause transition by systematically compiling available evidence using...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,meta分析
doi：10.1007/s11606-008-0655-4
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:Antibiotics are often prescribed for hospitalized patients with chronic obstructive pulmonary disease (COPD) exacerbations. The use of procalcitonin (PCT) in the management of pneumonia has safely reduced antibiotic durations, but limited data on the impact of PCT guidance on the management of COPD exacerbat...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-018-4312-2
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:Social risk factors (SRFs) such as minority race-and-ethnicity or low income are associated with quality-of-care, health, and healthcare outcomes. Organizations might prioritize improving care for easier-to-treat groups over those with SRFs, but measuring, reporting, and further incentivizing quality-of-care...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05473-x
更新日期：2019-11-11 00:00:00
abstract：BACKGROUND:Use of electronic health records (EHRs) is associated with physician stress and burnout. While emergency departments and subspecialists have used scribes to address this issue, little is known about the impact of scribes in academic primary care. OBJECTIVE:Assess the impact of a scribe on physician and pati...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-018-4434-6
更新日期：2018-07-01 00:00:00
abstract：:Much of medical practice involves the exercise of such basic cognitive tasks as estimating probabilities and synthesizing information. Scientists studying cognitive processes have identified impediments to accurate performance on these tasks. Together the impediments foster "cognitive bias." Five factors that can detr...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/BF02596149
更新日期：1987-05-01 00:00:00
abstract：:The authors surveyed 112 recent alumni and 92 current residents (70% responded) at a residency program that requires original research. Most alumni felt that the research project was a valuable learning experience, particularly in improving their abilities to critically review the medical literature. Almost a third fe...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599759
更新日期：1993-03-01 00:00:00
abstract：BACKGROUND:As electronic health records (EHRs) become widely adopted, alerts and reminders can improve medication safety, but excessive alerts may irritate or overwhelm clinicians, thereby reducing their effectiveness. We developed a novel "stealth" alert in an EHR to improve anticoagulation monitoring for patients pre...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-012-2137-y
更新日期：2012-12-01 00:00:00
abstract：:African Americans and Latinos use services that require a doctor's order at lower rates than do whites. Racial bias and patient preferences contribute to disparities, but their effects appear small. Communication during the medical interaction plays a central role in decision making about subsequent interventions and ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2003.20532.x
更新日期：2003-02-01 00:00:00
abstract：:This paper deals with the varied sites and teachers that can and should be used in educating residents and medical students in ambulatory care. A basic premise is that sites other than academic medical centers and teachers other than physician faculty members should be among those used. The paper describes how institu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02600436
更新日期：1990-01-01 00:00:00
abstract：:The purpose of this paper is to address why the three dominant alternatives to compensating physicians (fee-for-service, capitation, and salary) fall short of what is needed to support enhanced primary care in the patient-centered medical home, and the relevance of such payment reforms as pay-for-performance and episo...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1295-z
更新日期：2010-06-01 00:00:00
abstract：:The study examined the relative contribution of caregivers' conduct and physical conditions of the hospital setting to patients' global satisfaction with health care, while controlling for self-assessed health status. The study was performed in the Soroka Medical Center, which is the only inpatient facility for a popu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02598274
更新日期：1996-05-01 00:00:00
abstract：OBJECTIVE:To review the current information on medical complications, psychological implications, and legislative issues related to body piercing, a largely unregulated industry in the United States. METHODS:We conducted a MEDLINE search of English language articles from 1966 until May 1998 using the search terms "bod...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1046/j.1525-1497.1999.00357.x
更新日期：1999-06-01 00:00:00
abstract：:In 1989, the internal medicine residency training program at St. John's Episcopal Hospital changed from a standard one-in-four on-call system to a night float system of resident on call. Using a confidential questionnaire that assessed the opinions of medical nurses, the nurses were asked which system they preferred, ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599842
更新日期：1995-07-01 00:00:00
abstract：BACKGROUND:Heterogeneity of existing physician burnout studies impairs analyses of longitudinal trends, geographic distribution, and organizational factors impacting physician burnout. The Department of Veterans Affairs (VA) is one of the largest integrated healthcare systems in the USA, offering a unique opportunity t...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05582-7
更新日期：2020-05-01 00:00:00
abstract：BACKGROUND:As a result of market forces and maturing technology, generalists are currently providing services, such as colonoscopy, that in the past were deemed the realm of specialists. OBJECTIVE:To determine whether there were differences in patient characteristics, procedure complexity, and clinical indications whe...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2000.06039.x
更新日期：2000-03-01 00:00:00
abstract：:This report examines alternative methods of paying for clinical preventive care services. First, the extent of coverage of preventive health care services in public and private health insurance plans is reviewed. Included in this review are Medicare, Medicaid, health maintenance organizations, and private health insur...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02600851
更新日期：1990-09-01 00:00:00
abstract：BACKGROUND:Most research on transitions of care has focused on the transition from acute to outpatient care. Little is known about the transition from outpatient to acute care. We conducted a systematic review of the literature on the transition from outpatient to acute care, focusing on provider-to-provider communicat...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-015-3547-4
更新日期：2016-04-01 00:00:00
abstract：BACKGROUND:We sought to examine the relationship between literacy and heart failure-related quality of life (HFQOL), and to explore whether literacy-related differences in knowledge, self-efficacy and/or self-care behavior explained the relationship. METHODS:We recruited patients with symptomatic heart failure (HF) fr...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s11606-011-1668-y
更新日期：2011-09-01 00:00:00
abstract：BACKGROUND:In 2005 the Spoken Knowledge in Low Literacy in Diabetes scale (SKILLD) was introduced as a diabetes knowledge test. The SKILLD has not been validated since its introduction. OBJECTIVE:To perform a validation analysis on the SKILLD. DESIGN AND PARTICIPANTS:Cross-sectional observational study of 240 patient...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-011-1900-9
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:Post-hospital discharge follow-up appointments are intended to evaluate patients' recovery following a hospitalization, but it is unclear how appointment statuses are associated with readmissions. OBJECTIVE:To examine the association between post-discharge ambulatory follow-up status, (1) having a scheduled...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06569-5
更新日期：2021-01-19 00:00:00
abstract：:Americans are living longer - a mark of success in public health and medical care - but more will live the last few years with progressive illness and disability. The dominant conception of care delivery separates "aggressive" or life-extending care from "palliative" or death-accepting care, with an assumed "transitio...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2001.90901.x
更新日期：2001-05-01 00:00:00
abstract：BACKGROUND:There are currently roughly 10,000 Germans on the organ waiting list, and that number is over 113,000 in the USA. There is a clear need to increase support for organ donation in general and to increase the number of registered donors in particular. OBJECTIVE:The current study examines the relationship betwe...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05734-0
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:The patient-centered medical home (PCMH) model has several components to improve care for patients with high comorbidity, including greater access to face-to-face primary care. OBJECTIVE:We examined whether high-comorbidity patients had larger increases in primary care provider (PCP) visits attributable to ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-016-3833-9
更新日期：2016-12-01 00:00:00
abstract：BACKGROUND:Financial compensation for participating in research is controversial, especially when participants are recruited from economically disadvantaged and/or marginalized populations such as drug users. Little is known about these participants' own views regarding payment for research participation. OBJECTIVE:Th...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0319-9
更新日期：2007-10-01 00:00:00
abstract：:This article highlights the timely situation that resident physicians, faculty, and staff are facing after the recent highly publicized murders of Black Americans and its impact on our healthcare communities. We discuss our experiences of how the hospital can serve as a meeting place for anti-racism, as well as how an...
journal_title：Journal of general internal medicine
pub_type： 社论
doi：10.1007/s11606-020-06291-2
更新日期：2020-10-20 00:00:00
