CommunityRx: A Population Health Improvement Innovation That Connects Clinics To Communities

Lindau, Stacy Tessler; Makelarski, Jennifer A.; Abramsohn, Emily; Beiser, David G.; Escamilla, Verónica; Jerome, Jessica; Johnson, Daniel; Kho, Abel N.; Lee, Karen K.; Long, Timothy; Miller, Doriane

doi:10.1377/hlthaff.2016.0694

Cited by 75 publications

(80 citation statements)

References 9 publications

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“…Moreover, 21% of food-secure caregivers requested food support referrals. 36 As suggested by our previous work, these food-secure individuals may value information about resources to help family members or friends 23 or may be food secure because they are utilizing similar resources and need additional resources to maintain food security.…”

Section: Discussionmentioning

confidence: 92%

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Diagnostic Accuracy of Two Food Insecurity Screeners Recommended for Use in Health Care Settings

et al. 2017

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Objectives To test the diagnostic accuracy of the American Academy of Pediatrics (AAP) recommended food insecurity screener. Methods We conducted prospective diagnostic accuracy studies between July and November 2016, in Chicago, Illinois. We recruited convenience samples of adults from adult and pediatric emergency departments (12-month recall study: n|=|188; 30-day recall study: n|=|154). A self-administered survey included the 6-item Household Food Security Screen (gold standard), the validated 2-item Hunger Vital Sign (HVS; often, sometimes, never response categories), and the 2-item AAP tool (yes-or-no response categories). Results Food insecurity was prevalent (12-month recall group: 46%; 30-day group: 39%). Sensitivity of the AAP tool using 12-month and 30-day recall was, respectively, 76% (95% confidence interval [CI]|=|65%, 85%) and 72% (95% CI|=|57%, 84%). The HVS sensitivity was significantly higher than the AAP tool (12-month: 94% [95% CI|=|86%, 98%; P|=|.002]; 30-day: 92% [95% CI|=|79%, 98%; P|=|.02]). Conclusions The AAP tool missed nearly a quarter of food-insecure adults screened in the hospital; the HVS screening tool was more sensitive. Public health implications Health care systems adopting food insecurity screening should optimize ease of administration and sensitivity of the screening tool.

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Section: Discussionmentioning

confidence: 92%

“…Participants were also given the contact information for a “community health information specialist,” a community health worker employed by the research team who could help locate food or other resources in their community. 23 …”

Section: Methodsmentioning

confidence: 99%

Diagnostic Accuracy of Two Food Insecurity Screeners Recommended for Use in Health Care Settings

et al. 2017

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“…The northwest region was almost entirely African American (98%). 8 The southeast region was majority Hispanic (83%). If more than one individual in a household was 35 years or older, random sampling was used to select which eligible household resident was approached for enrollment.…”

Section: Methodsmentioning

confidence: 99%

Pharmacy accessibility and cost-related underuse of prescription medications in low-income Black and Hispanic urban communities

Qato¹,

Wilder²,

Zenk³

et al. 2017

Journal of the American Pharmacists Association

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Background Policy efforts to reduce the cost of prescription medications in the U.S. have failed to reduce disparities in cost-related underuse. Little is known about the relationships between pharmacy accessibility, utilization and cost-related underuse of prescription medications among residents of low-income minority communities. Objectives To examine the association between pharmacy accessibility, utilization and cost-related underuse of prescription medications among residents of predominantly low-income, Black and Hispanic urban communities. Methods Data from a population-based probability sample of adults 35 years and older residing on the South Side of Chicago in 2012–13 were linked with geocoded information on the type and location of primary and nearest pharmacy. Multivariable regression models were used to examine associations between pharmacy accessibility, utilization of, and travel distance to, primary pharmacy and cost-related underuse overall and by pharmacy type. Results One-third of South Side residents primarily filled their prescriptions at the pharmacy nearest to their home. Among those who did not use mail order, median distance traveled from home to the primary pharmacy was 1.2 miles. Residents whose primary pharmacy was at a community health center or clinic where they usually received care traveled the furthest but were least likely to report cost-related underuse of their prescription medications. Conclusions Most residents of minority communities on Chicago’s South Side were not using pharmacies closest to their home to obtain their prescription medications. Efforts to improve access to prescription medications in these communities should focus on improving the accessibility of affordable pharmacies at site of care.

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“…CommunityRx combines e-prescribing and community engagement to connect patients with community resources, via the diagnoses generated in EHRs. 44 Hennepin Health integrated a public health department, medical center, federally qualified health center, and health plan across payment, delivery, and data systems to better coordinate services and address SDH. 45 Although these 2 organizations transformed care at great cost, practices can make meaningful changes on smaller scales.…”

Section: Discussionmentioning

confidence: 99%

Living in “Cold Spot” Communities Is Associated with Poor Health and Health Quality

et al. 2018

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Purpose:Little is known about incorporating community data into clinical care. This study sought to understand the clinical associations of cold spots (census tracts with worse income, education, and composite deprivation).Methods: Across 12 practices, we assessed the relationship between cold spots and clinical outcomes (obesity, uncontrolled diabetes, pneumonia vaccination, cancer screening-colon, cervical, and prostate-and aspirin chemoprophylaxis) for 152,962 patients. We geocoded and linked addresses to census tracts and assessed, at the census tract level, the percentage earning less than 200% of the Federal Poverty Level, without high school diplomas, and the social deprivation index (SDI). We labeled those census tracts in the worst quartiles as cold spots and conducted bivariate and logistic regression.Results: There was a 10-fold difference in the proportion of patients in cold spots between the highest (29.1%) and lowest practices (2.6%). Except for aspirin, all outcomes were influenced by cold spots. Fifteen percent of low-education cold-spot patients had uncontrolled diabetes compared with 13% of noncold-spot patients (P < .05). In regression, those in poverty, low education, and SDI cold spots were less likely to receive colon cancer screening (odds ratio [

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CommunityRx: A Population Health Improvement Innovation That Connects Clinics To Communities

Cited by 75 publications

References 9 publications

Diagnostic Accuracy of Two Food Insecurity Screeners Recommended for Use in Health Care Settings

Diagnostic Accuracy of Two Food Insecurity Screeners Recommended for Use in Health Care Settings

Pharmacy accessibility and cost-related underuse of prescription medications in low-income Black and Hispanic urban communities

Living in “Cold Spot” Communities Is Associated with Poor Health and Health Quality

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