Feasibility and Effectiveness of System Redesign for Diabetes Care Management in Rural Areas

Abstract

A redesigned care delivery system that uses case management with structured group visits and an electronic registry can be successfully incorporated into rural primary care practices and appears to significantly improve both care processes and practice productivity.

Recommendations for Prevention of Childhood Obesity

“…[258][259][260][261][262] There is indirect evidence from these collaboratives to suggest that the following practice changes may improve care to prevent obesity in children.…”

“…Indirect evidence on the use of group visits 259,266 suggests that it is a cost-effective and efficient way to deliver care. The group setting allows the provider to offer information to larger groups of individuals at one time and allows family members to interact with others who are facing the same challenges.…”

“…259,262 We suggest flagging charts to identify those who are at risk of overweight or are gaining weight at an accelerated rate, so that future providers can address the effects of weight gain on the child's health. Practice changes may be needed to provide ongoing support to clients in the at-risk category.…”

Survival Disparities in Patients With Lymphoma According to Place of Residence and Treatment Provider: A Population-Based Study

“…[1][2][3][4][5][6][7][8] Rural patients are less likely to receive optimal treatment, and have less favorable outcomes for different types of illnesses. 1,2,5,[8][9][10] This disparity can be due to many factors including lack of access to quality health care providers. 2,11,12 Rural patients have also been shown to present with more severe disease, have lower socioeconomic status, and have generally poorer health habits.…”

Low Health Literacy: Overview, Assessment, and Steps Toward Providing High-Quality Diabetes Care

“…Care modeled on the CCM includes providing not only self-management support to patients through goal-setting and routine follow-up, but also links to community resources and support to care providers through clinical information systems and decision support. [60][61][62][63][64][65] Modeling primary care services on the CCM improves diabetes outcomes overall, [66][67][68][69] but data suggest that improvements for patients with limited literacy may be even greater in these systems that provide proactive, coordinated diabetes care, particularly those that help patients address access barriers such as insurance and transportation problems.…”