Examining the relationship between hospital ownership and population health efforts.

PURPOSE: The purpose of this paper is to investigate the relationship between ownership type and population health initiatives adopted by hospitals using the 2015 American Hospital Association data. DESIGN/METHODOLOGY/APPROACH: Hospitals of various sizes, ownership structures and geographic locations are represented in the survey. The outcome variables of interest include measures of hospital population health activities. FINDINGS: Findings indicate that nonprofit hospitals are most likely to express commitment to population health and participate in population health activities, with for-profit hospitals being least likely. Implications for policy and practice are discussed. RESEARCH LIMITATIONS/IMPLICATIONS: This study demonstrates that discrepancies in population health approaches exist across ownership status - particularly, nonprofit hospitals appear to be the most likely to be involved in population health efforts. PRACTICAL IMPLICATIONS: As we continue to push for population health management in the hospital setting, grappling with the definition and purpose of population health management will be essential. SOCIAL IMPLICATIONS: Overall, these results suggest that nonprofit hospitals are more likely to be implementing population health efforts than for-profit or government-owned hospitals. ORIGINALITY/VALUE: Although there are several studies on population health in hospitals, this study is the first to investigate the relationship between ownership type and population health initiatives adopted by hospitals.

Strategies to Modify the Risk of Heart Failure Readmission: A Systematic Review and Meta-Analysis.

BACKGROUND: Human factors play an important role in health-care outcomes of heart failure (HF) patients. A systematic review and meta-analysis of clinical trial studies on HF hospitalization may yield positive proofs of the beneficial effect of specific care management strategies. PURPOSE: To investigate how the 8 guiding principles of choice, rest, environment, activity, trust, interpersonal relationships, outlook, and nutrition reduce HF readmissions. BASIC PROCEDURES: Appropriate keywords were identified related to the (1) independent variable of hospitalization and treatment, (2) the moderating variable of care management principles, (3) the dependent variable of readmission, and (4) the disease of HF to conduct searches in 9 databases. Databases searched included CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ERIC, MEDLINE, PubMed, PsycInfo, Science Direct, and Web of Science. Only prospective studies associated with HF hospitalization and readmissions, published in English, Chinese, Spanish, and German journals between January 1, 1990, and August 31, 2015, were included in the systematic review. In the meta-analysis, data were collected from studies that measured HF readmission for individual patients. MAIN FINDINGS: The results indicate that an intervention involving any human factor principles may nearly double an individual's probability of not being readmitted. Participants in interventions that incorporated single or combined principles were 1.4 to 6.8 times less likely to be readmitted. PRINCIPAL CONCLUSIONS: Interventions with human factor principles reduce readmissions among HF patients. Overall, this review may help reconfigure the design, implementation, and evaluation of clinical practice for reducing HF readmissions in the future.

Comparison of strategies to increase HIV testing among African-American gay, bisexual, and other men who have sex with men in Washington, DC.

This paper presents results from a study conducted to compare the relative effectiveness of three strategies - alternate venue testing (AVT), the social network strategy (SNS), and partner counseling and referral services (PCRS; standard care) - for reaching and motivating previously undiagnosed, African-American men who have sex with men (AA MSM) to be tested for HIV. Data were collected between June 2008 and February 2010 at a gay-identified, community-based organization (CBO) serving AA MSM in Washington, DC. Men were eligible to participate if they were 18-64 years old, self-identified as black or African-American, were biologically male, and self-reported oral or anal sex with a man in the past six months. Fisher's exact test of independence was used to assess differences in demographics, testing history, HIV status and sexual behaviors across the three strategies. The final sample included 470 men who met all eligibility requirements. There were no statistically significant differences in HIV positivity rates across the three strategies. However, relative to standard care, the SNS, and (to a lesser degree) the AVT strategies were more successful in recruiting men that had never been tested. Additionally, the results indicate that each strategy recruited different subgroups of men. Specifically, heterosexually identified men and men who reported engaging in unprotected sex were most likely to be recruited via SNS. Bisexually identified men and older men were most likely to be recruited via AVT or SNS, while standard care tended to reach greater proportions of young men and homosexually identified men. These findings suggest that a combination of strategies may be the best approach for engaging African-American MSM in HIV testing.