Evidence map›Paper›PMID 30202774›Full record

ArticleHealth services research and managerial epidemiology

Utilization Outcomes of a Pilot Primary Care Team Redesign.

Alison R Landrey, Valerie S Harder, Marie B Sandoval, John G King, David S Ziegelman, Charles D MacLean

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In one paragraph

Article in Health services research and managerial epidemiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alison R LandreyDepartment of Medicine, University of Vermont Medical Center, Burlington, VT, USA.
Valerie S HarderDepartments of Pediatrics and Psychiatry, University of Vermont Medical Center, Burlington, VT, USA.
Marie B SandovalDepartment of Medicine, University of Vermont Medical Center, Burlington, VT, USA.
John G KingDepartment of Family Medicine, University of Vermont Medical Center, Burlington, VT, USA.
David S ZiegelmanDepartment of Medicine, University of Vermont Medical Center, Burlington, VT, USA.
Charles D MacLeanDepartment of Medicine, University of Vermont Medical Center, Burlington, VT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the effect of a team-based primary care redesign on primary care, emergency department (ED) and urgent care (UC) utilization, and new patient access to primary care. STUDY

designA retrospective pre-post difference-in-differences analysis of utilization outcomes for patients on a redesigned primary care team compared to a standard primary care group.

methodsWithin a patient-centered medical home, a pilot team was developed comprising 2 colocated "teamlets" of 1 physician, 1 nurse practitioner (NP), 1 registered nurse (RN), and 2 licensed practical nurses (LPNs). The redesigned team utilized physician-NP comanagement, expanded roles for RNs and LPNs, and dedicated provider time for telephone and e-mail medicine. We compared changes in number of office, ED, and UC visits during the implementation year for patients on the redesigned team compared to patients receiving the standard of care in the same clinic. Proportion of new patient visits was also compared between the pilot and the control groups.

resultsThere were no differences between the redesign group and control group in per-patient mean change in office visits (Δ = -0.04 visits vs Δ = -0.07;

conclusionsThe redesign did not significantly impact ED, UC, or primary care utilization within 1 year of follow-up. It did improve access for new patients.

Indexed as

access to careemergency visitspractice managementprimary careprogram evaluation

Identifiers

PMID30202774
PMCPMC6125848

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.