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Disruptive Models in Primary Care: Caring for High-Needs, High-Cost Populations

Overview of attention for article published in JGIM: Journal of General Internal Medicine, February 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • High Attention Score compared to outputs of the same age and source (88th percentile)

Mentioned by

news
1 news outlet
twitter
41 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
22 Dimensions

Readers on

mendeley
53 Mendeley
Title
Disruptive Models in Primary Care: Caring for High-Needs, High-Cost Populations
Published in
JGIM: Journal of General Internal Medicine, February 2017
DOI 10.1007/s11606-016-3945-2
Pubmed ID
Authors

Michael Hochman, Steven M. Asch

Abstract

Starfield and colleagues have suggested four overarching attributes of good primary care: "first-contact access for each need; long-term person- (not disease) focused care; comprehensive care for most health needs; and coordinated care when it must be sought elsewhere." As this series on reinventing primary care highlights, there is a compelling need for new care delivery models that would advance these objectives. This need is particularly urgent for high-needs, high-cost (HNHC) populations. By definition, HNHC patients require extensive attention and consume a disproportionate share of resources, and as a result they strain traditional office-based primary care practices. In this essay, we offer a clinical vignette highlighting the challenges of caring for HNHC populations. We then describe two categories of primary care-based approaches for managing HNHC populations: complex case management, and specialized clinics focused on HNHC patients. Although complex case management programs can be incorporated into or superimposed on the traditional primary care system, such efforts often fail to engage primary care clinicians and HNHC patients, and proven benefits have been modest to date. In contrast, specialized clinics for HNHC populations are more disruptive, as care for HNHC patients must be transferred to a multidisciplinary team that can offer enhanced care coordination and other support. Such specialized clinics may produce more substantial benefits, though rigorous evaluation of these programs is needed. We conclude by suggesting policy reforms to improve care for HNHC populations.

Twitter Demographics

The data shown below were collected from the profiles of 41 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 53 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 53 100%

Demographic breakdown

Readers by professional status Count As %
Unspecified 13 25%
Student > Ph. D. Student 8 15%
Researcher 8 15%
Student > Master 6 11%
Other 4 8%
Other 14 26%
Readers by discipline Count As %
Unspecified 16 30%
Medicine and Dentistry 15 28%
Nursing and Health Professions 13 25%
Social Sciences 3 6%
Business, Management and Accounting 2 4%
Other 4 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 38. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 April 2018.
All research outputs
#403,308
of 12,788,180 outputs
Outputs from JGIM: Journal of General Internal Medicine
#351
of 4,471 outputs
Outputs of similar age
#16,324
of 252,545 outputs
Outputs of similar age from JGIM: Journal of General Internal Medicine
#11
of 99 outputs
Altmetric has tracked 12,788,180 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,471 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.7. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 252,545 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 99 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.