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Increased Organizational Stress in Primary Care: Understanding the Impact of the COVID-19 Pandemic, Medicaid Expansion, and Practice Ownership.
Britz, Jacqueline B; Huffstetler, Alison N; Brooks, E Marshall; Richards, Alicia; Sabo, Roy T; Webel, Ben K; McCray, Neil; Krist, Alex H.
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  • Britz JB; From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Rich
  • Huffstetler AN; From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Rich
  • Brooks EM; From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Rich
  • Richards A; From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Rich
  • Sabo RT; From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Rich
  • Webel BK; From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Rich
  • McCray N; From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Rich
  • Krist AH; From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB, ANH, EMB, AR, RTS, BKW, AHK), Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC (ANH), Virginia Department of Medical Assistance Services, Rich
J Am Board Fam Med ; 36(6): 892-904, 2024 Jan 05.
Article en En | MEDLINE | ID: mdl-38092433
BACKGROUND: Primary care is the foundation of health care, resulting in longer lives and improved equity. Primary care was the frontline of the COVID-19 pandemic public response and essential for access to care. Yet primary care faces substantial structural and systemic challenges. As part of a longitudinal analysis to track the capacity and health of primary care, we surveyed every primary care practice in Virginia in 2018 and again in 2022. METHODS: Surveys were emailed or mailed up to 6 times and nonresponders received a phone call. Questions assessed organizational characteristics, scope of care, capacity, and organizational stress in the prior year. From respondents, 39 clinicians, nurses, staff, administrators, and practice managers were interviewed. RESULTS: 526 out of 2296 primary care practices (23% response rate) completed the survey, with broad representation across geography, ownership, and payer mix. Compared with 2018, in 2022 there were increases in practices owned by health systems (25% vs 43%, P < .0001) and average percent of patients with Medicaid per practice (12% vs 22%, P < .0001). The percent of practices reporting any major stressor increased from 34% to 53% (P < .0001). The main increased stress was losing a clinician, with 13% of practices in 2018 versus 42% in 2022 reporting losing a clinician (P < .0001). CONCLUSIONS: Primary care practices are resilient and continue to serve their communities, including a broad scope of services and care for underserved people. However, the COVID-19 pandemic caused significant stress. With an increase in clinicians leaving clinical practice, we anticipate worsening access to primary care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicaid / COVID-19 Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Am Board Fam Med Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Medicaid / COVID-19 Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Am Board Fam Med Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos