Publications: Vulnerable Populations

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Patient Centeredness, Cultural Competence, and Healthcare Quality

February 2, 2009 - A comparison of the histories of patient centeredness and cultural competence in health care delivery reveals that, despite some differences, these quality initiatives share many of the same core concepts.

In the Literature

Patient-Centered Communication, Ratings of Care, and Concordance of Patient and Physician Race

December 1, 2003 - This study examines how race concordance affects patient–physician communication and patients' perceptions of the quality of their care.

In the Literature

Patient-Provider Communication About the Health Effects of Obesity

February 5, 2009 - A Commonwealth Fund-supported study of overweight and obese patients found disparities in how patients of different racial and ethnic backgrounds perceive the health effects of their weight. Health care providers can play an important role in helping patients understand the often serious implications.

In the Literature

Patients' Attitudes Toward Health Care Providers Collecting Information About Their Race and Ethnicity

January 6, 2006 - Most patients can see the importance of collecting and tracking data on race and ethnicity, but many are uncomfortable disclosing their information to administrators or clerks, a new Fund-supported study finds. Having doctors and nurses collect the information can help ease patients' concerns.

In the Literature

Pay-for-Performance Programs to Reduce Racial/Ethnic Disparities: What Might Different Designs Achieve?

April 9, 2012 - With Commonwealth Fund support, researchers used Hospital Quality Alliance data on more than 4 million patients at 4,500 hospitals to analyze the effects of different pay-for-performance designs on disparities in care between minority and white patients.

In Brief

Physician Effects on Racial and Ethnic Disparities in Patients’ Experiences of Primary Care

February 1, 2010 - A Commonwealth Fund–supported study published in the Journal of General Internal Medicine investigated the extent to which racial and ethnic disparities can be attributed to differences within physician practices—meaning they are potentially related to discrimination or differential treatment—or to differences between practices, an indication that minority patients tend to receive treatment in low-performing practices.

Literature Abstract

Policies to Reduce Racial and Ethnic Disparities in Child Health and Health Care

September 8, 2004 - Minority children often receive poorer health care than other children. While a variety of public and private sector programs are taking on these disparities, better coordination and monitoring at the federal level is needed to maximize their effectiveness, the Fund's Anne C. Beal, M.D., says in a Health Affairs article.

In the Literature

The Post-Katrina Conversion of Clinics in New Orleans to Medical Homes Shows Change Is Possible, But Hard to Sustain

August 6, 2012 - Given the right incentives, safety-net primary care clinics can make the transition to become patient-centered medical homes. The results of the New Orleans program, however, underscore that primary care transformation is a long process, and one difficult to achieve and sustain.

In the Literature

Preventive Care and Physician Counseling

May 1, 1999 - Despite national attention to increasing preventive health care for women, The Commonwealth Fund 1998 Survey of Women's Health finds little change in preventive health screening rates since a similar study commissioned by the Fund in 1993. The 1998 survey also finds that wide disparities in screening rates persist across income and education levels and racial and ethnic groups.

Data Brief

Promising Practices for Patient-Centered Communication with Vulnerable Populations: Examples from Eight Hospitals

August 22, 2006 - This Fund report identifies "promising practices" that address language barriers and low health literacy to help hospitals and providers better communicate with their vulnerable patients.

Fund Report

Promoting the Integration and Coordination of Safety-Net Health Care Providers Under Health Reform: Key Issues

October 13, 2011 - Safety-net health care providers face particular challenges in coordinating care for their low-income and uninsured patients. This Commonwealth Fund issue brief finds that successful efforts will require flexibility, as well as federal, state, and local financial resources to sustain the safety net and make the investments needed to upgrade capabilities.

Issue Brief

Providing Language Interpretation Services in Health Care Settings: Examples from the Field

May 1, 2002 - The report profiles a variety of programs around the country that provide interpretation services in health care settings, and also identifies federal, state, local, and private funding sources for interpretation services.

Fund Report

Providing Language Services in Small Health Care Provider Settings: Examples from the Field

April 8, 2005 - Community health centers and small physician practices can have a particularly difficult time effectively serving patients with limited English proficiency. A new Fund report shows how a number of solo practitioners, small group practices, and clinics around the country have found creative methods for meeting the needs of these patients.

Fund Report

Providing Language Services in State and Local Health-Related Benefits Offices: Examples From the Field

January 18, 2007 - Many benefits offices, which help people apply for Medicaid and other public programs, lack knowledge and resources about language services. The National Health Law Program evaluted these offices and offers strategies, such as written language access plans, recruiting bilingual staff for dual roles, and interpreter competency testing.

Fund Report

Providing Underserved Patients with Medical Homes: Assessing the Readiness of Safety-Net Health Centers

May 3, 2010 - This brief surveys safety-net health centers to determine their potential to become medical homes. Safety-net health centers that provide vulnerable and low-income populations with comprehensive primary care have unique opportunities for successful transformation, but also face challenges.

Issue Brief