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The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain.

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  • Additional Information
    • Subject Terms:
    • NAICS/Industry Codes:
      913910 Other local, municipal and regional public administration
      624190 Other Individual and Family Services
      623220 Residential Mental Health and Substance Abuse Facilities
      621498 All Other Outpatient Care Centers
      621494 Community health centres
    • Abstract:
      Hurricane Katrina destroyed much of the health care infrastructure in and around New Orleans in 2005. We describe a natural experiment that occurred afterward, amid efforts to rebuild the city's health care system, in which diverse safety-net clinics were transformed into medical homes. Using surveys of clinic leaders and administrative data, we found that clinics made substantial progress in implementing new clinical processes to improve access, quality and safety, and care coordination and integration. But there was wide variation, with some clinics making only minimal progress. Because the transformation was closely tied to the receipt of federal grants and bonus payments, we observed declines in performance toward the end of the study, when clinics faced diminished federal funding and refocused their priorities on survival. Now that federal funds have dried up, moreover, clinics may be losing ground in sustaining their practice changes. The experience shows that payment to support medical home transformation must be robust and stable, and clinics need to be fully integrated into the broader health care system to improve overall coordination of care. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of Health Affairs is the property of Project HOPE/HEALTH AFFAIRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1Associate Professor, Dept. of Family and Community Medicine, University of California, San Francisco (UCSF)
      2Associate Professor, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (UCSF)
      3Professor, Philip R. Lee Institute for Health Policy Studies, UCSF
      4Dept. of Anthropology, History, and Social Medicine, School of Medicine, UCSF
      5Project Director, Researcher, Analyst, Dept. of Family and Community Medicine, UCSF
      6Professor, Dept. of Family and Community Medicine, UCSF
    • ISSN:
      0278-2715
    • Accession Number:
      10.1377/hlthaff.2012.0402
    • Accession Number:
      78542728
  • Citations
    • ABNT:
      RITTENHOUSE, D. R. et al. The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain. Health Affairs, [s. l.], v. 31, n. 8, p. 1729–1738, 2012. DOI 10.1377/hlthaff.2012.0402. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=78542728&custid=s8280428. Acesso em: 8 ago. 2020.
    • AMA:
      Rittenhouse DR, Schmidt LA, Wu KJ, Wiley J. The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain. Health Affairs. 2012;31(8):1729-1738. doi:10.1377/hlthaff.2012.0402
    • APA:
      Rittenhouse, D. R., Schmidt, L. A., Wu, K. J., & Wiley, J. (2012). The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain. Health Affairs, 31(8), 1729–1738. https://doi.org/10.1377/hlthaff.2012.0402
    • Chicago/Turabian: Author-Date:
      Rittenhouse, Diane R., Laura A. Schmidt, Kevin J. Wu, and James Wiley. 2012. “The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain.” Health Affairs 31 (8): 1729–38. doi:10.1377/hlthaff.2012.0402.
    • Harvard:
      Rittenhouse, D. R. et al. (2012) ‘The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain’, Health Affairs, 31(8), pp. 1729–1738. doi: 10.1377/hlthaff.2012.0402.
    • Harvard: Australian:
      Rittenhouse, DR, Schmidt, LA, Wu, KJ & Wiley, J 2012, ‘The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain’, Health Affairs, vol. 31, no. 8, pp. 1729–1738, viewed 8 August 2020, .
    • MLA:
      Rittenhouse, Diane R., et al. “The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain.” Health Affairs, vol. 31, no. 8, Aug. 2012, pp. 1729–1738. EBSCOhost, doi:10.1377/hlthaff.2012.0402.
    • Chicago/Turabian: Humanities:
      Rittenhouse, Diane R., Laura A. Schmidt, Kevin J. Wu, and James Wiley. “The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain.” Health Affairs 31, no. 8 (August 2012): 1729–38. doi:10.1377/hlthaff.2012.0402.
    • Vancouver/ICMJE:
      Rittenhouse DR, Schmidt LA, Wu KJ, Wiley J. The Post-Katrina Conversion Of Clinics In New Orleans To Medical Homes Shows Change Is Possible, But Hard To Sustain. Health Affairs [Internet]. 2012 Aug [cited 2020 Aug 8];31(8):1729–38. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=78542728&custid=s8280428