자료유형  

 학위논문

Control Number  

0016932457

International Standard Book Number  

9798379590079

Dewey Decimal Classification Number  

614

Main Entry-Personal Name  

Provenzano, Anthony Michael.

Publication, Distribution, etc. (Imprint  

[S.l.] : University of Michigan., 2023

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2023

Physical Description  

1 online resource(186 p.)

General Note  

Source: Dissertations Abstracts International, Volume: 84-12, Section: B.

General Note  

Advisor: Platt, Jodyn E.;Piatt, Gretchen A.

Dissertation Note  

Thesis (Ph.D.)--University of Michigan, 2023.

Restrictions on Access Note  

This item must not be sold to any third party vendors.

Summary, Etc.  

요약Health systems and medical practices are taking a greater role in providing social care. Federally Qualified Health Centers (FQHCs) lead these efforts, offering a model for using technology to manage care and exchange patient information. This study describes Michigan FQHC services, partnerships, and technological capabilities that support the delivery of social care. Methods. Theories and frameworks from public health and information science were applied in mixed methods research. A sample of Michigan FQHCs (n=15) were recruited into the study. Quantitatively, a health information technology (HIT) capability practice survey was developed. Semi-structured interviews were then conducted with FQHC leadership, clinicians, and staff (n=24) to explore workforce and technological factors associated with developing care management and partnership data activities. The analyses of the survey and interviews addressed three broad research questions: (i) What preventive and social care services do FQHCs deliver, and to what extent are those services provided in partnership with other organizations? (Chapter 2), (ii) What information infrastructure is available to support these services? (Chapter 3), and (iii) What are the facilitators and barriers to providing preventive and social care? (Chapter 4). Results. On average, Michigan FQHCs delivered eight (M=7.9, SD=3.6) cross-sector services. Most Michigan FQHCs addressed public health prevention (n=12, 80%). For behavioral healthcare, the majority of FQHCs (n=10, 69.3%) delivered both mental health (MH) and substance use disorder (SUD) services. There was one health center that delivered all 10 social care services studied. Most provided at least 3: food assistance, transportation, and domestic violence. FQHCs formed collaborations with health systems, mental health agencies, and local health departments to improve communication, care quality, and data management. FQHCs also integrated services and developed partnerships to ensure patients accessed a broader range of preventive services and social care (Chapter 2). Michigan FQHCs developed HIT infrastructure to digitally exchange patient information. Data was typically shared with maternal and infant health (n=5, 33.3%), mental health (n=5, 33.3%), and substance use (n=6, 40%) providers, but FQHCs had not developed similar capabilities with the social care sector. FQHCs leveraged health care and government investments in HIT as a strategy to circumvent non-automated types of data sharing (Chapter 3). Interviews revealed Michigan FQHCs participated in communitywide activities to establish value-based practices and quality care initiatives using shared data and technology. Study participants discussed that their involvement facilitated data management, digital information exchange, and quality improvement efforts. Ultimately, however, limited housing services and inadequate behavioral healthcare created barriers for Michigan FQHCs to refer patients to local resources and treatment (Chapter 4). Conclusions. Developing information infrastructure and technological capabilities to manage patient social needs and improve care quality is necessary but insufficient. Investments in both technology and human capital are critical to create a social care infrastructure. Building on the evidence gained from FQHC partnership activities offers insight into policy changes and investments needed. This study provides foundational research to support future investigations of how community health information exchanges and collaborative data practices can be leveraged to deliver high-quality care and improve outcomes.

Subject Added Entry-Topical Term  

Health sciences.

Subject Added Entry-Topical Term  

Health care management.

Index Term-Uncontrolled  

Care management

Index Term-Uncontrolled  

Federally qualitied health centers

Index Term-Uncontrolled  

Health information technology

Index Term-Uncontrolled  

Partnerhships

Index Term-Uncontrolled  

Social determinants of health

Index Term-Uncontrolled  

Technological capabilities

Added Entry-Corporate Name  

University of Michigan Health Service Organizations and Policy & Social and Administrative Sciences

Host Item Entry  

Dissertations Abstracts International. 84-12B.

Host Item Entry  

Dissertation Abstract International

Electronic Location and Access  

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Control Number  

joongbu:642770