Practice Patterns and Service Delivery

The Role of Community Health Centers

During the mid-1990s, Mathematica conducted a survey of Community Health Centers (CHCs) for the U.S. Department of Health and Human Services, Bureau of Primary Health Care. The study provided the first nationally representative data about the users of CHCs and the services they received. It also provided policymakers with a better understanding of the population being served and the extent to which CHCs fill a gap in the health care system.

In a follow-up project, we drew from the CHC survey, as well as a number of other national surveys, to examine the content and quality of CHC care. Three areas of interest were examined more closely: primary care for patients without insurance, with diabetes, and hypertension. To obtain copies of the final reports on these topics, contact Publications at (609) 275-2350.

WISEWOMAN Best Practices

Mathematica is developing evidence-based best practices for delivering nutrition and physical activity lifestyle interventions to financially disadvantaged women who participate in the Well Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program for the Centers for Disease Control and Prevention using the RE-AIM framework. To identify best practices, we conducted a literature review and five in-depth case studies at selected WISEWOMAN projects. The case studies included interviews with federal, state, and local staff; observations of lifestyle intervention sessions; and focus groups with current program participants. We are also developing resources, in the form of a manuscript and a tool kit, for dissemination to the appropriate audiences.

In another study, we reported on existing practices in the delivery of clinical preventive services to women enrolled in managed care organizations. The study focused on strategies that use data and information systems to improve the delivery of breast and cervical cancer screening services. In addition, we convened experts to recommend approaches to improve these health promotion strategies. Strategies included developing improved data systems for monitoring delivery of services and using these systems to develop reminder systems for patients and/or providers. We also examined improving medical office efficiency in delivering preventive care and carrying out related initiatives.

Increasing Colon Cancer Screening

Mathematica is assisting in questionnaire development and a survey of participants in large primary care practices to assess the impact of educational materials on decision making and colon cancer screening compliance.

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