دورية أكاديمية
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Improved Access to and Impact of Registered Dietitian Nutritionist Services Associated with an Integrated Care Model in a High-Risk, Minority Population.

التفاصيل البيبلوغرافية
العنوان: Improved Access to and Impact of Registered Dietitian Nutritionist Services Associated with an Integrated Care Model in a High-Risk, Minority Population.
المؤلفون: Warner MF, Miklos KE, Strowman SR, Ireland K, Pojednic RM
المصدر: Journal of the Academy of Nutrition and Dietetics [J Acad Nutr Diet] 2018 Oct; Vol. 118 (10), pp. 1951-1957. Date of Electronic Publication: 2018 Jul 17.
نوع المنشور: Comparative Study; Evaluation Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101573920 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2212-2672 (Print) Linking ISSN: 22122672 NLM ISO Abbreviation: J Acad Nutr Diet Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York : Elsevier
مواضيع طبية MeSH: Delivery of Health Care, Integrated/*statistics & numerical data , Minority Groups/*statistics & numerical data , Nutrition Therapy/*statistics & numerical data , Nutritionists/*statistics & numerical data , Patient Acceptance of Health Care/*statistics & numerical data, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Boston ; Child ; Child, Preschool ; Female ; Health Services Accessibility/statistics & numerical data ; Humans ; Male ; Middle Aged ; Nutrition Therapy/methods ; Outcome Assessment, Health Care ; Retrospective Studies ; Young Adult
مستخلص: Background: Integrated health care models create opportunities for registered dietitian nutritionists (RDNs) to provide nutrition-related care and engage in multidisciplinary teams to improve clinical outcomes. While benefits of integrated care (IC) have been reported, little is known about the impact of the RDN within an IC model.
Objective: Our primary objective was to identify whether IC vs traditional care (TC) increases the number of RDN patient visits. Our secondary objective was to evaluate clinical outcomes of patients seeing an RDN vs not, regardless of care model.
Design: This was a retrospective cohort study.
Participants/setting: Patients were aged 3 to 94 years and from a patient-centered medical home in Boston, MA.
Main Outcome Measures: We measured 3-month total and average number of patients seen by the RDN in TC vs IC. Changes in adult hemoglobin A1c, weight, and pediatric body mass index (measured as kg/m 2 ) among high-risk patients seen by an RDN compared to patients not seen by an RDN.
Statistical Analysis: Data were obtained from electronic medical records and analyzed utilizing Mann-Whitney U test, analysis of covariance, and paired sample t tests.
Results: The RDN saw 145 patients (137 adult, 8 pediatric) in the TC model compared to 185 patients (135 adult, 50 pediatric) in the IC model. Mean number of patients seen per session was 3.20 in the TC model vs 4.63 in the IC model (P=0.004). Adult hemoglobin A1c within-group differences decreased by 0.42%±1.49% (P=0.007) for patients seen by an RDN and decreased 0.15%±1.47% (P=0.012) for patients not seen by an RDN. Adult weight within-group differences decreased 1.0±7.2 kg (P=0.15) for patients seen by a RDN and increased 0.1±5.6 kg (P=0.70) for patients not seen by a RDN. Pediatric BMI showed no change between or within groups.
Conclusions: The IC model increased 3-month total number of patients seen by an RDN. High-risk patients who saw an RDN had a significant decrease in hemoglobin A1c.
(Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Diabetes; Integrated care and patient-centered medical homes; Minority/black population; Obesity; Registered dietitian nutritionist (RDN)
تواريخ الأحداث: Date Created: 20180722 Date Completed: 20191004 Latest Revision: 20191210
رمز التحديث: 20231215
DOI: 10.1016/j.jand.2018.05.004
PMID: 30029962
قاعدة البيانات: MEDLINE
الوصف
تدمد:2212-2672
DOI:10.1016/j.jand.2018.05.004