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Accountable care organizations (ACO) emerge each year aiming to improve care quality while controlling rising health care costs. This cross-sectional study examined whether ACO arrangements within a Preferred Provider Organization and a Health Maintenance Organization (HMO) effected patient experience. A modified Consumer Assessment of Healthcare Providers and Systems ACO survey was used to assess care domain differences overall and by product. The association between ACO and non-ACO populations and items in each significant care domain, flu vaccination, and delayed and emergency department care are explored using multivariable logistic regression. Accountable care organizations patients were more likely to report it was easy to get a specialist appointment (adjusted odds ratio [AOR], 1.54; 95% CI = 1.11-2.13), less likely to report visiting the emergency department for care (AOR, 0.70; 95% CI = 0.55-0.90) and communicating with their provider using technology (AOR, 0.79; 95% CI = 0.65-0.96). Reported experience differed for Access to Specialists between ACO and non-ACO groups among overall and HMO respondents (79.4% vs 74.7% and 79.9% vs 75.5%, P < .05, respectively). The ACO patient experience was not substantially better. Strategies incorporating satisfaction and experience, whether linked to contracts or not, should be encouraged given ACOs goal to optimize patient care. Survey instruments must be improved to capture nuances of provider care and patient bond that is vital in ACO integrated systems.

The Health Care Systems Research Network (HCSRN; formerly HMO Research Network) held its annual conference in Atlanta, Georgia, in April 2016. A consortium of research organizations affiliated with 20 large health care delivery systems, the HCSRN met for the 22nd consecutive year to report on scientific achievements, develop and share skills and best practices, and promote new research collaborations. The 2016 conference, with a theme of “Advancing Population Health: New Models and the Role of Research,” was co-hosted on behalf of HCSRN by Marshfield Clinic Research Foundation and Henry Ford Health System’s Public Health Sciences Department. The 350 conference attendees included member investigators, research staff, federal funders, other research sponsors and a variety of existing and prospective collaborative partners. Key sessions reflecting the theme included plenary panels with a research focus on patient-centered care and population health management, a full-day symposium on precision oncology and a half-day patient-engaged research training workshop.

China promotes prefabrication technology in facade industry, which encourages the utilization of prefabricated facade system. Prefabricated facade system needs more integration, which can be achieved through reorganizing the facade development process. Theoretically, integrated principles would be helpful to reorganize the process in achieving integrations. However, in implementation, Chinese facade professionals face barriers, due to current delivery practice and traditional procurement context. The purpose of this paper is to present a case study on the attempt to reorganize facade development process to enjoy the benefits of integration in a traditional Design-Bid-Built (DBB) commercial building project, in China. The scope of the paper covers: i) the current facade development process, and the problems faced by facade subcontractor, ii) the constructive facade development process inspired by integrated delivery principles, and iii) the barriers to implement new delivery process. It was found that the benefits of the integration may not be completed realized on facade subcontractor side due to some task-related barriers, contract-related barriers, and people-related barriers. Suggestions for those who are working or will work in Chinese facade industry are provided.

IntroductionDelivering child health services through integrated child health events (ICHEs) has been a useful and popular strategy implemented in many in low-income and middle-income countries (LMICs) to accelerate the reduction of child mortality. The study aims to portray the scope of ICHEs and examine the association between the number of child health-nutrition interventions and types of ICHE packages delivered through these campaigns with vitamin A supplementation (VAS) and measles vaccination.MethodsSecondary data analysis was conducted using Unicef global campaign database (1999–2010), where 597 ICHEs from 76 countries were analysed. Panel random effects regression models were used to explore the association between the number of interventions and coverage for VAS and measles vaccination, and non-parametric Kruskal-Wallis test to explore the association between different intervention packages and VAS coverage.ResultsAn average of 100 ICHEs were conducted per year between 2005 and 2010, highest in sub-Saharan Africa (60%). By 2010, 40 ICHEs out of 66 (60%) across 24 countries delivered 5 or more interventions during 1 ICHE. No statistically significant effect of the number of ICHE interventions on VAS coverage was found (−0·76, p=0·185). There was a small significant effect on measles coverage (−1·81, p=0·057), which was not robust to model specifications removing outlier observations with measles coverage lower than 40%. The Kruskal-Wallis test did not suggest a significant association between different intervention packages and VAS coverage at 5% significance level (p=0·07).ConclusionICHEs were found to be a widely used strategy to deliver essential child health-nutrition interventions in LMICs. ICHEs appear to represent a commonly used platform with the capacity to incorporate multiple interventions without compromising coverage of some key interventions as VAS and measles vaccination. More research is required to better understand what operational factors may affect the coverage outcomes delivered together through ICHEs.

In 2012, an estimated 8.6 million people developed tuberculosis (TB) and 1.3 million died from the disease. With its recent resurgence with the human immunodeficiency virus (HIV); TB prevention and management has become further challenging. We systematically evaluated the effectiveness of community based interventions (CBI) for the prevention and treatment of TB and a total of 41 studies were identified for inclusion. Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates (RR: 3.1, 95% CI: 2.92, 3.28) with non-significant impact on TB incidence. CBI for treating patients with active TB showed an overall improvement in treatment success rates (RR: 1.09, 95% CI: 1.07, 1.11) and evidence from a single study suggests significant reduction in relapse rate (RR: 0.26, 95% CI: 0.18, 0.39). The results were consistent for various study design and delivery mechanism. Qualitative synthesis suggests that community based TB treatment delivery through community health workers (CHW) not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems. CBI coupled with the DOTS strategy seem to be an effective approach, however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.

Fast networks and multipurpose terminals enable the integrated delivery and use of media content originally targeted at different media. The emerging multiple media portals accessed by a variety of terminals require semi- and fully automatic procedures for managing the content. News services benefit from an integration of news sources that goes deeper than mere listings of links provided by many current Internet portals. This deep integration groups news articles from different sources and media into common and personal categories as well as interlinks the articles. The IMUsystem, developed in this work, automates parts of the news content acquirement and processing work of the portal web master. The IMU active proxy server extracts the metadata from news web sites and also - through video analyses - from television news broadcasts. This makes an automatic classification and linking of related articles and TV clips possible. The deeply integrated material is partitioned into news composites called channels, which can be personalised by the user. The automatically computed event and media calendar allows for a new type of integration of news and information about up-coming events. The news content is further utilised by setting up personalisation procedures for monitoring the business environment. Through the interfaces for PC, TV, WAP and MP3 terminals, the user accesses the same news content at work, at home in the living room and on the move. To balance the automatic procedures with journalistic judgement, we created web tools for human editors to control and override the automatic operations and for creating new content. The community feature enables groups to produce and share their own news and to discuss topics internally. The trial included households with fast network connections through cable modems, ADSL or campus networks. The trial users tested the service over a 6-month period. In addition to the PC users, several households used the service through their TV sets. Some used the service from their WAP phones. The interviews showed that the service was appreciated; one in five users could even imagine using it as their only news source. The interest in the service was fairly steady over the test period; the average use was a 7-minute session once a week, whereas the heavy users viewed it every day. Most users praised the integration of news sources, because it saved time and gave complete information - this was also reflected in the fact that one in four articles was retrieved through the automatically computed links. Only one in five users personalised channels - however personalisation showed clear potential, because the personalised channels were used often and the heavy users created many channels. Even though television set users retrieved more material than the PC users, they thought that the PC service was more convenient. The use of WAP and the environment monitoring was marginal. Television content interested most users, both television news and program schedules. News packages made explicitly for IMU, interested users, but did not launch discussions. Navigating in the TV-IMU application with the remote control was felt to be a bit cumbersome. The users thought that the service would benefit from adding more news publications as sources. Some of these sources - but not all - should provide news in real time. A targeting of the content towards well-defined interest communities would be appealing. With these enhancements, there should be possibilities to bill for the integrated service.

Fast networks and multipurpose terminals enable the integrated delivery and use of media content originally targeted at different media. The emerging multiple media portals accessed by a variety of terminals require semi- and fully automatic procedures for managing the content. News services benefit from an integration of news sources that goes deeper than mere listings of links provided by many current Internet portals. This deep integration groups news articles from different sources and media into common and personal categories as well as interlinks the articles. The IMUsystem, developed in this work, automates parts of the news content acquirement and processing work of the portal web master. The IMU active proxy server extracts the metadata from news web sites and also - through video analyses - from television news broadcasts. This makes an automatic classification and linking of related articles and TV clips possible. The deeply integrated material is partitioned into news composites called channels, which can be personalised by the user. The automatically computed event and media calendar allows for a new type of integration of news and information about up-coming events. The news content is further utilised by setting up personalisation procedures for monitoring the business environment. Through the interfaces for PC, TV, WAP and MP3 terminals, the user accesses the same news content at work, at home in the living room and on the move. To balance the automatic procedures with journalistic judgement, we created web tools for human editors to control and override the automatic operations and for creating new content. The community feature enables groups to produce and share their own news and to discuss topics internally. The trial included households with fast network connections through cable modems, ADSL or campus networks. The trial users tested the service over a 6-month period. In addition to the PC users, several households used the service through their TV sets. Some used the service from their WAP phones. The interviews showed that the service was appreciated; one in five users could even imagine using it as their only news source. The interest in the service was fairly steady over the test period; the average use was a 7-minute session once a week, whereas the heavy users viewed it every day. Most users praised the integration of news sources, because it saved time and gave complete information - this was also reflected in the fact that one in four articles was retrieved through the automatically computed links. Only one in five users personalised channels - however personalisation showed clear potential, because the personalised channels were used often and the heavy users created many channels. Even though television set users retrieved more material than the PC users, they thought that the PC service was more convenient. The use of WAP and the environment monitoring was marginal. Television content interested most users, both television news and program schedules. News packages made explicitly for IMU, interested users, but did not launch discussions. Navigating in the TV-IMU application with the remote control was felt to be a bit cumbersome. The users thought that the service would benefit from adding more news publications as sources. Some of these sources - but not all - should provide news in real time. A targeting of the content towards well-defined interest communities would be appealing. With these enhancements, there should be possibilities to bill for the integrated service.

The Integrated Delivery System Research Network (IDSRN) is a major initiative of the Agency for Healthcare Research and Quality that seeks to further the agency’s goals of knowledge transfer and movement of research to practice. The IDSRN involves contracts with nine teams of insurer/delivery system-affiliated researchers organized in various ways to complete specific and diverse projects in priority topic areas. This report describes and analyzes the IDSRN with the aim of helping to understand how it works on the ground, what is has accomplished, and how it is viewed by its partners and collaborators. In addition, the authors build on the evaluation findings to make recommendations for future change.