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The article highlights a report on the survey of variability in care management programs (CMPs) in medical care Accountable Care Organizations (ACOs) by medical directors. Topics discussed include method of the survey involves questionnaire development based on interviews with clinicians, patients, and administrators in CMPs; results indicating high variability in the annual programs; and discussion on health management strategy.

The article focuses on the residency program called Clinical Learning Environment Review (CLER) by the organization Accreditation Council of Graduate Medical Education (ACGME). Topics discussed include experiences of residents who completed the course, with subjects such as work life balance, information processing, and self confidence.

Objective To compare asthma care roles of maternal and paternal caregivers, and examine associations between caregiver involvement and the outcomes of adherence, morbidity, and parental quality of life (QoL). Methods Mothers and fathers in 63 families of children, ages 5-9 years, with persistent asthma completed semistructured interviews and questionnaires. Adherence was measured via electronic monitoring. Paired t tests compared parental asthma care roles, and analysis of covariance, controlling for socioeconomic status, evaluated associations of asthma outcomes with caregiver involvement scores. Results Mothers had higher scores on measures of involvement, beliefs in medication necessity, and on four subscales of the Family Asthma Management System Scale interview (Asthma Knowledge, Relationship with Provider, Symptom Assessment, and Response to Symptoms). Maternal QoL was lowest when both maternal and paternal involvement was high. Paternal involvement was associated with increased morbidity. Conclusions There is room for enhancement of fathers' asthma care roles. Higher levels of paternal involvement may be driven by family need. [ABSTRACT FROM AUTHOR]

Objectives. Develop and pilot test the Health in Community Survey (HCS), to collect patients perceptions of care integration between traditional care providers and community-based services that address social determinants of health. Research design. Interviews of working-age, English- or Spanish-speaking patients with multiple chronic conditions to identify survey domains; cognitive interviews and pilot test of HCS Version 1. Results. Preliminary interview subjects identified diverse care concerns. From these findings, we designed six HCS domains. Cognitive interviews identified problems relating to patients' perceptions about limited function and disability. Nearly one-third of pilot test subjects reported they did not definitely have enough resources for food, transportation, doctor and hospital bills, and medications; 41.6% said their clinicians only sometimes or never knew about their resource problems. Conclusions. Although it requires further validation, the HCS offers insights into patients' perceptions of care integration between traditional health care providers and services addressing social determinants of health. [ABSTRACT FROM AUTHOR]