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Medical Care

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https://www.readbyqxmd.com/read/29781924/changes-in-psychiatric-and-medical-conditions-and-health-care-utilization-following-a-diagnosis-of-sexual-assault-a-retrospective-cohort-study
#1
Kelly C Young-Wolff, Varada Sarovar, Daniella Klebaner, Felicia Chi, Brigid McCaw
INTRODUCTION: Sexual assault (SA) is alarmingly common and is associated with higher prevalence of psychiatric and medical conditions. However, many prior studies are limited to cross-sectional designs. Health care systems with electronic health records provide unique longitudinal data to examine whether SA is associated with changes in health and health care utilization. METHODS: The sample included 1350 Kaiser Permanente Northern California adult female patients with a SA diagnosis from 2009 to 2015 and 4050 adult female patients without a SA diagnosis, matched on age, medical facility, and continuous enrollment during the study period...
May 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29781923/going-beyond-clinical-care-to-reduce-health-care-spending-findings-from-the-j-chip-community-based-population-health-management-program-evaluation
#2
Shannon M E Murphy, Douglas E Hough, Martha L Sylvia, Melissa Sherry, Linda J Dunbar, Raymond Zollinger, Regina Richardson, Scott A Berkowitz, Kevin D Frick
BACKGROUND: Addressing both clinical and nonclinical determinants of health is essential for improving population health outcomes. In 2012, the Johns Hopkins Community Health Partnership (J-CHiP) implemented innovative population health management programs across acute and community environments. The community-based program involved multidisciplinary teams [ie, physicians, care managers (CM), health behavior specialists (HBS), community health workers, neighborhood navigators] and collaboration with community-based organizations to address social determinants...
May 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29781922/screening-for-sexually-transmitted-infections-after-cervical-cancer-screening-guideline-and-medicaid-policy-changes-a-population-based-analysis
#3
Natasha Parekh, Julie M Donohue, Jennifer Corbelli, Aiju Men, David Kelley, Marian Jarlenski
BACKGROUND: Sexually transmitted infection (STI) screening prevents complications and is cost-effective. Annual screening is recommended in sexually active women <25 years and older women at increased risk. Cervical cancer (CC) screening guideline changes in 2009 and 2012 recommended less frequent screening, causing concern that STI screening would decrease. Pennsylvania Medicaid implemented a family planning program in 2007 which covered women's health services (including STI testing) for uninsured women...
May 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29768311/impact-of-provider-participation-in-aco-programs-on-preventive-care-services-patient-experiences-and-health-care-expenditures-in-us-adults-aged-18-64
#4
Young-Rock Hong, Kalyani Sonawane, Samantha Larson, Arch G Mainous, Nicole M Marlow
BACKGROUND: Little is known about the impact of accountable care organization (ACO) on US adults aged 18-64. OBJECTIVES: To examine whether having a usual source of care (USC) provider participating in an ACO affects receipt of preventive care services, patient experiences, and health care expenditures among nonelderly Americans. RESEARCH DESIGN: A cross-sectional analysis of the 2015 Medical Organizations Survey linked with the Medical Expenditure Panel Survey...
May 15, 2018: Medical Care
https://www.readbyqxmd.com/read/29768310/examining-women-veteran-s-experiences-perceptions-and-challenges-with-the-veterans-choice-program-vcp
#5
Kristin M Mattocks, Elizabeth M Yano, Amber Brown, Jose Casares, Lori Bastian
BACKGROUND: The Veterans Choice Program (VCP) was launched in 2014 to address the growing concerns about the timeliness and quality of Veterans Health Administration (VHA) care. Given that many sex-specific health services, such as mammography and maternity care, are not routinely provided in all VHA facilities, women Veterans may disproportionately rely on VCP care. Understanding the provision and coordination of VCP care is crucial in order to ensure that care is not fragmented across the 2 health care systems...
May 15, 2018: Medical Care
https://www.readbyqxmd.com/read/29768309/the-impact-of-a-change-in-the-price-of-va-health-care-on-utilization-of-va-and-medicare-services
#6
Richard E Nelson, Bret Hicken, Megan Vanneman, Chuan-Fen Liu, Randall Rupper
INTRODUCTION: The passage of the Veterans Access, Choice, and Accountability Act of 2014 has expanded the non-Veteran Affairs (VA) care options for eligible US Veterans. In order for these new arrangements to provide the best care possible for Veterans, it is important to understand the relationship between VA and non-VA care options. The purpose of this study was to use another recent VA policy change, one that increased the reimbursement rate that eligible Veterans receive for travel for health care to VA, to understand the use of VA and Medicare services among Medicare-enrolled Veterans...
May 15, 2018: Medical Care
https://www.readbyqxmd.com/read/29762274/decomposing-medicaid-spending-during-health-system-reform-and-aca-expansion-evidence-from-oregon
#7
Stephanie Renfro, Stephan Lindner, K John McConnell
BACKGROUND: Expansion of the Medicaid program is likely to create new budgetary pressures at the state and federal levels, creating a need for greater understanding of how program dollars are allocated and what drives spending growth. OBJECTIVE: To characterize Oregon Medicaid expenditures across diseases and medical conditions, during periods of payment reform and coverage expansion. RESEARCH DESIGN: Decomposition of changes in Medicaid expenditures using a person-based allocation of spending across 50 diseases/medical conditions...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29762273/patient-engagement-in-aco-practices-and-patient-reported-outcomes-among-adults-with-co-occurring-chronic-disease-and-mental-health-conditions
#8
Susan L Ivey, Stephen M Shortell, Hector P Rodriguez, Yue Emily Wang
BACKGROUND: Accountable care organizations (ACOs) have increased their use of patient activation and engagement strategies, but it is unknown whether they achieve better outcomes for patients with comorbid chronic physical and mental health conditions. OBJECTIVES: To assess the extent to which practices with patient-centered cultures, greater shared decision-making strategies, and better coordination among team members have better patient-reported outcomes (PROs) for patients with diabetes and/or cardiovascular and comorbid mental health diagnoses...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29762272/differences-in-experiences-with-care-between-homeless-and-nonhomeless-patients-in-veterans-affairs-facilities-with-tailored-and-nontailored-primary-care-teams
#9
Audrey L Jones, Leslie R M Hausmann, Stefan Kertesz, Ying Suo, John P Cashy, Maria K Mor, James H Schaefer, Adi V Gundlapalli, Adam J Gordon
BACKGROUND: Homeless patients describe poor experiences with primary care. In 2012, the Veterans Health Administration (VHA) implemented homeless-tailored primary care teams (Homeless Patient Aligned Care Team, HPACTs) that could improve the primary care experience for homeless patients. OBJECTIVE: To assess differences in primary care experiences between homeless and nonhomeless Veterans receiving care in VHA facilities that had HPACTs available (HPACT facilities) and in VHA facilities lacking HPACTs (non-HPACT facilities)...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29762271/economic-value-of-greater-access-to-bariatric-procedures-for-patients-with-severe-obesity-and-diabetes
#10
David D Kim, David E Arterburn, Sean D Sullivan, Anirban Basu
OBJECTIVE: Designing optimal insurance is important to ensure access to care for individuals that are most likely to benefit. We examined the potential impact of lowering patient cost-sharing for bariatric procedures. METHODS: After defining 10 subgroups by body mass index (BMI) and type 2 diabetes mellitus (T2DM), we analyzed the National Health and Nutrition Examination Survey datasets to estimate the prevalence of each subgroup. The MarketScan claims database provided utilization rates and costs of bariatric procedures...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29750682/personal-bias-in-peer-review
#11
Charles Maynard
No abstract text is available yet for this article.
May 10, 2018: Medical Care
https://www.readbyqxmd.com/read/29750681/predischarge-and-postdischarge-risk-factors-for-hospital-readmission-among-patients-with-diabetes
#12
Abhijana Karunakaran, Huaqing Zhao, Daniel J Rubin
BACKGROUND: Hospital readmission within 30 days of discharge (30-d readmission) is an undesirable outcome. Readmission of patients with diabetes is common and costly. Most of the studies that have examined readmission risk factors among diabetes patients did not include potentially important clinical data. OBJECTIVES: To provide a more comprehensive understanding of 30-day readmission risk factors among patients with diabetes based on predischarge and postdischarge data...
May 10, 2018: Medical Care
https://www.readbyqxmd.com/read/29668651/examining-trends-in-obstetric-quality-measures-for-monitoring-health-care-disparities
#13
Teresa Janevic, Natalia N Egorova, Jennifer Zeitlin, Amy Balbierz, Paul L Hebert, Elizabeth A Howell
BACKGROUND: Elective delivery (ED) before 39 weeks, low-risk cesarean delivery, and episiotomy are routinely reported obstetric quality measures and have been the focus of quality improvement initiatives over the past decade. OBJECTIVE: To estimate trends and differences in obstetric quality measures by race/ethnicity. RESEARCH DESIGN: We used 2008-2014 linked birth certificate-hospital discharge data from New York City to measure ED before 39 gestational weeks (ED <39), low-risk cesarean, and episiotomy by race/ethnicity...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29668649/examining-parental-medication-adherence-as-a-predictor-of-child-medication-adherence-in-pediatric-anxiety-disorders
#14
Greta A Bushnell, M Alan Brookhart, Bradley N Gaynes, Scott N Compton, Stacie B Dusetzina, Til Stürmer
BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) are the recommended first-line pharmacotherapy for pediatric anxiety disorders but adherence remains difficult to predict. OBJECTIVES: To estimate SSRI adherence in children with anxiety disorders and determine if prior parental medication adherence is predictive of child high SSRI adherence. METHODS: We identified children (3-17 y) initiating SSRI treatment after an anxiety disorder diagnosis in a commercial claims database (2005-2014)...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29668648/in-data-we-trust-comparison-of-electronic-versus-manual-abstraction-of-antimicrobial-prescribing-quality-metrics-for-hospitalized-veterans-with-pneumonia
#15
Barbara E Jones, Candace Haroldsen, Karl Madaras-Kelly, Matthew B Goetz, Jian Ying, Brian Sauer, Makoto M Jones, Molly Leecaster, Tom Greene, Scott K Fridkin, Melinda M Neuhauser, Matthew H Samore
BACKGROUND: Electronic health records provide the opportunity to assess system-wide quality measures. Veterans Affairs Pharmacy Benefits Management Center for Medication Safety uses medication use evaluation (MUE) through manual review of the electronic health records. OBJECTIVE: To compare an electronic MUE approach versus human/manual review for extraction of antibiotic use (choice and duration) and severity metrics. RESEARCH DESIGN: Retrospective...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29668647/case-mix-for-performance-management-cpm-a-risk-algorithm-based-on-icd-10-cm
#16
Jian Gao, Eileen Moran, Peter L Almenoff
BACKGROUND: Accurate risk adjustment is the key to a reliable comparison of cost and quality performance among providers and hospitals. However, the existing case-mix algorithms based on age, sex, and diagnoses can only explain up to 50 percent of the cost variation. More accurate risk adjustment is desired for provider performance assessment and improvement. OBJECTIVE: To develop a case-mix algorithm that hospitals and payers can use to measure and compare cost and quality performance of their providers...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29668646/choice-defines-qalys-a-us-valuation-of-the-eq-5d-5l
#17
Benjamin M Craig, Kim Rand
BACKGROUND: The 5-level version of the EQ-5D (EQ-5D-5L) was introduced as an improvement on the original 3-level version (EQ-5D-3L). To date, 6 country-specific value sets have been published for EQ-5D-5L and 9 US value sets have been published for other instruments. Our aims were to (1) produce EQ-5D-5L values on a quality-adjusted life year (QALY) scale from the perspective of US adults and (2) compare them with US EQ-5D-3L values and the other country-specific EQ-5D-5L values. METHODS: In 2016, 8222 US respondents from all 50 states and Washington, DC completed an online survey including a discrete choice experiment with 20 paired comparisons...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29668645/coverage-of-medications-that-treat-opioid-use-disorder-and-opioids-for-pain-management-in-marketplace-plans-2017
#18
Haiden A Huskamp, Lauren E Riedel, Colleen L Barry, Alisa B Busch
BACKGROUND: Efficacious medications to treat opioid use disorders (OUDs) have been slow to diffuse into practice, and insurance coverage limits may be one important barrier. OBJECTIVES: To compare coverage for medications used to treat OUDs and opioids commonly prescribed for pain management in plans offered on the 2017 Health Insurance Marketplace exchanges. RESEARCH DESIGN: We identified a sample of 100 plans offered in urban and in rural counties on the 2017 Marketplaces, weighting by population...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29629922/medicaid-managed-care-in-florida-and-racial-and-ethnic-disparities-in-preventable-emergency-department-visits
#19
Tianyan Hu, Karoline Mortensen, Jie Chen
BACKGROUND: In an effort to address health care spending growth, coordinate care, and improve access to primary care in the Medicaid program, Florida implemented the Statewide Mandatory Managed Care (SMMC) program in May of 2014. OBJECTIVES: The objective of this study is to investigate the impact of implementation of mandatory managed care in Medicaid on the preventable emergency department (ED) utilizations, with a focus on racial/ethnic minorities. RESEARCH DESIGN: The primary data source is the universe of Florida ED visit and inpatient discharge data from 2010 to 2015, maintained by the Florida Agency for Health Care Administration...
April 7, 2018: Medical Care
https://www.readbyqxmd.com/read/29629923/organizational-processes-and-patient-experiences-in-the-patient-centered-medical-home
#20
Jaya Aysola, Marilyn M Schapira, Hairong Huo, Rachel M Werner
BACKGROUND: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. OBJECTIVE: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. RESEARCH DESIGN: We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system...
April 6, 2018: Medical Care
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