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Medical Care

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https://www.readbyqxmd.com/read/30439795/do-hospital-and-physician-volume-thresholds-for-the-volume-outcome-relationship-in-heart-failure-exist
#1
Ying-Yi Chou, Tsung-Hsien Yu, Yu-Chi Tung
BACKGROUND: Although volume-outcome relationships have been explored for various procedures and interventions, limited information is available concerning the effect of hospital and physician volume on heart failure mortality. Most importantly, little is known about whether there are optimal hospital and physician volume thresholds to reduce heart failure mortality. OBJECTIVES: We used nationwide population-based data to identify the optimal hospital and physician volume thresholds to achieve optimum mortality and to examine the relative and combined effects of the volume thresholds on heart failure mortality...
November 14, 2018: Medical Care
https://www.readbyqxmd.com/read/30439794/a-comparison-of-methods-for-classifying-and-modeling-respondents-who-endorse-multiple-racial-ethnic-categories-a-health-care-experience-application
#2
David J Klein, Marc N Elliott, Amelia M Haviland, Peter A Morrison, Nate Orr, Sarah Gaillot, Robert Weech-Maldonado
BACKGROUND: Race/ethnicity information is vital for measuring disparities across groups, and self-report is the gold standard. Many surveys assign simplified race/ethnicity based on responses to separate questions about Hispanic ethnicity and race and instruct respondents to "check all that apply." When multiple races are endorsed, standard classification methods either create a single heterogenous multiracial group, or attempt to impute the single choice that would have been selected had only one choice been allowed...
November 14, 2018: Medical Care
https://www.readbyqxmd.com/read/30439793/lasso-regression-for-the-prediction-of-intermediate-outcomes-related-to-cardiovascular-disease-prevention-using-the-transit-quality-indicators
#3
Cynthia Khanji, Lyne Lalonde, Céline Bareil, Marie-Thérèse Lussier, Sylvie Perreault, Mireille E Schnitzer
BACKGROUND: Cardiovascular disease morbidity and mortality are largely influenced by poor control of hypertension, dyslipidemia, and diabetes. Process indicators are essential to monitor the effectiveness of quality improvement strategies. However, process indicators should be validated by demonstrating their ability to predict desirable outcomes. The objective of this study is to identify an effective method for building prediction models and to assess the predictive validity of the TRANSIT indicators...
November 14, 2018: Medical Care
https://www.readbyqxmd.com/read/30439792/the-effects-of-the-patient-protection-and-affordable-care-act-on-children-s-health-coverage
#4
Patience Ugwi, Wei Lyu, George L Wehby
BACKGROUND: Prior research of the impacts of the Patient Protection and Affordable Care Act (PPACA) on children's health coverage has been largely descriptive and focused on the Medicaid expansions. OBJECTIVE: This study examined the causal impacts of the PPACA Medicaid expansions and of the PPACA as a whole on children's health coverage through 2016. RESEARCH DESIGN: We utilized quasiexperimental difference in differences designs to estimate the Medicaid expansion and overall PPACA effects...
November 14, 2018: Medical Care
https://www.readbyqxmd.com/read/30439791/care-coordination-and-population-health-management-strategies-and-challenges-in-a-behavioral-health-home-model
#5
Gail L Daumit, Elizabeth M Stone, Alene Kennedy-Hendricks, Seema Choksy, Jill A Marsteller, Emma E McGinty
OBJECTIVES: Behavioral health home (BHH) models have been developed to integrate physical and mental health care and address medical comorbidities for individuals with serious mental illnesses. Previous studies identified population health management capacity and coordination with primary care providers as key barriers to BHH implementation. This study examines the BHH leaders' perceptions of and organizational capacity to conduct these functions within the community mental health programs implementing BHHs in Maryland...
November 14, 2018: Medical Care
https://www.readbyqxmd.com/read/30422840/assessing-residual-bias-in-estimating-influenza-vaccine-effectiveness-comparison-of-high-dose-versus-standard-dose-vaccines
#6
Anne M Butler, J Bradley Layton, Whitney S Krueger, Abhijit V Kshirsagar, Leah J McGrath
BACKGROUND: Estimating influenza vaccine effectiveness using an unvaccinated comparison group may result in biased effect estimates. OBJECTIVES: To explore the reduction of confounding bias in an active comparison of high-dose versus standard-dose influenza vaccines, as compared with vaccinated versus unvaccinated comparisons. METHODS: Using Medicare data from the United States end-stage renal disease program (2009-2013), we compared the risk of all-cause mortality among recipients of high-dose vaccine (HDV) versus standard-dose vaccine (SDV), HDV versus no vaccine, and SDV versus no vaccine...
November 12, 2018: Medical Care
https://www.readbyqxmd.com/read/30422839/feasibility-of-distinguishing-performance-among-provider-groups-using-patient-reported-outcome-measures-in-older-adults-with-multiple-chronic-conditions
#7
Adam J Rose, Elizabeth Bayliss, Lesley Baseman, Emily Butcher, Wenjing Huang, Maria O Edelen
OBJECTIVE: To examine minimum sample sizes and follow-up times required for patient-reported outcome-based performance measures (PMs) to achieve acceptable reliability as PMs. PARTICIPANTS: We used 2 groups of patients age 65+ with at least 2 of 13 chronic conditions. The first was a sample of Medicare Advantage beneficiaries, who reported health-related quality of life (HRQoL) at baseline and 2 years. The second was a sample of primary care patients, who reported HRQoL at baseline and 6 months...
November 12, 2018: Medical Care
https://www.readbyqxmd.com/read/30394981/variation-in-laboratory-test-naming-conventions-in-ehrs-within-and-between-hospitals-a-nationwide-longitudinal-study
#8
Wyndy L Wiitala, Brenda M Vincent, Jennifer A Burns, Hallie C Prescott, Akbar K Waljee, Genna R Cohen, Theodore J Iwashyna
BACKGROUND: Electronic health records provide clinically rich data for research and quality improvement work. However, the data are often unstructured text, may be inconsistently recorded and extracted into centralized databases, making them difficult to use for research. OBJECTIVES: We sought to quantify the variation in how key laboratory measures are recorded in the Department of Veterans Affairs (VA) Corporate Data Warehouse (CDW) across hospitals and over time...
November 1, 2018: Medical Care
https://www.readbyqxmd.com/read/30383571/improving-patient-centered-care-how-clinical-staff-overcome-barriers-to-patient-engagement-at-the-vha
#9
Aneeza Z Agha, Rachel M Werner, Shimrit Keddem, Tiffany L Huseman, Judith A Long, Judy A Shea
BACKGROUND: While patient engagement can be beneficial for patient care, there are barriers to engaging patients. These barriers exist for health care organizations, for health care personnel, and for the patients themselves. Solutions to barriers are not well documented. OBJECTIVES: Our objective was to explore barriers to patient engagement efforts and their corresponding solutions. RESEARCH DESIGN: Qualitative interviews and site visits from a national sample of primary care facilities within the Veterans Health Administration were analyzed to understand patient engagement barriers and solutions...
October 31, 2018: Medical Care
https://www.readbyqxmd.com/read/30363024/optimism-a-building-block-for-organizational-change
#10
Jessica Halem
No abstract text is available yet for this article.
October 22, 2018: Medical Care
https://www.readbyqxmd.com/read/30363023/national-testing-of-the-emergency-department-patient-experience-of-care-edpec-discharged-to-community-dtc-survey-and-implications-for-adjustment-in-scoring
#11
Layla Parast, Megan Mathews, Anagha Tolpadi, Marc Elliott, Elizabeth Flow-Delwiche, Kirsten Becker
BACKGROUND: The emergency department (ED) setting is unique and measuring quality of care in the ED requires the development of ED-specific tools. The Emergency Department Patient Experience of Care Discharged to Community Survey was designed to measure patient experience in the ED setting. OBJECTIVES: Describe results from the Emergency Department Patient Experience of Care Discharged to Community Survey including respondent characteristics and reported patient experience, and examine factors, including mode of survey administration, associated with response propensity and response patterns...
October 22, 2018: Medical Care
https://www.readbyqxmd.com/read/30363022/use-of-nonpalliative-medications-following-burdensome-health-care-transitions-in-hospice-patients-a-matched-cohort-analysis
#12
Patrick M Zueger, Holly M Holmes, Dima M Qato, A Simon Pickard, Gregory S Calip, Todd A Lee
BACKGROUND: Limited benefit medications (LBMs), those medications with questionable benefit at the end of life, are often recommended for discontinuation in hospice patients. Transitions in care are associated with inappropriate prescribing in older and terminally ill populations. OBJECTIVES: To evaluate the association between burdensome health care transitions and subsequent receipt of LBMs in older hospice patients. METHODS: We conducted a matched cohort analysis of patients admitted to hospice between 2008 and 2013 using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database...
October 22, 2018: Medical Care
https://www.readbyqxmd.com/read/30363021/risk-factors-associated-with-7-versus-30-day-readmission-among-patients-with-heart-failure-using-the-nationwide-readmission-database
#13
Phuong N Pham, Hong Xiao, Amir Sarayani, Ming Chen, Joshua D Brown
BACKGROUND: The 30-day all-cause readmission for heart failure (HF) is a standard measure to evaluate hospital performance. A recent study found that a shorter period after discharge may be more indicative of hospital quality. OBJECTIVE: To compare risk factors for 7- versus 30-day readmission in patients with HF. DESIGN: This is a retrospective cohort using the 2014 Nationwide Readmissions Database. SUBJECTS: Patients 65 years and older with Medicare coverage discharged after HF admission...
October 22, 2018: Medical Care
https://www.readbyqxmd.com/read/30339575/differences-in-hospitalizations-between-fee-for-service-and-medicare-advantage-beneficiaries
#14
Chima D Ndumele, Marc N Elliott, Amelia M Haviland, Q Burkhart, Nate Orr, Sarah Gaillot, Paul D Cleary
BACKGROUND: Previous studies found lower hospitalization rates for enrollees in Medicare Advantage (MA) plans than for beneficiaries with Fee-For-Service (FFS) coverage. MA enrollment is increasing, especially for those newly eligible for Medicare, but little is known about how service use in FFS or MA differs for new beneficiaries. OBJECTIVE: To compare differences in rates of hospitalization between MA and FFS. RESEARCH DESIGN: A retrospective study of hospitalization among FFS and MA respondents to the Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) survey...
October 18, 2018: Medical Care
https://www.readbyqxmd.com/read/30339573/evidence-for-the-quadruple-aim-a-systematic-review-of-the-literature-on-physician-burnout-and-patient-outcomes
#15
Cheryl Rathert, Eric S Williams, Hillary Linhart
BACKGROUND: Experts express concern that attaining of the Triple Aim of reducing health care costs, improving patient experiences and ultimately population health, may be compromised by high levels of burnout among physicians. Some have called for a fourth aim of improving the work environment for care providers. OBJECTIVES: Burnout has been linked to poor outcomes in many occupational settings. This study's aim was to investigate linkages between physician burnout and patient outcomes through a systematic review of the literature...
October 18, 2018: Medical Care
https://www.readbyqxmd.com/read/30256279/effects-of-pain-insomnia-and-depression-on-psychoactive-medication-supply-in-older-adults-with-osteoarthritis
#16
Minhui Liu, Susan M McCurry, Basia Belza, Diana T Buchanan, Adrian Dobra, Michael Von Korff, Michael V Vitiello
BACKGROUND: Determinants of prescribing psychoactive medications for symptom management in older adults remain underexamined despite known risks and cautions concerning these medications. OBJECTIVE: To examine independent and combined effects of pain, concurrent insomnia and depression symptoms on psychoactive medications supplied to older adults with osteoarthritis (OA). RESEARCH DESIGN: Survey data on pain, insomnia, and depression obtained from OA patients screened for a randomized controlled trial were used to identify predictors of psychoactive medication supply [opioids, sedatives, tricyclic antidepressants (TCAs), and non-TCAs] over a 4-year period...
September 25, 2018: Medical Care
https://www.readbyqxmd.com/read/30234765/lack-of-health-insurance-associated-with-lower-probability-of-head-computed-tomography-among-united-states-traumatic-brain-injury-patients
#17
Audrey Renson, Finn D Schubert, Marc A Bjurlin
BACKGROUND: Uninsured traumatic brain injury (TBI) patients have higher mortality than their insured counterparts. One possible reason is disparities in receipt of appropriate diagnostic imaging. OBJECTIVE: Examine the association between lack of insurance and use of diagnostic imaging. RESEARCH DESIGN: This is a retrospective cohort study. SUBJECTS: All adult patients admitted with severe (AIS>4 and GCS<15) TBI, in the National Trauma Data Bank 2010-2015...
September 18, 2018: Medical Care
https://www.readbyqxmd.com/read/30234764/the-prevalence-of-culture-change-practice-in-us-nursing-homes-findings-from-a-2016-2017-nationwide-survey
#18
Susan C Miller, Margot L Schwartz, Julie C Lima, Renée R Shield, Denise A Tyler, Clara W Berridge, Pedro L Gozalo, Michael J Lepore, Melissa A Clark
BACKGROUND AND OBJECTIVES: Given the dynamic nursing home (NH) industry and evolving regulatory environment, depiction of contemporary NH culture-change (person/resident-centered) care practice is of interest. Thus, we aimed to portray the 2016/2017 prevalence of NH culture change-related processes and structures and to identify factors associated with greater practice prevalence. RESEARCH DESIGN AND METHODS: We administered a nationwide survey to 2142 NH Administrators at NHs previously responding to a 2009/2010 survey...
September 18, 2018: Medical Care
https://www.readbyqxmd.com/read/30234763/innovations-in-occupational-health-care-delivery-can-prevent-entry-into-permanent-disability-8-year-follow-up-of-the-washington-state-centers-for-occupational-health-and-education
#19
Thomas M Wickizer, Gary M Franklin, Deborah Fulton-Kehoe
BACKGROUND: Long-term work disability is known to have an adverse effect on the nation's labor force participation rate. To reduce long-term work disability, the Washington State Department of Labor and Industries established a quality improvement initiative that created 2 pilot Centers of Occupational Health and Education (COHE). OBJECTIVES: To document the level of work disability in a sample of injured workers with musculoskeletal injuries and to examine (8-y) work disability outcomes associated with the COHE health care model...
September 18, 2018: Medical Care
https://www.readbyqxmd.com/read/30418962/safety-of-obese-persons-in-nursing-homes
#20
Holly C Felix, Christine Bradway, Tommy Mac Bird, Rohit Pradhan, Robert Weech-Maldonado
No abstract text is available yet for this article.
December 2018: Medical Care
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