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Inquiry: a Journal of Medical Care Organization, Provision and Financing

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https://www.readbyqxmd.com/read/28914111/analyzing-how-discursive-practices-affect-physicians-decision-making-processes-a-phenomenological-based-qualitative-study-in-critical-care-contexts
#1
Luigina Mortari, Roberta Silva
An intensive care unit (ICU) is a demanding environment, defined by significant complexity, in which physicians must make decisions in situations characterized by high levels of uncertainty. This study used a phenomenological approach to investigate the decision-making (DM) processes among ICU physicians' team with the aim of understanding what happens when ICU physicians must reach a decision about the infectious status of a patient. The focus was put on the identification of how the discursive practices influence physicians' DM processes and on how different ICU environments make different discursive profiles emerge, particularly when a key issue is at the center of the physicians' discussion...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28863719/the-effects-of-multiple-chronic-conditions-on-adult-patient-readmissions-and-hospital-finances-a-management-case-study
#2
Michael Mihailoff, Shreyasi Deb, James A Lee, Joanne Lynn
Medicare and other payers have launched initiatives to reduce hospital utilization, especially targeting readmissions within 30 days of discharge. Hospital managers have traditionally contended that hospitals would prosper better by ignoring the penalties for high readmission rates and keeping the beds more full. We aimed to test the financial effects of admissions and readmissions by persons with and without specified chronic conditions in one regional hospital. This is a management case study with a descriptive brief report...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28856941/racial-and-ethnic-disparities-in-patient-provider-communication-with-breast-cancer-patients-evidence-from-2011-meps-and-experiences-with-cancer-supplement
#3
Shelley I White-Means, Ahmad Reshad Osmani
The current study explores racial/ethnic disparities in the quality of patient-provider communication during treatment, among breast cancer patients. A unique data set, Medical Expenditure Panel Survey and Experiences With Cancer Supplement 2011, is used to examine this topic. Using measures of the quality of patient-provider communication that patients are best qualified to evaluate, we explore the relationship between race/ethnicity and patients' perspectives on whether (1) patient-provider interactions are respectful, (2) providers are listening to patients, (3) providers provide adequate explanations of outcomes and treatment, and (4) providers spend adequate time in interacting with the patients...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28853314/stakeholders-perspectives-on-strategies-for-the-recruitment-and-retention-of-primary-health-care-employees-in-qatar-a-qualitative-approach
#4
Mohamad Alameddine, Rami Yassoub, Yara Mourad, Hiba Khodr
This study explores the recruitment and retention conditions influencing primary health care (PHC) human resources for health (HRH) in Qatar and suggests strategies for their improvement. A qualitative design employing semistructured key informant interviews with PHC stakeholders in Qatar was utilized. Key interviewees were originally recognized, and snowball sampling was used to identify additional interviewees until reaching saturation point. Interview scripts were transcribed and then analyzed thematically using the Nvivo software package...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28853306/aftermarket-performance-of-health-care-and-biopharmaceutical-ipos-evidence-from-asean-countries
#5
Kulabutr Komenkul, Santi Kiranand
We examine the evidence from the long-run abnormal returns using data for 76 health care and biopharmaceutical initial public offerings (IPOs) listed in a 29-year period between 1986 and 2014 in the Association of Southeast Asian Nations (ASEAN) countries such as Indonesia, Malaysia, Singapore, Thailand, the Philippines, Vietnam, Myanmar, and Laos. Based on the event-time approach, the 3-year stock returns of the IPOs are investigated using cumulative abnormal return (CAR) and buy-and-hold abnormal return (BHAR)...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28853305/freestanding-emergency-departments-are-associated-with-higher-medicare-costs-a-longitudinal-panel-data-analysis
#6
Nitish Patidar, Robert Weech-Maldonado, Stephen J O'Connor, Bisakha Sen, Jerry M Trimm, Carlos A Camargo
The number of freestanding emergency departments (FSEDs) is growing rapidly in the United States. Proponents of FSEDs cite potential benefits of FSEDs including lower waiting time and reduced travel distance for needed emergency care. Others have suggested that increased access to emergency care may lead to an increase in the use of emergency departments for lower acuity patients, resulting in higher overall health care expenditures. We examined the relationship between the number of FSEDs in each county and total Medicare expenditures between 2003 and 2009...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28853303/hypertension-prevalence-health-service-utilization-and-participant-satisfaction-findings-from-a-pilot-randomized-controlled-trial-in-aged-chinese-canadians
#7
RANDOMIZED CONTROLLED TRIAL
Ping Zou, Cindy-Lee Dennis, Ruth Lee, Monica Parry
Responding to high prevalence of hypertension and patients' preference of integrating traditional Chinese medicine for blood pressure control, the Dietary Approach to Stop Hypertension With Sodium Reduction for Chinese Canadian (DASHNa-CC) intervention was newly designed as a culturally sensitive dietary educational intervention to facilitate middle-aged and senior Chinese Canadians' blood pressure control in community. The aim of this study was to report the hypertension prevalence rate according to the data from blood pressure screening events, to describe the characteristics of health service utilization among aged Chinese Canadians, and to report the evaluation of participant satisfaction to the DASHNa-CC intervention...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28844166/nurses-burnout-the-influence-of-leader-empowering-behaviors-work-conditions-and-demographic-traits
#8
Rola H Mudallal, Wafa'a M Othman, Nahid F Al Hassan
Nurse burnout is a widespread phenomenon characterized by a reduction in nurses' energy that manifests in emotional exhaustion, lack of motivation, and feelings of frustration and may lead to reductions in work efficacy. This study was conducted to assess the level of burnout among Jordanian nurses and to investigate the influence of leader empowering behaviors (LEBs) on nurses' feelings of burnout in an endeavor to improve nursing work outcomes. A cross-sectional and correlational design was used. Leader Empowering Behaviors Scale and the Maslach Burnout Inventory (MBI) were employed to collect data from 407 registered nurses, recruited from 11 hospitals in Jordan...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28844163/a-qualitative-study-of-the-experiences-of-parents-with-an-adult-child-who-has-a-severe-disease-existential-questions-will-be-raised
#9
Inger Benkel, Ulla Molander
A prominent existential concept is that elderly parents should naturally become severely ill or die before a younger person does. If the reverse should happen, it may influence the parent's existential view of life. The aim of this study was to investigate the existential issues during illness time. This was a qualitative study with in-depth interviews and was conducted in a University Hospital in western Sweden. Eleven parents agreed to participate in individual interviews at baseline and 1 year later. The total number of interviews completed was 19...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28814174/the-patient-centered-care-and-receipt-of-preventive-services-among-older-adults-with-chronic-diseases-a-nationwide-cross-sectional-study
#10
Hailun Liang, Junya Zhu, Xiangrong Kong, May A Beydoun, Jennifer A Wenzel, Leiyu Shi
This article investigates the associations between the patient-centered care (PCC) and receipt of preventive services among older adults with chronic diseases. Data were derived from the nationally representative Medical Expenditure Panel Survey. The full-year consolidated data files from 2009 to 2013 were pooled to yield a final analytic sample (N = 16 654). Study outcomes included the receipt of 7 types of preventive screenings and 2 types of health education services. Patients' PCC groups were categorized as PCC, partial PCC, and non-PCC, based on 9 questions classified under the 3 distinctive attributes of PCC-whole-person care, patient engagement, and enhanced access to care...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28741398/effects-of-role-playing-scenarios-on-the-self-efficacy-of-students-in-resisting-against-substance-addiction-a-pilot-study
#11
Gülnaz Karatay, Nazan Gürarslan Baş
During the first phases of adolescent development, young people have little self-efficacy and resistance against substance use. The aim of this study was to demonstrate the effectiveness of role-playing scenarios on the self-efficacy of students in resisting substance use. A pre test and post test study design was used with a single group. The study was carried out with 245 secondary school students. The scenario-based training, developed by the researchers, was presented by the school counselors once a week for 4 weeks...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28660771/service-quality-assessment-of-hospitals-in-asian-context-an-empirical-evidence-from-pakistan
#12
Muhammad Shafiq, Muhammad Azhar Naeem, Zartasha Munawar, Iram Fatima
Hospitals vary from one another in terms of their specialty, services offered, and resource availability. Their services are widely measured with scales that gauge patients' perspective. Therefore, there is a need for research to develop a scale that measures hospital service quality in Asian hospitals, regardless of their nature or ownership. To address this research need, this study adapted the SERVQUAL instrument to develop a service quality measurement scale. Data were collected from inpatients and outpatients at 9 different hospitals, and the scale was developed using structural equation modeling...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28617202/hospital-capital-investment-during-the-great-recession
#13
Sung Choi
Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28617196/factors-associated-with-having-a-physician-nurse-practitioner-or-physician-assistant-as-primary-care-provider-for-veterans-with-diabetes-mellitus
#14
Perri Morgan, Christine M Everett, Valerie A Smith, Sandra Woolson, David Edelman, Cristina C Hendrix, Theodore S Z Berkowitz, Brandolyn White, George L Jackson
Expanded use of nurse practitioners (NPs) and physician assistants (PAs) is a potential solution to workforce issues, but little is known about how NPs and PAs can best be used. Our study examines whether medical and social complexity of patients is associated with whether their primary care provider (PCP) type is a physician, NP, or PA. In this national retrospective cohort study, we use 2012-2013 national Veterans Administration (VA) electronic health record data from 374 223 veterans to examine whether PCP type is associated with patient, clinic, and state-level factors representing medical and social complexity, adjusting for all variables simultaneously using a generalized logit model...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28617065/unmet-needs-for-family-caregivers-of-elderly-people-with-dementia-living-in-italy-what-do-we-know-so-far-and-what-should-we-do-next
#15
Maria C De Cola, Viviana Lo Buono, Agata Mento, Mariella Foti, Silvia Marino, Placido Bramanti, Alfredo Manuli, Rocco S Calabrò
Care of the elderly with dementia represents one of the major challenges for the modern society worldwide. The burden of dementia care often falls on the family members, entailing heavy psychosocial and economic consequences. The aim of this study was to evaluate the caregiver's perspective concerning the support for disease management on behalf of the physicians and the local Sicilian administrations (Italy), and the burden of care and effects on their lifestyle, to propose new prevention strategies and service for managing dementia and caregiver's burden...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28604260/developing-high-functioning-teams-factors-associated-with-operating-as-a-real-team-and-implications-for-patient-centered-medical-home-development
#16
Somava Stout, Leah Zallman, Lisa Arsenault, Assaad Sayah, Karen Hacker
Team-based care is a foundation of health care redesign models like the patient-centered medical home (PCMH). Yet few practices rigorously examine how the implementation of PCMH relates to teamwork. We identified factors associated with the perception of a practice operating as a real team. An online workforce survey was conducted with all staff of 12 primary care sites of Cambridge Health Alliance at different stages of PCMH transformation. Bivariate and multivariate analyses of factors associated with teamwork perceptions were conducted...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28597725/physicians-voices-what-skills-and-supports-are-needed-for-effective-practice-in-an-integrated-delivery-system-a-case-study-of-kaiser-permanente
#17
Benjamin Chesluk, Laura Tollen, Joy Lewis, Samantha DuPont, Marc H Klau
Payers are demanding that US health care become more accountable and integrated, posing new demands for physicians and the organizations that partner with them. We conducted focus groups with 30 physicians in a large integrated delivery system who had previous experience practicing in less integrated settings and asked about skills they need to succeed in this environment. Physicians identified 3 primary skills: orienting to teams and systems, engaging patients as individuals and as a panel, and integrating cost awareness into practice...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28578608/do-gender-predominant-primary-health-care-organizations-have-an-impact-on-patient-experience-of-care-use-of-services-and-unmet-needs
#18
Raynald Pineault, Roxane Borgès Da Silva, Sylvie Provost, Michel Fournier, Alexandre Prud'homme, Jean-Frédéric Levesque
Physicians' gender can have an impact on many aspects of patient experience of care. Organization processes through which the influence of gender is exerted have not been fully explored. The aim of this article is to compare primary health care (PHC) organizations in which female or male doctors are predominant regarding organization and patient characteristics, and to assess their influence on experience of care, preventive care delivery, use of services, and unmet needs. In 2010, we conducted surveys of a population stratified sample (N = 9180) and of all PHC organizations (N = 606) in 2 regions of the province of Québec, Canada...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28578605/mortality-differences-between-traditional-medicare-and-medicare-advantage-a-risk-adjusted-assessment-using-claims-data
#19
Roy A Beveridge, Sean M Mendes, Arial Caplan, Teresa L Rogstad, Vanessa Olson, Meredith C Williams, Jacquelyn M McRae, Stefan Vargas
Medicare Advantage (MA) has grown rapidly since the Affordable Care Act; nearly one-third of Medicare beneficiaries now choose MA. An assessment of the comparative value of the 2 options is confounded by an apparent selection bias favoring MA, as reflected in mortality differences. Previous assessments have been hampered by lack of access to claims diagnosis data for the MA population. An indirect comparison of mortality as an outcome variable was conducted by modeling mortality on a traditional fee-for-service (FFS) Medicare data set, applying the model to an MA data set, and then evaluating the ratio of actual-to-predicted mortality in the MA data set...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28548005/geographic-variation-in-diagnostic-ability-and-quality-of-care-metrics-a-case-study-of-ankylosing-spondylitis-and-low-back-pain
#20
Jason Shafrin, Jenny Griffith, Jin Joo Shim, Caroline Huber, Arijit Ganguli, Wade Aubry
Studies examining geographic variation in care for low back pain often focus on process and outcome measures conditional on patient diagnosis but generally do not take into account a physician's ability to diagnose the root cause of low back pain. In our case study, we used increased detection of ankylosing spondylitis-a relatively rare inflammatory back disease-as a proxy for diagnostic ability and measured the relationship between ankylosing spondylitis detection, potentially inappropriate low back pain care, and cost...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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