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

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https://www.readbyqxmd.com/read/29756503/social-relationships-and-suicidal-ideation-among-the-elderly-who-live-alone-in-republic-of-korea-a-logistic-model
#1
Hyun-Jung Kwon, Ji-Ung Jeong, Mihyang Choi
With population aging and change in family structure, the number of the elderly who live alone is rapidly increasing in Korea. The aim of this study was to explore the association between social relationships-especially newly formed formal social relationships (FSRs)-and suicidal ideation among Korean elderly who live alone. The elderly who live alone (N = 2509) from the 2014 Survey of Living Conditions and Welfare Needs of Older Koreans were analyzed using logistic regression. This study found that informal social relationships (ISRs) (eg, children, friends and neighbors) of the elderly who live alone had statistically significant association with suicidal ideation, whereas FSRs (eg, formal helper and social participation) did not have significant association with suicidal ideation...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29749287/a-qualitative-exploration-of-weight-bias-and-quality-of-health-care-among-health-care-professionals-using-hypothetical-patient-scenarios
#2
Justine Seymour, Jennifer L Barnes, Julie Schumacher, Rachel L Vollmer
The purpose of this study was to determine whether weight bias exhibited by health care professionals (HCPs) impacts quality of health care provided to individuals with obesity. HCPs (n = 220; 88% female, 87% nurses) in the Midwest region of the United States were recruited to complete an online survey. In this within-subjects study design, participants completed the Attitudes Towards Obese Persons (ATOP) scale to assess weight bias and responded to 2 (1 person with obesity and 1 person without obesity) hypothetical patient scenarios to evaluate quality of care...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29745284/regional-and-temporal-variations-in-comorbidity-among-us-dialysis-patients-a-longitudinal-study-of-medicare-claims-data
#3
Yi Mu, Andrew I Chin, Abhijit V Kshirsagar, Yi Zhang, Heejung Bang
Medicare claims data are commonly used to query comorbidities for case-mix adjustment in research of patients with end-stage renal disease (ESRD) in the United States. These adjustments may affect reimbursement and quality rating through comparative profiling and ranking of dialysis facilities. We studied regional and temporal variations in comorbidity from claims data in the United States Renal Data System. Patients with a previous 1-year Medicare history who initiated dialysis therapy between 2006 and 2009 were examined with a follow-up period until 2012...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29730971/racial-ethnic-disparities-in-readmissions-in-us-hospitals-the-role-of-insurance-coverage
#4
Jayasree Basu, Amresh Hanchate, Arlene Bierman
We examine differences in rates of 30-day readmissions across patients by race/ethnicity and the extent to which these differences were moderated by insurance coverage. We use hospital discharge data of patients in the 18 years and above age group for 5 US states, California, Florida, Missouri, New York, and Tennessee for 2009, the latest year prior to the start of Centers for Medicare & Medicaid Services' Hospital Compare program of public reporting of hospital performance on 30-day readmissions. We use logistic regression models by state to estimate the association between insurance status, race, and the likelihood of a readmission within 30 days of an index hospital admission for any cause...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29717616/neighborhood-environment-and-disparities-in-health-care-access-among-urban-medicare-beneficiaries-with-diabetes-a-retrospective-cohort-study
#5
Miriam Ryvicker, Sridevi Sridharan
Older adults' health is sensitive to variations in neighborhood environment, yet few studies have examined how neighborhood factors influence their health care access. This study examined whether neighborhood environmental factors help to explain racial and socioeconomic disparities in health care access and outcomes among urban older adults with diabetes. Data from 123 233 diabetic Medicare beneficiaries aged 65 years and older in New York City were geocoded to measures of neighborhood walkability, public transit access, and primary care supply...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29701115/medium-term-health-of-seniors-following-exposure-to-a-natural-disaster
#6
Oscar Labra, Danielle Maltais, Gabriel Gingras-Lacroix
The article aims to describe the medium-term impacts of a major earthquake event (Chile, February 27, 2010) on 26 seniors. The authors adopted a qualitative study approach. Data obtained using the Impact of Event Scale-Revised (IES-R) show the presence of manifestations of posttraumatic stress in the majority of respondents. In addition, data collected in interviews demonstrated a progressive deterioration of the health of respondents over a period of 4 years following the disaster. Seniors are particularly vulnerable to the effects of material loss, emotional stress, and postdisaster health complications...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29633899/predictors-of-nursing-facility-entry-by-medicaid-only-older-adults-and-persons-with-disabilities-in-california
#7
Michelle Ko, Robert J Newcomer, Charlene Harrington, Denis Hulett, Taewoon Kang, Andrew B Bindman
Nearly one-third of adult Medicaid beneficiaries who receive long-term services and supports (LTSS) consist of older adults and persons with disabilities who are not eligible for Medicare. Beneficiaries, advocates, and policymakers have all sought to shift LTSS to home and community settings as an alternative to institutional care. We conducted a retrospective cohort study of Medicaid-only adults in California with new use of LTSS in 2006-2007 (N = 31 849) to identify unique predictors of entering nursing facilities versus receiving Medicaid home and community-based services (HCBS)...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29591540/comprehensive-support-for-family-caregivers-of-post-9-11-veterans-increases-veteran-utilization-of-long-term-services-and-supports-a-propensity-score-analysis
#8
Megan Shepherd-Banigan, Valerie A Smith, Karen M Stechuchak, Katherine E M Miller, Susan Nicole Hastings, Gilbert Darryl Wieland, Maren K Olsen, Margaret Kabat, Jennifer Henius, Margaret Campbell-Kotler, Courtney Harold Van Houtven
Family caregivers are an important component of the long-term services and supports (LTSS) system. However, caregiving may have negative consequences for caregiver physical and emotional health. Connecting caregivers to formal short-term home- and community-based services (HCBS), through information resources and referrals, might alleviate family caregiver burden and delay nursing home entry for the patient. The aim of this study was to evaluate the early impact of the Program of Comprehensive Assistance for Family Caregivers (PCAFC) (established by P...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29591539/reducing-high-users-visits-to-the-emergency-department-by-a-primary-care-intervention-for-the-uninsured-a-retrospective-study
#9
Meng-Han Tsai, Sudha Xirasagar, Scott Carroll, Charles S Bryan, Pamela J Gallagher, Kim Davis, Edward C Jauch
Reducing avoidable emergency department (ED) visits is an important health system goal. This is a retrospective cohort study of the impact of a primary care intervention including an in-hospital, free, adult clinic for poor uninsured patients on ED visit rates and emergency severity at a nonprofit hospital. We studied adult ED visits during August 16, 2009-August 15, 2011 (preintervention) and August 16, 2011-August 15, 2014 (postintervention). We compared pre- versus post-mean annual visit rates and discharge emergency severity index (ESI; triage and resource use-based, calculated Agency for Healthcare Research and Quality categories) among high-users (≥3 ED visits in 12 months) and occasional users...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29591538/quality-measurement-recommendations-relevant-to-clinical-guidelines-in-germany-and-the-united-kingdom-what-can-we-learn-from-each-other
#10
Thomas Petzold, Stefanie Deckert, Paula R Williamson, Jochen Schmitt
We conducted a systematic review of clinical guidelines (CGs) to examine the methodological approaches of quality indicator derivation in CGs, the frequency of quality indicators to check CG recommendations in routine care, and clinimetric properties of quality indicators. We analyzed the publicly available CG databases of the Association of the Scientific Medical Societies in Germany (AWMF) and National Institute for Health and Care Excellence (NICE). Data on the methodology of subsequent quality indicator derivation, the content and definition of recommended quality indicators, and clinimetric properties of measurement instruments were extracted...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29569968/organizational-health-literacy-review-of-theories-frameworks-guides-and-implementation-issues
#11
Elina Farmanova, Luc Bonneville, Louise Bouchard
Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29553296/what-causes-racial-health-care-disparities-a-mixed-methods-study-reveals-variability-in-how-health-care-providers-perceive-causal-attributions
#12
Sarah E Gollust, Brooke A Cunningham, Barbara G Bokhour, Howard S Gordon, Charlene Pope, Somnath S Saha, Dina M Jones, Tam Do, Diana J Burgess
Progress to address health care equity requires health care providers' commitment, but their engagement may depend on their perceptions of the factors contributing to inequity. To understand providers' perceptions of causes of racial health care disparities, a short survey was delivered to health care providers who work at 3 Veterans Health Administration sites, followed by qualitative interviews (N = 53). Survey data indicated that providers attributed the causes of disparities to social and economic conditions more than to patients' or providers' behaviors...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29529899/awareness-of-hearing-loss-in-older-adults-results-of-a-survey-conducted-in-500-subjects-across-5-european-countries-as-a-basis-for-an-online-awareness-campaign
#13
Patrick S C D'Haese, Marc De Bodt, Vincent Van Rompaey, Paul Van de Heyning
The objectives of this study were to assess the factors which contribute to individuals' health motivation to address hearing loss and to gather baseline data that could then be used to measure the impact of an awareness campaign. An online questionnaire with 13 closed set questions was completed by 100 subjects in each country including Austria, Germany, France, Sweden, and the United Kingdom. The questionnaire was based around the Health Belief Model, which describes how, in order to take action to address a medical problem, the individual must perceive that the condition presents a threat to their well-being that exceeds any barriers to treatment...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29502481/a-successful-pharmacist-based-quality-initiative-to-reduce-inappropriate-stress-ulcer-prophylaxis-use-in-an-academic-medical-intensive-care-unit
#14
Umair Masood, Anuj Sharma, Zabeer Bhatti, Jessica Carroll, Amit Bhardwaj, Devamohan Sivalingam, Amit S Dhamoon
Stress ulcer prophylaxis (SUP) is often inappropriately utilized, particularly in critically ill patients. The objective of this study is to find an effective way of reducing inappropriate SUP use in an academic medical intensive care unit (ICU). Medical ICU patients receiving SUP were identified over a 1-month period, and their charts were reviewed to determine whether American Society of Health-System Pharmacists guidelines were followed. Inappropriate usage was calculated as inappropriate patient-days and converted to incidence per 100 patient-days...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29502479/public-trust-in-physicians-health-care-commodification-as-a-possible-deteriorating-factor-cross-sectional-analysis-of-23-countries
#15
Ellery Chih-Han Huang, Christy Pu, Yiing-Jenq Chou, Nicole Huang
Trust in physicians has declined, and surveys of public opinion show a poor level of public trust in physicians. Commodification of health care has been speculated as a plausible driving force. We used cross-national data of 23 countries from the International Social Survey Programme 2011 to quantify health care commodification and study its role in the trust that patients generally place in physicians. A modified health care index was used to quantify health care commodification. There were 34 968 respondents...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29502466/new-breast-cancer-radiotherapy-technology-confers-higher-complications-and-costs-before-effectiveness-proven-a-medicare-data-analysis
#16
Heather T Gold, Dawn Walter, Eleni Tousimis, Mary Katherine Hayes
A new breast cancer treatment, brachytherapy-based accelerated partial breast radiotherapy (RT), was adopted before long-term effectiveness evidence, potentially increasing morbidity and costs compared with whole breast RT. The aim of this study was to estimate complication rates and RT-specific and 1-year costs for a cohort of female Medicare beneficiaries diagnosed with breast cancer (N = 47 969). We analyzed 2005-2007 Medicare claims using multivariable logistic regression for complications and generalized linear models (log link, gamma distribution) for costs...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29490533/state-level-variability-in-veteran-reliance-on-veterans-health-administration-and-potentially-preventable-hospitalizations-a-geospatial-analysis
#17
Drew A Helmer, Mazhgan Rowneki, Xue Feng, Chin-Lin Tseng, Danielle Rose, Orysya Soroka, Dennis Fried, Nisha Jani, Leonard M Pogach, Usha Sambamoorthi
Most Veterans who use the Veterans Health Administration (VHA) also utilize private-sector health care providers. To better inform local and regional health care planning, we assessed the association between reliance on VHA ambulatory care and total and system-specific preventable hospitalization rates (PHRs) at the state level. We conducted a retrospective dynamic cohort study using Veterans with diabetes mellitus, aged 66 years or older, and dually enrolled in VHA and Medicare parts A and B from 2004 to 2010...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29482411/a-triangulated-qualitative-study-of-veteran-decision-making-to-seek-care-during-heart-failure-exacerbation-implications-of-dual-health-system-use
#18
Charlene A Pope, Boyd H Davis, Leticia Wine, Lynne S Nemeth, Robert N Axon
Among Veterans, heart failure (HF) contributes to frequent emergency department visits and hospitalization. Dual health care system use (dual use) occurs when Veterans Health Administration (VA) enrollees also receive care from non-VA sources. Mounting evidence suggests that dual use decreases efficiency and patient safety. This qualitative study used constructivist grounded theory and content analysis to examine decision making among 25 Veterans with HF, for similarities and differences between all-VA users and dual users...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29482410/the-impact-of-applying-quality-management-practices-on-patient-centeredness-in-jordanian-public-hospitals-results-of-predictive-modeling
#19
Heba H Hijazi, Heather L Harvey, Mohammad S Alyahya, Hussam A Alshraideh, Rabah M Al Abdi, Sanjai K Parahoo
Targeting the patient's needs and preferences has become an important contributor for improving care delivery, enhancing patient satisfaction, and achieving better clinical outcomes. This study aimed to examine the impact of applying quality management practices on patient centeredness within the context of health care accreditation and to explore the differences in the views of various health care workers regarding the attributes affecting patient-centered care. Our study followed a cross-sectional survey design wherein 4 Jordanian public hospitals were investigated several months after accreditation was obtained...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29442533/variation-of-care-time-between-nursing-units-in-classification-based-nurse-to-resident-ratios-a-multilevel-analysis
#20
Albert Brühl, Katarina Planer, Anja Hagel
A validity test was conducted to determine how care level-based nurse-to-resident ratios compare with actual daily care times per resident in Germany. Stability across different long-term care facilities was tested. Care level-based nurse-to-resident ratios were compared with the standard minimum nurse-to-resident ratios. Levels of care are determined by classification authorities in long-term care insurance programs and are used to distribute resources. Care levels are a powerful tool for classifying authorities in long-term care insurance...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
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