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

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https://www.readbyqxmd.com/read/29345180/depression-among-caregivers-of-patients-with-dementia
#1
Abdullelah S Alfakhri, Ahmed W Alshudukhi, Ali A Alqahtani, Abdulrahman M Alhumaid, Omer A Alhathlol, Abdullah I Almojali, Muteb A Alotaibi, Meshal K Alaqeel
We aimed to assess depressive symptoms in caregivers of patients with dementia, taking into account variables such as severity of dementia, sex, age, and financial state of the patient. We recruited 222 caregivers of patients with dementia from King Abdulaziz Medical City, Saudi Alzheimer's Disease Association, and online, from February to June 2017, and employed the Patient Health Questionnaire to assess depression, and the Blessed Dementia Scale to assess severity of dementia. The prevalence of clinical depression among the caregivers was 14...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29310496/survey-to-identify-depth-of-penetration-of-critical-incident-reporting-systems-in-austrian-healthcare-facilities
#2
Gerald Sendlhofer, Harald Eder, Karina Leitgeb, Roland Gorges, Heidelinde Jakse, Marianne Raiger, Silvia Türk, Walter Petschnig, Gudrun Pregartner, Lars-Peter Kamolz, Gernot Brunner
Incident reporting systems or so-called critical incident reporting systems (CIRS) were first recommended for use in health care more than 15 years ago. The uses of these CIRS are highly variable among countries, ranging from being used to report critical incidents, falls, or sentinel events resulting in death. In Austria, CIRS have only been introduced to the health care sector relatively recently. The goal of this work, therefore, was to determine whether and specifically how CIRS are used in Austria. A working group from the Austrian Society for Quality and Safety in Healthcare (ASQS) developed a survey on the topic of CIRS to collect information on penetration of CIRS in general and on how CIRS reports are used to increase patient safety...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29233057/from-servicescape-to-loyalty-in-the-medical-tourism-industry-a-medical-clinic-s-service-perspective
#3
Minseong Kim, Dong-Woo Koo, Dong-Jin Shin, Sae-Mi Lee
Medical tourism organizations have increasingly recognized that loyalty makes a medical clinic a marketing success. To increase understanding of the importance of medical clinics, this study examined the roles of servicescapes, emotions, and satisfaction in the development of customer loyalty toward medical clinics and destination. Data were collected among international medical tourists visiting Korea. Results identified that dimensions of medical clinics' servicescape (ie, medical clinic environment, medical treatment, staff, and doctor) influenced emotions and satisfaction among international medical tourists...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29166812/disparities-in-insurance-coverage-health-services-use-and-access-following-implementation-of-the-affordable-care-act-a-comparison-of-disabled-and-nondisabled-working-age-adults
#4
Jae Kennedy, Elizabeth Geneva Wood, Lex Frieden
The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as their previously limited insurance options...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29161948/what-happens-to-a-nursing-home-chain-when-private-equity-takes-over-a-longitudinal-case-study
#5
Aline Bos, Charlene Harrington
We analyzed what happens to a nursing home chain when private equity takes over, with regard to strategy, financial performance, and resident well-being. We conducted a longitudinal (2000-2012) case study of a large nursing home chain that triangulated qualitative and quantitative data from 5 different data sources. Results show that private equity owners continued and reinforced several strategies that were already put in place before the takeover, including a focus on keeping staffing levels low; the new owners added restructuring, rebranding, and investment strategies such as establishing new companies, where the nursing home chain served as an essential "launch customer...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29161947/associations-between-waiting-times-service-times-and-patient-satisfaction-in-an-endocrinology-outpatient-department-a-time-study-and-questionnaire-survey
#6
Zhenzhen Xie, Calvin Or
The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29161944/a-structured-process-description-of-a-pragmatic-implementation-project-improving-integrated-care-for-older-persons-in-residential-care-homes
#7
Antonius J Poot, Claudia S de Waard, Annet W Wind, Monique A A Caljouw, Jacobijn Gussekloo
Evaluation of the implementation of integrated care can differ from trial-based research due to complexity. Therefore, we examined whether a theory-based method for process description of implementation can contribute to improvement of evidence-based care. MOVIT, a Dutch project aimed at implementing integrated care for older vulnerable persons in residential care homes, was used as a case study. The project activities were defined according to implementation taxonomy and mapped in a matrix of theoretical levels and domains...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/29144184/rates-and-predictors-of-professional-interpreting-provision-for-patients-with-limited-english-proficiency-in-the-emergency-department-and-inpatient-ward
#8
Jennifer Ryan, Samantha Abbato, Ristan Greer, Petra Vayne-Bossert, Phillip Good
The provision of professional interpreting services in the hospital setting decreases communication errors of clinical significance and improves clinical outcomes. A retrospective audit was conducted at a tertiary referral adult hospital in Brisbane, Australia. Of 20 563 admissions of patients presenting to the hospital emergency department (ED) and admitted to a ward during 2013-2014, 582 (2.8%) were identified as requiring interpreting services. In all, 19.8% of admissions were provided professional interpreting services in the ED, and 26...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28992759/a-qualitative-evaluation-of-an-online-expert-facilitated-course-on-tobacco-dependence-treatment
#9
Arezoo Ebn Ahmady, Megan Barker, Rosa Dragonetti, Myra Fahim, Peter Selby
Qualitative evaluations of courses prove difficult due to low response rates. Online courses may permit the analysis of qualitative feedback provided by health care providers (HCPs) during and after the course is completed. This study describes the use of qualitative methods for an online continuing medical education (CME) course through the analysis of HCP feedback for the purpose of quality improvement. We used formative and summative feedback from HCPs about their self-reported experiences of completing an online expert-facilitated course on tobacco dependence treatment (the Training Enhancement in Applied Cessation Counselling and Health [TEACH] Project)...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28990452/do-medicare-beneficiaries-living-with-hiv-aids-choose-prescription-drug-plans-that-minimize-their-total-spending
#10
Katherine A Desmond, Thomas H Rice, Arleen A Leibowitz
This article examines whether California Medicare beneficiaries with HIV/AIDS choose Part D prescription drug plans that minimize their expenses. Among beneficiaries without low-income supplementation, we estimate the excess cost, and the insurance policy and beneficiary characteristics responsible, when the lowest cost plan is not chosen. We use a cost calculator developed for this study, and 2010 drug use data on 1453 California Medicare beneficiaries with HIV who were taking antiretroviral medications. Excess spending is defined as the difference between projected total spending (premium and cost sharing) for the beneficiary's current drug regimen in own plan vs spending for the lowest cost alternative plan...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28984509/asking-about-pets-enhances-patient-communication-and-care-a-pilot-study
#11
Kate Hodgson, Marcia Darling, Douglas Freeman, Alan Monavvari
This research explored whether asking patients about their pets would enable better environmental/social history taking, and improve patient communication/care. Primary health care providers (PHPs) were surveyed about prevalence of patients living with pets, the health impact of pets, and influences on patient communication. Following an educational intervention, they committed to asking patients about their pets. A follow-up survey was conducted electronically. PHPs were recruited at a continuing medical education (CME) conference and at CME workshops...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28984496/spending-carveouts-substantially-improve-the-accuracy-of-performance-measurement-in-shared-savings-arrangements-findings-from-simulation-analysis-of-medicaid-acos
#12
Derek DeLia
Accuracy of spending-based provider performance metrics is limited by random variation and components of spending that are uncontrollable by providers. Such components vary according to the care management focus and operational maturity of each provider group. This study uses data from New Jersey Medicaid accountable care organizations (ACOs) to examine how carving out uncontrollable components of spending affects the accuracy of performance measures in shared savings arrangements. Spending on injury care, custodial care in facilities (CCF), and amounts above $100 000 per patient are used as examples of potentially uncontrollable spending...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28975850/comparing-health-care-financial-burden-with-an-alternative-measure-of-unaffordability
#13
Edward S Kielb, Corwin N Rhyan, James A Lee
Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage. To better understand the relationship between out-of-pocket (OOP) spending and access, we used the 2011-2014 Medical Expenditure Panel Survey (MEPS) data and a logistic model to analyze the likelihood of avoiding or delaying needed medical care based on health insurance design and other individual and family characteristics...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28972427/does-awareness-of-the-affordable-care-act-reduce-adverse-selection-a-study-of-the-long-term-uninsured-in-south-carolina
#14
Lu Shi, Chaoling Feng, Sarah Griffin, Joel E Williams, Lee A Crandall, Khoa Truong
Adverse selection predicts that individuals with lower health status would be more likely to sign up for health insurance. This hypothesis was tested among the long-term uninsured population in South Carolina (SC). This study used data from an in-person survey conducted from May 2014 to January 2015. Interviews were held with the long-term uninsured individuals at multiple sites throughout the state, using a multistage sampling method. SC residents aged 18 to 64 years who had had no health insurance for at least 24 consecutive months were eligible for the survey...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28965434/psychosocial-support-issues-affecting-older-patients-a-cross-sectional-paramedic-perspective
#15
Linda Ross, Paul Jennings, Brett Williams
This research aimed to gain an understanding of the psychosocial support needs of older patients in the out-of-hospital setting from the perspective of paramedics. Specifically, we investigate if and how paramedics are able to meet the needs of older adults, and the barriers preventing them from achieving this. This study was a cross-sectional study utilizing a sequential design with both quantitative and qualitative methodologies. All participants agreed or strongly agreed that older patients have needs beyond the physical and that they would like to do more for older patients...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28942701/feeding-tubes-and-health-care-service-utilization-in-amyotrophic-lateral-sclerosis-benefits-and-limits-to-a-retrospective-multicenter-study-using-big-data
#16
Keith M Swetz, Stephanie M Peterson, Lindsey R Sangaralingham, Ryan T Hurt, Shannon M Dunlay, Nilay D Shah, Jon C Tilburt
Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurologic disorder with predictable challenges regarding disease progression and end-of-life care. These include need for respiratory and nutritional support. Little is known about how such choices impact end-of-life health service utilization for these patients. Using OptumLabs Data Warehouse, a large administrative claims database with more than 150 million privately insured, geographically diverse enrollees, we sought to explore outcomes associated with the use of enteral nutrition (EN)...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28914111/analyzing-how-discursive-practices-affect-physicians-decision-making-processes-a-phenomenological-based-qualitative-study-in-critical-care-contexts
#17
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
#18
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
#19
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
#20
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
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