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Health Services Research and Managerial Epidemiology

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https://www.readbyqxmd.com/read/30246058/general-practitioners-barriers-toward-medication-reviews-in-polymedicated-multimorbid-patients-how-can-a-focus-on-the-pharmacotherapy-in-an-outpatient-clinic-support-gps
#1
Jannie Laursen, Jonatan Kornholt, Cecilie Betzer, Tonny S Petersen, Mikkel B Christensen
Purpose: The aim of this study was to explore whether general practitioners (GPs) experienced barriers toward medication reviews in polymedicated, multimorbid patients, and how a clinical pharmacologist with a focus on pharmacotherapy can support the GPs in an outpatient clinic. Design: The study was descriptive and exploratory and had a qualitative design with a phenomenological/hermeneutic orientation for the interviews. Participants: The study comprised 14 interviews with 14 different GPs from the Capital Region of Denmark...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/30225273/association-of-trauma-alert-response-charges-with-volume-and-hospital-ownership-type-in-florida
#2
Jessica L Ryan, Etienne E Pracht, Barbara Langland-Orban
Objective: The purpose was to analyze the association of trauma volume and hospital trauma center (TC) ownership type with trauma alert (TA) response charges, which are billed for activation of the trauma team to the emergency department (ED). Methods: All Florida ED and inpatients who were billed a TA charge from 2012 to 2014 were included (62 974 observations). Multiple linear regression, controlling for patient and hospital factors, was used to identify associations between TA charges and trauma volume and hospital ownership type...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/30202774/utilization-outcomes-of-a-pilot-primary-care-team-redesign
#3
Alison R Landrey, Valerie S Harder, Marie B Sandoval, John G King, David S Ziegelman, Charles D MacLean
Objectives: To evaluate the effect of a team-based primary care redesign on primary care, emergency department (ED) and urgent care (UC) utilization, and new patient access to primary care. Study Design: A retrospective pre-post difference-in-differences analysis of utilization outcomes for patients on a redesigned primary care team compared to a standard primary care group. Methods: Within a patient-centered medical home, a pilot team was developed comprising 2 colocated "teamlets" of 1 physician, 1 nurse practitioner (NP), 1 registered nurse (RN), and 2 licensed practical nurses (LPNs)...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/30182036/mental-health-and-disability-pension-onset-changes-in-consumption-of-antianxiety-and-hypnotic-drugs
#4
Ingunn Fride Tvete, Trine Bjørner, Tor Skomedal
Introduction: In Norway, disability pension (DP) has been more prevalent over the later years, with mental disorders being a frequent cause. Previous analyses have questioned whether receiving DP is beneficial for mental health by considering changes in antidepressant drug consumption. To explore this further, we examined changes in antianxiety and hypnotic drug consumption following DP onset. Methods: Based on national Norwegian register data, this retrospective study encompassed 8617 working-age individuals (25-50 years) who became DP during 2005 to 2013...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/30083576/a-pilot-study-factors-influencing-compliance-with-tetanus-diphtheria-vaccine-in-katsina-state-northwestern-nigeria
#5
Shafique Sani Nass
Background: Tetanus-diphtheria vaccine (Td+) coverage has been steadily declining in Katsina State, Nigeria. The pilot study was guided by The Andersen and Newman Framework of Health Services Utilization. The goal of the pilot study was to identify the Td+ vaccination coverage and identify any association between maternal residence, educational status, occupational status, access to routine immunization services, availability of routine immunization services, perceived need for Td+, perceived severity of maternal and neonatal tetanus (MNT), and compliance with Td+ in Katsina State...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/30083575/inequality-in-responsiveness-a-study-of-comprehensive-physical-rehabilitation-centers-in-capital-of-iran
#6
Manijeh Alavi, Ameneh Setareh Forouzan, Maziar Moradi-Lakeh, Mohammad Reza Khodaie Ardakani, Mohsen Shati, Mehdi Noroozi, Homeira Sajjadi
Objective: Responsiveness refers to meeting the legitimate expectations of people who interact with the health system. This study aimed to assess the presence of any inequality in responsiveness based on the different sociodemographic groups. Methods: This cross-sectional study was carried out in Tehran. A total of 610 people with a physical disability from 10 comprehensive physical rehabilitation centers (5 public and 5 private) were included in the study through quota sampling...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/30083574/a-3-state-analysis-of-black-white-disparities-in-diabetes-hospitalizations-among-medicaid-beneficiaries
#7
William N Mkanta, Michelle C Reece, Abeer D Alamri, Emmanuel U Ezekekwu, Aishwarya Potluri, Neale R Chumbler
Introduction: Although diabetes is one of the leading chronic disease in the country, efforts in primary care and patient self-care management could prevent most of the diabetes-related hospitalizations and produce cost savings and improvements in quality of life. We used information from Medicaid beneficiaries in 3 states to predict racial differences in diabetes hospitalizations and demonstrate how they vary across states. Methods: We conducted a cross-sectional study to examine differences between black and white patients with diabetes hospitalizations...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/30083573/predictors-of-optimal-antenatal-care-service-utilization-among-adolescents-and-adult-women-in-bangladesh
#8
Nausad Ali, Marufa Sultana, Nurnabi Sheikh, Raisul Akram, Rashidul Alam Mahumud, Muhammad Asaduzzaman, Abdur Razzaque Sarker
Introduction: Utilization of recommended antenatal care (ANC) throughout the pregnancy period is a proven healthy behavior in reducing maternal mortalities and morbidities. The objective of this study is to identify the demand side factors that are associated with the recommended utilization of ANC services among adolescents and adult women in Bangladesh. Method: This study utilized cross-sectional data from latest Bangladesh Demographic and Health Survey 2014. Data of a total of 4626 adolescents and adult women were analyzed...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29761131/depression-and-anxiety-among-patients-on-chronic-opioid-therapy
#9
Muhamad Y Elrashidi, Lindsey M Philpot, Priya Ramar, William B Leasure, Jon O Ebbert
Background: Chronic noncancer pain (CNCP) and chronic opioid therapy (COT) commonly coexist with comorbid depression and anxiety. We investigated the prevalence of depression and anxiety and their correlates at the time of controlled substance agreement (CSA) enrollment among patients with CNCP and a history of depression or anxiety on COT. Methods: Retrospective analysis of 1066 patients in a Midwest primary care practice enrolled in CSAs for COT between May 9, 2013, and August 15, 2016...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29657959/improvement-of-early-antenatal-care-initiation-the-effects-of-training-local-health-volunteers-in-the-community
#10
Tippawan Liabsuetrakul, Nurlisa Oumudee, Masuenah Armeeroh, Niamina Nima, Nurosanah Duerahing
Background: Although antenatal care (ANC) coverage has been increasing in low- and middle-income countries, the adherence to the ANC initiation standards at gestational age <12 weeks was inadequate including Thailand. The study aimed to improve the rate of early ANC initiation by training the existing local health volunteers (LHVs) in 3 southernmost provinces of Thailand. Methods: A clustered nonrandomized intervention study was conducted from November 2012 to February 2014...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29623286/shared-care-models-in-the-treatment-of-pediatric-attention-deficit-hyperactivity-disorder-adhd-are-they-effective
#11
REVIEW
Meshal A Sultan, Carlos S Pastrana, Kathleen A Pajer
Objectives: The aim of this review is to evaluate the effectiveness of shared/collaborative care between mental health-care providers and primary care providers (PCPs) on the outcomes of children and adolescents with attention-deficit/hyperactivity disorder (ADHD). This evaluation will be very helpful in the allocation of ADHD resources for models with the strongest evidence. Methods: Using the Preferred Reporting Items for Systematic Review and Meta-analysis statement, we searched for randomized controlled trials, cohort, case-control, and cross-sectional studies on shared/collaborative care models in the treatment of ADHD...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29568790/treatment-changes-in-general-practice-patients-with-chronic-mental-disorders-following-a-psychiatric-psychosomatic-consultation
#12
Michael Linden, Beate Muschalla, Nils Noack, Christoph Heintze, Susanne Doepfmer
Objective: To determine whether a psychiatric-psychosomatic consultation can identify unmet treatment needs and improve treatment of patients with mental disorders in general practice. Methods: In 40 primary care practices, 307 consecutive primary patients who met criteria for chronic mental disorders were assessed by a psychiatric-psychosomatic consultant. After random assignment, general practitioners (GPs) were informed for half of the patients about the results of the assessment and received recommendations on how to improve treatment...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29568789/ending-cervical-cancer-screening-in-low-risk-women-after-age-65-understanding-barriers-to-adherence-with-evidence-based-guidelines-among-primary-care-providers
#13
Emily Boone, Michael Karp, LaVonna Lewis
Background: Current evidence-based cervical cancer testing guidelines recommend that screening of low-risk women ceases after age 65. Despite this, research suggests that continued testing by primary care providers remains common and represents unnecessary patient discomfort, cost, and consumption of valuable primary care resources. Objective: To understand why primary care providers might knowingly ignore consensus evidence-based screening guidelines for cervical cancer in low-risk women of this age-group and to identify barriers to adherence with best practice recommendations...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29552599/identifying-successful-practices-to-overcome-access-to-care-challenges-in-community-health-centers-a-positive-deviance-approach
#14
Tammy Toscos, Maria Carpenter, Mindy Flanagan, Kislaya Kunjan, Bradley N Doebbeling
Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These "positive deviant" practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29479557/benefits-and-barriers-to-teaching-medical-students-in-an-ob-gyn-clinic
#15
Michael F Fialkow, Carrie M Snead, Jay Schulkin
Introduction: As the US health-care system has evolved over the past decade, access to obstetric care in rural communities has declined, and there has been a challenge in retaining obstetrics and gynecology (OB-GYN) providers to train the next generation of physicians. The current pilot study sought to identify the factors that influence faculty who train medical students within the field of OB-GYN with the hope of influencing recruitment and retention of providers for the future. Methods: Clinical OB-GYN faculty within the University of Washington School of Medicine regional medical education program were surveyed about practice patterns and beliefs regarding medical student training as part of a pilot study on provider recruitment and retention...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29450216/a-multidisciplinary-delphi-consensus-based-checklist-to-define-clinical-documentation-tools-for-both-routine-and-research-purposes
#16
Cecilia Veraar, Paul Hasler, Michael Schirmer
Background: To the best of our knowledge, a strategic approach to define the contents of structured clinical documentation tools for both clinical routine patient care and research purposes has not been reported so far, although electronic health record will become more and more structured and detailed in the future. Objective: To achieve an interdisciplinary consensus on a checklist to be considered for the preparation of disease- and situation-specific clinical documentation tools...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29383325/acceptability-of-health-kiosks-within-african-american-community-settings-a-pilot-study
#17
Olufunmilola Abraham, Megha Patel, Alison Feathers
Introduction: Health kiosks have been increasingly adopted to provide health-care services to those with limited access. Kiosks have the potential to reach people who may have undiagnosed health conditions or those who are not under regular physician care. Thus far, there is limited research assessing the usefulness of health kiosks in the community. This study aimed to explore the acceptability, usability, usefulness, and overall satisfaction of health kiosks in African American majority community settings...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29383324/a-predictive-algorithm-to-detect-opioid-use-disorder-what-is-the-utility-in-a-primary-care-setting
#18
Chee Lee, Maneesh Sharma, Svetlana Kantorovich, Ashley Brenton
Purpose: The purpose of this study was to determine the clinical utility of an algorithm-based decision tool designed to assess risk associated with opioid use in the primary care setting. Methods: A prospective, longitudinal study was conducted to assess the utility of precision medicine testing in 1822 patients across 18 family medicine/primary care clinics in the United States. Using the profile, patients were categorized into low, moderate, and high risk for opioid use...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29376110/documentation-of-contraception-and-pregnancy-intention-in-medicaid-managed-care
#19
Heike Thiel de Bocanegra, Alia McKean, Philip Darney, Erin Saleeby, Denis Hulett
Context: Clinical guidelines recommend the documentation of pregnancy intention and family planning needs during primary care visits. Prior to the 2014 Medicaid expansion and release of these guidelines, the documentation practices of Medicaid managed care providers are unknown. Methods: We performed a chart review of 1054 Medicaid managed care visits of women aged 13 to 49 to explore client, provider, and visit characteristics associated with documentation of immediate or future plans for having children and contraceptive method use...
January 2018: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/29326964/transportation-and-other-nonfinancial-barriers-among-uninsured-primary-care-patients
#20
Akiko Kamimura, Samin Panahi, Zobayer Ahmmad, Mu Pye, Jeanie Ashby
Introduction: Nonfinancial barriers are frequent causes of unmet need in health-care services. The significance of transportation barriers can weigh more than the issues of access to care. The purpose of this cross-sectional study was to examine transportation and other nonfinancial barriers among low-income uninsured patients of a safety net health-care facility (free clinic). Methods: The survey data were collected from patients aged 18 years and older who spoke English or Spanish at a free clinic, which served uninsured individuals in poverty in the United States...
January 2018: Health Services Research and Managerial Epidemiology
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