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https://www.readbyqxmd.com/read/29457583/financial-incentives-to-reduce-hospital-acquired-infections-under-alternative-payment-arrangements
#1
Catherine Crawford Cohen, Jianfang Liu, Bevin Cohen, Elaine L Larson, Sherry Glied
OBJECTIVE The financial incentives for hospitals to improve care may be weaker if higher insurer payments for adverse conditions offset a portion of hospital costs. The purpose of this study was to simulate incentives for reducing hospital-acquired infections under various payment configurations by Medicare, Medicaid, and private payers. DESIGN Matched case-control study. SETTING A large, urban hospital system with 1 community hospital and 2 tertiary-care hospitals. PATIENTS All patients discharged in 2013 and 2014...
February 19, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29406969/socioeconomic-class-and-universal-healthcare-analysis-of-stroke-cost-and-outcomes-in-us-military-healthcare
#2
Matthew Blattner, James Price, Matthew D Holtkamp
OBJECTIVE: Do socioeconomic disparities exist in the US military healthcare system with ischemic stroke admissions? METHODS: Civilian healthcare in the United States is paid for by a variety of payers. Significant disparities exist in this system based upon socioeconomic status (SES). In contrast, the military healthcare system (MHS) is a universal healthcare system. Military rank is a SES surrogate. Data was collected from the MHS database for years 2010 through 2015...
March 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29395303/care-pathway-towards-the-establishment-of-tailored-funding-reasons-and-criteria-for-success
#3
Grégory Emery, Camille Le Fur, Anne-Aurélie Epis-de-Fleurian, Anne Josseran
Care pathways are often at the forefront of political thinking about health care practices in France without ever finding a durable means for their extension. Closely linked to funding of healthcare system, they have, once again, been the object of so many economical discussions in 2017, as part of a more optimistic climate of governance which is therefore more open to change. Our changing system, the development and increasingly chronic nature of diseases, the scale of technological breakthroughs, these are all factors driving this topic forward...
December 29, 2017: Thérapie
https://www.readbyqxmd.com/read/29380822/hospitalizations-for-autoimmune-hepatitis-disproportionately-affect-black-and-latino-americans
#4
Jason W Wen, Michael A Kohn, Robert Wong, Ma Somsouk, Mandana Khalili, Jacquelyn Maher, Michele M Tana
OBJECTIVES: The healthcare burden of autoimmune hepatitis (AIH) in the United States has not been characterized. We previously showed that AIH disproportionately affects people of color in a single hospital system. The current study aimed to determine whether the same disparity occurs nationwide. METHODS: We analyzed hospitalizations with a primary discharge diagnosis corresponding to the ICD-9 code for AIH in the National Inpatient Sample between 2008 and 2012...
January 30, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29380478/a-comparison-of-care-delivered-in-hospital-based-and-freestanding-emergency-departments
#5
Jesse M Pines, Mark S Zocchi, Bernard S Black
OBJECTIVE: We compare case-mix, hospitalization rates, length of stay (LOS), and resource use in independent freestanding emergency departments (FSEDs) and hospital-based emergency departments (H-EDs). METHODS: Data from 74 FSEDs (2013-5) in Texas and Colorado, were compared to H-ED data from the 2013-14 National Hospital Ambulatory Medical Care Survey. In the unrestricted sample, large differences in visit characteristics (e.g. payer and case mix) were found between patients that use FSEDs compared to H-EDs...
January 30, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29372876/the-impact-of-spine-disease-relative-to-cranial-disease-on-perception-of-health-and-care-experience-an-analysis-of-1484-patients-in-a-tertiary-center
#6
Panagiotis Kerezoudis, Mohammed Ali Alvi, Daniel S Ubl, Kristine T Hanson, William E Krauss, Fredric B Meyer, Robert J Spinner, Elizabeth B Habermann, Mohamad Bydon
OBJECTIVE Patient-reported outcomes have been increasingly mandated by regulators and payers to evaluate hospital and physician performance. The purpose of this study is to delineate the differences in patient-reported experience of hospital care for cranial and spinal operations. METHODS The authors selected all patients who underwent inpatient, elective cranial or spinal procedures and completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey at a single, high-volume, tertiary care institution between October 2012 and September 2015...
January 26, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29370917/are-minimum-volume-standards-appropriate-for-lung-and-esophageal-surgery
#7
Sebron Harrison, Virginia Tangel, Xian Wu, Paul Christos, Licia Gaber-Baylis, Zachary Turnbull, Jeff Port, Nasser Altorki, Brendon Stiles
BACKGROUND: Several medical systems have adopted minimum volume standards for surgical procedures, including lung and esophageal resection. We sought to determine whether these proposed hospital cutoffs are associated with differences in outcomes. METHODS: Analyzing the State Inpatient Databases and Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, we evaluated all patients (aged ≥ 18 years) who underwent lobectomy/pneumonectomy or esophagectomy for cancer in California, Florida, and New York (2009-2011)...
December 6, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29366347/correlation-of-hospital-magnet-status-with-the-quality-of-physicians-performing-neurosurgical-procedures-in-new-york-state
#8
Kimon Bekelis, Symeon Missios, Todd A MacKenzie
PURPOSE: The quality of physicians practicing in hospitals recognized for nursing excellence by the American Nurses Credentialing Center has not been studied before. We investigated whether Magnet hospital recognition is associated with higher quality of physicians performing neurosurgical procedures. MATERIALS AND METHODS: We performed a cohort study of patients undergoing neurosurgical procedures from 2009-2013, who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database...
January 24, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29352437/cost-effectiveness-of-treatments-for-chronic-constipation-a-systematic-review
#9
REVIEW
Dolly Han, Nicolas Iragorri, Fiona Clement, Diane Lorenzetti, Eldon Spackman
BACKGROUND: Chronic constipation (CC) has a significant impact on patients' quality of life and imposes an economic burden on individuals and the healthcare system. Treatment options include dietary changes, lifestyle modifications, fibre supplements, stool softeners, and laxatives. OBJECTIVE: We undertook this systematic review to comprehensively evaluate the cost effectiveness of treatments for CC. METHODS: We searched ten common databases to identify economic evaluations published to 13 June 2017...
January 19, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29338952/behavioral-risk-factors-and-regional-variation-in-cardiovascular-health-care-and-death
#10
Kathleen M Fairfield, Adam W Black, F Lee Lucas, Andrea E Siewers, Mylan C Cohen, Christopher T Healey, Allison C Briggs, Paul K J Han, John E Wennberg
INTRODUCTION: Reducing the burden of death from cardiovascular disease includes risk factor reduction and medical interventions. METHODS: This was an observational analysis at the hospital service area (HSA) level, to examine regional variation and relationships between behavioral risks, health services utilization, and cardiovascular disease mortality (the outcome of interest). HSA-level prevalence of cardiovascular disease behavioral risks (smoking, poor diet, physical inactivity) were calculated from the Behavioral Risk Factor Surveillance System; HSA-level rates of stress tests, diagnostic cardiac catheterization, and revascularization from a statewide multi-payer claims data set from Maine in 2013 (with 606,260 patients aged ≥35 years), and deaths from state death certificate data...
January 12, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29337604/the-current-status-of-outcomes-based-contracting-for-manufacturers-and-payers-an-amcp-membership-survey
#11
Amy Duhig, Soumi Saha, Stacie Smith, Stew Kaufman, Janet Hughes
BACKGROUND: As the United States health care system shifts from traditional volume-based payments to value-based payments, outcomes-based contracts (OBCs) are gaining popularity among payers and manufacturers as a mechanism for the shift toward value. Under this model, stakeholders hope to align drug payment and value to real-world performance metrics (e.g., biomarkers and health care resource utilization). OBJECTIVE: To understand the experiences, perceptions, and needs of payers and manufacturers related to OBCs...
December 22, 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29337427/outcomes-from-the-first-helene-fuld-health-trust-national-institute-for-evidence-based-practice-in-nursing-and-healthcare-invitational-expert-forum
#12
Bernadette Mazurek Melnyk, Lynn Gallagher-Ford, Cindy Zellefrow, Sharon Tucker, Laurel Van Dromme, Bindu Koshy Thomas
BACKGROUND: Even though multiple positive outcomes are the result of evidence-based care, including improvements in healthcare quality, safety, and costs, it is not consistently delivered by clinicians in healthcare systems throughout the world. AIMS: In an attempt to accelerate the implementation of evidence-based practice (EBP) across the United States, an invitational Interprofessional National EBP Forum to determine major priorities for the advancement of EBP was held during the launch of the newly established Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at The Ohio State University College of Nursing...
January 16, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29330310/social-determinants-of-community-level-human-papillomavirus-vaccination-coverage-in-a-school-based-vaccination-programme
#13
Stephen Jean, Malak Elshafei, Alison Buttenheim
OBJECTIVE: To assess social patterns in human papillomavirus (HPV) vaccine coverage in a school-based, government-funded vaccination programme located within a single-payer universal healthcare system. DESIGN: We conducted a cross-sectional analysis of HPV vaccine uptake data for the 2013-2014 school year for 131 local authorities in England, and then evaluated the association between vaccine uptake and socioeconomic status at the aggregate level. DATA SOURCES: HPV vaccination coverage data from Public Health England's vaccine uptake guidance and the UK's March 2011 Census...
January 12, 2018: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/29324605/estimating-the-hospital-delivery-costs-associated-with-severe-maternal-morbidity-in-new-york-city-2008-2012
#14
Renata E Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Tsu-Yu Tsao
OBJECTIVE: To quantify the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries over a 5-year period in New York City adjusting for other sociodemographic and clinical factors. METHODS: We conducted a population-based cross-sectional study using linked birth certificates and hospital discharge data for New York City deliveries from 2008 to 2012. Severe maternal morbidity was defined using a published algorithm of International Classification of Diseases, 9 Revision, Clinical Modification disease and procedure codes...
February 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29310703/management-of-persistent-epistaxis-using-floseal-hemostatic-matrix-vs-traditional-nasal-packing-a-prospective-randomized-control-trial
#15
Scott Murray, Adrian Mendez, Alexander Hopkins, Hamdy El-Hakim, Caroline C Jeffery, David W J Côté
BACKGROUND: Epistaxis is the most common emergent consultation to otolaryngology-head & neck surgery (OHNS) and with 60% of the population having experienced an episode and 1.6 in 10,000 requiring hospitalization in their lifetime. In preliminary studies Floseal® (Baxter, USA) Hemostatic Matrix has shown efficacy in up to 80% of persistent anterior epistaxis. We sought to evaluate the clinical efficacy and cost-effectiveness of Floseal® (Baxter, USA) compared to traditional nasal packing for persistent epistaxis...
January 8, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29303621/cost-effectiveness-of-de-escalation-from-micafungin-versus-escalation-from-fluconazole-for-invasive-candidiasis-in-china
#16
Dechang Chen, Xianyao Wan, Eliza Kruger, Can Chen, Xiaomeng Yue, Liang Wang, Jiuhong Wu
AIMS: Guidelines on treating invasive candidiasis recommend initial treatment with a broad-spectrum echinocandin (e.g. micafungin), then switching to fluconazole if isolates prove sensitive (de-escalation strategy). This study aimed to evaluate the cost-effectiveness of de-escalation from micafungin vs escalation from fluconazole from a Chinese public payers perspective. MATERIALS AND METHODS: Cost-effectiveness was estimated using a decision analytic model, in which patients begin treatment with fluconazole 400 mg/day (escalation) or micafungin 100 mg/day (de-escalation)...
January 11, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29290175/future-considerations-for-the-evaluation-of-hepatitis-c-virus-treatments-in-pan-genotypic-therapy-for-noncirrhotic-treatment-naive-patients
#17
Martin J Calabrese, Lauren M Hynicka, Magaly Rodriguez de Bittner, Fadia T Shaya
Given the recent approval of the first pan-genotypic chronic hepatitis C virus (HCV) therapy, managed care, health systems, and clinicians will need to evaluate current practices related to essential laboratory assessments used to select therapy. Historically, clinicians and payers required a battery of tests to determine HCV genotype, viral load, degree of fibrosis, and organ function. In light of current and forthcoming approvals of pan-genotypic therapy, clinicians and payers can expect a more competitive marketplace and a downward curve in the price of therapy...
January 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29273370/is-there-a-weekend-effect-in-emergency-general-surgery
#18
David Metcalfe, Manuel Castillo-Angeles, Arturo J Rios-Diaz, Joaquim M Havens, Adil Haider, Ali Salim
BACKGROUND: Weekend admission is associated with increased mortality across a range of patient populations and health-care systems. The aim of this study was to determine whether weekend admission is independently associated with serious adverse events (SAEs), in-hospital mortality, or failure to rescue (FTR) in emergency general surgery (EGS). METHODS: An observational study was performed using the National Inpatient Sample in 2012-2013; the largest all-payer inpatient database in the United States, which represents a 20% stratified sample of hospital discharges...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29248240/higher-surgeon-annual-volume-but-not-years-of-experience-is-associated-with-reduced-rates-of-postoperative-complications-and-reoperations-after-open-abdominal-aortic-aneurysm-repair
#19
Luc Dubois, Britney Allen, Krista Bray-Jenkyn, Adam H Power, Guy DeRose, Thomas L Forbes, Audra Duncan, Salimah Z Shariff
OBJECTIVE: Volume-outcome relationships for open abdominal aortic aneurysm (AAA) repair have received less attention in publicly funded health systems. Furthermore, the roles of surgeon seniority (years of experience) and composite volume (encompassing all major arterial cases) on outcomes after open AAA repair are less well known. We sought to determine the effects of surgeon volume, surgeon years of experience, and composite volume on outcomes after elective open AAA repairs performed in Ontario, Canada...
December 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29196176/assessing-value-in-breast-reconstruction-a-systematic-review-of-cost-effectiveness-studies
#20
Clifford C Sheckter, Evan Matros, Arash Momeni
INTRODUCTION: Breast reconstruction is one of the most common procedures performed by plastic surgeons and is achieved through various choices in both technology and method. Cost-effectiveness analyses are increasingly important in assessing differences in value between treatment options, which is relevant in a world of confined resources. A thorough evaluation of the cost-effectiveness literature can assist surgeons and health systems evaluate high-value care models. METHODS: A systematic review of PubMed, Web of Science, and the Cost-Effectiveness Analysis Registry was conducted...
October 9, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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