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https://www.readbyqxmd.com/read/28424057/personalized-medicine-in-europe-not-yet-personal-enough
#1
Antonello Di Paolo, François Sarkozy, Bettina Ryll, Uwe Siebert
BACKGROUND: Personalized medicine has the potential to allow patients to receive drugs specific to their individual disease, and to increase the efficiency of the healthcare system. There is currently no comprehensive overview of personalized medicine, and this research aims to provide an overview of the concept and definition of personalized medicine in nine European countries. METHODS: A targeted literature review of selected health databases and grey literature was conducted to collate information regarding the definition, process, use, funding, impact and challenges associated with personalized medicine...
April 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28420648/association-of-magnet-status-with-hospitalization-outcomes-for-ischemic-stroke-patients
#2
Kimon Bekelis, Symeon Missios, Todd A MacKenzie
BACKGROUND: It is not clear whether Magnet recognition by the American Nurses Credentialing Center (nursing excellence program) is associated with improved patient outcomes. We investigated whether hospitalization in a Magnet hospital is associated with improved outcomes for patients with ischemic stroke. METHODS AND RESULTS: We performed a cohort study of patients with ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database...
April 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28410960/a-randomized-controlled-trial-of-a-citywide-emergency-department-care-coordination-program-to-reduce-prescription-opioid-related-visits-an-economic-evaluation
#3
Sean M Murphy, Donelle Howell, Sterling McPherson, Rebecca Grohs, John Roll, Darin Neven
BACKGROUND: Care provided in the emergency department (ED) can cost up to five times as much as care received for comparable diagnoses in alternative settings. Small groups of patients, many of whom suffer from an opioid use disorder, often account for a large proportion of total ED visits. We recently conducted, and demonstrated the effectiveness of, the first randomized controlled trial of a citywide ED care-coordination program intending to reduce prescription-opioid-related ED visits...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28385026/scaling-lean-in-primary-care-impacts-on-system-performance
#4
Dorothy Y Hung, Michael I Harrison, Meghan C Martinez, Harold S Luft
OBJECTIVES: We examined a wide range of performance outcomes after Lean methodology-a leading strategy to enhance efficiency and patient value-was implemented and scaled across all primary care clinics in a nonprofit, ambulatory care delivery system. STUDY DESIGN: Using a stepped wedge approach, we assessed changes associated with the phased introduction of Lean-based redesigns across 46 primary care departments in 17 different clinic locations. Longitudinal analysis of operational metrics included: workflow efficiency, physician productivity, operating expenses, clinical quality, and satisfaction among patients, physicians, and staff...
March 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28382397/does-scope-of-practice-correlate-with-the-outcomes-of-craniotomy-for-tumor-resection-in-children
#5
Symeon Missios, Kimon Bekelis
BACKGROUND: The relationship of scope of practice (predominantly adult, versus predominantly pediatric) with the outcomes of brain tumor surgery in children remains uncertain. We investigated the association of practice focus with the outcomes of neurosurgical oncology operations in pediatric patients. METHODS: We performed a cohort study of all pediatric patients (younger than 18 years old) who underwent craniotomies for tumor resections from 2009 to 2013 and were registered in the Statewide Planning and Research Cooperative System (SPARCS) database...
April 5, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28379819/outcomes-of-integrated-behavioral-health-with-primary-care
#6
Bijal A Balasubramanian, Deborah J Cohen, Katelyn K Jetelina, L Miriam Dickinson, Melinda Davis, Rose Gunn, Kris Gowen, Frank V deGruy, Benjamin F Miller, Larry A Green
BACKGROUND: Integrating behavioral health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients' experience of care. METHODS: This study used a convergent mixed-methods design, merging findings from a quasi-experimental study with patient interviews conducted as part of Advancing Care Together, a community demonstration project that created an innovation incubator for practices implementing evidence-based integration strategies...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28369024/a-statewide-survey-report-of-roles-and-responsibilities-in-current-utah-care-management-processes
#7
Brenda Luther, Marc-Aurel Martial, Joyce Barra
PURPOSE OF THE STUDY: Measure current roles and responsibilities of care managers in the state of Utah. PRIMARY PRACTICE SETTING: All settings of health care including inpatient, outpatient, community, payer, post-acute, and transitional care settings. METHODS AND SAMPLE: A quantitative descriptive survey design was used to assess and describe current care management roles and responsibilities of 191 care managers within the state of Utah...
May 2017: Professional Case Management
https://www.readbyqxmd.com/read/28358791/methadone-prescribing-and-overdose-and-the-association-with-medicaid-preferred-drug-list-policies-united-states-2007-2014
#8
Mark Faul, Michele Bohm, Caleb Alexander
Drug overdose is a leading cause of injury death in the United States; 47,055 fatal drug overdoses were reported in 2014, a 6.5% increase from the previous year (1), driven by opioid use disorder (2,3). Methadone is an opioid prescribed for pain management and is also provided through opioid treatment programs to treat opioid use disorders. Because methadone might remain in a person's system long after the pain-relieving benefits have been exhausted, it can cause slow or shallow breathing and dangerous changes in heartbeat that might not be perceived by the patient (4,5)...
March 31, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28328670/the-trauma-ecosystem-the-impact-and-economics-of-new-trauma-centers-on-a-mature-statewide-trauma-system
#9
David J Ciesla, Etienne E Pracht, Pablo T Leitz, David A Spain, Joseph J Tepas, Kristan L Staudenmayer
INTRODUCTION: Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened along side 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patient profiles. METHODS: A statewide dataset was queried for all injury related discharges from adult acute care hospitals using ICD-9 codes for 2010 and 2014. The dataset, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida department of health in its trauma registry...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28306419/does-the-ranking-of-surgeons-in-a-publicly-available-online-platform-correlate-with-objective-outcomes
#10
Kimon Bekelis, Symeon Missios, Shannon Coy, Jeremiah N Johnson
OBJECTIVE The accuracy of public reporting in health care, especially from private vendors, remains an issue of debate. The authors investigated the association of the publicly reported physician complication rates in an online platform with real-world adverse outcomes of the same physicians for patients undergoing posterior lumbar fusion. METHODS The authors performed a cohort study involving physicians performing posterior lumbar fusions between 2009 and 2013 who were registered in the Statewide Planning and Research Cooperative System database...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28301213/academic-radiologist-subspecialty-identification-using-a-novel-claims-based-classification-system
#11
Andrew B Rosenkrantz, Wenyi Wang, Danny R Hughes, Luke A Ginocchio, David A Rosman, Richard Duszak
OBJECTIVE: The objective of the present study is to assess the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. MATERIALS AND METHODS: Using a categorization scheme based on the Neiman Imaging Types of Service (NITOS) system, we mapped the Medicare Part B services billed by all radiologists from 2012 to 2014, assigning them to the following subspecialty categories: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, nuclear medicine, interventional radiology, and neuroradiology...
March 16, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28299620/patient-acuity-and-operative-technique-associated-with-post-colectomy-mortality-across-new-york-state-an-analysis-of-160-792-patients-over-20%C3%A2-years
#12
Ryan Lamm, Steven N Mathews, Jie Yang, Jihye Park, Mark Talamini, Aurora D Pryor, Dana Telem
This study sought to characterize in-hospital post-colectomy mortality in New York State. One hundred sixty thousand seven hundred ninety-two patients who underwent colectomy from 1995 to 2014 were analyzed from the all-payer New York Statewide Planning and Research Cooperative System (SPARCS) database. Linear trends of in-hospital mortality rate over 20 years were calculated using log-linear regression models. Chi-square tests were used to compare categorical variables between patients. Multivariable regression models were further used to calculate risk of in-hospital mortality associated with specific demographics, co-morbidities, and perioperative complications...
March 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28295260/hospital-readmission-and-social-risk-factors-identified-from-physician-notes
#13
Amol S Navathe, Feiran Zhong, Victor J Lei, Frank Y Chang, Margarita Sordo, Maxim Topaz, Shamkant B Navathe, Roberto A Rocha, Li Zhou
OBJECTIVE: To evaluate the prevalence of seven social factors using physician notes as compared to claims and structured electronic health records (EHRs) data and the resulting association with 30-day readmissions. STUDY SETTING: A multihospital academic health system in southeastern Massachusetts. STUDY DESIGN: An observational study of 49,319 patients with cardiovascular disease admitted from January 1, 2011, to December 31, 2013, using multivariable logistic regression to adjust for patient characteristics...
March 13, 2017: Health Services Research
https://www.readbyqxmd.com/read/28283236/cost-effectiveness-of-mediastinal-lymph-node-staging-in-non-small-cell-lung-cancer
#14
Katarzyna Czarnecka-Kujawa, Ursula Rochau, Uwe Siebert, Eshetu Atenafu, Gail Darling, Thomas Kenneth Waddell, Andrew Pierre, Marc De Perrot, Marcelo Cypel, Shaf Keshavjee, Kazuhiro Yasufuku
OBJECTIVE: To assess the cost-effectiveness of various modes of mediastinal staging in non-small cell lung cancer (NSCLC) in a single-payer health care system. METHODS: We performed a decision analysis to compare the health outcomes and costs of 4 mediastinal staging strategies: no invasive staging, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), mediastinoscopy, and EBUS-TBNA followed by mediastinoscopy if EBUS-TBNA is negative. We determined incremental cost effectiveness ratios (ICER) for all strategies and performed comprehensive deterministic sensitivity analyses using a willingness to pay threshold of $80,000/quality adjusted life year (QALY)...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28283046/recommendations-from-the-european-working-group-for-value-assessment-and-funding-processes-in-rare-diseases-orph-val
#15
Lieven Annemans, Ségolène Aymé, Yann Le Cam, Karen Facey, Penilla Gunther, Elena Nicod, Michele Reni, Jean-Louis Roux, Michael Schlander, David Taylor, Carlo Tomino, Josep Torrent-Farnell, Sheela Upadhyaya, Adam Hutchings, Lugdivine Le Dez
Rare diseases are an important public health issue with high unmet need. The introduction of the EU Regulation on orphan medicinal products (OMP) has been successful in stimulating investment in the research and development of OMPs. Despite this advancement, patients do not have universal access to these new medicines. There are many factors that affect OMP uptake, but one of the most important is the difficulty of making pricing and reimbursement (P&R) decisions in rare diseases. Until now, there has been little consensus on the most appropriate assessment criteria, perspective or appraisal process...
March 10, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28265347/value-added-medicines-what-value-repurposed-medicines-might-bring-to-society
#16
Mondher Toumi, Cécile Rémuzat
Background & objectives: Despite the wide interest surrounding drug repurposing, no common terminology has been yet agreed for these products and their full potential value is not always recognised and rewarded, creating a disincentive for further development. The objectives of the present study were to assess from a wide perspective which value drug repurposing might bring to society, but also to identify key obstacles for adoption of these medicines and to discuss policy recommendations. Methods: A preliminary comprehensive search was conducted to assess how the concept of drug repurposing was described in the literature...
2017: Journal of Market Access & Health Policy
https://www.readbyqxmd.com/read/28257438/a-population-based-matched-cohort-study-examining-the-mortality-and-costs-of-patients-with-community-onset-clostridium-difficile-infection-identified-using-emergency-department-visits-and-hospital-admissions
#17
Natasha Nanwa, Beate Sander, Murray Krahn, Nick Daneman, Hong Lu, Peter C Austin, Anand Govindarajan, Laura C Rosella, Suzanne M Cadarette, Jeffrey C Kwong
Few studies have evaluated the mortality or quantified the economic burden of community-onset Clostridium difficile infection (CDI). We estimated the attributable mortality and costs of community-onset CDI. We conducted a population-based matched cohort study. We identified incident subjects with community-onset CDI using health administrative data (emergency department visits and hospital admissions) in Ontario, Canada between January 1, 2003 and December 31, 2010. We propensity-score matched each infected subject to one uninfected subject and followed subjects in the cohort until December 31, 2011...
2017: PloS One
https://www.readbyqxmd.com/read/28247092/socioeconomic-factors-and-parity-of-access-to-robotic-surgery-in-a-county-health-system
#18
Leah Carey Tatebe, Regan Gray, Ken Tatebe, Fernando Garcia, Bradley Putty
Equal access to novel surgical technologies remains a policy concern as hospitals adopt robotic surgery with increasing prevalence. This study sought to determine whether socioeconomic factors influence access to robotic surgery. All laparoscopic and robotic fundoplications and paraesophageal hernia repairs performed by a surgical group over 6 years at a county and two neighboring private hospitals were identified. Robotic use by hospital setting, age, gender, reported ethnicity, estimated income, insurance payer, and diagnosis were examined...
February 28, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28235972/outcomes-associated-with-prescribed-medications-in-older-adults-with-multimorbidity-protocol-for-a-scoping-review
#19
Jennifer Watt, Andrea C Tricco, Manav Vyas, Kapil Kohli, Sarthak Soin, Mitra Abaeian, Stephanie Watt, Sharon E Straus
INTRODUCTION: Multimorbidity becomes increasingly prevalent with ageing. Polypharmacy is often associated with multimorbidity because patients accrue medications to treat each individual disease; however, there is uncertainty around the generalisability of disease-specific guidelines. Namely, the extrapolation of results from studies conducted in younger patients to older adults with multimorbidity. The main objective of this scoping review is to explore our current knowledge of the outcomes that older adults with multimorbidity experience from taking prescribed medications...
February 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28199029/healthcare-costs-of-type-2-diabetes-in-germany
#20
E Jacobs, A Hoyer, R Brinks, A Icks, O Kuß, W Rathmann
AIM: To describe for the first time the direct costs of Type 2 diabetes treatment by analysing nationwide routine data from statutory health insurance in Germany. METHODS: This cost-of-illness-study was based on a 6.8% random sample of all German people with statutory health insurance (4.3 out of 70 million people). The healthcare expenses show direct per capita costs from the payer perspective. Healthcare expenses for physicians, dentists, pharmacies, hospitals, sick benefits and other healthcare costs were considered...
February 15, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
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