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https://www.readbyqxmd.com/read/29159756/patient-provider-communication-and-health-outcomes-among-individuals-with-hepato-pancreato-biliary-disease-in-the-usa
#1
Qinyu Chen, Eliza W Beal, Eric B Schneider, Victor Okunrintemi, Xu-Feng Zhang, Timothy M Pawlik
BACKGROUND: Patient-provider communication (PPC) is utilized as a value-based metric in pay-for-performance programs. We sought to evaluate the association of PPC with patient-reported health outcomes, as well as healthcare resource utilization among a nationally representative cohort of patients with hepato-pancreato-biliary (HPB) diagnoses. METHODS: Patients with HPB diseases were identified from the 2008-2014 Medical Expenditure Panel Survey cohort. A weighted PPC composite score was categorized using the responses from the CAHPS (Consumer Assessment of Healthcare Providers and Systems) survey as optimal, average, or poor...
November 20, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29154203/unbending-mind-individuals-with-hoarding-disorder-do-not-modify-decision-strategy-in-response-to-feedback-under-risk
#2
Helen Pushkarskaya, David F Tolin, Daniel Henick, Ifat Levy, Christopher Pittenger
Cognitive-behavioral models of hoarding disorder emphasize impairments in information processing and decision making in the genesis of hoarding symptomology. We propose and test the novel hypothesis that individuals with hoarding are maladaptively biased towards a deliberative decision style. While deliberative strategies are often considered normative, they are not always adaptable to the limitations imposed by many real-world decision contexts. We examined decision-making patterns in 19 individuals with hoarding and 19 healthy controls, using a behavioral task that quantifies selection of decision strategies in a novel environment with known probabilities (risk) in response to feedback...
November 2, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/29153367/real-time-two-dimensional-shear-wave-elastography-for-liver-stiffness-in-children-interobserver-variation-and-effect-of-breathing-technique
#3
Hee Mang Yoon, Young Ah Cho, Jeong Rye Kim, Seung Soo Lee, Ah Young Jung, Jin Seong Lee, Seak Hee Oh, Kyung Mo Kim
OBJECTIVES: To evaluate interobserver variation and to assess the effect of the breathing technique on liver stiffness (LS) measurement using real-time two-dimensional shear-wave elastography (2D-SWE) in children. METHODS: Patients who underwent real-time 2D-SWE by two operators (group 1) and patients who underwent real-time 2D-SWE by one operator using the free-breathing and breath-holding techniques (group 2) were included. In group 1, interobserver agreement was assessed using the intraclass correlation coefficient (ICC) and the 95% limits-of-agreement was analyzed to evaluate the maximum change in the LS values based on Bland-Altman analysis...
December 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/29151390/reflections-on-the-nice-decision-to-reject-patient-production-losses
#4
James Shearer, Sarah Byford, Steve Birch
OBJECTIVES: Patient production losses occur when individuals' capacities to work, whether paid or unpaid, are impaired by illness, treatment, disability, or death. There is controversy about whether and how to include patient production losses in economic evaluations in health care. Patient production losses have not previously been considered when evaluating medications for reimbursement under the U.K. National Health Service. Proposals for value-based assessment of health technologies in the United Kingdom created renewed interest in whether and how to include costs from a wider societal perspective, such as patient production losses, within economic evaluation of healthcare interventions...
November 20, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29148349/hospital-supply-expenses-an-important-ingredient-in-health-services-research
#5
Yousef Abdulsalam, Eugene Schneller
The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U...
July 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29147978/predictors-of-client-satisfaction-with-outpatient-mental-health-clinic-services-in-italy-and-new-york
#6
Luca Pauselli, Chiara Galletti, Norma Verdolini, Enrico Paolini, Daniela Gallucci, Pierfrancesco Maria Balducci, Francesco Bernardini, Jerome H Kogan, Ruth Shim, Patrizia Moretti, Michael T Compton
The aim of this cross-sectional study was to assess factors associated with client satisfaction in two mental health outpatient settings in Italy and the US. Sociodemographic and clinical variables, hope, and personality characteristics were evaluated in 18-65-year-old patients who had been receiving services for at least 2 months in one of two outpatient clinics, in Italy and the US. Patients were administered: the Healthy Days Core Module, the Kessler Screening Scale for Psychological Distress, the Verona Service Satisfaction Survey, the Client Satisfaction Inventory, the Health Service OutPatient Experience questionnaire, the Herth Hope Index, and the NEO Five-Factor Inventory-3...
November 17, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/29147894/chest-x-ray-prior-to-thyroidectomy-is-it-really-needed
#7
Alexandra Mikhael, Rushad Patell, Michael Tabet, James Bena, Eren Berber, Christian Nasr
BACKGROUND: Chest X-ray (CXR) prior to thyroid surgery continues to be routinely obtained at some institutions despite the lack of evidence for its utility. This study aimed to determine the utility of preoperative CXR in patients undergoing thyroidectomy at a single institution. METHODS: In total, 594 thyroidectomy patients were included in the study. Demographics, CXR findings, anesthesia records and pathologic data were assessed. We investigated whether difficult intubation or cancer stage correlated with the presence of CXR abnormalities...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29145137/uncertainty-in-positive-matrix-factorization-solutions-for-pahs-in-surface-sediments-of-the-yangtze-river-estuary-in-different-seasons
#8
Ruimin Liu, Cong Men, Wenwen Yu, Fei Xu, Qingrui Wang, Zhenyao Shen
To examine the variabilities of source contributions in the Yangtze River Estuary (YRE), the uncertainty based on the positive matrix factorization (PMF) was applied to the source apportionment of the 16 priority PAHs in 120 surface sediment samples from four seasons. Based on the signal-to-noise ratios, the PAHs categorized as "Bad" might drop out of the estimation of bootstrap. Next, the spatial variability of residuals was applied to determine which species with non-normal curves should be excluded. The median values from the bootstrapped solutions were chosen as the best estimate of the true factor contributions, and the intervals from 5th to 95th percentile represent the variability in each sample factor contribution...
October 13, 2017: Chemosphere
https://www.readbyqxmd.com/read/29144981/barriers-to-self-compassion-for-female-survivors-of-childhood-maltreatment-the-roles-of-fear-of-self-compassion-and-psychological-inflexibility
#9
Derrecka M Boykin, Sara J Himmerich, Caitlin M Pinciotti, Lindsay M Miller, Lynsey R Miron, Holly K Orcutt
Preliminary evidence has demonstrated the benefits of targeting self-compassion in the treatment of posttraumatic stress disorder (PTSD). However, survivors of childhood maltreatment may present with unique challenges that compromise the effectiveness of these and other PTSD treatments. Specifically, childhood maltreatment victims often exhibit a marked fear and active resistance of self-kindness and warmth (i.e., fear of self-compassion). Victims may also attempt to control distressing internal experiences in a way that hinders engagement in value-based actions (i...
November 13, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29139104/ancestry-and-dental-development-a-geographic-and-genetic-perspective
#10
Brunilda Dhamo, Lea Kragt, Olja Grgic, Strahinja Vucic, Carolina Medina-Gomez, Fernando Rivadeneira, Vincent W V Jaddoe, Eppo B Wolvius, Edwin M Ongkosuwito
OBJECTIVE: In this study, we investigated the influence of ancestry on dental development in the Generation R Study. METHODS: Information on geographic ancestry was available in 3,600 children (1,810 boys and 1,790 girls, mean age 9.81 ± 0.35 years) and information about genetic ancestry was available in 2,786 children (1,387 boys and 1,399 girls, mean age 9.82 ± 0.34 years). Dental development was assessed in all children using the Demirjian method. The associations of geographic ancestry (Cape Verdean, Moroccan, Turkish, Dutch Antillean, Surinamese Creole and Surinamese Hindustani vs Dutch as the reference group) and genetic content of ancestry (European, African or Asian) with dental development was analyzed using linear regression models...
November 15, 2017: American Journal of Physical Anthropology
https://www.readbyqxmd.com/read/29136233/a-simple-method-for-calibrating-pixel-values-of-the-ct-localizer-radiograph-for-calculating-water-equivalent-diameter-and-size-specific-dose-estimate
#11
Choirul Anam, Toshioh Fujibuchi, Takatoshi Toyoda, Naoki Sato, Freddy Haryanto, Rena Widita, Idam Arif, Geoff Dougherty
The purpose of this study is to establish the relationship between the pixel value (I) of the CT localizer radiograph and water-equivalent thickness (tw) in a straightforward procedure. We used a body CTDI phantom, which was scanned in the AP and LAT projections. After transformation from the pixel values of the images to tw, water-equivalent diameter (Dw) and size-specific dose estimate were calculated on an anthropomorphic phantom and 30 patients retrospectively. We found a linear correlation between I and tw, with R2 ≥ 0...
November 9, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29135761/ten-ceo-imperatives-for-healthcare-transformation-lessons-from-top-performing-academic-medical-centers
#12
J Seth Chatfield, Clinton O Longenecker, Laurence S Fink, Jeffery P Gold
The transition from a delivery model based on volume to a model based on value is underpinning an unprecedented rate of change in healthcare. Our research identifies academic medical centers that have successfully moved their organizations from a volume-based care delivery model to a model that is based on value, achieving top decile performance in the transition. We asked senior leaders about their key imperatives in achieving system-wide healthcare transformations.Major teaching hospitals were sampled using data envelopment analysis to identify hospitals that produced the best value-based purchasing process of care, Hospital Consumer Assessment of Healthcare Providers and Systems scores, and mortality scores with the most efficient utilization of human and financial organizational resources...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#13
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29132634/a-model-to-determine-payments-associated-with-radiology-procedures
#14
Thusitha Mabotuwana, Christopher S Hall, Shiby Thomas, Christoph Wald
OBJECTIVE: Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29131857/internal-tissue-references-for-18fluorodeoxyglucose-vascular-inflammation-imaging-implications-for-cardiovascular-risk-stratification-and-clinical-trials
#15
Mark A Ahlman, Davis M Vigneault, Veit Sandfort, Roberto Maass-Moreno, Jenny Dave, Ahmed Sadek, Marissa B Mallek, Mariana A F Selwaness, Peter Herscovitch, Nehal N Mehta, David A Bluemke
INTRODUCTION: 18Fluorodeoxyglucose (FDG) positron emission tomography (PET) uptake in the artery wall correlates with active inflammation. However, in part due to the low spatial resolution of PET, variation in the apparent arterial wall signal may be influenced by variation in blood FDG activity that cannot be fully corrected for using typical normalization strategies. The purpose of this study was to evaluate the ability of the current common methods to normalize for blood activity and to investigate alternative methods for more accurate quantification of vascular inflammation...
2017: PloS One
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#16
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29129043/economic-evaluation-of-environmental-epidemiological-projects-in-national-industrial-complexes
#17
Youngchul Shin
In this economic evaluation of environmental epidemiological monitoring projects, we analyzed the economic feasibility of these projects by determining the social cost and benefit of these projects and conducting a cost/benefit analysis. Here, the social cost was evaluated by converting annual budgets for these research and survey projects into present values. Meanwhile, the societal benefit of these projects was evaluated by using the contingent valuation method to estimate the willingness to pay of residents living in or near industrial complexes...
November 13, 2017: Environmental Health and Toxicology
https://www.readbyqxmd.com/read/29127851/autonomy-to-health-care-professionals-as-a-vehicle-for-value-based-health-care-results-of-a-quasi-experiment-in-hospital-governance
#18
Kristian Nørgaard Larsen, Søren Rud Kristensen, Rikke Søgaard
Health care systems increasingly aim to create value for money by simultaneous incentivizing of quality along with classical goals such as activity increase and cost containment. It has recently been suggested that letting health care professionals choose the performance metrics on which they are evaluated may improve value of care by facilitating greater employee initiative, especially in the quality domain. There is a risk that this strategy leads to loss of performance as measured by the classical goals, if these goals are not prioritized by health care professionals...
November 6, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/29125220/a-dynamic-power-prior-for-borrowing-historical-data-in-noninferiority-trials-with-binary-endpoint
#19
G Frank Liu
Traditionally, noninferiority hypotheses have been tested using a frequentist method with a fixed margin. Given that information for the control group is often available from previous studies, it is interesting to consider a Bayesian approach in which information is "borrowed" for the control group to improve efficiency. However, construction of an appropriate informative prior can be challenging. In this paper, we consider a hybrid Bayesian approach for testing noninferiority hypotheses in studies with a binary endpoint...
November 10, 2017: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/29121199/the-next-19-years-of-the-american-head-and-neck-society
#20
Jeffrey N Myers
Jeffrey N. Myers, MD, PhD, president of the American Head and Neck Society (AHNS) for 2016 to 2017, offered his perspectives on the AHNS's history, present-day activities, and future plans at this year's annual meeting of the society. The society was created from the 1998 merger of 2 societies, the Society for Head and Neck Surgeons (SHNS), founded in 1954, and the American Society for Head and Neck Surgery (ASHNS), founded in 1959, to become the largest organization in North America for the advancement of research and education in head and neck oncology...
November 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
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