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https://www.readbyqxmd.com/read/29349249/the-differential-effects-of-rural-health-care-access-on-race-specific-mortality
#1
Jeralynn Cossman, Wesley James, Julia Kay Wolf
We examined the relationship between race-specific rural mortality and the health infrastructure of rural counties in light of America's recent emergence of a rural mortality penalty. Using the Compressed Mortality File from National Center for Health Statistics (2008-2012) and county-level demographic, socioeconomic, and health care indicators from the Area Health Resource File and the US Census, we created a rural public health infrastructure index which encompasses four types of health care access (public health employees, critical access hospital/rural referral centers, rural health clinics, and emergency departments) within counties...
December 2017: SSM—Population Health
https://www.readbyqxmd.com/read/29341100/underdiagnosis-of-influenza-virus-infection-in-hospitalized-older-adults
#2
Lauren Hartman, Yuwei Zhu, Kathryn M Edwards, Marie R Griffin, H Keipp Talbot
OBJECTIVE: To describe factors associated with provider-ordered influenza testing among hospitalized adults. DESIGN: Information on patient demographics, symptoms, and provider-ordered influenza testing were collected by questionnaire and chart review. We conducted prospective laboratory-based surveillance using reverse-transcriptase polymerase chain reaction (RT-PCR), the gold-standard for diagnosis of influenza, to determine how patient characteristics and provider-ordered testing impacted accurate influenza diagnosis...
January 17, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29340564/changes-in-health-care-use-associated-with-the-introduction-of-hospital-global-budgets-in-maryland
#3
Eric T Roberts, J Michael McWilliams, Laura A Hatfield, Sule Gerovich, Michael E Chernew, Lauren G Gilstrap, Ateev Mehrotra
Importance: In 2014, the State of Maryland placed the majority of its hospitals under all-payer global budgets for inpatient, hospital outpatient, and emergency department care. Goals of the program included reducing unnecessary hospital utilization and encouraging greater use of primary care. Objective: To compare changes in hospital and primary care use through the first 2 years of Maryland's hospital global budget program among fee-for-service Medicare beneficiaries in Maryland vs matched control areas...
January 16, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29338028/does-providing-more-services-increase-the-primary-hospitals-revenue-an-assessment-of-national-essential-medicine-policy-based-on-2-675-counties-in-china
#4
Fei Chen, Min Yang, Qian Li, Jay Pan, Xiaosong Li, Qun Meng
OBJECTIVE: To understand whether the increased outpatient service provision (OSP) brings in enough additional income (excluding income from essential medicine) for primary hospitals (INCOME) to compensate for reduced costs of medicine. METHODS: The two outcomes, annual OSP and INCOME for the period of 2008-2012, were collected from 34,506 primary hospitals in 2,675 counties in 31 provinces in China by the national surveillance system. The data had a four-level hierarchical structure; time points were nested within primary hospital, hospitals within county, and counties within province...
2018: PloS One
https://www.readbyqxmd.com/read/29335101/outcomes-and-complication-rates-of-primary-resident-performed-cataract-surgeries-at-a-large-tertiary-care-county-hospital
#5
Cameron Clarke, Shazia F Ali, Michael Murri, Saagar N Patel, Li Wang, Marie Tuft, Mitchell P Weikert, Zaina Al-Mohtaseb
PURPOSE: To identify the preoperative risk factors, intraoperative events, and postoperative complications increasing the risk for poor visual outcomes in resident-performed cataract surgeries at a tertiary-care county hospital. SETTING: Ben Taub General Hospital, Houston, Texas, USA. DESIGN: Retrospective case series. METHODS: Resident-performed cataract surgeries were analyzed for risk factors, comorbidities, and intraoperative and postoperative complications...
December 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29331220/-impact-of-chronic-illness-on-hospital-nursing-workloads
#6
S Vallés, E Valdavida, C Menéndez, C Natal
OBJECTIVES: To evaluate the short-term impact of chronic illness in hospital units and to establish a method that allows nursing workloads to be adapted according to the care needs of patients. METHODS: A descriptive study of the evolution of workloads of nursing staff associated with the care needs of patients between 1 July 2014 and 30 June 2016, in a county hospital. The care needs of the patients were assessed daily using an adaptation of the Montesinos scheme...
January 10, 2018: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/29330309/poverty-a-risk-factor-overlooked-a-cross-sectional-cohort-study-comparing-poverty-rate-and-cardiovascular-disease-outcomes-in-the-state-of-florida
#7
Bashar Al-Turk, Ciel Harris, Grant Nelson, Carmen Smotherman, Carlos Palacio, Jeff House
The purpose of this study is to examine the relationship between poverty rate and heart disease in our state. A cross-sectional data analysis was performed using figures provided by the Center for Disease Control's Interactive Atlas of Heart Disease and Stroke Tables. Spearman's correlations and simple regressions were used to determine if there was a relationship between poverty and cardiovascular hospitalization rate and cardiovascular death rate. There was a positive monotonic correlation between poverty rate and cardiovascular hospitalization rate (Rho=0...
January 12, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29329234/poor-people-are-hospitalized-three-times-more-for-mental-health-services-than-the-non-poor-in-central-valley-california
#8
Gyanesh Lama, Emmanuel Alcala, John A Capitman
Introduction: Providing health insurance to the poor has become a standard policy response to health disparities between the poor and the non-poor. It is often assumed that if the poor people are given health insurance, they will use preventative care, which will prevent more expensive emergency visits and inpatient hospitalization, and in turn, it will save healthcare cost in the long run. This paper presents the findings from our study in California about what happens to the poor when they are given health insurance...
January 12, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29324431/a-descriptive-qualitative-study-to-assess-patient-experiences-following-stoma-reversal-after-rectal-cancer-surgery
#9
Maria Reinwalds, Andrea Blixter, Eva Carlsson
Standard surgical treatment for patients operated for rectal cancer is abdominoperineal excision of the tumor result- ing in a permanent colostomy or an anterior resection, often with construction of a temporary loop ileostomy. Both options impact bowel function. Living with a permanent colostomy has been studied in depth, but knowledge is limited about patients' experiences living with a resected rectum after stoma reversal and how it affects daily life. A qualitative study was conducted to describe the rst 4 to 6 weeks after reversal of a temporary loop ileostomy due to rectal cancer...
December 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29323430/transsphincteric-repair-of-rectourethral-fistulas-15-years-of-experience-with-the-york-mason-approach
#10
George Dafnis
OBJECTIVES: To evaluate the surgical and functional outcomes of our single institution's 15-year experience with surgically treated rectourethral fistulas using a modification of the York Mason technique. METHODS: Prospectively recorded data between 2002 and 2016 of all patients who underwent transsphincteric repair of rectourethral fistula using a modified York Mason technique at Eskilstuna County Hospital, Eskilstuna, Sweden, were assessed. A total of 20 consecutive patients, including 17 referrals (85%) and three patients (15%) from our hospital have undergone the modified York Mason procedure...
January 11, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29319393/sex-based-differences-in-discharge-disposition-and-outcomes-for-st-segment-elevation-myocardial-infarction-patients-within-a-regional-network
#11
James R Langabeer, Timothy D Henry, Raymond Fowler, Tiffany Champagne-Langabeer, Junghyun Kim, Alice K Jacobs
BACKGROUND: It is known that women with ST-segment elevation myocardial infarction (STEMI) have higher mortality in comparison to men. While the reasons for this sex-based difference are not completely understood, biologic differences and disparities in care have been implicated. Whether these differences persist within an urban, regional STEMI system of care with defined protocols is unclear. Our objective was to explore sex-related effects in outcomes in a large regional system of care...
January 10, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29318743/associations-between-lifestyle-factors-and-smoking-status-during-pregnancy-in-a-group-of-romanian-women
#12
S Voidazan, M Tarcea, Z Abram, M Georgescu, C Marginean, O Grama, F Buicu, F Ruţa
BACKGROUND: There is an estimated birth rate of 9.27 births/1,000 population in Romania each year, with approximately 8.4% born with low birth weight (LBW). Our purpose was to evaluate the relationships between maternal smoking and LBW and preterm birth in Mureș County, Romania. METHODS: We conducted a cross-sectional survey of 1,278 mothers who had given birth in Mureș County obstetrical wards in 2015, based on a lifestyle questionnaire of 109 items and personal and laboratory data from hospitals records...
January 10, 2018: Birth Defects Research
https://www.readbyqxmd.com/read/29317437/infant-feeding-practices-among-hiv-exposed-infants-less-than-6-months-of-age-in-bomet-county-kenya-an-in-depth-qualitative-study-of-feeding-choices
#13
Purity Chepkorir Lang'at, Irene Ogada, Audrey Steenbeek, Noni E MacDonald, Sophie Ochola, Wesley Bor, Godfrey Odinga
BACKGROUND: In children, HIV can be acquired from the mother during pregnancy, delivery and through breast milk. The WHO recommends exclusive breast feeding or exclusive replacement feeding for the first 6 months after birth for HIV-exposed infants. Barriers such as HIV-related stigma, inadequate resources, lack of access to safe water and negative cultural beliefs have been shown to influence infant feeding among HIV-exposed infants in some settings. In Kenya, there is limited literature on the barriers...
January 9, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#14
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patient patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29310580/evaluation-of-fluorescent-in-situ-hybridization-technique-for-diagnosis-of-malaria-in-ahero-sub-county-hospital-kenya
#15
Regina Kandie, Rachel Ochola, Kariuki Njaanake
BACKGROUND: Malaria is a major cause of morbidity and mortality. Treatment of malaria in a timely manner could avert deaths. Treatment ultimately relies on the rapid and accurate diagnosis. Fluorescence in situ hybridization (FISH), a cytogenetic technique based on detection of specific nucleic acid, has the potential to address the limitations of the current diagnostic approaches. This study investigates further the performance of FISH for the diagnosis of malaria in a rural setting in Western Kenya...
January 8, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29306870/gender-differences-in-the-well-being-of-patients-diagnosed-with-chlamydia-trachomatis-a-cross-sectional-study
#16
Nirina Andersson, Helena Carré, Urban Janlert, Jens Boman, Elisabet Nylander
OBJECTIVES: We aimed to investigate how an infection with Chlamydia trachomatis (CT) influenced patients' well-being and whether there were differences due to gender, age or relationship status, in an effort to strengthen preventive measures and provide better healthcare for patients with CT. METHODS: Patients diagnosed with CT in the county of Västerbotten, Sweden, were asked to fill out a questionnaire about their feelings, thoughts and actions after CT diagnosis...
January 6, 2018: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/29305081/extending-knowledge-of-the-clinical-picture-of-balkan-adder-vipera-berus-bosniensis-envenoming-the-first-photographically-documented-neurotoxic-case-from-south-western-hungary
#17
Csaba Varga, Tamás Malina, Viktória Alföldi, Gergely Bilics, Ferenc Nagy, Tibor Oláh
We report a severe envenoming associated with minimal local symptoms following a Balkan adder (Vipera berus bosniensis) bite in South-Western Hungary. A 63-year-old male with a history of hypertension and sinus bradycardia (45/min) was bitten by a sub-adult specimen of V. b. bosniensis in Somogy County on 04 May 2017. The patient was transported to and treated at the Emergency Department of Somogy County "Moritz Kaposi" General Hospital, Kaposvár. Locally only pain and minimal swelling with a small haematoma developed on the bitten finger...
January 2, 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29300258/effectiveness-of-assessing-ureteral-patency-using-preoperative-phenazopyridine
#18
Elizabeth M Strom, Zaid Q Chaudhry, Rong Guo, Axeline J Maisonet, Christine H Holschneider, Cecilia K Wieslander
OBJECTIVES: The aims of this study were to determine the efficacy of phenazopyridine when used intraoperatively to assess ureteral patency and to investigate factors that may influence its efficacy. METHODS: This is a retrospective chart review performed at the Olive View-UCLA Medical Center, a Los Angeles County teaching hospital, from January 2014 through July 2016. Patients undergoing cystoscopy at the time of gynecologic surgery were identified via department case logs...
January 3, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29299519/expeditious-emergency-room-referral-pathway-improves-patient-access-to-otolaryngology-care
#19
Jeffrey Johnson, Zi Yang Jiang, Daniel Martinez, David Smith, Elizabeth Curtis, David Robinson, Ibrahim Alava
Objectives: Historically at a multi-hospital residency program, there was an unexpected number of non-urgent consults from the county hospital emergency room (ER) that caused residents to make more trips between hospitals and come closer to violating duty hours. Moreover, there was also a poor follow-up rate for these patients. An alternate pathway to redirect such consults to the Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) clinic, staffed by an attending physician, was devised...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29298407/a-hybrid-form-of-telemedicine-a-unique-way-to-extend-intensive-care-service-to-neonates-in-medically-underserved-areas
#20
Abhishek Makkar, Mike McCoy, Gene Hallford, Marilyn Escobedo, Edgardo Szyld
BACKGROUND: More than 90% of neonatal intensive care units (NICUs) in the United States are in urban areas, denying rural residents' easy NICU access. Telemedicine use for patient contact and management, although studied in adults and children, is understudied in neonates. A hybrid telemedicine system, with 24/7 neonatal nurse practitioner coverage and with a neonatologist physically present 3 days per week and telemedicine coverage the remaining days, was recently implemented at Comanche County Memorial Hospital's (CCMH) Level II NICU...
January 3, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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