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https://www.readbyqxmd.com/read/27906004/a-quantitative-evidence-base-for-population-health-applying-utilization-based-cluster-analysis-to-segment-a-patient-population
#1
Sabine I Vuik, Erik Mayer, Ara Darzi
BACKGROUND: To improve population health it is crucial to understand the different care needs within a population. Traditional population groups are often based on characteristics such as age or morbidities. However, this does not take into account specific care needs across care settings and tends to focus on high-needs patients only. This paper explores the potential of using utilization-based cluster analysis to segment a general patient population into homogenous groups. METHODS: Administrative datasets covering primary and secondary care were used to construct a database of 300,000 patients, which included socio-demographic variables, morbidities, care utilization, and cost...
November 25, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27905970/a-feasibility-study-on-using-smartphones-to-conduct-short-version-verbal-autopsies-in-rural-china
#2
Jing Zhang, Rohina Joshi, Jixin Sun, Samantha R Rosenthal, Miao Tong, Cong Li, Rasika Rampatige, Meghan Mooney, Alan Lopez, Lijing L Yan
BACKGROUND: Currently there are two main sources of mortality data with cause of death assignments in China. Both sources-the Ministry of Health-Vital Registration system and the Chinese Disease Surveillance Point system-present their own challenges. A new approach to cause of death assignment is a smartphone-based shortened version of a verbal autopsy survey. This study evaluates the feasibility and acceptability of this new method conducted by township health care providers (THP) and village doctors (VD) in rural China, where a large proportion of deaths occur in homes and cause of death data are inaccurate or lacking...
August 20, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27905909/development-of-a-measure-of-model-fidelity-for-mental-health-crisis-resolution-teams
#3
Brynmor Lloyd-Evans, Gary R Bond, Torleif Ruud, Ada Ivanecka, Richard Gray, David Osborn, Fiona Nolan, Claire Henderson, Oliver Mason, Nicky Goater, Kathleen Kelly, Gareth Ambler, Nicola Morant, Steve Onyett, Danielle Lamb, Sarah Fahmy, Ellie Brown, Beth Paterson, Angela Sweeney, David Hindle, Kate Fullarton, Johanna Frerichs, Sonia Johnson
BACKGROUND: Crisis Resolution Teams (CRTs) provide short-term intensive home treatment to people experiencing mental health crisis. Trial evidence suggests CRTs can be effective at reducing hospital admissions and increasing satisfaction with acute care. When scaled up to national level however, CRT implementation and outcomes have been variable. We aimed to develop and test a fidelity scale to assess adherence to a model of best practice for CRTs, based on best available evidence. METHODS: A concept mapping process was used to develop a CRT fidelity scale...
December 1, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27905896/the-impact-of-medical-tourism-on-colorectal-screening-among-korean-americans-a-community-based-cross-sectional-study
#4
Linda K Ko, Victoria M Taylor, Jihye Yoon, Wade K Copeland, Joo Ha Hwang, Eun Jeong Lee, John Inadomi
BACKGROUND: Colorectal cancer (CRC) remains the most commonly diagnosed cancer among Korean Americans (KAs) in part due to low screening rates. Recent studies suggest that some KA patients engage in medical tourism and receive medical care in their home country. The impact of medical tourism on CRC screening is unknown. The purpose of this paper was to 1) investigate the frequency of medical tourism, 2) examine the association between medical tourism and CRC screening, and 3) characterize KA patients who engage in medical tourism...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27905814/medicare-and-medicaid-programs-cy-2017-home-health-prospective-payment-system-rate-update-home-health-value-based-purchasing-model-and-home-health-quality-reporting-requirements-final-rule
#5
(no author information available yet)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP)...
November 3, 2016: Federal Register
https://www.readbyqxmd.com/read/27903062/geographically-weighted-regression-for-modelling-the-accessibility-to-the-public-hospital-network-in-concepci%C3%A3-n-metropolitan-area-chile
#6
Marcela Martínez Bascuñán, Carolina Rojas Quezada
Accessibility models in transport geography based on geographic information systems have proven to be an effective method in determining spatial inequalities associated with public health. This work aims to model the spatial accessibility from populated areas within the Concepción metropolitan area (CMA), the second largest city in Chile. The city's public hospital network is taken into consideration with special reference to socio-regional inequalities. The use of geographically weighted regression (GWR) and ordinary least squares (OLS) for modelling accessibility with socioeconomic and transport variables is proposed...
November 22, 2016: Geospatial Health
https://www.readbyqxmd.com/read/27902840/team-based-interprofessional-competency-training-for-dementia-screening-and-management
#7
Zaldy S Tan, JoAnn Damron-Rodriguez, Mary Cadogan, Daphna Gans, Rachel M Price, Sharon S Merkin, Lee Jennings, Heather Schickedanz, Sam Shimomura, Dan Osterweil, Joshua Chodosh
As many as 50% of people satisfying diagnostic criteria for dementia are undiagnosed. A team-based training program for dementia screening and management was developed targeting four professions (medicine, nursing, pharmacy, social work) whose scope of practice involves dementia care. An interprofessional group of 10 faculty members was trained to facilitate four interactive competency stations on dementia screening, differential diagnoses, dementia management and team care planning, and screening for and managing caregiver stress...
November 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27902575/veterans-voice-through-the-lens-of-their-medical-records-what-it-reveals-about-congestive-heart-failure-readmissions
#8
Carl W Stevenson, Kattie Payne
PURPOSE OF STUDY: The medical record is a sea of information that can reveal what patients are trying to tell us about their health condition. It can reveal hints and trends as to why veterans with congestive heart failure (CHF) are being readmitted within 30 days after hospital discharge. These hints and trends lead caregivers to key contributing variables to veterans' readmission. Furthermore, these variables can be used to predict patient outcomes such as readmission and even prognosis...
January 2017: Professional Case Management
https://www.readbyqxmd.com/read/27901404/military-veteran-cancer-survivors-preferences-for-a-program-to-address-lifestyle-change-and-psychosocial-wellness-following-treatment
#9
Gregory P Beehler, Jonathan Novi, Marc T Kiviniemi, Lynn Steinbrenner
OBJECTIVE: This study aimed to understand military veteran cancer survivors' preferences regarding the delivery of post-treatment wellness services. METHODS: Thirty-three military veteran cancer survivors were interviewed about their perceptions of three models of health service delivery (home-, primary care-, and oncology-based services). RESULTS: Conventional qualitative content analysis revealed strengths and weaknesses of each service delivery model's content and structure (e...
November 30, 2016: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/27901402/frailty-determinants-in-two-long-term-settings-assistant-living-facilities-and-home-and-community-based-programs
#10
Christine Tocchi, Ruth McCorkle, Jane Dixon
There is limited knowledge on differences in frailty among residents in assisted living facilities (ALF) and home and community-based services (HCBS). This study used a retrospective cross-sectional design to compare frailty determinants in two long-term care settings. The HCBS setting had a greater proportion of positive responses to 9 of 14 frailty indicators. The ALF setting had a greater proportion to only 2 or the 14 frailty indicators. The finding that the HCBS setting had a significantly greater proportion of participants with positive frailty indicators as compared to the ALF setting suggests the degree of frailty risk is different by health care setting...
November 30, 2016: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/27901247/anabolic-steroids-for-rehabilitation-after-hip-fracture-in-older-people
#11
Vaqas Farooqi, Maayken E L van den Berg, Ian D Cameron, Maria Crotty
BACKGROUND: Hip fracture occurs predominantly in older people, many of whom are frail and undernourished. After hip fracture surgery and rehabilitation, most patients experience a decline in mobility and function. Anabolic steroids, the synthetic derivatives of the male hormone testosterone, have been used in combination with exercise to improve muscle mass and strength in athletes. They may have similar effects in older people who are recovering from hip fracture. OBJECTIVES: To examine the effects (primarily in terms of functional outcome and adverse events) of anabolic steroids after surgical treatment of hip fracture in older people...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27900923/-the-infection-risk-scan-in-clinical-practice-improving-infection-prevention-and-antibiotic-use-through-transparency
#12
I Willemsen, J A J W Kluytmans
OBJECTIVE: The increase in Highly Resistant Micro-Organisms (HRMO) in hospitals and nursing homes requires an intensification of infection prevention measures. This paper describes a new, standardised approach to infection prevention and monitoring of antibiotic use. DESIGN: Cross-sectional, observational study. METHOD: The Infection RIsk Scan (IRIS) measures a number of objectifiable variables in the field of infection prevention, including the dissemination of HRMO, the use of antibiotics and indwelling medical devices, environmental contamination, hand hygiene and personal hygiene of healthcare workers, and various infection control preconditions...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27900501/a-comparison-of-home-based-versus-outreach-event-based-community-hiv-testing-in-ugandan-fisherfolk-communities
#13
Laura M Bogart, Glenn J Wagner, William Musoke, Rose Naigino, Sebastian Linnemayr, Emily Maistrellis, David J Klein, Riana B Jumamil, Barbara Mukasa, Ingrid V Bassett, Thomas P Giordano, Rhoda K Wanyenze
We compared two community-based HIV testing models among fisherfolk in Lake Victoria, Uganda. From May to July 2015, 1364 fisherfolk residents of one island were offered (and 822 received) home-based testing, and 344 fisherfolk on another island were offered testing during eight community mobilization events (outreach event-based testing). Of 207 home-based testing clients identified as HIV-positive (15% of residents), 82 were newly diagnosed, of whom 31 (38%) linked to care within 3 months. Of 41 who screened positive during event-based testing (12% of those tested), 33 were newly diagnosed, of whom 24 (75%) linked to care within 3 months...
November 29, 2016: AIDS and Behavior
https://www.readbyqxmd.com/read/27900185/benefits-of-a-novel-concept-of-home-based-exercise-with-the-aim-of-preventing-aspiration-pneumonia-and-falls-in-frail-older-women-a-pragmatic-controlled-trial
#14
Katsuhiko Takatori, Daisuke Matsumoto, Munenori Nishida, Shinnichiro Matsushita, Tatsuya Noda, Tomoaki Imamura
AIM: To investigate whether home-based exercise with the aim of preventing aspiration pneumonia and accidental falls improves swallowing-related and physical functions in community-dwelling frail older women. METHODS: Participants were 266 community-dwelling frail older women in a long-term care prevention class (mean (SD): age 75 (5) years). Participants were allocated to either an intervention group or a control group. In the intervention group, participants were asked to perform, at least three times a week for 6 months, a home-based exercise programme that was specifically developed to prevent aspiration pneumonia and accidental falls...
2016: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/27899886/relearning-and-retaining-personally-relevant-words-using-computer-based-flashcard-software-in-primary-progressive-aphasia
#15
William S Evans, Megan Quimby, Michael Walsh Dickey, Bradford C Dickerson
Although anomia treatments have often focused on training small sets of words in the hopes of promoting generalization to untrained items, an alternative is to directly train a larger set of words more efficiently. The current case study reports on a novel treatment for a patient with semantic variant Primary Progressive Aphasia (svPPA), in which the patient was taught to make and practice flashcards for personally-relevant words using an open-source computer program (Anki). Results show that the patient was able to relearn and retain a large subset of her studied words for up to 20 months, the full duration of the study period...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27898626/dental-trauma-in-a-pediatric-emergency-department-referral-center
#16
Emily Hall, Patricia Hickey, Thuy Nguyen-Tran, Jeff Louie
OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27898281/goals-of-care-or-goals-of-trust-how-family-members-perceive-goals-for-dying-nursing-home-residents
#17
Cherie Rosemond, Laura C Hanson, Sheryl Zimmerman
PURPOSE OF STUDY: Dementia affects more than 5 million Americans, and is a leading cause of death. Family members of nursing home (NH) residents with advanced dementia report difficulty making decisions about care toward the end of life. As part of a randomized trial testing an intervention to improve decision making, this qualitative study aimed to understand how family decision makers experienced goal-based decision making in advance of the death of their relative. DESIGN AND METHODS: This qualitative study was conducted as part of the goals of care clinical trial...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27896873/identifying-fallacious-arguments-in-a-qualitative-study-of-antipsychotic-prescribing-in-dementia
#18
Parastou Donyai
BACKGROUND: Dementia can result in cognitive, noncognitive and behavioural symptoms which are difficult to manage. Formal guidelines for the care and management of dementia in the UK state that antipsychotics should only be prescribed where fully justified. This is because inappropriate use, particularly problematic in care-home settings, can produce severe side effects including death. The aim of this study was to explore the use of fallacious arguments in professionals' deliberations about antipsychotic prescribing in dementia in care-home settings...
November 29, 2016: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27895529/assessing-nursing-staff-s-competences-in-mobility-support-in-nursing-home-care-development-and-psychometric-testing-of-the-kinaesthetics-competence-kc-observation-instrument
#19
Heidrun Gattinger, Helena Leino-Kilpi, Virpi Hantikainen, Sascha Köpke, Stefan Ott, Beate Senn
BACKGROUND: Between 75 and 89% of residents living in long-term care facilities have limited mobility. Nurses as well as other licensed and unlicensed personnel directly involved in resident care are in a key position to promote and maintain the mobility of care-dependent persons. This requires a certain level of competence. Kinaesthetics is a training concept used to increase nursing staff's interaction and movement support skills for assisting care-dependent persons in their daily activities...
2016: BMC Nursing
https://www.readbyqxmd.com/read/27894271/effectiveness-of-a-physical-exercise-intervention-program-in-improving-functional-mobility-in-older-adults-after-hip-fracture-in-later-stage-rehabilitation-protocol-of-a-randomized-clinical-trial-reative-study
#20
Camila Astolphi Lima, Catherine Sherrington, Adriana Guaraldo, Suzana Albuquerque de Moraes, Renata Dos Ramos Varanda, Juliana de Araújo Melo, Kodi Edson Kojima, Monica Perracini
BACKGROUND: Hip fractures resulting from falls increase substantially with advancing age and less than half of older hip fracture survivors regain their former levels of mobility. There is increasing evidence that rehabilitation interventions with exercises that goes beyond the sub-acute phase or even in a later stage of care have a positive impact on various functional abilities. The purpose of this study is to determine if exercise program training for people who have suffered a fall-related hip fracture will improve functional mobility when compared with usual care...
November 29, 2016: BMC Geriatrics
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