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Physician productivity

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https://www.readbyqxmd.com/read/27913569/national-health-spending-faster-growth-in-2015-as-coverage-expands-and-utilization-increases
#1
Anne B Martin, Micah Hartman, Benjamin Washington, Aaron Catlin
Total nominal US health care spending increased 5.8 percent and reached $3.2 trillion in 2015. On a per person basis, spending on health care increased 5.0 percent, reaching $9,990. The share of gross domestic product devoted to health care spending was 17.8 percent in 2015, up from 17.4 percent in 2014. Coverage expansions that began in 2014 as a result of the Affordable Care Act continued to affect health spending growth in 2015. In that year, the faster growth in total health care spending was primarily due to accelerated growth in spending for private health insurance (growth of 7...
December 2, 2016: Health Affairs
https://www.readbyqxmd.com/read/27912949/seasonal-variations-of-prescriptions-for-the-major-syndrome-types-and-manifestations-of-upper-respiratory-tract-infection-in-tradition-chinese-medicine
#2
Yuh-Hsiang Yeh, Yiing-Jenq Chou, Nicole Huang, Christy Pu, Pesus Chou
OBJECTIVE: The aim of this study is to investigate the seasonal variations of prescriptions for the three most common syndrome types and the three major manifestations of upper respiratory infections (URIs) according to the theories of traditional Chinese medicine (TCM). DESIGN: This is a cross-sectional study. We examined a random sample comprising 1,000,000 beneficiaries from the National Health Insurance program in 2005. Primary diagnoses including International Classification of Diseases, Ninth Revision, Clinical Modification Codes 460-465 and 487 were regarded as URIs, for which 160,357 prescriptions of Chinese herbal medicine were analyzed...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27910035/self-care-as-a-professional-imperative-physician-burnout-depression-and-suicide
#3
Catherine M Kuhn, Ellen M Flanagan
PURPOSE: Burnout has been identified in approximately half of all practicing physicians, including anesthesiologists. In this narrative review, the relationship between burnout, depression, and suicide is explored, with particular attention to the anesthesiologist. Throughout this review, we highlight our professional imperative regarding this epidemic. SOURCE: The authors searched the existing English language literature via PubMed from 1986 until present using the search terms physician burnout, depression, and suicide, with particular attention to studies regarding anesthesiologists and strategies to address these problems...
December 1, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27909267/comparison-of-green-pit-viper-and-agkistrodon-halys-antivenom-in-inhibition-of-coagulopathy-due-to-trimeresurus-albolabris-venom-an-in-vitro-study-using-human-plasma
#4
S K Lam, S F Yip, P Crow, H T Fung, J Mh Cheng, K S Tan, O F Wong, D Yt Yeung, Y K Wong, K M Poon, G Ades
INTRODUCTION: There are two antivenoms that may be administered in Hong Kong following a bite by Trimeresurus albolabris: the green pit viper antivenom from the Thai Red Cross Society in Thailand and the Agkistrodon halys antivenom from the Shanghai Institute of Biological Products in China. Both are recommended by the Central Coordinating Committee of Accident and Emergency Services of the Hospital Authority for treating patients with a bite by Trimeresurus albolabris. The choice of which antivenom to use is based on physician preference...
December 2, 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27909252/nurses-as-antibiotic-brokers-institutionalized-praxis-in-the-hospital
#5
Alex Broom, Jennifer Broom, Emma Kirby, Graham Scambler
We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors' prescribing, with nurses' roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors' antibiotic decisions, nursing capacity to challenge doctors' decisions, and, "back stage" strategies for circumnavigating organizational constraints...
November 30, 2016: Qualitative Health Research
https://www.readbyqxmd.com/read/27906769/measuring-harm-in-health-care-optimizing-adverse-event-review
#6
Kathleen E Walsh, Polina Harik, Kathleen M Mazor, Deborah Perfetto, Milena Anatchkova, Colleen Biggins, Joann Wagner, Pamela J Schoettker, Cassandra Firneno, Robert Klugman, Jennifer Tjia
OBJECTIVE: The objective of this study was to identify modifiable factors that improve the reliability of ratings of severity of health care-associated harm in clinical practice improvement and research. METHODS: A diverse group of clinicians rated 8 types of adverse events: blood product, device or medical/surgical supply, fall, health care-associated infection, medication, perinatal, pressure ulcer, surgery. We used a generalizability theory framework to estimate the impact of number of raters, rater experience, and rater provider type on reliability...
November 30, 2016: Medical Care
https://www.readbyqxmd.com/read/27906442/the-role-of-fillers-in-aesthetic-medicine-medico-legal-aspects
#7
E Marinelli, G Montanari Vergallo, G Reale, A di Luca, I Catarinozzi, S Napoletano, S Zaami
In recent years there has been an exponential increase of fillers use in aesthetic medicine. The popularity of this anti-wrinkle product is based on their capacity to offer significant improvement in the aesthetic field, particularly to skin rejuvenating processes with non-invasive and less expensive techniques, if compared to the surgical methods (i.e. surgical lifting). The great number of fillers on the market is composed of a large heterogenic number of biomaterials. The aim of this review was to provide an overview and a classification of the filling materials that are most commonly used...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27906193/roadmap-to-a-successful-quality-improvement-project
#8
J R Swanson, S A Pearlman
Although the benefits of quality improvement initiatives are largely understood by practicing neonatologists and perinatologists, the vast majority have not received any formal training in quality improvement methodology. Even as reporting requirements of quality metrics has increased from a number of outside agencies and public reporting entities, education for physicians regarding how to carry out quality improvement projects has largely remained the individual's responsibility. The first in a series of quality improvement education papers, we focus on the reasons why quality improvement matters and how to develop a team of stakeholders that will be functional and productive in addressing specific quality and safety concerns...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27902551/do-years-of-experience-with-electronic-health-records-matter-for-productivity-in-community-health-centers
#9
Bianca K Frogner, Xiaoli Wu, Leighton Ku, Patricia Pittman, Leah E Masselink
This study investigated how years of experience with an electronic health record (EHR) related to productivity in community health centers (CHCs). Using data from the 2012 Uniform Data System, we regressed average annual medical visits, weighted for service intensity, as a function of full-time equivalent medical staff controlling for CHC size and location. Physician productivity significantly improved. Although the productivity of all other staff types was not significantly different by years of EHR experience, the trends showed lower productivity among nurses and other medical staff in CHCs with fewer years of EHR experience versus more years of experience...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27899143/presymptomatic-diagnosis-of-fabry-s-disease-a-case-report
#10
Rasmus Bo Hasselbalch, Per Lav Madsen, Henning Bundgaard, Juliane Theilade
BACKGROUND: Fabry's disease is a rare X-linked genetic disorder characterized by reduced levels of the α-galactosidase A enzyme. It may present with a cardiac phenotype resembling hypertrophic cardiomyopathy. However, as a specific enzyme replacement therapy is available, it remains an important differential diagnoses in patients presenting with cardiac hypertrophy. In boys, onset has been reported in early childhood with complaints initially comprising neuropathic pain, reduced sweat production, and gastrointestinal symptoms...
November 29, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27893508/best-practices-for-pressure-ulcer-prevention-in-the-burn-center
#11
Julia Warner, Mary Ann Raible, Gina Hajduk, Jacqueline Collavo
The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27892875/the-zoonotic-potential-of-lactococcus-garvieae-an-overview-on-microbiology-epidemiology-virulence-factors-and-relationship-with-its-presence-in-foods
#12
REVIEW
Alicia Gibello, Fátima Galán-Sánchez, M Mar Blanco, Manuel Rodríguez-Iglesias, Lucas Domínguez, José F Fernández-Garayzábal
Lactococcus garvieae is a relevant worldwide fish pathogen affecting various farmed and wild marine and freshwater species. It has also been isolated from other animals, such as ruminants with subclinical mastitis and pigs with pneumonia. From the early 90s, L. garvieae has been associated with different human infections, mainly endocarditis. During the last five years, human infections by this bacterium appear to be increasing, likely due to the improvement in microbiological methods for bacterial identification and the alertness of this bacterium by physicians...
September 17, 2016: Research in Veterinary Science
https://www.readbyqxmd.com/read/27891118/colistin-in-pig-production-chemistry-mechanism-of-antibacterial-action-microbial-resistance-emergence-and-one-health-perspectives
#13
REVIEW
Mohamed Rhouma, Francis Beaudry, William Thériault, Ann Letellier
Colistin (Polymyxin E) is one of the few cationic antimicrobial peptides commercialized in both human and veterinary medicine. For several years now, colistin has been considered the last line of defense against infections caused by multidrug-resistant Gram-negative such as Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Colistin has been extensively used orally since the 1960s in food animals and particularly in swine for the control of Enterobacteriaceae infections. However, with the recent discovery of plasmid-mediated colistin resistance encoded by the mcr-1 gene and the higher prevalence of samples harboring this gene in animal isolates compared to other origins, livestock has been singled out as the principal reservoir for colistin resistance amplification and spread...
2016: Frontiers in Microbiology
https://www.readbyqxmd.com/read/27890989/the-burden-of-segregated-respiratory-diseases-in-india-and-the-quality-of-care-in-these-patients-results-from-the-asia-pacific-burden-of-respiratory-diseases-study
#14
Aloke Gopal Ghoshal, G D Ravindran, Paras Gangwal, Girish Rajadhyaksha, Sang-Heon Cho, Abdul Razak Bin Abdul Muttalif, Horng-Chyuan Lin, Sanguansak Thanaviratananich, Shalini Bagga, Rab Faruqi, Shiva Sajjan, Pradeep Shetty, Raeesuddin Syed, Kim K Hamrosi, De Yun Wang
BACKGROUND: Chronic respiratory diseases such as asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), and rhinosinusitis are becoming increasingly prevalent in the Asia-Pacific region. The Asia-Pacific Burden of Respiratory Diseases study examined the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across the Asia-Pacific and more specifically India. OBJECTIVES: To estimate the proportion of adults receiving care for asthma, AR, COPD, and rhinosinusitis and assess the economic burden, both direct and indirect of these chronic respiratory disease...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27888942/lessons-learned-from-two-decades-of-patient-and-family-centered-care-in-radiology-part-2-building-a-culture
#15
James V Rawson, Layne Mitchell, Lewis Golden, Alisa Murdock, G Rebecca Haines
As reimbursements are increasingly linked to patient experience, physicians and hospitals will need to find ways to incorporate patient and family input into operational decisions. Rather than starting from the beginning, health systems could learn from practitioners who have been experimenting in this space and are willing to share their experience. The authors share lessons learned from two decades of experience incorporating patient and family advisers into the clinical operation of a radiology department and the resulting culture change...
December 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27887667/from-instinct-to-evidence-the-role-of-data-in-country-decision-making-in-chile
#16
Ximena Paz Aguilera, Consuelo Espinosa-Marty, Carla Castillo-Laborde, Claudia Gonzalez
BACKGROUND: The Chilean health system has undergone profound reforms since 1990, while going through many political upheavals, and faced demographic, health, and economic transformations. The full information requirements to develop an evidence-informed process implied the best possible use of available data, as well as efforts for improving the information systems. OBJECTIVE: To examine, from a historical perspective, the use of data during the health reforms undertaken in Chile since 1990, and to identify the factors that have determined its utilization and improvement...
2016: Global Health Action
https://www.readbyqxmd.com/read/27881189/pharmaceutical-patenting-and-the-transformation-of-american-medical-ethics
#17
Joseph M Gabriel
The attitudes of physicians and drug manufacturers in the US toward patenting pharmaceuticals changed dramatically from the mid-nineteenth century to the mid-twentieth. Formerly, physicians and reputable manufacturers argued that pharmaceutical patents prioritized profit over the advancement of medical science. Reputable manufactures refused to patent their goods and most physicians shunned patented products. However, moving into the early twentieth century, physicians and drug manufacturers grew increasingly comfortable with the idea of pharmaceutical patents...
November 24, 2016: British Journal for the History of Science
https://www.readbyqxmd.com/read/27878710/the-differential-effect-of-compensation-structures-on-the-likelihood-that-firms-accept-new-patients-by-insurance-type
#18
Justin B Bullock, W David Bradford
Adequate access to primary care is not universally achieved in many countries, including the United States, particularly for vulnerable populations. In this paper we use multiple years of the U.S.-based Community Tracking Survey to examine whether a variety of physician compensation structures chosen by practices influence the likelihood that the practice takes new patients from a variety of different types of insurance. Specifically, we examine the roles of customer satisfaction and quality measures on the one hand, and individual physician productivity measures on the other hand, in determining whether or not firms are more likely to accept patients who have private insurance, Medicare, or Medicaid...
March 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27878677/rating-the-digital-help-electronic-medical-records-software-providers-and-physicians
#19
Richard J Butler, William G Johnson
To separate the effects of physicians' characteristics on the perceived productivity of EMRs from the effects of limitations on usability inherent in EMR design, a multivariate regression model is used to estimate the factors influencing physicians' rankings of five attributes of their EMRs, namely; ease of use and reliability; the EMRs effect on physician and staff productivity and the EMRs performance vs. vendor's promises. We divide the factors influencing the rankings into three groups: physician characteristics, EMR characteristics and practice characteristics (type of practice, size, and location)...
September 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27878470/%C3%AE-2-agonists
#20
Charlotte K Billington, Raymond B Penn, Ian P Hall
History suggests β agonists, the cognate ligand of the β2 adrenoceptor, have been used as bronchodilators for around 5,000 years, and β agonists remain today the frontline treatment for asthma and chronic obstructive pulmonary disease (COPD). The β agonists used clinically today are the products of significant expenditure and over 100 year's intensive research aimed at minimizing side effects and enhancing therapeutic usefulness. The respiratory physician now has a therapeutic toolbox of long acting β agonists to prophylactically manage bronchoconstriction, and short acting β agonists to relieve acute exacerbations...
November 23, 2016: Handbook of Experimental Pharmacology
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