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Preventable emergency visits

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https://www.readbyqxmd.com/read/28333606/patterns-of-multiple-emergency-department-visits-do-primary-care-physicians-matter
#1
Daniel D Maeng, Jing Hao, John B Bulger
CONTEXT: Overutilization and overreliance on Emergency Departments (EDs) as a usual source of care can lead to unnecessarily high costs and undesirable consequences, such as a gap in care coordination and inadequate provision of preventive care. OBJECTIVE: To identify factors associated with multiple ED visits by patients, in particular, the impact of primary care physicians (PCPs) on their patients' multiple ED visit rates. DESIGN: Geisinger Health Plan claims data among adult patients who averaged more than 1 ED visit within a 12-month period between 2013 and 2014 were obtained (N = 20,351)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28331347/environmental-triggers-and-avoidance-in-the-management-of-asthma
#2
REVIEW
Clarisse Gautier, Denis Charpin
Identifying asthma triggers forms the basis of environmental secondary prevention. These triggers may be allergenic or nonallergenic. Allergenic triggers include indoor allergens, such as house dust mites (HDMs), molds, pets, cockroaches, and rodents, and outdoor allergens, such as pollens and molds. Clinical observations provide support for the role of HDM exposure as a trigger, although avoidance studies provide conflicting results. Molds and their metabolic products are now considered to be triggers of asthma attacks...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28330829/does-telehealth-monitoring-identify-exacerbations-of-chronic-obstructive-pulmonary-disease-and-reduce-hospitalisations-an-analysis-of-system-data
#3
Melissa Kargiannakis, Deborah A Fitzsimmons, Claire L Bentley, Gail A Mountain
BACKGROUND: The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD...
March 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28306648/site-specific-approach-to-reducing-emergency-department-visits-following-surgery
#4
Hassaan Abdel Khalik, Haley Stevens, Arthur M Carlin, Amanda Stricklen, Rachel Ross, Carl Pesta, Jonathan F Finks, Andrew Ibrahim, Amir A Ghaferi
OBJECTIVE: The aim of this study was to explore the efficacy of current bariatric perioperative measures at reducing emergency department (ED) visits following bariatric surgery in the state of Michigan. SUMMARY OF BACKGROUND DATA: Many ED visits following bariatric surgery do not result in readmission and may be preventable. Little research exists evaluating the efficacy of perioperative measures aimed at reducing ED visits in this population. Therefore, understanding the driving factors behind these preventable ED visits may be a fruitful approach to prevention...
March 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28301451/traumatic-brain-injury-related-emergency-department-visits-hospitalizations-and-deaths-united-states-2007-and-2013
#5
Christopher A Taylor, Jeneita M Bell, Matthew J Breiding, Likang Xu
PROBLEM/CONDITION: Traumatic brain injury (TBI) has short- and long-term adverse clinical outcomes, including death and disability. TBI can be caused by a number of principal mechanisms, including motor-vehicle crashes, falls, and assaults. This report describes the estimated incidence of TBI-related emergency department (ED) visits, hospitalizations, and deaths during 2013 and makes comparisons to similar estimates from 2007. REPORTING PERIOD: 2007 and 2013. DESCRIPTION OF SYSTEM: State-based administrative health care data were used to calculate estimates of TBI-related ED visits and hospitalizations by principal mechanism of injury, age group, sex, and injury intent...
March 17, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28286057/quality-of-primary-care-for-children-with-disabilities-enrolled-in-medicaid
#6
Alyna T Chien, Karen A Kuhlthau, Sara L Toomey, Jessica A Quinn, Megumi J Okumura, Dennis Z Kuo, Amy J Houtrow, Jeanne Van Cleave, Mary Beth Landrum, Jisun Jang, Isabel Janmey, Michael J Furdyna, Mark A Schuster
OBJECTIVE: The quality of primary care delivered to Medicaid-insured children with disabilities (CWD) is unknown. We used the newly validated CWD algorithm (CWDA) to examine CWD prevalence among Medicaid enrollees 1 to 18 years old, primary care quality for CWD, and differences in primary care quality for CWD and non-CWD. METHODS: Cross-sectional study using 2008 Medicaid Analytic eXtract claims data from 9 states, including children with at least 11 months of enrollment (N = 2,671,922 enrollees)...
March 9, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28283919/preventing-returns-to-the-emergency-department-followingbariatric-surgery
#7
Jennwood Chen, Justin Mackenzie, Yan Zhai, James O'Loughlin, Rebecca Kholer, Ellen Morrow, Robert Glasgow, Eric Volckmann, Anna Ibele
BACKGROUND: Unnecessary emergency department (ED) visits following bariatric surgery represent a significant source of inefficient resource utilization. This study aimed to identify potential strategies aimed at preventing unnecessary returns to the ED following bariatric surgery. The study was conducted in University Hospital, USA. METHODS: The electronic medical records of all patients who underwent bariatric surgery at our institution between January 2011 and October 2015 were retrospectively reviewed...
March 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28280513/spectrum-of-congenital-anomalies-among-surgical-patients-at-a-tertiary-care-centre-over-4-years
#8
Arushi Agarwal, K N Rattan, Ankur Dhiman, Ananta Rattan
Introduction. Congenital anomalies are important causes of childhood death, chronic illness, and disability in many countries. Congenital malformations are rapidly emerging as one of the major worldwide problems. Aim. To study the percentage of various congenital anomalies among the patients admitted in Department of Pediatric Surgery at a tertiary care centre over a period of four years from 2011 to 2015 in our centre. Results. Neural tube defects were found to be the most common anomalies in 24.3% of the children admitted...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28277487/a-randomized-controlled-trial-of-an-intervention-to-maintain-suppression-of-hiv-viremia-following-prison-release-the-impact-trial
#9
David Alain Wohl, Carol E Golin, Kevin Knight, Michele Gould, Jessica Carda-Auten, Jennifer S Groves, Sonia Napravnik, Stephen R Cole, Becky L White, Cathie Fogel, David L Rosen, Michael J Mugavaro, Brian W Pence, Patrick M Flynn
BACKGROUND: HIV-infected individuals transitioning from incarceration to the community are at risk for loss of viral suppression. We compared the effects of imPACT, a multi-dimensional intervention to promote care engagement after release, to standard care on sustaining viral suppression after community re-entry. METHODS: This trial randomized 405 HIV-infected inmates being released from prisons in Texas and North Carolina with HIV-1 RNA levels <400 copies/mL to imPACT versus standard care...
March 8, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28275556/selective-arterial-embolization-of-symptomatic-and-asymptomatic-renal-angiomyolipomas-a-retrospective-study-of-safety-outcomes-and-tumor-size-reduction
#10
Florian Bardin, Olivier Chevallier, Aurélie Bertaut, Emmanuel Delorme, Morgan Moulin, Pierre Pottecher, Lucy Di Marco, Sophie Gehin, Eric Mourey, Luc Cormier, Christiane Mousson, Marco Midulla, Romaric Loffroy
BACKGROUND: Angiomyolipoma (AML) is the most common renal benign tumor. Treatment should be considered for symptomatic patients or for those at risk for complications, especially retroperitoneal bleeding which is correlated to tumor size, grade of the angiogenic component and to the presence of tuberous sclerosis complex (TSC). This study reports our single-center experience with the use of selective arterial embolization (SAE) in the management of symptomatic and asymptomatic renal AMLs...
February 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28273217/epidemiology-of-urolithiasis-consultations-in-the-para%C3%A3-ba-valley
#11
Guilherme Ricardo Nunes Silva, Luiz Carlos Maciel
OBJECTIVE: to know the epidemiological profile of patients with urolithiasis in the Paraíba Valley region, identifying its prevalence and spatial distribution. METHOD: we conducted a cross-sectional study, by residence location in the Paraíba Valley, on morbidity data due to urolithiasis obtained from the DATASUS, covering the period between 2010 and 2012. We aimed at identifying the general, male and female prevalence of urolithiasis, the distribution by age, type of visit, year season and spatial distribution...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28270891/visit-to-visit-low-density-lipoprotein-cholesterol-variability-is-an-independent-determinant-of-carotid-intima-media-thickness-in-patients-with-type-2-diabetes
#12
Akiko Takenouchi, Ayaka Tsuboi, Kaori Kitaoka, Satomi Minato, Miki Kurata, Keisuke Fukuo, Tsutomu Kazumi
BACKGROUND: Studies demonstrated that visit-to-visit variability in low-density lipoprotein cholesterol (LDLC) is an independent predictor of cardiovascular events in subjects with coronary artery disease. Whether visit-to-visit variability in LDLC levels affects subclinical atherosclerosis is unknown. This study sought to evaluate the role of visit-to-visit variability in LDLC levels on subclinical atherosclerosis. METHODS: We evaluated 162 type 2 diabetic patients with measurement of carotid intima-media thickness (IMT)...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28267595/economic-burden-of-herpes-zoster-culebrilla-in-latin-america
#13
Emmanouil Rampakakis, Clare Pollock, Claudia Vujacich, Joao Toniolo Neto, Alejandro Ortiz Covarrubias, Homero Monsanto, Kelly D Johnson
BACKGROUND: Herpes zoster (HZ) is characterized by debilitating pain and blistering dermatomal rash. The most common complication of HZ is postherpetic neuralgia (PHN), a persistent pain that can substantially affects patients' quality of life. HZ has significant impact on patients' lives with considerable implications for healthcare systems and society. The purpose of this study was to evaluate the healthcare resource utilization (HCRU) and medical costs associated with HZ in Latin America...
March 3, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28264942/impact-of-the-ymca-of-the-usa-diabetes-prevention-program-on-medicare-spending-and-utilization
#14
Maria L Alva, Thomas J Hoerger, Ravikumar Jeyaraman, Peter Amico, Lucia Rojas-Smith
The YMCA of the USA received a Health Care Innovation Award from the Centers for Medicare and Medicaid Services to provide a diabetes prevention program to Medicare beneficiaries with prediabetes in seventeen regional networks of participating YMCAs nationwide. The goal of the program is to help participants lose weight and increase physical activity. We tested whether the program reduced medical spending and utilization in the Medicare population. Using claims data to compute total medical costs for fee-for-service Medicare participants and a matched comparison group of nonparticipants, we found that the overall weighted average savings per member per quarter during the first three years of the intervention period was $278...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28260435/role-of-more-active-identification-of-brain-dead-cases-in-increasing-organ-donation
#15
Farahnaz Sadegh Beigee, Mojtaba Mohsenzadeh, Shagin Shahryari, Meysam Mojtabaee
OBJECTIVES: Organ donor shortage is a worldwide problem, resulting in 10% to 30% mortality rates for patients on wait lists for organ transplant. For brain-dead patients in Iran, it is mandatory for intensive care unit patients with Glasgow Coma Scale below 5/15 to be reported to an organ procurement unit. However, this process has not been functioning effectively. Here, we present the effects of changing the strategies on detecting brain-dead cases on the organ donor pool. MATERIALS AND METHODS: From March 2015 to March 2016, we changed our strategy in active detection of brain-dead cases...
February 2017: Experimental and Clinical Transplantation
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
#16
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/28252806/measuring-quality-caries-related-emergency-department-visits-and-follow-up-among-children
#17
Jill Boylston Herndon, James J Crall, Donna L Carden, Frank A Catalanotto, Scott L Tomar, Krishna Aravamudhan, Jennifer K Light, Elizabeth A Shenkman
OBJECTIVE: This study validated two Dental Quality Alliance system-level measures of oral healthcare quality for children - caries-related emergency department (ED) visits and timely follow-up of those visits with a dentist - including formal validation of diagnosis codes used to identify caries-related ED visits and measurement of follow-up care. METHODS: The measures were specified for implementation with administrative claims data and validated using data from the Florida and Texas Medicaid and Children's Health Insurance Programs...
March 2, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28251116/pediatric-hepatitis-b-treatment
#18
REVIEW
Haruki Komatsu, Ayano Inui, Tomoo Fujisawa
Although the introduction of hepatitis B vaccine has been contributing to the reduction in the prevalence of hepatitis B virus (HBV) carriers worldwide, the treatment of children with chronic HBV infection is a challenge to be addressed. HBeAg seroconversion, which induces low replication of HBV, is widely accepted as the first goal of antiviral treatment in children with chronic hepatitis B. However, spontaneous HBeAg seroconversion is highly expected in children with chronic HBV infection. Therefore, the identification of children who need antiviral treatment to induce HBeAg seroconversion is essential in the management of chronic HBV infection...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28238500/evaluation-of-early-childhood-home-visiting-to-prevent-medically-attended-unintentional-injury
#19
Alonzo T Folger, Katherine A Bowers, Judith W Dexheimer, Ting Sa, Eric S Hall, Judith B Van Ginkel, Robert T Ammerman
STUDY OBJECTIVE: We evaluated the influence of home visiting on the risk for medically attended unintentional injury during home visiting (0 to 3 years) and subsequent to home visiting (3 to 5 years). METHODS: A retrospective, quasi-experimental study was conducted in a cohort of mother-child pairs in Hamilton County, OH. The birth cohort (2006 to 2012) was linked to administrative home visiting records and data from a population-based injury surveillance system containing records of emergency department (ED) visits and hospitalizations...
February 24, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28218986/risk-factors-hindering-asthma-symptoms-control-in-saudi-children-and-adolescents
#20
Rabih Halwani, Alejandro Vazquez-Tello, Nour Horanieh, Said Dulgom, Zohair Al-Aseri, Nouf Al-Khamis, Zubaida Al-Sum, Hamdan Al-Jahdali, Saleh Al-Muhsen
BACKGROUND: Maintaining well control of asthma symptoms can help preventing exacerbations and its associated complications. The Asthma Control Test (ACT) can rapidly assess the effectiveness of asthma management plan and therapy. OBJECTIVE: To identify risk factors associated with uncontrolled asthma symptoms in young Saudi asthmatics (3-17 years-old). METHODS: In this cross-sectional hospital-based survey, the ACT was administered to 297 asthmatic children/adolescents, recruited at the emergency department (ED) of two major hospitals...
February 20, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
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