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https://www.readbyqxmd.com/read/28817376/association-between-hospice-spending-on-patient-care-and-rates-of-hospitalization-and-medicare-expenditures-of-hospice-enrollees
#1
Melissa D Aldridge, Andrew J Epstein, Abraham A Brody, Eric J Lee, R Sean Morrison, Elizabeth H Bradley
BACKGROUND: Care at the end of life is increasingly fragmented and is characterized by multiple hospitalizations, even among patients enrolled with hospice. OBJECTIVE: To determine whether hospice spending on direct patient care (including the cost of home visits, drugs, equipment, and counseling) is associated with hospital utilization and Medicare expenditures of hospice enrollees. DESIGN: Longitudinal, observational cohort study (2008-2010)...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28812193/cost-analysis-of-robot-assisted-choledochotomy-and-common-bile-duct-exploration-as-an-option-for-complex-choledocholithiasis
#2
Ahmed Almamar, Nawar A Alkhamesi, Ward T Davies, Christopher M Schlachta
AIM: The aim of this study is to evaluate the clinical outcomes and cost-effectiveness of elective, robot-assisted choledochotomy and common bile duct exploration (RCD/CBDE) compared to open surgery for ERCP refractory choledocholithiasis. METHOD: A prospective database of all RCD/CBDE has been maintained since our first procedure in April 2007 though April 2016. With ethics approval, this database was compared with all contemporaneous elective open procedures (OCD/CBDE) performed since March 2005...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28801791/effectiveness-of-healthcare-coordination-in-patients-with-chronic-respiratory-diseases
#3
Donata Kurpas, Katarzyna Szwamel, Dorota Lenarcik, Marika Guzek, Artur Prusaczyk, Paweł Żuk, Jolanta Michalowska, Agnieszka Grzeda, Bożena Mroczek
Coordination of healthcare effectively prevents exacerbations and reduces the number of hospitalizations, emergency visits, and the mortality rate in patients with chronic respiratory diseases. The purpose of this study was to determine clinical effectiveness of ambulatory healthcare coordination in chronic respiratory patients and its effect on the level of healthcare services as an indicator of direct medical costs. We conducted a retrospective health record survey, using an online database of 550 patients with chronic respiratory diseases...
August 12, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28781876/comparison-of-hospital-length-of-stay-in-patients-treated-with-non-vitamin-k-oral-anticoagulants-or-parenteral-agents-plus-warfarin-for-venous-thromboembolism
#4
Catherine A Saint, Michelle R Castelli, Andrew J Crannage, Zachary A Stacy, Erin K Hennessey
OBJECTIVES: Existing research comparing hospital length of stay for patients treated with non-vitamin K oral anticoagulants or parenteral bridging to warfarin has been conducted primarily with the agent rivaroxaban. The objective of this study was to compare hospital length of stay between patients initiated on the non-vitamin K oral anticoagulants, apixaban or rivaroxaban, and patients initiated on parenteral anticoagulation agents plus warfarin for the treatment of venous thromboembolism...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28777020/direct-medical-costs-of-treatment-in-newly-diagnosed-high-grade-glioma-among-commercially-insured-us-patients
#5
Shan Jiang, Kala Hill, Dipen Patel, A Reginald Waldeck, Marc Botteman, Abdalla Aly, Andrew D Norden
AIM: This analysis assessed the direct medical costs of newly-diagnosed, temozolomide (TMZ)-treated glioblastoma (GBM) from the perspective of a US commercial setting. MATERIALS AND METHODS: The analysis included subjects identified from the IMS PharMetrics LifeLink Plus™ claims database from January 1, 2008 to August 31, 2014 who were ≥18 years of age, had ≥1 malignant brain cancer diagnosis, had brain surgery ≤90 days prior to TMZ initiation, had TMZ treatment, and were continuously enrolled for ≥12 months pre-diagnosis and ≥1 month post-diagnosis...
August 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28769587/health-care-resource-use-and-cost-differences-by-opioid-therapy-type-among-chronic-noncancer-pain-patients
#6
Pamela B Landsman-Blumberg, Nathaniel Katz, Kavita Gajria, Anna O D'Souza, Sham L Chaudhari, Paul P Yeung, Richard White
The study assessed 12-month chronic pain (CP)-related health care utilization and costs among chronic noncancer pain (CNCP) patients who initiated various long-term opioid treatments. Treatments included monotherapy with long-acting opioids (mono-LAOs), mono-therapy with short-acting opioids (mono-SAOs), both LAOs and SAOs (combination), and opioid therapy initiated with SAO or LAO and switched to the other class (switch). Using MarketScan(®) claims databases (2006-2012), we identified CNCP patients with ≥90 days opioid supply after pain diagnosis and continuous enrollment 12 months before pain diagnosis (baseline period) and 12 months after opioid start (post-index period)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28763738/cost-effectiveness-of-simulation-based-team-training-in-obstetric-emergencies-tosti-study
#7
J van de Ven, G J van Baaren, A F Fransen, P J van Runnard Heimel, B W Mol, S G Oei
OBJECTIVE: Team training is frequently applied in obstetrics. We aimed to evaluate the cost-effectiveness of obstetric multi-professional team training in a medical simulation centre. STUDY DESIGN: We performed a model-based cost-effectiveness analysis to evaluate four strategies for obstetric team training from a hospital perspective (no training, training without on-site repetition and training with 6 month or 3-6-9 month repetition). Data were retrieved from the TOSTI study, a randomised controlled trial evaluating team training in a medical simulation centre...
July 23, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28759685/association-between-extending-carefirst-s-medical-home-program-to-medicare-patients-and-quality-of-care-utilization-and-spending
#8
G Greg Peterson, Kristin Lowe Geonnotti, Lauren Hula, Timothy Day, Laura Blue, Keith Kranker, Boyd Gilman, Kate Stewart, Sheila Hoag, Lorenzo Moreno
Importance: CareFirst, the largest commercial insurer in the mid-Atlantic Region of the United States, runs a medical home program focusing on financial incentives for primary care practices and care coordination for high-risk patients. From 2013 to 2015, CareFirst extended the program to Medicare fee-for-service (FFS) beneficiaries in participating practices. If the model extension improved quality while reducing spending, the Centers for Medicare and Medicaid Services could expand the program to Medicare beneficiaries broadly...
July 31, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28758337/changes-in-the-distribution-of-colonising-and-infecting-candida-spp-isolates-antifungal-drug-consumption-and-susceptibility-in-a-french-intensive-care-unit-a-10-year-study
#9
Milène Sasso, Claire Roger, Magali Sasso, Hélène Poujol, Saber Barbar, Jean-Yves Lefrant, Laurence Lachaud
Monitoring fungal ecology and resistance to antifungal agents within intensive care units (ICU) is essential for the management of invasive fungal infections. Therefore, a retrospective descriptive study was carried in the ICU of Nimes University Hospital, France, from 2007 to 2016. As the majority of invasive fungal infections in ICU are caused by Candida species, the study objectives were to describe Candida species distribution, to assess candidaemia incidence and to monitor the antifungal drug susceptibility of Candida isolates and the consumption of antifungal agents...
July 31, 2017: Mycoses
https://www.readbyqxmd.com/read/28757293/economic-cost-and-burden-of-dengue-during-epidemics-and-non-epidemic-years-in-taiwan
#10
Dih-Ling Luh, Cheng-Chieh Liu, Yun-Ru Luo, Szu-Chieh Chen
BACKGROUND: Determining the disease and economic burden of dengue is critical for the allocation of public health resources. Several studies have used disability-adjusted life-years (DALYs) to estimate the disease burden of dengue in different regions. However, there are no published studies discussing the estimates of dengue-related economic and disease burden specifically in Taiwan. OBJECTIVES: We assessed the economic cost and disease burden of dengue infections in Taiwan for the period 1998-2014, and compared these during epidemic and non-epidemic years...
July 27, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28756545/single-emergency-room-measurement-of-neutrophil-lymphocyte-ratio-for-early-detection-of-acute-kidney-injury-aki
#11
Mohsen Abu Alfeilat, Itzchak Slotki, Linda Shavit
Neutrophil-to-lymphocyte ratio (NLR) is considered a readily available biomarker of systemic inflammation. An association between elevated NLR and adverse outcomes in a variety of medical and surgical conditions including CKD has been demonstrated in several studies. In this study, we evaluated the accuracy of single Emergency Department (ED) measurement of NLR for early diagnosis of acute kidney injury (AKI). We prospectively studied 294 patients aged 71.6 ± 17. We measured NLR at presentation to the ED...
July 29, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28753675/can-home-care-for-homebound-patients-with-chronic-heart-failure-reduce-hospitalizations-and-costs
#12
Boris Punchik, Roman Komarov, Dmitry Gavrikov, Anna Semenov, Tamar Freud, Ella Kagan, Yury Goldberg, Yan Press
BACKGROUND: Congestive heart failure (CHF), a common problem in adults, is associated with multiple hospitalizations, high mortality rates and high costs. PURPOSE: To evaluate whether home care for homebound patients with CHF reduces healthcare service utilization and overall costs. METHODS: A retrospective study of healthcare utilization among homebound patients who received home care for CHF from 2012-1015. The outcome measures were number of hospital admissions per month, total number of hospitalization days and days for CHF only, emergency room visits, and overall costs...
2017: PloS One
https://www.readbyqxmd.com/read/28733686/comparison-of-the-proportion-and-healthcare-utilisation-of-adult-patients-with-uncontrolled-severe-asthma-versus-non-severe-asthma-seen-in-a-southeast-asian-hospital-based-respiratory-specialist-clinic
#13
Tunn Ren Tay, Hang Siang Wong, Rosna Ihsan, Hsiao Peng Toh, Xuening Choo, Augustine Kh Tee
INTRODUCTION: Understanding the burden of uncontrolled severe asthma is essential for disease-targeted healthcare planning. There is a scarcity of data regarding the proportion, healthcare utilisation and costs of patients with uncontrolled severe asthma in Asia. This study aimed to plug the knowledge gap in this area. MATERIALS AND METHODS: Consecutive patients with asthma managed in our respiratory specialist clinic were evaluated prospectively. Healthcare utilisation comprising unscheduled asthma-related primary care visits, emergency department (ED) visits and hospital admissions were obtained from the national health records system...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28727175/the-cost-of-treating-diabetic-ketoacidosis-in-the-uk-a-national-survey-of-hospital-resource-use
#14
K K Dhatariya, C Skedgel, R Fordham
AIM: Diabetic ketoacidosis is a commonly encountered metabolic emergency. In 2014, a national survey was conducted looking at the management of diabetic ketoacidosis in adult patients across the UK. The survey reported the clinical management of individual patients as well as institutional factors that teams felt were important in helping to deliver that care. However, the costs of treating diabetic ketoacidosis were not reported. METHODS: We used a 'bottom up' approach to cost analysis to determine the total expense associated with treating diabetic ketoacidosis in a mixed population sample...
July 20, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28723244/evaluation-of-the-national-health-service-nhs-direct-pilot-telehealth-program-cost-effectiveness-analysis
#15
Malcolm Clarke, Joanna Fursse, Nancy Connolly, Urvashi Sharma, Russell Jones
OBJECTIVE: To evaluate the cost-effectiveness of a pilot telehealth program applied to a wide population of patients with chronic obstructive pulmonary disease (COPD). DESIGN: Vital signs data were transmitted from the home of the patient on a daily basis using a patient monitoring system for review by community nurse to assist decisions on management. SETTING: Community services for patients diagnosed with COPD. PARTICIPANTS: Two Primary Care Trusts (PCTs) enrolled 321 patients diagnosed with COPD into the telehealth program...
July 18, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28721569/management-of-enterocutaneous-fistula-outcomes-in-276-patients
#16
Martha Quinn, Stuart Falconer, Ruth F McKee
OBJECTIVE: To assess the outcomes of patients with type II intestinal failure due to enterocutaneous fistulae in a tertiary referral centre over a 15 year period. Intestinal failure secondary to enterocutaneous fistula (ECF) requires multidisciplinary management at significant cost. Mortality and morbidity are high. METHODS: Patients were identified from a prospectively collected database of patients requiring inpatient parenteral nutrition (1998-2013). Data collected included: demographics, mode of admission, pathological grouping and outcome...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28719499/a-retrospective-cohort-study-of-the-incidence-healthcare-resource-utilization-and-costs-of-icd-9-diagnosed-influenza-and-related-complications-in-us-children
#17
Philip O Buck, David M Smith, Rahul Shenolikar, Debra E Irwin
BACKGROUND: There is a paucity of data on the clinical and economic impact of seasonal influenza in children. This study estimated the incidence of diagnosed influenza and related complications, and associated healthcare resource utilization (HRU) and costs in US children. METHODS: Children ≥6 months and <18 years old diagnosed with influenza using ICD-9 codes and enrolled in a health plan during at least one influenza season between 2010-2014 were matched to similar patients without diagnosed influenza (GSK study identifier: HO-15-15728)...
July 14, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28709581/trends-in-end-of-life-care-and-health-care-spending-in-women-with-uterine%C3%A2-cancer
#18
Benjamin Margolis, Ling Chen, Melissa K Accordino, Grace Clarke Hillyer, June Y Hou, Ana I Tergas, William M Burke, Alfred I Neugut, Cande V Ananth, Dawn L Hershman, Jason D Wright
BACKGROUND: High-intensity care including hospitalizations, chemotherapy, and other interventions at the end of life is costly and often of little value for cancer patients. Little is known about patterns of end-of-life care and resource utilization for women with uterine cancer. OBJECTIVE: We examined the costs and predictors of aggressive end-of-life care for women with uterine cancer. STUDY DESIGN: In this observational cohort study the Surveillance, Epidemiology, and End Results-Medicare linked database was used to identify women age ≥65 years who died from uterine cancer from 2000 through 2011...
July 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28695975/decreased-admissions-and-hospital-costs-with-a-neutral-effect-on-mortality-following-lowering-of-the-troponin-t-cutoff-point-to-the-99th-percentile
#19
Christian Bjurman, Matteus Zywczyk, Bertil Lindahl, Tobias Carlsson, Per Johanson, Max Petzold, Martin Holzmann, Michael Lx Fu, Ola Hammarsten
BACKGROUND: The implementation of high-sensitivity cardiac troponin T (hs-cTnT) assays and a cutoff based on the 99th cTnT percentile in the evaluation of patients with suspected acute coronary syndrome has not been uniform due to uncertain effects on health benefits and utilization of limited resources. METHODS: Clinical and laboratory data from patients with chest pain or dyspnea at the emergency department (ED) were evaluated before (n = 20516) and after (n = 18485) the lowering of the hs-cTnT cutoff point from 40 ng/L to the 99th hs-cTnT percentile of 14 ng/L in February 2012...
July 11, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28693520/strengthening-primary-health-care-teams-with-palliative-care-leaders-protocol-for-a-cluster-randomized-clinical-trial
#20
Joan Llobera, Noemí Sansó, Amador Ruiz, Merce Llagostera, Estefania Serratusell, Carlos Serrano, María Luisa Martín Roselló, Enric Benito, Eusebio J Castaño, Alfonso Leiva
BACKGROUND: The objective of the Balearic Islands Palliative Care (PC) Program is to improve the quality of PC through a shared model consisting of primary health care professionals, home-based PC teams, and PC units in hospitals. According to the World Health Organization (WHO), patients with advanced cancer and other terminal diseases benefit from early identification and proactive PC. We will evaluate the effectiveness of an intervention in which a PC leader is established in the primary health care center, and assess the effect of this intervention on the early identification of patients in need of PC, the efficient use of health care services, and direct health care costs...
July 10, 2017: BMC Palliative Care
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