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https://www.readbyqxmd.com/read/27909374/cardiorespiratory-physiotherapy-around-the-clock-experience-at-a-university-hospital
#1
Marianne Devroey, Catherine Buyse, Michelle Norrenberg, Anne-Marie Ros, Jean-Louis Vincent
Purpose: To document and describe the use of a hospital-wide, 24-hour cardiorespiratory physiotherapy service run by an intensive care unit (ICU) team of physiotherapists. Methods: We prospectively collected data on all non-ICU hospital patients who used the 24-hours-per-day cardiorespiratory physiotherapy service over a 1-year period between July 2013 and June 2014. The ICU physiotherapists documented the reason, origin of referral, time of call, and type and frequency of treatment of each patient. Results: Over the 1-year period, the ICU physiotherapists administered 2,192 out-of-hours cardiorespiratory physiotherapy treatments (n=685 patients) outside the ICU...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#2
Jennifer Hudson, Rachel Mayo, Lori Dickes, Liwei Chen, Windsor Westbrook Sherrill, Julie Summey, Bradley Dalton, Kindal Dankovich
Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted...
December 1, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27899531/a-respiratory-therapist-disease-management-program-for-patients-hospitalized-with-copd
#3
Patty C Silver, Marin H Kollef, Darnetta Clinkscale, Peggy Watts, Robin Kidder, Brittany Eads, Debbie Bennett, Carolyn Lora, Michael Quartaro
BACKGROUND: Patients with COPD often require repeated emergency department visits and hospitalizations for COPD exacerbations. Such readmissions increase health-care costs and expose COPD patients to the added risks of nosocomial infections and increased mortality. METHODS: To determine whether a respiratory therapist (RT) disease management program could reduce re-hospitalization and emergency department visits, a prospective, single-center, unblinded, randomized trial was performed...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27891664/healthcare-costs-doubled-when-children-had-urinary-tract-infections-caused-by-extended-spectrum-%C3%AE-lactamase-producing-bacteria
#4
Oona Nieminen, Matti Korppi, Merja Helminen
AIM: The impact of the emergence of antimicrobial resistant organisms has rarely been studied in children, including the healthcare costs of urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria. We evaluated the effect of ESBL on UTI healthcare costs and risk factors for paediatric UTIs. METHODS: This retrospective case-control study covered 2005-2014 and focused on children below 16 years of age treated in a University hospital: 22 children with UTIs caused by ESBL-producing bacteria and 56 ESBL-negative UTI controls...
November 7, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27888171/clinical-relevance-of-the-first-domomedicine-platform-securing-multidrug-chronotherapy-delivery-in-metastatic-cancer-patients-at-home-the-incasa-european-project
#5
Pasquale F Innominato, Sandra Komarzynski, Ali Mohammad-Djafari, Alexandre Arbaud, Ayhan Ulusakarya, Mohamed Bouchahda, Mazen Haydar, Rachel Bossevot-Desmaris, Virginie Plessis, Magali Mocquery, Davina Bouchoucha, Mehran Afshar, Jacques Beau, Abdoulaye Karaboué, Jean-François Morère, Joanna Fursse, Jordi Rovira Simon, Francis Levi
BACKGROUND: Telehealth solutions can improve the safety of ambulatory chemotherapy, contributing to the maintenance of patients at their home, hence improving their well-being, all the while reducing health care costs. There is, however, need for a practicable multilevel monitoring solution, encompassing relevant outputs involved in the pathophysiology of chemotherapy-induced toxicity. Domomedicine embraces the delivery of complex care and medical procedures at the patient's home based on modern technologies, and thus it offers an integrated approach for increasing the safety of cancer patients on chemotherapy...
November 25, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27881268/antithrombotic-therapy-and-direct-medical-costs-in-patients-with-acute-coronary-syndrome-in-shanghai-china
#6
Jeff J Guo, Yun Chen, Wenmin Du, Hongying Peng, Rui Wang, Ying Xia, Ping Xin, Patricia R Wigle, Emmanuel A Papadimitropoulos
BACKGROUND: Acute coronary syndrome (ACS) is a leading cause of morbidity and mortality worldwide. OBJECTIVES: To describe patient profile, treatment patterns, and disease burden for patients with ACS. METHODS: A retrospective descriptive cohort study was conducted. Data were obtained from electronic medical records from seven Shanghai medical centers. Patients with at least one primary diagnosis of ACS from 2006 to 2012 were included. Patient ACS-related antithrombotic medication use, laboratory tests, key comorbidities, health care utilization, and direct medical costs were examined...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27875708/does-restriction-of-public-health-care-dental-benefits-affect-the-volume-severity-or-cost-of-dental-related-hospital-visits
#7
David Salomon, R Eric Heidel, Antonia Kolokythas, Michael Miloro, Thomas Schlieve
PURPOSE: On July 1, 2012, the Illinois legislature passed the Save Medicaid Access and Resources Together (SMART) Act, which restricts adult public dental insurance coverage to emergency-only treatment. The purpose of this study was to measure the effect of this restriction on the volume, severity, and treatment costs of odontogenic infections in an urban hospital. MATERIALS AND METHODS: A retrospective cohort study of patients presenting for odontogenic pain or infection at the University of Illinois Hospital was performed...
October 29, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27872113/does-integrated-care-reduce-hospital-activity-for-patients-with-chronic-diseases-an-umbrella-review-of-systematic-reviews
#8
Sarah Damery, Sarah Flanagan, Gill Combes
OBJECTIVE: To summarise the evidence regarding the effectiveness of integrated care interventions in reducing hospital activity. DESIGN: Umbrella review of systematic reviews and meta-analyses. SETTING: Interventions must have delivered care crossing the boundary between at least two health and/or social care settings. PARTICIPANTS: Adult patients with one or more chronic diseases. DATA SOURCES: MEDLINE, Embase, ASSIA, PsycINFO, HMIC, CINAHL, Cochrane Library (HTA database, DARE, Cochrane Database of Systematic Reviews), EPPI-Centre, TRIP, HEED, manual screening of references...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#9
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870667/the-role-of-dedicated-musculoskeletal-urgent-care-centers-in-reducing-cost-and-improving-access-to-orthopaedic-care
#10
Travis J Anderson, Peter L Althausen
OBJECTIVES: Over the past few years, the United States has seen the rapid growth of dedicated musculoskeletal urgent care centers owned and operated by individual orthopaedic practices. In June of 2014, our practice opened the first dedicated orthopaedic urgent care in the region staffed by physician assistants and supervised by orthopaedic surgeons. Our hypothesis is that such centers can safely improve orthopaedic care for ambulatory orthopaedic injuries, decrease volume for overburdened emergency departments (EDs), reduce wait times and significantly decrease the cost of care while improving access to orthopaedic specialists...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27869620/safety-and-outcomes-of-inpatient-compared-with-outpatient-surgical-procedures-for-ankle-fractures
#11
Charles Qin, Robert G Dekker, Jordan T Blough, Anish R Kadakia
BACKGROUND: As the cost of health-care delivery rises in the era of bundled payments for care, there is an impetus toward minimizing hospitalization. Evidence to support the safety of open reduction and internal fixation (ORIF) of ankle fractures in the outpatient setting is largely anecdotal. METHODS: Patients who underwent ORIF from 2005 to 2013 were identified via postoperative diagnoses of ankle fracture and Current Procedural Terminology codes; patients with open fractures and patients who were emergency cases were excluded...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27865485/comparison-of-the-effectiveness-of-stress-echocardiography-versus-myocardial-perfusion-imaging-in-patients-presenting-to-the-emergency-department-with-low-risk-chest-pain
#12
Rhian Davies, Guodong Liu, Christopher Sciamanna, William R Davidson, Douglas L Leslie, Andrew J Foy
The aim of this study was to compare clinically relevant cardiovascular outcomes and downstream resource utilization associated with stress echocardiography (SE) and myocardial perfusion imaging (MPI) in emergency department patients with low-risk chest pain. This was a retrospective analysis of health insurance claims data for a national sample of privately insured patients over the period January 1 to December 31, 2011. Subjects were selected who presented to the emergency department with a primary or secondary diagnosis of chest pain and underwent either SE or MPI...
December 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27863889/same-day-discharge-in-laparoscopic-acute-non-perforated-appendectomy
#13
Andrew Scott, Shant Shekherdimian, Joshua D Rouch, Greg D Sacks, Aaron J Dawes, Wendy Y Lui, Letitia Bridges, Tracy Heisler, Steven R Crain, Mang-King W Cheung, Armen Aboulian
BACKGROUND: Small studies done during the past decade have demonstrated same-day discharge after appendectomy as an option for non-perforated appendicitis. Here we have examined a large cohort to confirm that same-day discharge in acute non-perforated appendicitis is a safe option. STUDY DESIGN: This was a retrospective study of patients from 14 Southern California Region Kaiser Permanente medical centers. All patients older than 18 years of age with acute, non-perforated appendicitis who underwent a laparoscopic appendectomy between 2010 and 2014 were included...
November 15, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27858564/preparing-for-value-based-payment-a-stepwise-approach-for-cancer-centers
#14
Kerin B Adelson, Salimah Velji, Kavita Patel, Basit Chaudhry, Catherine Lyons, Rogerio Lilenbaum
Most cancer centers are ill-equipped to pursue value-based payment (VBP) because of limited information on their population's cost of care. Herein, we outline the stepwise approach used by Smilow Cancer Hospital at Yale-New Haven in our pursuit of better value care. First, we addressed institutional barriers. A move toward value required demonstration to Yale-New Haven Health System leadership that OCM would improve patient care, fund new infrastructure, and provide the opportunity to gain experience with VBP without a major threat to the financial stability of the health system...
October 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27852789/patient-centered-medical-home-capacity-and-ambulatory-care-utilization
#15
Larry R Hearld, Kristine R Hearld, Claudia Guerrazzi
The patient-centered medical home (PCMH) has increasingly received attention as a model of care to potentially remedy the cost and quality problems that confront the US health care system, including and especially ambulatory care-related issues. This study examined the association between physician practices' PCMH capacity and 3 indicators of ambulatory care utilization: (1) emergency department utilization, (2) ambulatory care sensitive hospitalization rate, and (3) 30-day all-cause readmission rate. Results show that overall PCMH capacity is associated with lower rates, and technical aspects of the PCMH in particular were associated with lower utilization rates while interpersonal capabilities were not...
November 15, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27846005/novel-emergency-department-risk-score-discriminates-acute-coronary-syndrome-among-chest-pain-patients-with-known-coronary-artery-disease
#16
Matthew T Crim, Scott A Berkowitz, Mustapha Saheed, Jason Miller, Amy Deutschendorf, Gary Gerstenblith, Peter Hill, Frederick K Korley
BACKGROUND: Patients with known coronary artery disease presenting to the emergency department (ED) with chest pain are often admitted, yet may not be having an acute coronary syndrome (ACS). METHODS: We assessed whether the use of a novel risk score and a modified thrombolysis in myocardial infarction risk score obtained in the ED could discriminate which of these high-risk patients have ACS. Chart review was performed on a cohort of 285 patients with known coronary artery disease presenting to the ED with chest pain thought to be of ischemic origin and admitted to the hospital...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27842731/the-harm-score-for-gastrointestinal-surgery-application-and-validation-of-a-novel-reliable-and-simple-tool-to-measure-surgical-quality-and-outcomes
#17
Benjamin P Crawshaw, Deborah S Keller, Justin T Brady, Knut M Augestad, Nicholas K Schiltz, Siran M Koroukian, Suparna M Navale, Scott R Steele, Conor P Delaney
BACKGROUND: The HospitAl length of stay, Readmissions and Mortality (HARM) score is a simple, inexpensive quality tool, linked directly to patient outcomes. We assess the HARM score for measuring surgical quality across multiple surgical populations. METHODS: Upper gastrointestinal, hepatobiliary, and colorectal surgery cases between 2005 and 2009 were identified from the Healthcare Cost and Utilization Project California State Inpatient Database. Composite and individual HARM scores were calculated from length of stay, 30-day readmission and mortality, correlated to complication rates for each hospital and stratified by operative type...
November 8, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27837325/reduced-length-of-hospital-stay-through-a-point-of-care-placed-automated-blood-culture-instrument
#18
M J Bruins, M J Egbers, T M Israel, S H A Diepeveen, M J H M Wolfhagen
Early appropriate antimicrobial treatment of patients with sepsis has a large impact on clinical outcome. To enable prompt and efficient processing of blood cultures, the inoculated vials should be placed into an automated continuously monitoring blood culture system immediately after sampling. We placed an extra BACTEC FX instrument at the emergency department of our hospital and validated the twice-daily re-entering of ongoing vials from this instrument into the BACTEC FX at the laboratory. We subsequently assessed the benefits of shortening the transport time between sampling and monitored incubation of blood culture vials by comparing the turnaround times of positive blood cultures from emergency department patients with a historical control group...
November 11, 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27830088/impact-of-a-local-low-cost-ward-based-response-system-in-a-canadian-tertiary-care-hospital
#19
Andrea Blotsky, Louay Mardini, Dev Jayaraman
Background. Medical emergency teams (METs) or rapid response teams (RRTs) facilitate early intervention for clinically deteriorating hospitalized patients. In healthcare systems where financial resources and intensivist availability are limited, the establishment of such teams can prove challenging. Objectives. A low-cost, ward-based response system was implemented on a medical clinical teaching unit in a Montreal tertiary care hospital. A prospective before/after study was undertaken to examine the system's impact on time to intervention, code blue rates, and ICU transfer rates...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27822962/impact-of-apixaban-vs-low-molecular-weight-heparin-vitamin-k-antagonist-on-hospital-resource-use-in-patients-with-venous-thromboembolism
#20
C Browne, T Lanitis, M Hamilton, X Li, R Horbyluk, J Mardekian, T Kongnakorn, A Cohen
BACKGROUND: The clinical and economic benefits associated with apixaban treatment have been established in clinical trials and published economic evaluations. The benefits associated with apixaban could extend to improving hospital efficiencies, potentially influencing hospital resource use, and bed days. The objective of this study is to estimate the impact of 6-month treatment with apixaban vs low molecular weight heparin/vitamin k antagonist (LMWH/VKA) on hospital resource use among patients with venous thromboembolism (VTE)...
November 24, 2016: Journal of Medical Economics
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