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Value-based healthcare

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https://www.readbyqxmd.com/read/27908165/a-comparison-of-two-prospective-risk-analysis-methods-traditional-fmea-and-a-modified-healthcare-fmea
#1
Jeong-Eun Rah, Ryan P Manger, Adam D Yock, Gwe-Ya Kim
PURPOSE: To examine the abilities of a traditional failure mode and effects analysis (FMEA) and modified healthcare FMEA (m-HFMEA) scoring methods by comparing the degree of congruence in identifying high risk failures. METHODS: The authors applied two prospective methods of the quality management to surface image guided, linac-based radiosurgery (SIG-RS). For the traditional FMEA, decisions on how to improve an operation were based on the risk priority number (RPN)...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27907168/are-urinary-tubular-injury-markers-useful-in-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#2
Le-Ting Zhou, Lin-Li Lv, Ming-Ming Pan, Yu-Han Cao, Hong Liu, Ye Feng, Hai-Feng Ni, Bi-Cheng Liu
BACKGROUND: Adverse outcome of chronic kidney disease, such as end stage renal disease, is a significant burden on personal health and healthcare costs. Urinary tubular injury markers, such as NGAL, KIM-1 and NAG, could provide useful prognostic value for the early identification of high-risk patients. However, discrepancies between recent large prospective studies have resulted in controversy regarding the potential clinical value of these markers. Therefore, we conducted the first meta-analysis to provide a more persuasive argument to this debate...
2016: PloS One
https://www.readbyqxmd.com/read/27906759/development-of-a-disease-based-hernia-program-and-the-impact-on-cost-for-a-hospital-system
#3
David M Krpata, Ivy N Haskins, Steven Rosenblatt, Sharon Grundfest, Ajita Prabhu, Michael J Rosen
OBJECTIVE: The aim of this study was to assess the impact of developing a hernia program on mesh utilization. BACKGROUND: With the ongoing changes in healthcare, the value of all interventions will see increased scrutiny. Hernia mesh can be one of the most costly components of hernia repairs. A disease-based institutional hernia program that defines roles for mesh utilization and measures outcomes has the potential to add significant value to hospital systems. METHODS: In August 2014, a disease-based hernia program was initiated across a hospital system...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27900502/values-and-preferences-on-the-use-of-oral-pre-exposure-prophylaxis-prep-for-hiv-prevention-among-multiple-populations-a-systematic-review-of-the-literature
#4
Florence M Koechlin, Virginia A Fonner, Sarah L Dalglish, Kevin R O'Reilly, Rachel Baggaley, Robert M Grant, Michelle Rodolph, Ioannis Hodges-Mameletzis, Caitlin E Kennedy
Daily oral pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by HIV-negative people to prevent HIV infection. WHO released new guidelines in 2015 recommending PrEP for all populations at substantial risk of HIV infection. To prepare these guidelines, we conducted a systematic review of values and preferences among populations that might benefit from PrEP, women, heterosexual men, young women and adolescent girls, female sex workers, serodiscordant couples, transgender people and people who inject drugs, and among healthcare providers who may prescribe PrEP...
November 29, 2016: AIDS and Behavior
https://www.readbyqxmd.com/read/27898507/blood-pressure-control-in-hypertension-pros-and-cons-of-available-treatment-strategies
#5
Giuseppe Mancia, Federico Rea, Cesare Cuspidi, Guido Grassi, Giovanni Corrao
The low rate of blood pressure (BP) control that characterizes the hypertensive population in real life is traditionally associated to factors such as low adherence of patients to the prescribed treatment regimen, physicians' therapeutic inertia, and deficiencies of the healthcare systems. This study will focus on a fourth factor that may also be importantly involved, i.e. reluctance to adopt drug treatment strategies that more effectively reduce an elevated BP. The point will be made that, vis-à-vis strategies based on patients' persistence in monotherapy, drug combinations are accompanied by a much more frequent BP control...
November 24, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27890398/influenza-vaccination-in-people-with-type-2-diabetes-coverage-predictors-of-uptake-and-perceptions-result-of-the-madiabetes-cohort-a-7years-follow-up-study
#6
Rodrigo Jiménez-Garcia, Ana Lopez-de-Andres, Valentin Hernandez-Barrera, Paloma Gómez-Campelo, Francisco J San Andrés-Rebollo, Carmen de Burgos-Lunar, Juan Cárdenas-Valladolid, Juan Carlos Abánades-Herranz, Miguel Angel Salinero-Fort
OBJECTIVES: We aim to determine influenza vaccination uptake among people with diabetes included in the MADIABETES cohort study in order to identify predictors of uptake and to analyze reasons for adherence and non-adherence with vaccination. METHODS: Using data from the MADIABETES Study we conducted a retrospective case record form based study without controls. We included outpatients with type 2 diabetes mellitus. Information was obtained from computerized clinical records and by telephone survey...
November 24, 2016: Vaccine
https://www.readbyqxmd.com/read/27889399/a-natural-language-processing-based-model-to-automate-mri-brain-protocol-selection-and-prioritization
#7
Andrew D Brown, Thomas R Marotta
RATIONALE AND OBJECTIVES: Incorrect imaging protocol selection can contribute to increased healthcare cost and waste. To help healthcare providers improve the quality and safety of medical imaging services, we developed and evaluated three natural language processing (NLP) models to determine whether NLP techniques could be employed to aid in clinical decision support for protocoling and prioritization of magnetic resonance imaging (MRI) brain examinations. MATERIALS AND METHODS: To test the feasibility of using an NLP model to support clinical decision making for MRI brain examinations, we designed three different medical imaging prediction tasks, each with a unique outcome: selecting an examination protocol, evaluating the need for contrast administration, and determining priority...
November 23, 2016: Academic Radiology
https://www.readbyqxmd.com/read/27889288/quiet-dissent-the-attitudes-beliefs-and-behaviours-of-uk-osteopaths-who-reject-low-back-pain-guidance-a-qualitative-study
#8
Joanna Figg-Latham, Dévan Rajendran
INTRODUCTION: Clinical guidelines are derived from best research evidence and aim to: improve quality of non-specific low back pain (nsLBP) management and identify patients at risk of suffering chronic pain. However, guideline discordant attitudes and beliefs have been identified in healthcare students and practitioners, including osteopaths. DESIGN: A qualitative approach with elements of grounded theory was used to explore underlying attitudes and beliefs of practitioners/students working in a British osteopathic education institution...
October 18, 2016: Manual Therapy
https://www.readbyqxmd.com/read/27888232/parents-perspectives-on-whole-genome-sequencing-for-their-children-qualified-enthusiasm
#9
J A Anderson, M S Meyn, C Shuman, R Zlotnik Shaul, L E Mantella, M J Szego, S Bowdin, N Monfared, R Z Hayeems
OBJECTIVE: To better understand the consequences of returning whole genome sequencing (WGS) results in paediatrics and facilitate its evidence-based clinical implementation, we studied parents' experiences with WGS and their preferences for the return of adult-onset secondary variants (SVs)-medically actionable genomic variants unrelated to their child's current medical condition that predict adult-onset disease. METHODS: We conducted qualitative interviews with parents whose children were undergoing WGS as part of the SickKids Genome Clinic, a research project that studies the impact of clinical WGS on patients, families, and the healthcare system...
November 25, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27884928/macra-2-0-are-you-ready-for-mips
#10
REVIEW
Joshua A Hirsch, Andrew B Rosenkrantz, Sameer A Ansari, Laxmaiah Manchikanti, Gregory N Nicola
The annual cost of healthcare delivery in the USA now exceeds US$3 trillion. Fee for service methodology is often implicated as a cause of this exceedingly high figure. The Affordable Care Act created the Center for Medicare and Medicaid Innovation (CMMI) to pilot test value based alternative payments for reimbursing physician services. In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed into law. MACRA has dramatic implications for all US based healthcare providers. MACRA permanently repealed the Medicare Sustainable Growth Rate so as to stabilize physician part B Medicare payments, consolidated pre-existing federal performance programs into the Merit based Incentive Payments System (MIPS), and legislatively mandated new approaches to paying clinicians...
November 24, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27884150/identifying-and-prioritizing-lower-value-services-from-dutch-specialist-guidelines-and-a-comparison-with-the-uk-do-not-do-list
#11
Joost Johan Godert Wammes, M Elske van den Akker-van Marle, Eva W Verkerk, Simone A van Dulmen, Gert P Westert, Antoinette D I van Asselt, R B Kool
BACKGROUND: The term 'lower value services' concerns healthcare that is of little or no value to the patient and consequently should not be provided routinely, or not be provided at all. De-adoption of lower value care may occur through explicit recommendations in clinical guidelines. The present study aimed to generate a comprehensive list of lower value services for the Netherlands that assesses the type of care and associated medical conditions. The list was compared with the NICE do-not-do list (United Kingdom)...
November 25, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27881093/continuous-quality-improvement-in-nephrology-a-systematic-review
#12
Julie Wright Nunes, F Jacob Seagull, Panduranga Rao, Jonathan H Segal, Nandita S Mani, Michael Heung
BACKGROUND: Continuous quality improvement (CQI) has been successfully applied in business and engineering for over 60 years. While using CQI techniques within nephrology has received increased attention, little is known about where, and with what measure of success, CQI can be attributed to improving outcomes within nephrology care. This is particularly important as payors' focus on value-based healthcare and reimbursement is tied to achieving quality improvement thresholds. We conducted a systematic review of CQI applications in nephrology...
November 24, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27880025/attitudes-to-decisions-about-extremely-premature-infants-differed-between-swiss-linguistic-regions-in-population-based-study
#13
Manya J Hendriks, Sabine D Klein, Hans Ulrich Bucher, Ruth Baumann-Hölzle, Jürg C Streuli, Jean-Claude Fauchère
AIM: Studies have provided insights into the different attitudes and values of healthcare professionals and parents toward extreme prematurity. This study explored societal attitudes and values in Switzerland with regard to this patient group. METHODS: A nationwide trilingual telephone survey was conducted in the French, German and Italian speaking regions of Switzerland to explore the general population's attitudes and values with regard to extreme prematurity...
November 23, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27878711/a-framework-for-guiding-efforts-to-reward-value-instead-of-volume
#14
Taylor J Christensen
The U.S. healthcare system is in the midst of a major shift from fee-for-service to value-based reimbursement models. To date, these new reimbursement models have been focused on quality-contingent bonuses and cost-of-care risk sharing for providers, both of which have yielded only modest success.An analysis of health policy and business strategy literature was performed to identify the mechanisms of how value is rewarded in other industries and to understand the barriers to those mechanisms operating in the healthcare industry...
June 2016: Int J Health Econ Manag
https://www.readbyqxmd.com/read/27878524/muscle-injuries-in-sports-a-new-evidence-informed-and-expert-consensus-based-classification-with-clinical-application
#15
Xavier Valle, Eduard Alentorn-Geli, Johannes L Tol, Bruce Hamilton, William E Garrett, Ricard Pruna, Lluís Til, Josep Antoni Gutierrez, Xavier Alomar, Ramón Balius, Nikos Malliaropoulos, Joan Carles Monllau, Rodney Whiteley, Erik Witvrouw, Kristian Samuelsson, Gil Rodas
Muscle injuries are among the most common injuries in sport and continue to be a major concern because of training and competition time loss, challenging decision making regarding treatment and return to sport, and a relatively high recurrence rate. An adequate classification of muscle injury is essential for a full understanding of the injury and to optimize its management and return-to-play process. The ongoing failure to establish a classification system with broad acceptance has resulted from factors such as limited clinical applicability, and the inclusion of subjective findings and ambiguous terminology...
November 23, 2016: Sports Medicine
https://www.readbyqxmd.com/read/27874210/cost-effectiveness-of-using-cognitive-screening-tests-for-detecting-dementia-and-mild-cognitive-impairment-in-primary-care
#16
Thaison Tong, Praveen Thokala, Brian McMillan, Rob Ghosh, John Brazier
INTRODUCTION: We estimated the cost effectiveness of different cognitive screening tests for use by General Practitioners (GPs) to detect cognitive impairment in England. METHODS: A patient-level cost-effectiveness model was developed using a simulated cohort that represents the elderly population in England (65 years and older). Each patient was followed over a lifetime period. Data from published sources were used to populate the model. The costs include government funded health and social care, private social care and informal care...
November 22, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27869984/cesarean-delivery-rates-and-obstetric-culture-an-italian-register-based-study
#17
Cristina Plevani, Maddalena Incerti, Davide Del Sorbo, Armando Pintucci, Patrizia Vergani, Luca Merlino, Anna Locatelli
INTRODUCTION: Cesarean delivery (CD) rates are rising due to multiple factors, including less use of operative vaginal delivery (OVD) and vaginal birth after cesarean delivery (VBAC), which often reflect local obstetric practices. Objectives of the study were to analyze the relations between CD, these practices and perinatal outcomes. MATERIAL AND METHODS: We included all deliveries in the 72 hospitals of Lombardia, a Region in Northern Italy, during the year 2013...
November 21, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27869875/-the-added-value-of-information-summaries-supporting-clinical-decisions-at-the-point-of-care
#18
Rita Banzi, Marien González-Lorenzo, Koren Hyogene Kwag, Stefanos Bonovas, Lorenzo Moja
Evidence-based healthcare requires the integration of the best research evidence with clinical expertise and patients' values. International publishers are developing evidence-based information services and resources designed to overcome the difficulties in retrieving, assessing and updating medical information as well as to facilitate a rapid access to valid clinical knowledge. Point-of-care information summaries are defined as web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers...
November 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27861445/electronic-care-coordination-from-the-preoperative-clinic
#19
Vinca W Chow, David L Hepner, Angela M Bader
Fragmented and variable perioperative care exposes patients to unnecessary risks and handoff errors. The perioperative surgical home aims to optimize quality, value-based care. We performed a retrospective evaluation of how a preoperative assessment center could coordinate care through e-mails sent to a patient's healthcare team that initiate discussion on critical clinical information. During 100 clinic days on which 8122 patients were evaluated, 606 triggered e-mails, with a potential impact on 19 elements across the perioperative care spectrum...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27849349/health-systems-tackling-social-determinants-of-health-promises-pitfalls-and-opportunities-of-current-policies
#20
Krisda H Chaiyachati, David T Grande, Jaya Aysola
Although improving the quality and delivery of clinical care is a critical mission for health systems, they are increasingly being tasked with improving the overall health of patients. This new directive is reflected in the growing number of health sector efforts in population health-a concept intertwined with social forces that impact patient care and health outcomes: the social determinants of health. Three policies that have the potential to help health systems intervene on social determinants of health are: 1) the Internal Revenue Service-mandated Community Health Needs Assessment for nonprofit hospitals, 2) value-based payment reform, and 3) CMS' Accountable Health Communities program...
November 1, 2016: American Journal of Managed Care
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