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Value-based healthcare

Amit Acharyya, Pranit N Jadhav, Valentina Bono, Koushik Maharatna, Ganesh R Naik
BACKGROUND AND OBJECTIVE: EEG is a non-invasive tool for neuro-developmental disorder diagnosis and treatment. However, EEG signal is mixed with other biological signals including Ocular and Muscular artifacts making it difficult to extract the diagnostic features. Therefore, the contaminated EEG channels are often discarded by the medical practitioners which may result in less accurate diagnosis. Many existing methods require reference electrodes, which will create discomfort to the patient/children and cause hindrance to the diagnosis of the neuro-developmental disorder and Brain Computer Interface in the pervasive environment...
May 2018: Computer Methods and Programs in Biomedicine
Maria Lucia Specchia, Giuseppe La Torre, Giovanna Elisa Calabrò, Paolo Villari, Roberto Grilli, Antonio Federici, Walter Ricciardi, Chiara de Waure
Background: The current economic context calls for rationalizing health resources that can be pursued through disinvestment from low value health technologies to invest in the best performing ones, ensuring high healthcare quality. Oncology is a field where, because of high costs of health technologies and rapid innovation, disinvestment is crucial. Methods: On this basis, the research team investigated through a survey, based on a questionnaire, opinions and views of representatives of European countries about disinvestment, in terms of fields of application, potential advocates and barriers, specifically focusing on cancer care...
March 12, 2018: European Journal of Public Health
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
Samantha Tayne, Christian A Merrill, Rajeev C Saxena, Caitlin King, Karthik Devarajan, Stefan Ianchulev, Jon Chilingerian
Given the rising costs of healthcare delivery and reimbursement constraints, large academic medical centers (AMCs) must improve efficiency while delivering high-quality care. With standardized cases and high volumes, ambulatory surgery is a high-value target for efficiency improvement. Mining a data set of more than 7,500 cases consisting of the three highest-volume ambulatory procedures in orthopedics, otolaryngology-head and neck surgery, and urology, we analyzed process times and wait times involved in patient flow...
March 2018: Journal of Healthcare Management / American College of Healthcare Executives
Ilhan Sag, Ferhat Devrim Zengul, Amy Yarbrough Landry
Many hospitals are competing for survival in their service areas. Because of intense competition within markets, hospitals are developing strategies to differentiate themselves. One way to do so is to create a physical infrastructure and service environment that generate a positive impact on patient perceptions. The purpose of this study is to review the literature on servicescape (i.e., a total impression of a service encounter developed through the use of human senses) and its effects on service quality and patient outcomes in healthcare settings...
March 2018: Journal of Healthcare Management / American College of Healthcare Executives
Gwendolien Vanderschaeghe, Kris Dierickx, Rik Vandenberghe
BACKGROUND: Today, many healthcare or dementia organizations, clinicians, and companies emphasize the importance of detection of Alzheimer's disease in an early phase. This idea has gained considerable momentum due to the development of biomarkers, the recent FDA and EMA approval of three amyloid tracers, and the failure of a number of recent therapeutic trials conducted in the early dementia phase. On the one hand, an early etiological diagnosis can lead to early and more efficacious intervention...
March 12, 2018: Journal of Bioethical Inquiry
Jannik B Bertelsen, Nasrin Tayyari Dehbarez, Jens Refsgaard, Helle Kanstrup, Søren P Johnsen, Ina Qvist, Bo Christensen, Rikke Søgaard, Kent L Christensen
Background: Changes in the organisation of chronic healthcare, an increased awareness of costs and challenges of low adherence in cardiac rehabilitation (CR) call for the exploration of more flexible CR programmes as alternatives to hospital-based CR (H-CR). A model of shared care cardiac rehabilitation (SC-CR) that included general practitioners and the municipality was developed. The aim of this study was to analyse the cost utility of SC-CR versus H-CR. Methods: The cost-utility analysis was based on a randomised controlled trial of 212 patients who were allocated to SC-CR or H-CR and followed up for 12 months...
2018: Open Heart
Yemisi Takwoingi, Terence J Quinn
Diagnostic Test Accuracy (DTA) describes a field of research that aims to assess how well a test is able to detect or exclude a condition of interest. Although geriatric medicine is not as reliant on investigations as other medical disciplines, almost all patient encounters with older adults will involve some form of diagnostic assessment. Thus, understanding the terminology and methods of DTA is essential for any clinician. In this review we use examples based around the diagnosis of dementia to highlight issues in DTA research...
March 8, 2018: Age and Ageing
Manndy Nget, Kasorn Muijeen
Background: ASEAN integration aims to transform the GMS into a single market with free flows of products, services, and skilled labor, as well as investment openness, which will ultimately force regional economic growth. Therefore, this integration is likely to bring about a big change to this area in the new era; it can subsequently cause many problems as well, including mental health issues of the people in this region. The characteristic differences among the GMS member countries in terms of trade and investment, so-cial and cultural values, medical information and technology, and the living and working environment have become major problems affecting mental health disorders, which are usually identified as depression, stress, and substance abuse...
December 2017: Current Psychiatry Reviews
J Pandia Rajan, S Edward Rajan
BACKGROUND: Wireless physiological signal monitoring system designing with secured data communication in the health care system is an important and dynamic process. OBJECTIVE: We propose a signal monitoring system using NI myRIO connected with the wireless body sensor network through multi-channel signal acquisition method. Based on the server side validation of the signal, the data connected to the local server is updated in the cloud. The Internet of Things (IoT) architecture is used to get the mobility and fast access of patient data to healthcare service providers...
February 9, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Leàn Rolfes, Florence van Hunsel, Ola Caster, Henric Taavola, Katja Taxis, Eugène van Puijenbroek
OBJECTIVE: To explore if there is a difference between patients and healthcare professionals (HCPs) in time to reporting drug-adverse drug reaction (ADR) associations which led to drug safety signals. DESIGN: This was a retrospective comparison of time to reporting selected drug-ADR associations which led to drug safety signals between patients and healthcare professionals. SETTING: ADR reports were selected from the World Health Organization Global database of individual case safety reports, VigiBase...
March 9, 2018: British Journal of Clinical Pharmacology
K Van den Bussche, J Kottner, H Beele, D De Meyer, A M Dunk, S Ersse, T Lange, M Petrovic, L Schoonhoven, S Smet, N Van Damme, S Verhaeghe, A Van Hecke, D Beeckman
AIM: To report the development of a core set of outcome domains for clinical research involving adults with incontinence-associated dermatitis or at risk, independently from any geographical location or skin colour. BACKGROUND: The management of incontinence-associated dermatitis is important in caring for incontinent patients. The lack of comparability of clinical trial outcomes is a major challenge in the field of evidence-based incontinence-associated dermatitis prevention and treatment...
March 9, 2018: Journal of Advanced Nursing
Anna K Paschall, S Mojdeh Mirmomen, Rolf Symons, Amir Pourmorteza, Rabindra Gautam, Amil Sahai, Andrew J Dwyer, Maria J Merino, Adam R Metwalli, W Marston Linehan, Ashkan A Malayeri
PURPOSE: To determine whether objective volumetric whole-lesion apparent diffusion coefficient (ADC) distribution analysis improves upon the capabilities of conventional subjective small region-of-interest (ROI) ADC measurements for prediction of renal cell carcinoma (RCC) subtype. METHODS: This IRB-approved study retrospectively enrolled 55 patients (152 tumors). Diffusion-weighted imaging DWI was acquired at b values of 0, 250, and 800 s/mm2 on a 1.5T system (Aera, Siemens Healthcare)...
March 8, 2018: Abdominal Radiology
Filipa Pereira, Victoria Pellaux, Henk Verloo
AIMS AND OBJECTIVES: Describe beliefs about evidence-based practice (EBP) and record levels of implementation among community health nurses working independently and in community healthcare centers in the canton of Valais, Switzerland. BACKGROUND: In many settings, EBP is considered a key means of delivering better and secure healthcare. However, there is a paucity of published studies on the implementation of EBP in community healthcare. DESIGN: Cross-sectional descriptive study (n = 100)...
March 8, 2018: Journal of Clinical Nursing
Ashish Atreja, Emamuzo Otobo, Karthik Ramireddy, Allyssa Deorocki
PURPOSE OF REVIEW: Mobile apps are now increasingly used in conjunction with telemedicine and wearable devices to support remote patient monitoring (RPM). The goal of this paper is to review the available evidence and assess the scope of RPM integration into standard practices for care and management of chronic disease in general and, more specifically, inflammatory bowel disease (IBD). RECENT FINDINGS: RPM has been associated with improvements in health outcomes and indicators across a broad range of chronic diseases...
March 7, 2018: Current Gastroenterology Reports
Stephen A Stanhope, Mary C Cooley, Linda F Ellington, Gregory P Gadbois, Andrew L Richardson, Timothy C Zeddes, Jay P LaBine
BACKGROUND: In the United States, home-based primary care (HBPC) is increasingly proposed as a means of enabling frail elders to remain at home for as long as possible, while still receiving needed medical care. However, there are relatively few studies of either the medical outcome effects or cost benefits of HBPC. In this paper, we examine medical cost and mortality outcomes for enrollees in the HBPC program offered by Spectrum Health/Priority Health (SH/PH), a not-for-profit integrated health care/health insurance system located in Grand Rapids, MI, USA...
March 7, 2018: BMC Health Services Research
Jody Boffa, Maria Mayan, Sithembile Ndlovu, Tsholofelo Mhlaba, Tyler Williamson, Reginald Sauve, Dina Fisher
INTRODUCTION: In response to revisions in global and national policy in 2011, six-month isoniazid preventive therapy (IPT) became freely available as a preventive measure for people living with HIV in the uMgungundlovu District of KwaZulu-Natal province, South Africa. Given a difference in uptake and completion by sex, we sought to explore the reasons why Zulu women were more likely to accept and complete IPT compared to men in an effort to inform future implementation. METHODS: Utilising a community-based participatory research approach and ethnographic methods, we undertook 17 individual and group interviews, and met regularly with grassroots community advisory teams in three Zulu communities located in uMgungundlovu District between March 2012-December 2016...
2018: PloS One
Jacob A Martin, Christopher R Mayhew, Amanda J Morris, Angela M Bader, Mitchell H Tsai, Richard D Urman
Background: Time-driven activity-based costing (TDABC) is a methodology that calculates the costs of healthcare resources consumed as a patient moves along a care process. Limited data exist on the application of TDABC from the perspective of an anesthesia provider. We describe the use of TDABC, a bottom-up costing strategy and financial outcomes for three different medical-surgical procedures. Methods: In each case, a multi-disciplinary team created process maps describing the care delivery cycle for a patient encounter using the TDABC methodology...
April 2018: Journal of Clinical Medicine Research
Eleanor Chatburn, Carl Macrae, Jane Carthey, Charles Vincent
BACKGROUND: The Measurement and Monitoring of Safety Framework provides a conceptual model to guide organisations in assessing safety. The Health Foundation funded a large-scale programme to assess the value and impact of applying the Framework in regional and frontline care settings. We explored the experiences and reflections of key participants in the programme. METHODS: The study was conducted in the nine healthcare organisations in England and Scotland testing the Framework (three regional improvement bodies, six frontline settings)...
March 6, 2018: BMJ Quality & Safety
Allan Best, Alex Berland, Trisha Greenhalgh, Ivy L Bourgeault, Jessie E Saul, Brittany Barker
Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders...
March 19, 2018: Journal of Health Organization and Management
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